PROTOCOL FOR ALL MEDICAL MARIJUANA ADMINISTRATION TO STUDENTS
I. Introduction
In accordance with RIDOH regulation § 4.23.2[1] every school authority must develop protocols or procedures authorizing parents, parents’ designees, legal guardians, and school nurses to administer medical marijuana to a student while the student is on school campus.
School Committee Policy authorizes the use of medical marijuana by students on school premises on certain conditions based on their being issued a valid Rhode Island medical marijuana card. This protocol facilitates such policy.
II. Protocol
A. Establishing Authorization and Documentation and Dosing for student use of medical marijuana.
Under the direction of the Superintendent or designee, school nurse(s) shall for each school site:
1. Establish a written process for verifying the student's medical marijuana cardholder registration and ongoing medical marijuana cardholder authorization status[2]. Such process shall include obtaining written instructions for medical marijuana administration that includes:
o The signature of the certifying physician, advanced practice nurse practitioner, or physician assistant;
o The student’s debilitating medical condition;
o The dose of medical marijuana, including the amount of CBD and/or THC (where applicable) per dose;
o Minimum interval between dosage; and
o Possible side effects to be included in the student’s IHCP.
2. All medical marijuana products utilized pursuant to this policy and protocol shall only be obtained from a Rhode Island licensed compassion center. All medical marijuana products utilized must be labeled with the following information:
o The student’s name;
o The student’s date of birth;
o Dosage;
o Ingredients of product.
3. Dosing documentation.
Each dose of medical marijuana administered to a student shall be documented in writing:
o Date and time;
o Dosage;
o Route of administration; and
o The signature of the parent, parents’ designees, legal guardian, or school nurse who is administering the medical marijuana.
o In the event the dosage is not administered as dictated by the instructions required under RIDOH regulation § 4.23.1(A)(2), the reason(s) therefore must be noted.
o All medical marijuana to be administered by the school nurse must be kept in a secured cabinet designated by the school.
o Identification locations on the school campus where medical marijuana may be administered.
o Students shall not receive, and nurses shall not dispense medical marijuana in a form for smoking or other form of inhalation.
o Students handling or self-administering medical marijuana on the school campus.
B. Waiver and Release.
School nurses shall obtain a written and signed statement from the student's parent or legal guardian releasing the school, and employees and volunteers of the school, from liability, except in cases of willful or wanton conduct or disregard of the criteria of the IHCP. Such form shall be provided by the District.
C. Administration of Medical Marijuana by School Nurse and Opt-Out.
School nurse teachers may legally administer medical marijuana to a student[3]. Administration of medical marijuana to students by school nurses must follow all requirements of RIDOH regulations including § 4.23.1 et seq.
A school nurse shall not be required to administer medical marijuana to a student, provided that the school nurse’s decision not to administer medical marijuana applies to all students authorized to use medical marijuana.
If a school nurse refuses to administer medical marijuana the school nurse teacher shall make arrangements for the student to receive medical marijuana during the school day.
D. Administration of Medical Marijuana by Parents, Parents’ Designees, and Legal Guardians.
Parents, parents’ designees, and legal guardians may administer medical marijuana if a school nurse is not available, or the school nurse refuses to administer the medication. In this event, all the requirements of this policy and RIDOH regulation § 4.23.1 shall be followed. Additionally:
o Any medical marijuana taken onto the school campus by the parent, parents’ designee, or legal guardian must be either:
· Consumed/utilized in its entirety by the student; or
· The excess medical marijuana which is not consumed/utilized by the student must be removed in its entirety from the school campus, with the exception of any disposable packaging which no longer contains medical marijuana.
E. Medication Administration
A school nurse must administer medication(s) to student(s) within the public school setting except as provided in RIDOH regulation §§ 4.21.4(F), 4.22.1, 4.24.3, 4.24.4, or 4.24.5 and Section D above.
The school nurse must be licensed in Rhode Island in accordance with the requirements of R.I. Gen. Laws Chapter 5-34 must also be certified in accordance with the provisions of R.I. Gen. Laws § 16-21-8.
All medications, including prescription and over-the-counter (OTC), must be administered only in accordance with a written order from a licensed health care prescriber, except as provided in RIDOH regulations §§ 4.21.4(F), 4.22.1, 4.24.3, 4.24.4, or 4.24.5. All medications must be administered in keeping with safe standards of health care practice and in accordance with all applicable State and Federal laws and Regulations.
1. Nurse Administration of Medication
Each dose of medication administered by a school nurse or other registered nurse must be documented. Documentation shall include:
o date, time, dosage, route of administration and the signature of the school nurse or other registered nurse administering the medication or supervising the student in self-administration.
o In the event a dosage is not administered as ordered, the reason(s) therefore must be noted.
All medications to be administered by the school nurse or other registered nurse, as provided in this Part, must be kept in a secured cabinet.
A licensed provider's (with prescriptive privileges) order must be obtained and verified by the school nurse or other registered nurse for all medications to be administered by the school nurse or registered nurse, including school physician standing orders. Verbal orders to the nurse and facsimile transmissions may be accepted. Verbal orders must be followed up by a written order from the licensed prescriber within three (3) working days. Upon receipt, the orders must be confirmed with the parent by the nurse.
For prescription medications, all parent authorizations and licensed provider’s orders must be renewed at least annually by the school nurse or other registered nurse.
2. Controlled Substances
Except as provided herein or applicable sections of RIDOH regulations, no controlled substance is permitted to be in the possession of or administered by anyone other than a school nurse, other registered nurse, licensed prescriber, or parent of the child for whom the medications have been prescribed. A student may deliver his/her own medication to school in accordance with protocols or procedures developed by the school but may not self-administer the controlled substance while on school property.
[1] https://rules.sos.ri.gov/Regulations/part/216-20-10-4?reg_id=11495#first
[2] Only valid Rhode Island medical marijuana registration cards qualify under this protocol.
[3] R.I. Gen. Laws § 21-28.6-4(n)
ADOPTED: October 3, 2022