Federal law mandates that children with health needs receive school health services, e.g., the Education of All Handicapped Children Act of 1975 (P.L. 94-142); Section 504 of the Rehabilitation Act of 1973 (P.L. 93-112). But federal law does not specifically address the administering of medicine at the individual school level. Administering medicine entails physically providing it to the ultimate user, the patient.

Federal laws and regulations that do not expressly address, but, nonetheless impact, the administration of medication within schools deal mostly with controlled substances. They include:

• The Controlled Substances Act, 21 U.S.C. 801
• The Uniform Controlled Substances Act of 1994, 21 U.S.C. 802
• Title 21 (Food and Drugs) of the Code of Federal Regulations, Chapter II (Drug Enforcement Administration, Section 1300 (21 CFR 1300.01 et seq.)

The above federal references identify and define those substances included as “controlled substances” (any drug as defined in the five categories of the Acts). They include all opiates and their derivatives, hallucinogenic substances, anabolic steroids, and several psychotropic substances. Within school settings, most drugs used to treat ADHD are controlled substances, as is Ritalin. Controlled substances generally fall under the purview of local drug enforcement agencies, which derive their ultimate authority from the Federal Drug Enforcement Administration.

But students who need medications administered to them during the school day already have legal possession (or their parents do) of any controlled substances. The school’s role is therefore limited to ensuring safe custody, storage, and administering of the medication, once a valid authorization is received from parents/physician.

Most states have enacted statutes that delegate to school systems and school boards the authority to implement local policies addressing the administration of medicine on school premises. But those regu-lations and policies must comply and coordinate with state laws concerning the “unauthorized practice of medicine” or “unauthorized practice of nursing.”

In 1990, the Office of School Health Programs at the University of Colorado Health Science Center published national recommendations for school-based administration of medications to students. The recommendations encouraged local policy development with direct involvement of parents and the public.

In 1993, the American Academy of Pediatrics Committee on School Health published its policy statement, Guidelines for the Administration of Medication in School (RE9328) (reaffirmed in June 1997). The purpose of the policy statement was to assist state legislators and local school boards in establishing somewhat uniform approaches to the growing concern. As noted in the statement, “For most students, the use of medication will be a convenient benefit to control acute minor or major illnesses, allowing a timely return to the classroom with minimal interference to the student and to others.”