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CONSENT TO MEDICAL TREATMENT

For a minor student, the School may consent to medical, dental, psychological, and surgical treatment of that student, provided all of the following conditions are met:

  1. The person having the power to consent as otherwise provided by law cannot be contacted.
  2. Actual notice to the contrary has not been given by that person.
  3. Written authorization to consent has been received from that person.

Family Code 32.001(a)(4)

Form of Consent

Consent to medical treatment under this policy shall be in writing, signed by the school official giving consent, and given to the doctor, hospital, or other medical facility that administers the treatment.  The consent must contain:

  1. The name of the student.
  2. The name of one or both parents, if known, and the name of the managing conservator or guardian of the student, if either has been appointed.
  3. The name of the person giving consent and the person’s relation to the student.
  4. A statement of the nature of the medical treatment to be given.
  5. The date on which the treatment is to begin.

Family Code 32.002

The Superintendent or designee, Principal, Assistant Principal, Residential Director or the Health Center Director may provide emergency consent for a student’s medical treatment pursuant to this policy.

Minor’s Consent to Treatment

A minor may consent to medical, dental, psychological, and surgical treatment furnished by a licensed physician or dentist if the minor:

  1. Is 16 years of age and residing separate and apart from the minor’s parents, managing conservator, or guardian, with or without the consent of the parents, conservator or guardian and regardless of the duration of the residence, and is managing his or her own financial affairs, regardless of the source of the income;
  2. Consents to the diagnosis and treatment of any infectious, contagious, or communicable disease required to be reported to the Texas Department of State Health Services, including all reportable diseases under Health and Safety Code 81.041;
  3. Is unmarried and pregnant, and consents to hospital, medical, or surgical treatment, other than abortion, related to her pregnancy; or
  4. Consents to examination and treatment for drug or chemical addiction, drug or chemical dependency, or any other condition directly related to drug or chemical use.

Family Code 32.003; Planned Parenthood of Cent. Mo. v. Danforth, 428 U.S. 52 (1976); Bellotti v. Baird, 443 U.S. 622 (1979)

POWER OF ATTORNEY FOR MEDICAL CARE OF AN ADULT STUDENT

A student over the age of 18 years and under no guardianship or incapacity must appoint a Power of Attorney for medical care while attending TSBVI.

The medical power of attorney takes effect if the student becomes unable to make their personal health care decisions, and this fact is certified in writing by a physician or any other medical practitioner, including a licensed nurse or emergency medical person, or is otherwise incapacitated or unable to make decisions, for whatever reason, as determined by any staff member of TSBVI, in his or her sole and absolute discretion.

ADMINISTERING MEDICATION

Written Request from Parent

Prior to agreeing to administer medication to a student at the School, the student’s parent, guardian or person having authority to make decisions for the student:

  1. Shall provide the School a written request to administer student medication; and
  2. Shall provide the School a physician’s order for the medication to be administered; and
  3. Shall provide medication requested to be administered in a container that appears to be the original container and to be properly labeled.

Medication Administration at the School

Prescription and non-prescription medication for a student shall be administered in the School Health Center by a nurse or medication sponsor except that:

  1. Medication may be administered by a nurse or medication sponsor in a location other than the School Health Center with the approval of the Health Center Director, the Superintendent or the Principal;
  2. A student may self-administer certain medications in either the School Health Center or another location on the School campus with approval from the Health Center Director.
  3. A staff member, after completing medication sponsor training, may administer a student’s medication on a school field trip with written permission from the student’s parent, guardian or other person having authority to make decisions for the student.

BY VOLUNTEER PROFESSIONALS

If TSBVI provides liability insurance for a licensed physician or registered nurse who provides volunteer services to the School, the Board may allow the physician or nurse to administer to any student nonprescription medication or medication currently prescribed for the student by the student’s personal physician.

Immunity

The School, the Board, and School employees are immune with respect to administering student medication provided:

  1. The School has received a written request to administer the medication from the parent, legal guardian, or other person having legal control of the student.
  2. When administering prescription medication, the medication is administered either:
    1. From a container that appears to be the original container and to be properly labeled; or
    2. From a properly labeled unit dosage container filled by a registered nurse, licensed vocational nurse, or another qualified TSBVI employee, as determined by School policy, from a container that appears to be the original container and to be properly labeled.

Education Code 22.052(a), (b); 30.024(c)  [see DG for protection of nurses who refuse to perform acts.]

NURSING PEER REVIEW COMMITTEES

A nursing peer review committee may conduct nursing peer review under Occupation Code Chapter 303 and Chapter 301 if:

  1. For vocational nurses, when the employer regularly employs, hires, or contracts for the services of eight or more nurses; and
  2. For professional nurses, when the employer regularly employs, hires, or contracts for the services of eight or more nurses, at least four of whom are registered nurses.

The Health Center Director may contract with another entity to conduct a peer review.

Occupation Code 303.001(4), .0015

SELF-ADMINISTRATION OF ASTHMA OR ANAPHYLAXIS MEDICINE AND SELF-CARRY ADRENAL INSUFFICIENCY AND SEIZURE MEDICATION

A student with asthma or anaphylaxis may possess and self-administer prescription asthma or anaphylaxis medicine, or a student with adrenal insufficiency and seizure medication may possess but not self-administer emergency medication while on school property or at a school-related event or activity if:

  1. The medicine has been prescribed for that student as indicated by the prescription label on the medicine;
  2. The student has demonstrated to the student’s physician or other licensed health care provider and to the Health Center Director, the skill level necessary to self-administer and/or self-carry the prescription medication, including the use of any device required to administer the medication;
  3. The self-administration is done in compliance with the prescription or written instructions from the student’s physician or other licensed health care provider; and
  4. A parent of the student provides to the school:
    1. Written authorization, signed by the parent, for the student to self-administer the prescription asthma or anaphylaxis medicine while on school property or at a school-related event or activity; and
    2. A written statement, signed by the student’s physician or other licensed health care provider, that states:
      1. That the student has asthma, or dangerous allergies, seizures, or adrenal insufficiency and is capable of self-administering asthma and/or anaphylaxis medicines and/or self-carrying the seizure or adrenal insufficiency medicines;
      2. The name and purpose of the medicine;
      3. The prescribed dosage for the medicine;
      4. The times or circumstances the medicine may be administered; and
      5. The period of time the medicine is prescribed.

The physician’s statement must be kept on file in the student’s confidential Health Center file and later maintained in the Center for School Resources’ central file. 

[see FFAF for care of students with diagnosed food allergies at risk for anaphylaxis.]

SELF-ADMINISTRATION OF SCHEDULED MEDICATIONS

A student with regularly scheduled medications may possess and self-administer medications while on school property or at a school related event under the following conditions:

  1. A student is 16 years of age or older;
  2. Written authorization, signed by the parent, legal guardian or adult student, student’s dorm manager, student’s advisor, and Health Center Director has been obtained;
  3. The student has demonstrated to the licensed health care provider, the skill level necessary to self-administer the prescription medication, including the use of any device required to administer the medication;
  4. The self-administration is done in compliance with the prescription or written order;
  5. Instructions from the student’s physician or other licensed health care provider have been obtained; and
  6. The student must follow the rules expressed in the permission to self-administer medication form.

No Waiver of Immunity

The provisions above neither waive any liability or immunity, nor create any liability for or a cause of action against the School, the Board, or School employees.  Education Code 30.024, 38.015

MAINTENANCE AND ADMINISTRATION OF EPINEPHRINE AUTO-INJECTORS

TSBVI adopts and implements this policy regarding the maintenance, administration, and disposal or epinephrine auto-injectors.

School personnel who are authorized and trained may administer an epinephrine auto-injector to a person who is reasonably believed to be experiencing anaphylaxis at the School campus, off-campus event, or while in transit to or from a School event.

TSBVI requires that the School have one or more school personnel authorized and trained to administer an epinephrine auto-injector present during hours of operation.

Epinephrine auto-injectors may be administered as provided under this section at School and at off-campus school sanctioned events.  The immunity provisions of this section shall apply in such cases.

The supply of epinephrine auto-injectors at TSBVI shall be stored in a secure location or maintained securely while in transit to or from off-campus school-sanctioned event and must be easily accessible to school personnel authorized and trained to administer an epinephrine auto-injector.

Education Code 38.208 

Training

TSBVI is responsible for training school personnel and volunteers in the administration of an epinephrine auto-injector.  Each assigned school personnel or school volunteer shall receive initial training and an annual refresher training.  Training shall be consistent with the most recent Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Programs published by the federal Centers for Disease Control and Prevention.

25 TAC 37.607

Hands-on training must be completed annually; provided in a formal training session or through online education; and include information on recognizing the signs and symptoms of anaphylaxis, inspecting and administering an epinephrine auto-injector, and implementing emergency procedures, if necessary, after administering an epinephrine auto-injector and proper disposal. TSBVI shall maintain records on the required training.  The School must maintain a list of the people trained and authorized to administer the unassigned epinephrine auto-injector.  Education Code 38.210; 25 TAC 37.607

Personnel or Volunteers

At each campus in which a school adopts an unassigned epinephrine auto-injector policy, the principal may assign school personnel or school volunteers to be trained to administer unassigned epinephrine auto-injectors or seek school personnel or school volunteers who volunteer to be trained to administer unassigned epinephrine auto-injectors.

In order to increase the number of trained individuals in the administration of unassigned epinephrine auto-injectors, schools may distribute to school personnel or school volunteers, at least once per school year, a notice that includes a description of the request seeking volunteers to be trained to administer an epinephrine auto-injector to a person believed to be experiencing anaphylaxis and a description of the training that the school personnel or school volunteers will receive in the administration of epinephrine with an auto-injector.

25 TAC 37.606(a)-(b)

Standing Orders (Unassigned Auto-Injectors)

A physician may prescribe epinephrine auto-injectors in the name of TSBVI to be maintained for use when necessary.  The prescribing physician shall provide the School, as appropriate, a standing order for the administration of school-supplied epinephrine auto-injectors to undesignated individuals who are reasonably believed to be experiencing anaphylaxis.  The order shall not be required to be patient-specific, and the administration may occur without prior established physician-patient relationship.  Notwithstanding the provisions of other law regarding delegation or supervision, supervision or delegation by a physician shall be adequate if the physician periodically reviews the order and is available through direct telecommunication as needed for consultation, assistance and direction.

Definitions

All Hours the Campus is Open

“All hours the campus is open” is defined as, at a minimum, during regular on-campus school hours, and when school personnel are physically on-site for school-sponsored activities.

Unassigned Epinephrine Auto-Injector

An “unassigned epinephrine auto-injector” is an epinephrine auto-injector prescribed by an authorized health-care provider in the name of the school issued with a non-patient specific standing delegation order for the administration of an epinephrine auto-injector, issued by a physician or person who has been delegated prescriptive authority under Occupations Code Chapter 157.

25 TAC 37.603

Reports

Prompt Notification

Local emergency medical services must be promptly notified by the School when an individual is suspected of experiencing anaphylaxis and when an epinephrine auto-injector is administered.  If the trained school personnel or school volunteer is the only individual available to notify emergency medical services, the trained individual should administer the unassigned epinephrine auto-injector before notifying emergency medical services.

The parent, legal guardian, or emergency contact must be promptly notified by the School when an unassigned epinephrine auto-injector is utilized on their child as soon as is feasible during the emergency response to suspected anaphylaxis.

25 TAC 37.605(e)-(f)

Records

School records of the administration of the unassigned epinephrine auto-injector and suspected anaphylaxis must be provided to the parent or guardian of the recipient upon request.  25 TAC 37.605(f)

No later than 10 business days after the of an epinephrine auto-injector by a school employee under the terms of this section, the School shall report to the Department of State Health Services on the designated electronic form and provide the same information to the commissioner of education [see DSHS School Health Program Website].  Education Code 38.209; 25 TAC 37.608

Notice to Parents

TSBVI shall provide written notice of the policy for the maintenance, administration, and disposal of epinephrine auto-injectors, to a parent or guardian of each student enrolled in the School.  Notice of the policy must be provided by the School before the start of each school year.  Education Code 38.212

If a district changes or discontinues the policy under this subchapter, written or electronic notice detailing the change or discontinuation must be provided to the parent or guardian of each student within 15 calendar days.

25 TAC 37.609

Storage

Unassigned epinephrine auto-injectors shall be stored in a secure, easily accessible are for an emergency, in accordance with manufacturer’s guidelines.  It is recommended that the school administrator develop a map to be placed in high traffic areas that indicates that location of the unassigned epinephrine auto-injectors on each school campus.  It is recommended that the map also indicates the locations of the automated external defibrillator (AED).  25 TAC 37.605(h)

Replacement

TSBVI’s Health Center Director shall develop a plan to replace, as soon as reasonably possible, any unassigned epinephrine auto-injector that is used or close to expiration.  25 TAC 37.605(i)

Disposal

Used unassigned epinephrine auto-injectors shall be considered infectious waste and shall be disposed of according to the school’s bloodborne pathogen control policy.

Expired unassigned epinephrine auto-injectors shall be disposed of according to the school’s medication disposal policy.

25 TAC 37.605(j)-)k)  [see DBB]

Gifts, Grants, and Donations

TSBVI may accept gifts, donations, grants, and federal and local funds for the support of the School in carrying out the provisions of this section.  Education Code 38.213

MAINTENANCE AND ADMINISTRATION OF ASTHMA MEDICINE

TSBVI authorizes a school nurse to maintain and administer asthma medicine at the School.

The School nurse may administer prescription asthma medicine to a student only if the school nurse has written notification from a parent or guardian of the student stating that the student has been diagnosed as having asthma and stating that the school nurse may administer prescription asthma medicine to the student.  A school nurse may administer the prescription asthma medicine only on the TSBVI campus.

Education Code 38.208(a-1), (b-1)

Storage

The supply of asthma medicine at TSBVI must be stored in a secure location and be easily accessible to the school nurse.

No Negative Fiscal Impact

TSBVI is not required to purchase prescription asthma medicine or require any other expenditure related to the maintenance or administration of asthma medicine that would result in a negative fiscal impact on the School.

Education Code 38.208(e)-(f)

Asthma Medicine Standing Order

A physician or person who has been delegated prescriptive authority under Occupations Code Chapter 157, may prescribe asthma medicine in the name of TSBVI.  Education Code 38.211(a)

Notice to Parents

TSBVI shall provide written notice to a parent or guardian of each student enrolled in the School.  Notice required under Education Code 38.212 must be provided before a policy is implemented by TSBVI and before the start of each school year.  Education Code 38.212

Immunity from civil Liability

A person who in good faith takes, or fails to take, any of the following actions under this policy is immune from liability in any criminal or disciplinary action and for civil damages as a result of that act or failure to act, including:

  1. Issuing an order for epinephrine auto-injectors or asthma medicine;
  2. Supervising or delegating the administration of an epinephrine auto-injector or asthma medicine;
  3. Possessing, maintaining, storing, or disposing of an epinephrine auto-injector or asthma medicine;
  4. Prescribing an epinephrine auto-injector or asthma medicine;
  5. Dispensing an epinephrine auto-injector or asthma medicine, provided that permission has been granted under Education Code 38.208(b-1);
  6. Administering or assisting in administering, an epinephrine auto-injector, provided that permission has been granted under Education Code 38.208(b-1);
  7. Providing or assisting in providing, training, consultation, or advice in development, adoption, or implementation of policies, guidelines, rules, or plans; or
  8. Undertaking any other act permitted or required under Education Code Chapter 38, Subchapter E.

TSBVI, its Board and school personnel are immune from suit resulting from an act, or failure to act, including an act or failure to act under related policies and procedures. Education Code 22.052(a), (b)

An act or failure to act by school personnel including an act or failure to act under related policies and procedures, is the exercise of judgment or discretion on the part of the school personnel and is not considered to be a ministerial act for purposes of liability of the School. 

Education Code 38.215

DIETARY SUPPLEMENTS

A School employee commits a Class C misdemeanor offense if the employee:

  1. Knowingly sells, markets, or distributes a dietary supplement that contains performance enhancing compounds to a primary or secondary education student with whom the employee has contact as part of the employee’s school duties; or
  2. Knowingly endorses or suggests the ingestion, intranasal application, or inhalation of a dietary supplement that contains performance enhancing compounds by a primary or secondary education student with whom the employee has contact as part of the employee’s school duties.

Education Code 38.011(a), (c)

PRESCRIPTION MEDICATION AND SPECIAL EDUCATION STUDENTS

A School employee is prohibited from requiring a child to obtain a prescription for a substance covered under the federal Controlled Substances Act (21 U.S.C. 801 et seq.) as a condition of attending school, receiving an evaluation for special education, or receiving special education and related services.

An employee is not prohibited from consulting or sharing classroom-based observations with parents regarding a student’s academic and functional performance, behavior in the classroom or school, or the need for evaluation for special education or related services.

20 U.S.C. 1412(a)(25)

PSYCHOTROPICS AND PSYCHIATRIC EVALUATIONS

A School employee may not:

  1. Recommend that a student use a psychotropic drug; or
  2. Suggest any particular diagnosis; or
  3. Use the refusal by a parent to consent to administration of a psychotropic drug to a student or to a psychiatric evaluation or examination of a student as grounds, by itself, for prohibiting the child from attending a class or participating in a school-related activity.
  4. Psychotropic drug means a substance that is used in the diagnosis, treatment, or prevention of a disease or as a component of a medication and intended to have an altering effect on perception, emotion, or behavior.

Education Code 38.016(b) does not:

  1. Prevent an appropriate referral under the Child Find system required under 20 U.S.C. Section 1412, as amended; or
  2. Prohibit a School employee who is a registered nurse, advanced nurse practitioner, physician, or certified or appropriately credentialed mental health professional from recommending that a child be evaluated by an appropriate medical practitioner; or
  3. Prohibit a School employee from discussing any aspect of a child’s behavior or academic progress with the child’s parent or another School employee.

A violation of Education Code 38.016(b) does not override the immunity from personal liability granted in Education Code 22.0511 or other law or the School’s sovereign or governmental immunity.

The Board shall ensure implementation and enforcement of Education Code 38.016.

Education Code 38.016

Child Abuse Reporting

An employee may not use or threaten to use the refusal of a parent, guardian, or managing or possessory conservator to administer or consent to the administration of a psychotropic drug to a child, or to consent to any other psychiatric or psychological testing or treatment of the child, as the sole basis for making a report of neglect, unless the employee has cause to believe that the refusal:

  1. Presents a substantial risk of death, disfigurement, or bodily injury to the child; or
  2. Has resulted in an observable and material impairment to the growth, development, or functioning of the child.

Education Code 26.0091; Family Code 261.111(a)  [see FFG]

SUNSCREEN PRODUCTS

A student may possess and use a topical sunscreen product while on school property or at a school-related event or activity to avoid overexposure to the sun and not for the medical treatment of any injury or illness if the product is approved by the federal Food and Drug Administration for over-the-counter use.  This provision does not waive any immunity from liability of the School, its Board, or its employees; or create any liability for or a cause of action against TSBVI, its Board, or its employees.  Education Code 38.021

Low-THC Cannabis

TSBVI may not enact, adopt, or enforce a rule, ordinance, order, resolution, or other regulation that prohibits the cultivation, production, dispensing, or possession of low-THC cannabis, as authorized by the Texas Compassionate-Use Act.  Health and Safety Code 487.201

Dextromethorphan (Certain Cold Medication)

TSBVI may not adopt or enforce an ordinance, order, rule, regulation, or policy that govern the sale, distribution, or possession of dextromethorphan.  Health and Safety Coe 488.005

Adopted:         7/13/79

Amended:       1/11/80, 3/9/90, 5/28/92, 9/26/97, 5/28/03, 1/22/10, 9/29/17, 8/9/18, 5/28/20

Reviewed: