The board is committed to the inclusion of all students in the education program and recognizes that some students may need prescription and nonprescription medication to participate in their educational program.
Medication shall be administered when the student's parent or guardian (hereafter "parent") provides a signed and dated written statement requesting medication administration and the medication is in the original, labeled container, either as dispensed or in the manufacturer's container. Administration of medication may also occur consistent with board policy 804.05 – Stock Prescription Medication Supply.
When administration of the medication requires ongoing professional health judgment, an individual health plan shall be developed by an authorized practitioner with the student and the student's parent. Students who have demonstrated competence in administering their own medications may self-administer their medication. A written statement by the student's parent shall be on file requesting co-administration of medication, when competence has been demonstrated. By law, students with asthma, airway constricting diseases, respiratory distress or students at risk of anaphylaxis who use epinephrine auto-injectors may self-administer their medication upon the written approval of the student’s parents and prescribing licensed health care professional regardless of competency.
Persons administering medication shall include authorized practitioners, such as licensed registered nurses and physician, and persons to whom authorized practitioners have delegated the administration of medication (who have successfully completed a medication administration course). A medication administration course and periodic update shall be conducted by a registered nurse or licensed pharmacist, and a record of course completion shall be maintained by the school.
A written medication administration record shall be on file including:
Medication shall be stored in a secured area unless an alternate provision is documented. Emergency protocols for medication-related reactions shall be posted. Medication information shall be confidential information as provided by law
Disposal of unused, discontinued/recalled, or expired medication shall be in compliance with federal and state law. Prior to disposal school personnel shall make a reasonable attempt to return medication by providing written notification that expired, discontinued, or unused medications needs to be picked up. If medication is not picked up by the date specified, disposal shall be in accordance with the disposal procedures for the specific category of medication.
NOTE: Disposal procedures reflect the Iowa Department of Education School Medication Waste Guidance, issued in May 2015.
Legal Reference:
Iowa Code §§124.101(1), 147.107, 152.1, 155A.4(2), 280.16, 280.23
Education [281] IAC §41.404(3)
Pharmacy [657] IAC §8.32(124, 155A)
Nursing Board [655] IAC §6.2(152)
Cross Reference:
06 Student Records
507 Student Health and Well-Being
603.3 Special Education
607.2 Student Health Services
Approved February 2007
Reviewed July 2021
Revised August 2022
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Student's Name (Last), (First) (Middle) Birthday School Date
In order for a student to self-administer medication for asthma or any airway constricting disease:
Provided the above requirements are fulfilled, a student with asthma or other airway constricting disease may possess and use the student's medication while in school, at school-sponsored activities, under the supervision of school personnel, and before or after normal school activities, such as while in before-school or after-school care on school-operated property. If the student abuses the self-administration policy, the ability to self- administer may be withdrawn by the school or discipline may be imposed.
Pursuant to state law, the school district or accredited nonpublic school and its employees are to incur no liability, except for gross negligence, as a result of any injury arising from self-administration of medication by the student. The parent or guardian of the student shall sign a statement acknowledging that the school district or nonpublic school is to incur no liability, except for gross negligence, as a result of self-administration of medication by the student as established by Iowa Code § 280.16.
Medication Dosage Route Time
Purpose of Medication & Administration /Instructions
/ /
Special Circumstances Discontinue/Re-Evaluate/
Follow-up Date
/ /
Prescriber’s Signature Date
Prescriber’s Address Emergency Phone
/ /
Parent/Guardian Signature Date
(agrees to above statement)
Parent/Guardian Address Home Phone
Business Phone
Self-Administration Authorization Additional Information
UPLOAD FORM
Name of Student:
Parents’ Phone Number: Grade:
Medication:
Date to Begin: Date to End:
Dosage: Method Time:
Prescriber or person authorizing administration:
Phone #1: Phone #2:
Possible Adverse Reaction:
Person(s) Authorized to Administer Medication:
Date Given |
Time |
Dosage Given |
Signature of Employee Administering Medication and Title/Position |
Comments |
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UPLOAD FORM
_____________________________ ___/___/___ _________________ ___/___/___
Student's Name (Last), (First) (Middle) Birthday School Date
School medications and health services are administered following these guidelines:
Medication/Health Care Dosage Route Time at
School
Administration instructions
Special Directives Signs to observe and Side Effects
/ /
Discontinue/Re-Evaluate/Follow-up Date
/ /
Prescriber’s Signature Date
Prescriber's Address Emergency Phone
I request the above named student carry medication at school and school activities, according to the prescription, instructions, and a written record kept. Special considerations are noted above. The information is confidential except as provided to the Family Education Rights and Privacy Act (FERPA). I agree to coordinate and work with school personnel and prescriber when questions arise. I agree to provide safe delivery of medication and equipment to and from school and to pick up remaining medication and equipment.
/ /
Parent's Signature Date
Parent's Address Home Phone
Additional Information Business Phone
Authorization Form
UPLOAD FORM