TITLE 25HEALTH SERVICES - Texas



TITLE 25HEALTH SERVICESPART 1DEPARTMENT OF STATE HEALTH SERVICESCHAPTER 40EPINEPHRINE AUTO-INJECTOR AND ANAPHYLAXIS POLICIESSUBCHAPTER DMAINTENANCE AND ADMINISTRATION OF ASTHMA MEDICINE§40.25. Purpose.The purpose of this subchapter is to establish minimum standards for administering, maintaining, and disposing of unassigned asthma medication for K-12 schools that voluntarily adopt unassigned asthma medication policies. These standards are implemented under Texas Education Code, Chapter 38, Subchapter E.§40.26. Definitions.The following terms and phrases, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:(1) Authorized healthcare provider--A physician, as defined in Texas Education Code, §38.201, or person who has been delegated prescriptive authority by a physician under Texas Occupations Code, Chapter 157.(2) Campus--A unit of a public school district, open-enrollment charter school, or private school that:(A) has an assigned administrator; (B) has enrolled students who are counted for average daily attendance; (C) has assigned instructional staff; (D) provides instructional services to students; (E) has one or more grades in the range from early childhood education through grade 12 or is ungraded; and (F) complies with relevant Texas laws.(3) School nurse--Registered nurse, as defined in 19 TAC §153.1022, authorized to administer asthma medication or licensed vocational nurse working under supervision as described in Texas Occupations Code, §301.353.(4) Unassigned asthma medication--A fast acting bronchodilator delivered by metered dose inhaler with single use spacer or by nebulizer as a rescue medication, prescribed by an authorized healthcare provider in the name of the public-school district, open-enrollment charter school, or private school, issued with a non-patient-specific standing delegation order for the administration of an asthma medication, and issued by an authorized healthcare provider.§40.27. Applicability.This subchapter applies to any campus that voluntarily chooses to adopt and implement a written policy regarding the maintenance, administration, and disposal of unassigned asthma medication on each campus.§40.28. Voluntary Unassigned Asthma Medication Policies.(a) A campus may voluntarily adopt and implement a written policy regarding the maintenance, administration, and disposal of asthma medication at each campus. (1) If a written policy is adopted under this subchapter, the policy must comply with Texas Education Code, §38.208.(2) Subject to the availability of funding, a campus must purchase the suggested minimum dosage of unassigned asthma medication.(b) In development of an unassigned asthma medication policy, a campus may consider performing an assessment to include:(1) consultation with school nurses, the local school health advisory committee, local healthcare providers, or any department or organization involved with student well-being;(2) campus geography; and(3) student population size.(c) If a campus voluntarily adopts an unassigned asthma medication policy, the policy must include:(1) a process to obtain written notification from a parent or guardian of the student that the student has been diagnosed as having asthma and stating that the school nurse may administer prescription for unassigned asthma medicine to the student;(2) a designated campus department to coordinate and manage policy implementation that includes:(A) conducting an assessment; (B) training of designated personnel; (C) acquiring or purchasing, maintaining, storing, and using unassigned asthma medication, subject to available campus funding; and(D) disposing of expired unassigned asthma medication;(3) a list of school nurses who will be assigned to administer unassigned asthma medication; (4) locations of unassigned asthma medication;(5) procedures for notifying the parent, prescribing physician, and the student’s primary healthcare provider when unassigned asthma medication is administered; and (6) a plan to replace, as soon as reasonably possible, any unassigned asthma medication that is used or close to expiration.(d) The policy of the unassigned asthma medication must be publicly available. §40.29. Prescription, Administration, and Disposal of Unassigned Asthma Medications.(a) A campus that adopts an unassigned asthma medication policy must stock unassigned asthma medication, subject to available funding, as defined by §40.28 of this subchapter (relating to Voluntary Unassigned Asthma Medication Policies).(b) A campus must obtain a prescription from an authorized healthcare provider each year to stock, possess, and maintain at least two doses of unassigned asthma medication on each campus as described in Texas Education Code, §38.208.(1) The unassigned asthma medication prescription must be renewed annually. (2) The number of additional doses may be determined by an individual campus assessment led by an authorized healthcare provider, based on available funding. (c) An authorized healthcare provider must provide the campus with a standing order for the administration of unassigned asthma medicine to a person reasonably believed to be experiencing a symptom of asthma and who has provided written notification and permission as required by policy. The unassigned asthma medication standing order must be renewed annually. (d) The unassigned asthma medication must be stored in accordance with the manufacturer’s guidelines.(e) The unassigned asthma medication must be disposed in accordance with the manufacturer’s guidelines.§40.30. Training.(a) Each campus that voluntarily adopts a written policy under this subchapter is responsible for training school nurses about:(1) the adopted unassigned asthma medication policy; (2) the healthcare provider’s standing order; (3) follow-up with the prescribing healthcare provider and the student’s primary care physician; and (4) the report required after administering an unassigned asthma medication, under §40.31 of this subchapter (relating to Report on Administering Unassigned Asthma Medication).(b) Each campus must maintain training records and must make available upon request a list of school nurses trained and authorized to administer the unassigned asthma medication on the campus.§40.31. Report on Administering Unassigned Asthma Medication.(a) Records relating to implementing and administering the campus’ unassigned asthma medication policy must be retained per the school record retention schedule.(b) The campus must submit a report no later than the 10th business day after the date a school nurse administers asthma medication in accordance with the unassigned asthma medication policy adopted under this subchapter. The report must be documented in the student’s permanent record and submitted to the school administrator, prescribing healthcare provider, and to the commissioner of the Department of State Health Services (DSHS).(c) Notifications to the commissioner of the DSHS must be submitted on the designated electronic form available on DSHS’s School Health Program website found at dshs..§40.32. Immunity from Liability.A person who in good faith takes, or fails to take, any action under this subchapter or Texas Education Code, Chapter 38, Subchapter E is immune from civil or criminal liability or disciplinary action resulting from that action or failure to act in accordance with the Texas Education Code, §38.215(a). ................
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