Students who are required to take medication(s) during school hours must comply with the regulations
established by the Tennessee Department of Health and Education. Over the counter medications are
included in these regulations. The regulations are as follows:

1. Knox County Schools has the final decision-making authority with respect to the administration
   of and/or to reject requests for administering medications.
2. Written orders must be provided by a licensed healthcare provider. The order must include, student name, prescription number, name of the drug, dosage, frequency, route, and time administered, potential side effects, discontinuation date, and method of storage.
3. The student’s parent or legal guardian must give permission in writing for school personnel to
   assist the student with self-administration of medications. The written permission shall be kept on
   file in the student’s school records.
4. The student must be competent to self-administer nonprescription or prescription medication with assistance.
5. The student’s condition for which medication is authorized or prescribed must be stable according to the student’s prescribing doctor.
6. Medications administered at school should be limited to those required during school hours which are necessary to maintain the student’s health and those needed in the event of an emergency.
7. Each medication requires a separate Medication Administration Form, signed by the prescribing
   health care provider and parent/legal guardian. The Medication Administration Form must be
   renewed each school year. Medication(s) changes during the school year require a new Medication
   Administration Form.
8. Medication(s) must be brought to the school by an adult. Students may not carry medications of
   any kind on their person with the exception of asthma inhalers, Epi-Pens (anaphylaxis
   medications), pancreatic enzymes or insulin delivery systems with written permission from a
   parent and authorization by a medical health care provider. Failure to properly register medication
   shall lead to a presumption that any such medication is not lawfully in the possession of the student.
9. Medications must be in appropriate containers, properly labeled by a licensed medical care
   provider or pharmacy. Over-the-counter (OTC) medication(s) prescribed for a student must be
   provided in its original unopened, labeled, unexpired container and identified student's written
   name. 
10. If included in the student’s medical management plan and in the Individualized Health Plan (IHP),
    a student with diabetes shall be permitted to perform blood glucose checks, administer insulin,
    treat hypoglycemia and hyperglycemia, and otherwise attend to the care and management of the
    student’s diabetes in any area of the school or school grounds and at any school-related activity,
    and shall be permitted to possess on the student’s person at all times all necessary diabetes
    monitoring and treatment supplies, including sharps. Any sharps involved in diabetes care shall
    be stored in a secure but accessible location, including the student’s person, until use of the sharps
    is appropriate. Use and disposal of sharps shall be in compliance with the guidelines set forth by
    the Tennessee Occupational and Safety and Health Administration (TOSHA).
11. Upon receiving, the quantity of medication must be confirmed and documented by the school nurse or designated school employee and parent/legal guardian on the Medication Administration
    Record. A secure/locked location must be provided for medication storage.
12. All medications self-administered must contain the following documentation on the Medication
    Administration Record: time, date of administration, and signature of person administering.
    Medication records will be kept in the student's cumulative record when completed.
13. Only a school nurse can make changes to the Medication Administration Record. A written
    authorization from the licensed prescriber and parent is required.
14. School Nurses will monitor the administration, documentation, and storage of all medications on a regular basis. Only school nurses, trained school personnel, or a pictured-identified parent/legal guardian can administer medication(s) during school hours. A school nurse must train school personnel on medication administration yearly and as needed for reinforcement.
15. The parent/legal guardian is responsible for picking up any unused medication at the end of the
    treatment, out-of-date medication, or at the end of the school year. The parent/legal guardian will
    be notified to pick-up the medication. After notification attempts, if not picked-up in 14 days, the
    medication shall be destroyed per Knox County Schools procedures.
16. Medications must be destroyed by the school nurse or school administrator to include
    documentation and witnessed by at least one other school employee.
17. In the event a dosage is not administered as ordered or any other medication error occurs, a
    Medication Error Form must be completed and submitted to the Health Services Supervisor. The
    school nurse and parent or legal guardian must be notified.
18. If the medication is not time-critical (stat doses, one-time, loading doses, PRN medications)
    medications can be administered 1 hour before or after the scheduled time.
19. Any person assisting in self-administration shall not be liable in any court of law for injury
    resulting from the reasonable and prudent assistance in the self-administration of such medication,
    if performed pursuant to the policies and guidelines developed by the Tennessee Departments of
    Health and Education and approved by applicable regulatory or governing boards or agencies.

Legal References:

1. T.C.A. § 49-50-1601.
2. T.C.A. § 49-50-1602.
3. TRR/MS § 0520-01-03 (5)(a)(b)(c)(d).
4. Guidelines for Use of Health Care Professionals and Health Care Procedures in a School Setting.
5. Institute for Safe Medication Practices Guidelines.

Approved as to Legal Form
By Knox County Law Director 1/2/2024
/Gary T. Dupler/Deputy Law Director