-
DEPARTMENT OF HEALTH
NOTICE OF FINAL RULEMAKING
The Interim Director of the Department of Health, pursuant to the authority set forth in § 13 of the Student Access to Treatment Act of 2007 (Act), effective February 2, 2008 (D.C. Law 17-107; D.C. Official Code §§ 38-651.12 (2012 Supp.)) and Mayor's Order 2008-85, dated June 11, 2008, hereby gives notice of the adoption of the following amendments to Title 22B of the District of Columbia Municipal Regulations (DCMR) establishing implementing rules for the Act. The Interim Director took final rulemaking action to adopt the rule on November 26, 2012. A Notice of Emergency and Proposed Rulemaking was published August 24, 2012, at 59 DCR 10319. The Department received numerous comments with substantially the same wording. Most of the comments were received after September 22, 2012, when the comment period closed. The substance of the comments urged the Director to authorize abbreviated online training to allow teacher and other employees to administer emergency medication and to allow administration of medication without real-time consultation with a registered nurse or licensed practitioner. The Interim Director nonetheless considered all the comments, but has decided to publish final rules without any changes. The Director did not make changes regarding training because the final rules do not preclude the use of online training. The Director did not make changes regarding the general supervision requirement because the rules provide for electronic communication with the person providing general supervision.
The final rule shall take effect upon publication of a notice of final rulemaking in the District of Columbia Register.
Chapter 6 (Protection of Minors) of Title 22-B (Public Health and Medicine) is amended by amending section 699 to add and amend definitions and by adding a new section 610 to read as follows:
610 STUDENT ACCESS TO TREATMENT
610.1 A student may possess and self-administer medication at a school in which the student is enrolled, at school-sponsored activities, and while on school-sponsored transportation, for the treatment of asthma, anaphylaxis, and diabetes, provided that:
(a) A responsible person has submitted a valid medication action plan to the school, as required by D.C. Official Code § 38-651.02;
(b) The student has a current certificate of health on file at the school, as required by D.C. Official Code § 38-602; and
(c) The student properly disposes of sharps and medical waste by placing them in designated containers.
610.2 An employee or agent of a school may administer medication to a student for the treatment of asthma, anaphylaxis, and diabetes provided that:
(a) The employee or agent has successfully completed training in the administration of the medication to be given to the student and remains current with that training by taking and passing refresher training;
(b) A responsible person has delivered the medication to be administered to the school;
(c) The employee or agent is under the general supervision of a licensed health practitioner;
(d) Except in emergency circumstances, a responsible person has administered the initial dose of a new medication; and
(e) The employee or agent properly disposes of sharps and medical waste by placing them in designated containers.
610.3 A school that has a self-administering student or an employee- or agent-assisted student who, as a course of treatment, uses sharps or creates medical waste, shall provide appropriately placed medical waste containers. Each container shall be secured with a lock to prevent access by unauthorized persons. The medical waste shall be disposed of properly and shall not be commingled with other waste.
Section 699.1 is amended by adding and amending the following definitions:
Administer—the direct application of medication to the human body whether by ingestion, inhalation, subcutaneous and intramuscular injection, or topical means.
Agent—a person not directly employed by the school who serves the student population of the school in some capacity, including a contractor of the school or a volunteer at the school.
Emergency circumstances—reasonably apparent circumstances that indicate that a delay in treatment would endanger the health or life of a student.
Employee—a person employed by the school to serve the student population of the school including, but not limited to, a teacher, maintenance staff person, or coach.
General supervision—the availability of a registered nurse or licensed practitioner to a school employee or agent for consultation in person or by electronic communication.
Licensed nurse—a registered nurse or licensed practical nurse.
Licensed practitioner—a licensed physician, or advanced practice registered nurse.
Medication—a prescription or non-prescription drug used to treat conditions and illnesses.
Medication action plan—a written medical treatment plan for an individual student signed by a licensed health care provider.
Prescription—a written order for a drug, medicinal chemical, or combination or mixture thereof, or for a medical device signed by a licensed health professional, or an order given orally by a licensed health professional to a pharmacist and immediately reduced to writing by the pharmacist specifying the address of the person for whom the drug or device is ordered and directions for use.
Responsible person—a student eighteen (18) years of age or older or the parent or legal guardian of a minor student.
School—a public school, public charter school, parochial school, or private school.
Sharp—a syringe, lancet, or other medical device intended to break the surface of the skin for the delivery of medication or for testing of blood or bodily fluids.
