Chapter 6. Student Health Care.

Subchapter I. General Provisions.

§ 38–601. Definitions.

For the purposes of this subchapter:

(1) “Adult student” and “minor student” mean those terms as they are defined in § 499 of the Board of Education Rules, effective July 29, 1977 (5 DCMR 2099).

(2) “Certified nurse practitioner” means a registered nurse who is licensed in the United States or its territories, has had postgraduate education and training in pediatrics, adolescent medicine, or the assessment and care of school-aged children, and is certified as a nurse practitioner by the American Nurses’ Association, the National Board of Pediatric Nurse Practitioners and Associates, or any other certifying organization acceptable to the Mayor.

(3) “District” means the District of Columbia.

(4) “Physician” means an individual who is licensed to practice medicine in the United States or its territories and has had postgraduate education or training in pediatrics or adolescent medicine.

(Dec. 3, 1985, D.C. Law 6-66, § 2, 32 DCR 6086.)

Prior Codifications

1981 Ed., § 31-2401.

Short Title

Short title: The first section of D.C. Law 6-66 provided: “That this act may be cited as the ‘Student Health Care Act of 1985’.”

Editor's Notes

Because of the codification of D.C. Law 7-45 as subchapter II of this chapter, and the designation of the preexisting text of this chapter as subchapter I, “subchapter” has been substituted for “chapter” in the introductory language.

Delegation of Authority

Delegation of Authority Pursuant to D.C. Law 6-66, the “Student Health Care Act of 1985”, see Mayor’s Order 2004-102, June 14, 2004 ( 51 DCR 6669).

§ 38–602. Examination requirements; certificates of health, testing for lead poisoning and dental health.

(a) Except as provided in § 38-603, each student attending prekindergarten through grade 12 in a public, public charter, private, or independent school in the District of Columbia shall furnish the school annually with a certificate of health completed and signed by a physician or advanced practice nurse who has examined the student during the 12-month period immediately preceding the 1st day of the school year or the date of the student's enrollment in the school, whichever occurs later. The examination shall cover all items required by the certificate of health form for the student's particular age group.

(a-1) Upon entry of a student under 6 years of age into a licensed day care center, Head Start or similar early childhood program, pre-kindergarten, kindergarten or first grade in a public or private school in the District, the student shall furnish the school with a certificate of testing for lead poisoning.

(b) The Mayor shall establish requirements for periodic testing for lead poisoning and dental examinations. The Mayor shall also establish requirements for the submission of certificates of testing for lead poisoning for the students subject to the provisions of subsection (a-1) of this section, and submission of certificates of dental health for elementary and secondary school students.

(c) The Mayor shall develop standard forms for certificates of health, testing for lead poisoning, and dental health, and shall make blank forms available in sufficient quantities to carry out the purposes of this subchapter. The certificate of health form shall contain, at a minimum, the following:

(1) All items required by the American Academy of Pediatrics for each relevant age group; and

(2) A plain language explanation of the following:

(A) Body mass index;

(B) How to access health insurance programs; and

(d) Except as provided in § 38-603, the Mayor may require that prekindergarten, elementary, and secondary school students who participate in special programs or have been exposed to certain hazards meet examination requirements in addition to those established by this subchapter.

§ 38–603. Exemption for religious beliefs.

Certificates of health, testing for lead poisoning and dental health shall not be required under this subchapter, and no physical, lead poisoning or dental examination shall be required by the Mayor, if a minor student’s parent or guardian or an adult student submits in good faith a written notarized statement to the principal or other appropriate school official affirming that the examination(s) in question would violate the established tenets and practices of the parent’s, guardian’s or student’s church or religious denomination.

§ 38–604. Notice of noncompliance; attendance unaffected.

(a) No student shall be excluded from school on account of his or her failure to furnish a required certificate of health, testing for lead poisoning or dental health. If a certificate of health, testing for lead poisoning or dental health is not furnished when required, the principal or other appropriate school official shall give both oral and written notice to a minor student’s parent(s) or guardian or an adult student that submission of the certificate is required by law. The notice shall explain how to contact the public health authorities for the purpose of having the student examined if private health care is not available or desired. If after 30 calendar days the student has still not furnished the required certificate of health, testing for lead poisoning or dental health, the principal or other appropriate school official shall inquire into whether the student has had an examination. If the student has not been given an examination and none is scheduled, the principal or other appropriate school official shall notify the public health authorities, who shall make prompt and, if necessary, continuing efforts to secure the consent of the parent(s), guardian, or adult student so that the student may as soon as possible be given the required examination(s) either in a public health facility or at school.

(b) Notwithstanding the provisions in subsection (a) of this section, any parent or guardian who, without good cause, fails to comply with the provisions of this subchapter or any rule issued pursuant to § 38-608 shall, at the discretion of the Mayor, be subject to a fine not to exceed $100 per school year.

§ 38–605. Fee for examination by public health authorities; indigency.

A fee, based on rates to be established by the Mayor, shall be charged to a minor student’s parent(s) or guardian or an adult student when the student has been examined by public health authorities pursuant to this subchapter and the parent(s), guardian, or adult student is not indigent. The Mayor shall define “indigency” under this section and may establish a sliding scale of partial payment based on the parents’, guardian’s, or adult student’s reasonable ability to pay some of the examination costs. Under no circumstances shall a student be excluded from school pending the payment of a fee imposed under this section.

§ 38–606. Duty to obtain treatment.

If a student is excluded from school pursuant to subchapter II of Chapter 1 of Title 7, it shall be his or her responsibility if an adult student, and the responsibility of his or her parent(s) or guardian if a minor student, to obtain any treatment necessary for him or her to resume attendance at school. If private health care is not available or desired, the Mayor shall ensure that the necessary treatment is made available by public health authorities after obtaining the consent of the parent(s), guardian, adult student, or, when authorized by District law, minor student. Fees shall be determined in the same manner as provided in § 38-605.

§ 38–607. Student health files.

(a) The Board of Education, with respect to public school students, and the Mayor, with respect to private school students, shall establish uniform procedures requiring elementary and secondary schools in the District to maintain health files for each student. Each student’s health file shall contain all health-related documents submitted by or on behalf of the student.

(b) A student’s health file and all certificates of health and dental health furnished pursuant to this subchapter shall be confidential and subject to inspection, disclosure, and use only as provided by applicable District and federal law.

§ 38–608. Joint administration by Mayor and Board of Education; rules.

The Mayor and the Board of Education shall jointly administer this subchapter and each shall issue rules pursuant to subchapter I of Chapter 5 of Title 2, to carry out its purposes.

§ 38–609. Protection from liability.

Neither the District government or its agencies, officials, and employees nor any private school or its officials and employees shall be subject to civil or criminal liability for failing to recognize or communicate a need for treatment from information contained in a student’s health file, or to obtain treatment for a student solely on account of such information.

§ 38–610. Reporting and studies of lead poisoning tests.

(a) The Mayor shall establish requirements for the mandatory reporting of all lead poisoning tests conducted in the District of Columbia.

(b) The Mayor shall use the data collected in subsection (a) of this section to conduct an epidemiological study for the purpose of preventing future lead poisoning. The Mayor shall submit the study to the Council of the District of Columbia within 2 years from October 15, 1993.

Subchapter II. Public School Nurses.

§ 38–621. Assignment to schools; hours; level of services; nurse or athletic trainer at sponsored athletic events; funding.

(a) A registered nurse shall be assigned to each District of Columbia (“District”) elementary and secondary public and public charter school a minimum of 12 hours per week during each semester and during summer school if a summer school program is operated.

(b)(1) The minimum hours per week of registered nurse services at each school shall increase from 12 to 16 hours per week beginning 1 year after December 10, 1987. The minimum hours per week of registered nurse services at each school shall increase from 16 to 20 hours per week beginning 2 years after December 10, 1987.

(2) Licensed practical nurses may be used to supplement the registered nurse work force in meeting the required 20 hours per week minimum registered nurse services at each elementary and middle school. The licensed practical nurses shall perform their duties under the appropriate supervision and in general collaboration with the registered nurses.

(c-1) Any school that, on October 25, 2016, received school nursing services pursuant to this section that exceeded the hours per week prescribed by subsection (b) of this section shall continue the level of service existing on that date, or the level recommended by the Department of Health's risk-based assessment, whichever is greater, for school year 2018-2019.

(d) Appropriate medical coverage, as defined in rules issued by the Board of Education in accordance with subchapter I of Chapter 5 of Title 2, and in consultation with the Director, Department of Health, shall be provided by the Board of Education at any interscholastic athletic event if the event is sponsored by a District public school, occurs in the District, and is identified as requiring medical coverage by rule. This medical coverage may include, but is not limited to:

(1) A licensed medical doctor;

(2) A registered nurse;

(3) A certified athletic trainer;

(4) An emergency medical technician (“EMT”) or paramedic;

(5) A certified prehospital care provider (as determined by the Director, Department of Health); or

(6) An adult trained by the Red Cross with current certification in cardiopulmonary resuscitation (“CPR”), first aid, or life-saving.

(e)(1) Appropriate medical coverage shall be consistent with the risk of injury involved in the interscholastic athletic event. The medical personnel that shall be present at an interscholastic athletic event that occurs in the District and that is sponsored by a District secondary public school shall be detailed as follows:

(A) For varsity football, a licensed medical doctor and for non-varsity football, a licensed medical doctor or certified athletic trainer;

(B) For basketball, wrestling, soccer, indoor or outdoor track and field events, or cross-country, at least 1 licensed doctor, certified athletic trainer, registered nurse, EMT or paramedic, or any other certified prehospital care provider, as determined by the Director, Department of Health;

(C) For volleyball, baseball, softball, or swimming, at least 1 licensed medical doctor, certified athletic trainer, registered nurse, EMT or paramedic, any other certified prehospital care provider, as determined by the Director, Department of Health, or adult trained by the American Red Cross with current certification in CPR, first aid, or life-saving;

(D) For tennis or golf, medical personnel coverage shall be optional as financial resources allow; and

(E) For any other sport, the appropriate level of medical personnel coverage, commensurate with the risk of injury involved, shall be set by the Superintendent of Schools of the District of Columbia, in consultation with the Director, Department of Health, and approved by the Board of Education; and

(2) The medical personnel coverage services shall be in addition to the minimum hours of registered nurse services required by subsection (a) or (b) of this section.

(f) Sufficient funds to carry out the requirements of this section shall be appropriated out of the general revenues of the District.

(g) Beginning with the fiscal year 1991, the responsibility for implementation of this act shall be transferred from the Department of Human Services to the Board of Education.

(Dec. 10, 1987, D.C. Law 7-45, § 2, 34 DCR 6845; July 25, 1990, D.C. Law 8-149, § 2, 37 DCR 3717; Aug. 17, 1991, D.C. Law 9-29, § 2, 38 DCR 4213; Mar. 20, 1998, D.C. Law 12-60, § 401, 44 DCR 7378; Apr. 13, 1999, D.C. Law 12-224, § 2, 46 DCR 483; Apr. 13, 2005, D.C. Law 15-353, § 602, 52 DCR 2331; Feb. 17, 2018, D.C. Law 22-61, § 2, 65 DCR 127; Oct. 30, 2018, D.C. Law 22-164, § 304, 65 DCR 9324; Sept. 6, 2023, D.C. Law 25-50, § 7002, 70 DCR 10366.)

Prior Codifications

1981 Ed., § 31-2421.

Effect of Amendments

D.C. Law 15-353, in subsec. (a), inserted “and public charter” following “public”.

Applicability

Section 7002 of D.C. Law 25-50 repealed D.C. Law 22-61 including the applicability provision impacting this section.

Applicability of D.C. Law 22-61: § 3 of D.C. Law 22-61 provided that the change made to this section by § 2 of D.C. Law 22-61 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Emergency Legislation

For temporary (90 days) amendment of this section, see § 2 of Public School Nurse Assignment Emergency Amendment Act of 2018 (D.C. Act 22-428, July 25, 2018, 65 DCR 7992).

For temporary (90 days) amendment of this section, see § 2 of Public School Nurse Assignment Congressional Review Emergency Amendment Act of 2017 (D.C. Act 22-179, Nov. 22, 2017, 64 DCR 12290).

For temporary (90 days) amendment of this section, see § 2 of Public School Nurse Assignment Emergency Amendment Act of 2017 (D.C. Act 22-147, Oct. 10, 2017, 64 DCR 10445).

For temporary (90 days) amendment of this section, see § 2 of Public School Nurse Assignment Congressional Review Emergency Amendment Act of 2017 (D.C. Act 22-15, Feb. 27, 2017, 64 DCR 2359).

For temporary (90 days) amendment of this section, see § 2 of Public School Nurse Assignment Emergency Amendment Act of 2016 (D.C. Act 21-535, Nov. 18, 2016, 63 DCR 14347).

For temporary amendment of section, see § 401 of the Fiscal Year 1998 Revised Budget Support Emergency Act of 1997 (D.C. Act 12-152, October 17, 1997, 44 DCR 6196), and § 401 of the Fiscal Year 1998 Revised Budget Support Congressional Review Emergency Act of 1997 (D.C. Act 12-239, January 13, 1998, 45 DCR 508).

For temporary amendment of section, see § 2 of the Public School Nurse Assignment Emergency Amendment Act of 1998 (D.C. Act 12-448, September 18, 1998, 45 DCR 6665), and § 2 of the Public School Nurse Assignment Congressional Review Emergency Amendment Act of 1998 (D.C. Act 12-555, December 30, 1998, 45 DCR 570).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Emergency Amendment Act of 2002 (D.C. Act 14-310, March 26, 2002, 49 DCR 3420).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Emergency Amendment Act of 2003 (D.C. Act 15-3, January 22, 2003, 50 DCR 1426).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Congressional Review Emergency Amendment Act of 2003 (D.C. Act 15-71, April 16, 2003, 50 DCR 3593).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Second Emergency Amendment Act of 2003 (D.C. Act 15-279, December 18, 2003, 51 DCR 60).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Congressional Review Emergency Amendment Act of 2004 (D.C. Act 15-407, March 18, 2004, 51 DCR 3659).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Emergency Amendment Act of 2004 (D.C. Act 15-630, November 30, 2004, 52 DCR 1143).

For temporary (90 day) amendment of section, see § 602 of Child and Youth, Safety and Health Omnibus Congressional Review Emergency Amendment Act of 2005 (D.C. Act 16-30, February 17, 2005, 52 DCR 2993).

Temporary Legislation

For temporary (225 days) amendment of this section, see § 2 of Public School Nurse Assignment Temporary Amendment Act of 2017 (D.C. Law 22-32, Dec. 7, 2017, 64 DCR 10738).

For temporary (225 days) amendment of this section, see § 2 of Public School Nurse Assignment Temporary Amendment Act of 2016 (D.C. Law 21-207, Feb. 18, 2017, 63 DCR 15054).

D.C. Law 12-59 substituted “Director, Department of Health” for “Commissioner of Public Health” in the introductory language of (d) and in (d)(5), (e)(1)(B), (e)(1)(C), and (e)(1)(E).

Section 2001(b) of D.C. Law 12-59 provided that the act shall expire after 225 days of its having taken effect.

Section 2 of D.C. Law 12-182 in (e)(1)(A), inserted “varsity,” and added “and for non-varsity football, a licensed medical doctor or certified athletic trainer.”

Section 4(b) of D.C. Law 12-182 provided that the act shall expire after 225 days of its having taken effect.

Section 602 of D.C. Law 14-164, in subsec. (a), inserted “and public charter” following “public”.

Section 1101(b) of D.C. Law 14-164 provided that the act shall expire after 225 days of its having taken effect.

Section 602 of D.C. Law 15-2 amended subsec. (a) by inserting “and public charter” after “public”.

Section 1101 (b) of D.C. Law 15-2 provided that the act shall expire after 225 days of its having taken effect.

Section 602 of D.C. Law 15-117, in subsec. (a), inserted “and public charter” after “public”.

Section 1101(b) of D.C. Law 15-117 provided that the act shall expire after 225 days of its having taken effect.

Section 602 of D.C. Law 15-319, in subsec. (a), substituted “public and public charter” for “public.”

Section 901(b) of D.C. Law 15-319 provided that the act shall expire after 225 days of its having taken effect.

References in Text

“This act” referred to in (g) is D.C. Law 8-149.

Subchapter III. Administration of Medication by Public School Employees. [Repealed].

§ 38–631. Definitions [Repealed]

Repealed.

§ 38–632. Administration of medication by a public school employee.

Repealed.

§ 38–633. Requirements for the licensed practitioner.

Repealed.

§ 38–634. Rules and regulations for implementation of subchapter.

Repealed.

Subchapter IV. Student Access to Treatment.

§ 38–651.01. Definitions.

For the purposes of this subchapter, the term:

(1) "Designated epinephrine auto-injector" means a disposable drug-delivery system with a spring-activated needle, which is obtained with a prescription for a particular person, that is designed for the emergency administration of epinephrine to a person suffering an episode of anaphylaxis.

(1A) “Emergency circumstances” means reasonably apparent circumstances that indicate that any delay in treatment would endanger the health or life of the student.

(2) “Medication” means any prescription or non-prescription drug used to treat conditions and illnesses covered by this subchapter. The term "medication" does not include sunscreen.

(3) “Medication action plan” means a written medical treatment plan for an individual student that is developed and submitted to a school in accordance with § 38-651.03.

(3A) "OSSE" means the Office of the State Superintendent of Education established by § 38-2601.

(3B) "Public school" means a District of Columbia Public Schools school or a public charter school. The term "public school" excludes any parochial school or private school in the District.

(4) “Responsible person” means, in the case of a student under 18 years of age, a parent, legal guardian, legal custodian, foster parent, or other adult charged with the ongoing care and supervision of the student, and, in the case of a student 18 years of age or older, the student himself or herself.

(5) “School” means:

(A) Any public school operated under the authority of the Mayor of the District of Columbia; and

(B) Any charter school, parochial school, or private school in the District.

(5A) "Sunscreen" means a lotion, cream, spray, or gel regulated by the federal Food and Drug Administration that is used for purposes of absorbing, reflecting, or scattering ultraviolet radiation and preventing sunburn.

(5B) "Undesignated emergency medications" means:

(A) Albuterol;

(B) Glucagon; and

(C) Any other medication designated by the Department of Health by rule pursuant to § 38-651.12 that would be administered in emergency circumstances to a student without a prescription for that medication on file with the school.

(6) "Undesignated epinephrine auto-injector" means a disposable drug delivery system with a spring-activated needle, which is obtained without a prescription for a particular person, that is designed for the emergency administration of epinephrine to a person suffering an episode of anaphylaxis.

(7) "UEA plan" means the undesignated epinephrine auto-injector plan established pursuant to § 38-651.04a.

[(8)] "UEMA plan" means the undesignated emergency medications action plan established pursuant to § 38-651.06.

§ 38–651.02. Possession and self-administration of medication.

(a) A student may possess and self-administer medication at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation, in order to treat asthma, anaphylaxis, or other illness; provided, that:

(1) The responsible person has submitted a valid medication action plan to the school; and

(2) All other conditions set forth in this subchapter are met.

(b)(1) A student may possess and self-administer sunscreen at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation to protect against ultraviolet radiation and sunburn without the submission of a medication action plan; provided, that the responsible person has not provided written notice to the school principal or school nurse that the student may not possess or self-administer sunscreen.

(2) School staff may administer sunscreen to a student at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation to protect against ultraviolet radiation and sunburn without the school possessing a medication action plan for that student; provided, that the student or responsible person has provided sunscreen for that purpose and the responsible person has not provided written notice to the school principal or school nurse that the student may not use sunscreen.

(Feb. 2, 2008, D.C. Law 17-107, § 3, 54 DCR 12230; Apr. 16, 2020, D.C. Law 23-81, § 3(b), 67 DCR 2498.)

Emergency Legislation

For temporary (90 days) amendment of this section, see § 2(b) of School Sunscreen Safety Emergency Amendment Act of 2019 (D.C. Act 23-124, Oct. 7, 2019, 66 DCR 13156).

For temporary (90 day) addition, see § 3 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

For temporary (90 day) addition, see § 3 of Student Access to Treatment Congressional Review Emergency Act of 2007 (D.C. Act 17-140, October 17, 2007, 54 DCR 10736).

Temporary Legislation

For temporary (225 days) amendment of this section, see § 2(b) of School Sunscreen Safety Temporary Amendment Act of 2019 (D.C. Law 23-34, Dec. 24, 2019, 66 DCR 14300).

Section 3 of Law 17-52 added a section to read as follows:

“Sec. 3. Possession and self-administration of medication.

“A student may possess and self-administer medication at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation, to treat asthma, anaphylaxis, or other potentially life-threatening illness; provided, that:

“(1) The responsible person has submitted a valid medication action plan to the school; and

“(2) All other conditions set forth in this act, or in rules promulgated pursuant to this act, are met.”

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

§ 38–651.03. Medication action plan.

(a) A valid medication action plan shall include:

(1) Written medical authorization, signed by a licensed health practitioner, that states:

(A) The name of the student;

(B) Emergency contact information for the responsible person, or, if the student is 18 years of age or older, another adult suitable to serve as an emergency contact;

(D) The name, purpose, and prescribed dosage of the medication;

(E) The frequency that the medication is to be administered;

(F) The possible side effects of the medication as listed on the label;

(G) Special instructions or emergency procedures; and

(H) In the case of self-administered medication, confirmation that the student has been instructed in the proper technique for self-administration of the medication and has demonstrated the ability to self-administer the medication effectively.

(2) Written authorization, signed by the responsible person, that states:

(A) A trained employee or agent of the school may administer medication to the student in accordance with rules established by the Mayor; or

(B) In the case of self-administration, the student may possess and self-administer the medication at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation; and

(3) Written acknowledgment that the District, a school, or an employee or agent of a school shall be immune from civil liability for the good-faith performance of responsibilities under this subchapter; except, that no immunity shall extend to criminal acts, intentional wrongdoing, gross negligence, or wanton or willful misconduct.

(a-1)(1) If a student is a qualifying patient and the failure to administer medical marijuana during the school day would disrupt the student's ability to participate in school instruction, a medication action plan may include administration of medical marijuana, in a non-smokable form, to the student.

(2) The medication action plan of a student who seeks to administer medical marijuana during the school day shall include a certification from an authorized practitioner, as that term is defined in § 7-1671.01(1C), that the failure to administer medical marijuana during the school day would disrupt the student's ability to participate in school instruction.

(3) A school shall adopt policies that permit a student who is a qualifying patient to administer medical marijuana on campus during the school day as necessary based on the terms of the student's medical authorization.

(4) A school may discontinue compliance with paragraphs (1) through (3) of this subsection if, after October 7, 2019, the federal government issues a communication indicating that federal funding will be withheld from the District or a school within the District if the school continues to authorize administration of medical marijuana on its campus.

(5) For the purposes of this subsection "qualifying patient" shall have the same meaning as provided in § 7-1671.01(19).

(b) Immediately following any changes regarding the health or treatment of the student, the responsible person shall submit to the school an amended medication action plan.

(c) The medication action plan shall be updated at least annually, in accordance with a schedule determined by the Mayor.

(Feb. 2, 2008, D.C. Law 17-107, § 4, 54 DCR 12230; Mar. 9, 2016, D.C. Law 21-77, § 2(b), 63 DCR 756; Apr. 16, 2020, D.C. Law 23-81, § 3(c), 67 DCR 2498.)

Section References

This section is referenced in § 38-651.01.

Effect of Amendments

The 2016 amendment by D.C. Law 21-77 would have added “or, if the student is 18 years of age or older, another adult suitable to serve as an emergency contact” in (a)(1)(B).

Applicability

Section 7002 of D.C. Law 21-160 repealed section 4 of D.C. Law 21-77. Therefore the changes made to this section by D.C. Law 21-177 have been given effect.

Applicability of D.C. Law 21-77: § 4 of D.C. Law 21-77 provided that the change made to this section by § 2(b) of D.C. Law 21-77 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Emergency Legislation

For temporary (90 days) amendment of this section, see § 3 of Student Medical Marijuana Patient Fairness Congressional Review Emergency Amendment Act of 2019 (D.C. Act 23-199, Jan. 16, 2020, 67 DCR 585).

For temporary (90 days) amendment of this section, see § 3 of Student Medical Marijuana Patient Fairness Emergency Amendment Act of 2019 (D.C. Act 23-126, Oct. 7, 2019, 66 DCR 13161).

For temporary (90 day) addition, see § 4 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

Temporary Legislation

For temporary (225 days) amendment of this section, see § 3 of Student Medical Marijuana Patient Fairness Temporary Amendment Act of 2019. (D.C. Law 23-35, Dec. 24, 2019, 66 DCR 14302).

Section 4 of Law 17-52 added a section to read as follows:

“Sec. 4. Medication action plan.

“(a) No student shall possess or self-administer medication at the school in which the student is currently enrolled, at school-sponsored activities, or while on school-sponsored transportation, unless the school has a valid medication action plan for that student.

“(b) A valid medication action plan shall include:

“(1) Written medical authorization, signed by the student’s health practitioner, that states:

“(A) The name of the student;

“(B) Emergency contact information for the responsible person;

“(C) Contact information for the health practitioner;

“(D) The name, purpose, and prescribed dosage of the medication;

“(E) The frequency that the medication is to be administered;

“(F) The possible side effects of the medication;

“(G) Special instructions or emergency procedures; and

“(H) In the case of self-administered medication, confirmation that the student has been instructed in the proper technique for self-administration of the medication and has demonstrated the ability to self-administer the medication effectively;

“(2) Written authorization, signed by the responsible person, that states:

“(A) A trained school employee may administer medication to the student in accordance with rules established by the Mayor; or

“(B) In the case of self-administration, the student may possess and self-administer the medication at the school in which the student is currently enrolled, at school-sponsored activities, and while on school-sponsored transportation; and

“(3) Written acknowledgment that the school and its employees shall incur no liability and that the responsible person shall indemnify and hold harmless the school and its employees against any claims that may arise relating to the administration, general supervision, training, administration, or self-administration of the authorized medication.

“(c) Within 30 days of any changes in the student’s health that affect the medication action plan, the responsible person shall revise the medication action plan and submit the amended plan to the school.

“(d) The medication action plan shall be updated at least annually, in accordance with a schedule determined by the Mayor.

“(e) A school may deny a medication action plan, pursuant to terms established by the Mayor.”

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

§ 38–651.04. Medication administration training program.

(a) By July 1, 2008, the Mayor shall develop and implement a medication administration training program, which shall provide training and certification of employees and agents of a school to:

(1) Administer medication to students with valid medication action plans who are not authorized to possess that medication or are not competent to self-administer the medication; and

(2) Administer medication in emergency circumstances to any student experiencing an acute episode of asthma, anaphylaxis, or other illness.

(b) All training provided pursuant to subsection (a) of this section shall be conducted by a health-care professional licensed in the District of Columbia.

(c) A health-care professional shall provide a school with written certification of successful completion of the training for each employee or agent of the school. The certification shall be valid for 3 years.

§ 38–651.04a. Student access to epinephrine.

(a) OSSE shall establish and administer an undesignated epinephrine auto-injector plan that authorizes a public school to possess and administer undesignated epinephrine auto-injectors.

(b)(1) By June 1, 2016, the Department of Health shall obtain a standing order signed by at least one practicing physician, physician assistant, or advanced practice nurse licensed in the District to permit public schools to use undesignated epinephrine auto-injectors in emergency circumstances.

(2) By July 1, 2016, OSSE shall develop and implement an epinephrine administration training program, which shall provide training and certification of employees and agents of a public school on the storage and emergency use of a designated or undesignated epinephrine auto-injector on a person suffering an episode of anaphylaxis.

(3) Upon implementation of the UEA plan, each public school shall ensure that it has at least 2 employees or agents certified in the use of an undesignated epinephrine auto-injector who are available to administer epinephrine during all hours of the school day.

(4) For the purposes of this subsection, the term "certified" means an individual who has obtained a certificate of completion of the epinephrine administration training that is developed and implemented by OSSE and approved by the Mayor.

(c)(1) Under the UEA plan, OSSE shall:

(A) Implement the UEA plan, with guidance from the Department of Health;

(B) Procure and distribute undesignated epinephrine auto-injectors to public schools for use in emergency circumstances;

(C) Monitor the supply of undesignated epinephrine auto-injectors, including ensuring that the supply is restocked as auto-injectors are used;

(D) Ensure the destruction of expired undesignated epinephrine auto-injectors at public schools; and

(E) Maintain records regarding the procurement, distribution, and disposition of undesignated epinephrine auto-injectors for 3 years.

(2)(A) A public school shall store undesignated epinephrine auto-injectors in a secure but easily accessible location in accordance with the manufacturer's instructions.

(B) Each public school shall maintain, at all times, no fewer than 2 unexpired undesignated epinephrine auto-injectors of each dosage available through the UEA plan.

(d)(1) An employee or agent of a public school who is certified pursuant to this section may administer an undesignated epinephrine auto-injector to a student who the employee or agent believes in good faith to be suffering or about to suffer an anaphylactic episode.

(2) Undesignated epinephrine auto-injectors may be used on public school property, including the school building, playground, and school bus, as well as during field trips or sanctioned excursions away from public school property. The certified employee or agent of the public school may carry an appropriate supply of the public school's undesignated epinephrine auto-injectors on field trips or excursions.

(3) Within 24 hours of the administration of an undesignated epinephrine auto-injector, the public school shall notify OSSE and the physician, physician assistant, or advance practice nurse who provided the standing order for the undesignated epinephrine auto-injector of its use.

(4) As soon as practicable following the administration of medication pursuant to this section, the public school shall inform the student's responsible person that the medication was administered.

(e) An employee or agent of a public school who is certified pursuant to this section may administer a designated epinephrine auto-injector to the student to whom it is prescribed, who the employee or agent believes in good faith to be suffering or about to suffer an anaphylactic episode.

§ 38–651.05. Administration of medication.

An employee or agent trained and certified pursuant to § 38-651.04 may administer medication to a student with a valid medication action plan; provided, that:

(1) The responsible person has delivered the medication to be administered to the school;

(2) The employee or agent is under the general supervision of licensed health practitioner; and

(3) Except in emergency circumstances, the responsible person has administered the initial dose of a new medication.

§ 38–651.06. Student access to undesignated emergency medications.

(a) By February 1, 2024, the Department of Health ("Department") shall establish a UEMA plan that authorizes a public school to possess and administer undesignated emergency medications to students without prescriptions for those medications.

(b) By June 1, 2024, the Department shall obtain a standing order signed by at least one physician, physician assistant, or advanced practice nurse licensed in the District to permit public schools to use undesignated emergency medications.

(1) Ensure that undesignated emergency medications are procured and distributed to public schools for use in emergency circumstances;

(2) Ensure the removal and replacement of expired undesignated emergency medications in a timely manner;

(3) Monitor the supply of undesignated emergency medications and ensure sufficient supply is provided to public schools;

(4) Maintain records of the types and quantities of undesignated emergency medications at each public school;

(5) Maintain records regarding the procurement, distribution, and disposition of undesignated emergency medications for 3 years; and

(6) Establish written protocols for schools to notify a student's responsible person and health suite personnel after the school's certified staff or agent administers an undesignated emergency medication.

(d)(1) Beginning July 1, 2024, each public school shall:

(A) Designate at least 2 employees or agents of the school to be certified in the use of undesignated emergency medications who are available to administer medications during all hours of the school day;

(B) Store undesignated emergency medications in a secure but easily accessible location in accordance with the manufacturer's instructions; and

(C) Communicate the contact information of the school's certified employees or agents to all staff and personnel at the school.

(2) For the purposes of this subsection, the term "certified" means an individual who has obtained a certificate of completion of the Department's medication administration training program established by section 5.

(e) OSSE shall:

(1) Require written proof of compliance with subsection (d) of this section from each public school on an annual basis;

(2) Require any public school not in compliance to submit a plan outlining the steps the school shall take to address the noncompliance;

(3) Provide public schools with resources to implement the requirements of subsection (d) of this section; and

(4) Maintain records regarding each public school's compliance with subsection (d) of this section for 3 years.

(f)(1) An employee or agent of a public school who is certified pursuant to this section may administer an undesignated emergency medication to a student whom the employee or agent believes in good faith to immediately require the medication.

(2)(A) Undesignated emergency medications may be used on public school property, including the school building, playground, and school bus, as well as during field trips or sanctioned excursions away from public school property.

(B) The certified employee or agent of the public school may carry an appropriate supply of the public school's undesignated emergency medications on field trips or excursions; provided, that there remains a sufficient supply of the undesignated emergency medication in the school building.

(3) Within one business day of administering an undesignated emergency medication to a student, the public school shall notify the Department, who shall in turn:

(A) Notify OSSE;

(B) Notify the physician, physician assistant, or advance practice nurse who provided the standing order for the undesignated emergency medication; and

(C) Provide guidance to the school on how to notify the student's responsible person and health suite personnel that undesignated emergency medication was administered.

(g) An employee or agent of a public school who is certified pursuant to this section may also administer medication for which they are trained to a student to whom it is prescribed, who the employee or agent believes in good faith requires the immediate use of the medication.

(h) The Department shall develop a procedure by which the responsible person may request that the student not receive treatment in emergency circumstances.

(Feb. 2, 2008, D.C. Law 17-107, § 7, 54 DCR 12230; Mar. 9, 2016, D.C. Law 21-77, § 2(d), 63 DCR 756; Feb. 15, 2024, D.C. Law 25-124, § 2(b), 70 DCR 16578.)

Effect of Amendments

The 2016 amendment by D.C. Law 21-77 would have substituted “the student” for “a minor student” in (d).

Applicability

Section 7289 of D.C. Law 25-217 repealed section 3 of D.C. Law 25-124 removing the applicability provision impacting subsections (b) through (h) of this section. Therefore the amendment of this section by section 3 of Law 25-124 has been implemented.

Section 7289 of D.C. Act 25-506 repealed section 3 of D.C. Law 25-124 removing the applicability provision impacting subsections (b) through (h) of this section. Therefore the amendment of this section by section 3 of Law 25-124 has been implemented.

Applicability of D.C. Law 25-124: § 3 of D.C. Law 25-124 provided that the amendments to subsections (b) through (h) of this section by § 2(b) of D.C. Law 25-124 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Section 7002 of D.C. Law 21-160 repealed section 4 of D.C. Law 21-77. Therefore the changes made to this section by D.C. Law 21-177 have been given effect.

Applicability of D.C. Law 21-77: § 4 of D.C. Law 21-77 provided that the change made to this section by § 2(d) of D.C. Law 21-77 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Emergency Legislation

For temporary (90 days) amendment of this section, see § 7289 of Fiscal Year 2025 Budget Support Emergency Act of 2024 (D.C. Act 25-506, July 15, 2024, 71 DCR 8406).

Delegation of Authority

Delegation of Authority to the Student Access to Treatment Act of 2007, see Mayor’s Order 2008-85, June 11, 2008 ( 55 DCR 9362).

§ 38–651.07. Posting of emergency response information.

By July 1, 2008, the Mayor shall develop a standardized form for posting emergency response information. The information shall be posted in all schools and shall include:

(1) An explanation of the symptoms and possible consequences of conditions covered by this subchapter;

(2) The names of all the employees or agents of the particular school who are trained and certified to administer medication in emergency circumstances; and

(3) The emergency response steps, as identified by the Mayor, to be taken by the school.

§ 38–651.08. Maintenance of records.

(a) A school shall keep the medication action plans in the school health suite or other designated, easily accessible location.

(b) A school shall create and maintain a list of students with valid medication action plans, including the emergency contact information for each student. The principal of the school may distribute the list among appropriate employees or agents of the school.

(d) A school shall maintain accurate records of all incidents where medication was administered to a student in an emergency circumstance.

(Feb. 2, 2008, D.C. Law 17-107, § 9, 54 DCR 12230.)

Emergency Legislation

For temporary (90 day) addition, see § 5 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

For temporary (90 day) addition, see § 5 of Student Access to Treatment Congressional Review Emergency Act of 2007 (D.C. Act 17-140, October 17, 2007, 54 DCR 10736).

Temporary Legislation

Section 5 of Law 17-52 added a section to read as follows:

“Sec. 5. Maintenance of records.

“(a) A school shall keep the medication action plan in the school health suite, or other designated, easily accessible location.

“(b) A school shall create and maintain a list of students with valid medication action plans, including the emergency contact information for each student. The principal of the school may distribute this list among appropriate school employees.

“(c) Each school that has a student with a medication action plan for self-administration may schedule a meeting at the beginning of the school year with the school nurse, the principal, the student, the responsible person, and any other appropriate school staff to review the student’s medication action plan. Authorization to possess and self-administer previously approved medication shall not be dependent on having had this meeting.”

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

§ 38–651.09. Storage of medication.

(a) Except as provided in § 38-651.04a, a school may procure medication for the treatment of asthma or other illness for use in emergency circumstances. The medication shall be properly stored and maintained in an easily accessible location.

(b)(1) A school may receive medication to store for the treatment of asthma, anaphylaxis, or other illness from the responsible person for a student with a valid medication action plan.

(2) The medication shall be:

(A) Properly stored at the school in a location to which the student has immediate access in case of an emergency; and

(B) Labeled with the:

(i) Name of the student;

(ii) Name of the medication;

(iii) Dosage;

(iv) Time of administration; and

(v) Duration of medication.

(3) No school shall be required to store more than a 3-school-day supply of medication for any one student.

(Feb. 2, 2008, D.C. Law 17-107, § 10, 54 DCR 12230; Mar. 9, 2016, D.C. Law 21-77, § 2(e), 63 DCR 756.)

Effect of Amendments

The 2016 amendment by D.C. Law 21-77, in (a), would have added "Except as provided in § 38-0651.04a” and would have deleted “anaphylaxis” following “asthma.”

Applicability

Section 7002 of D.C. Law 21-160 repealed section 4 of D.C. Law 21-77. Therefore the changes made to this section by D.C. Law 21-177 have been given effect.

Applicability of D.C. Law 21-77: § 4 of D.C. Law 21-77 provided that the change made to this section by § 2(e) of D.C. Law 21-77 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Emergency Legislation

For temporary (90 day) addition, see § 6 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

For temporary (90 day) addition, see § 6 of Student Access to Treatment Congressional Review Emergency Act of 2007 (D.C. Act 17-140, October 17, 2007, 54 DCR 10736).

Temporary Legislation

Section 6 of Law 17-52 added a section to read as follows:

“Sec. 6. Storage of medication.

“(a) A school may receive additional medication from the responsible person for a student with a valid medication action plan; provided, that no school shall be required to store more than a 30-school-day supply of medication for any one student.

“(b) Additional medication shall be:

“(1) Properly stored at the school in a location to which the student has immediate access in case of an emergency; and

“(2) Labeled with the name of the student and the name of the medication, including the dosage, the frequency of administration, and the duration of the medication.

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

§ 38–651.10. Misuse.

(a) A school may deny a medication action plan pursuant to terms established by the Mayor.

(b) A student who self-administers medication while at school, at a school-sponsored activity, or while on school-sponsored transportation for a purpose other than his or her own treatment may be subject to disciplinary action by the school; provided, that disciplinary action shall not limit or restrict the access of a student to his or her prescribed medication. The school shall promptly notify the responsible person of any disciplinary action imposed.

(Feb. 2, 2008, D.C. Law 17-107, § 11, 54 DCR 12230.)

Emergency Legislation

For temporary (90 day) addition, see § 7 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

For temporary (90 day) addition, see § 7 of Student Access to Treatment Congressional Review Emergency Act of 2007 (D.C. Act 17-140, October 17, 2007, 54 DCR 10736).

Temporary Legislation

Section 7 of Law 17-52 added a section to read as follows:

“Sec. 7. Misuse.

“A student who self-administers medication while at school, at a school-sponsored activity, or while on school-sponsored transportation for a purpose other than his or her own authorized treatment may be subject to disciplinary action by the school; provided, that disciplinary action shall not limit or restrict the access of a student to his or her prescribed medication. The school shall promptly notify the responsible person of any disciplinary action imposed.”

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

§ 38–651.11. Liability.

The District, a school, an employee or agent of a school, or the practicing physician, physician assistant, or advanced practice nurse who has issued the standing order pursuant to this subchapter shall be immune from civil liability for the good-faith performance of responsibilities under this subchapter; except, that no immunity shall extend to criminal acts, intentional wrongdoing, gross negligence, or wanton or willful misconduct.

(Feb. 2, 2008, D.C. Law 17-107, § 12, 54 DCR 12230; Mar. 9, 2016, D.C. Law 21-77, § 2(f), 63 DCR 756.)

Effect of Amendments

The 2016 amendment by D.C. Law 21-77 would have substituted “an employee or agent of a school, or the practicing physician, physician assistant, or advanced practice nurse who has issued the standing order pursuant to this subchapter” for “or an employee or agent of a school.”

Applicability

Section 7002 of D.C. Law 21-160 repealed section 4 of D.C. Law 21-77. Therefore the changes made to this section by D.C. Law 21-177 have been given effect.

Applicability of D.C. Law 21-77: § 4 of D.C. Law 21-77 provided that the change made to this section by § 2(f) of D.C. Law 21-77 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Emergency Legislation

For temporary (90 day) addition, see § 8 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

For temporary (90 day) addition, see § 8 of Student Access to Treatment Congressional Review Emergency Act of 2007 (D.C. Act 17-140, October 17, 2007, 54 DCR 10736).

Temporary Legislation

Section 8 of Law 17-52 added a section to read as follows:

“Sec. 8. Liability waiver.

“(a) No school nor any employee or agent of a school shall be held liable for the good-faith performance of responsibilities under this act.

“(b) Except as provided in subsection (a) of this section, nothing in this act shall be interpreted to create a cause of action or to increase or diminish the liability of any person.”

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

§ 38–651.12. Rules.

(a) The Mayor, pursuant to subchapter I of Chapter 5 of Title 2 [§ 2-501 et seq.], shall issue rules to implement the provisions of this subchapter.

(b) The Mayor may establish, by regulation, additional types of medication that a student may self-administer and other illnesses for which a student may self-administer medication other than those provided in this subchapter.

(c) All existing rules and regulations promulgated pursuant to subchapter III of this chapter [§ 38-631 et seq.] [repealed], shall remain in effect until rules promulgated pursuant to this subchapter become effective.

(d) By August 1, 2016, pursuant to the authority granted by § 38-2602(b)(11), OSSE, in consultation with the Department of Health, shall issue rules to implement the provisions of § 38-651.04a, including establishing a protocol for record keeping whenever epinephrine is administered pursuant to § 38-651.04a.

(e) The Department of Health shall issue rules to implement the provisions of § 38-651.06, including the creation of a list designating specific medications that would be administered in emergency circumstances.

(Feb. 2, 2008, D.C. Law 17-107, § 13, 54 DCR 12230; Mar. 9, 2016, D.C. Law 21-77, § 2(g), 63 DCR 756; Feb. 15, 2024, D.C. Law 25-124, § 2(c), 70 DCR 16578.)

Effect of Amendments

The 2016 amendment by D.C. Law 21-77 would have added (d).

Applicability

Section 7002 of D.C. Law 21-160 repealed section 4 of D.C. Law 21-77. Therefore the changes made to this section by D.C. Law 21-177 have been given effect.

Applicability of D.C. Law 21-77: § 4 of D.C. Law 21-77 provided that the change made to this section by § 2(g) of D.C. Law 21-77 is subject to the inclusion of the law’s fiscal effect in an approved budget and financial plan. Therefore that amendment has not been implemented.

Emergency Legislation

For temporary (90 day) addition, see § 9 of Student Access to Treatment Emergency Amendment Act of 2007 (D.C. Act 17-82, July 26, 2007, 54 DCR 7999).

For temporary (90 day) addition, see § 9 of Student Access to Treatment Congressional Review Emergency Act of 2007 (D.C. Act 17-140, October 17, 2007, 54 DCR 10736).

Temporary Legislation

Section 9 of Law 17-52 added a section to read as follows:

“Sec. 9. Rules.

“(a) The Mayor, pursuant to Title 1 of the District of Columbia Administrative Procedure Act, approved October 21, 1968 (82 Stat. 1204; D.C. Official Code § 2-501 et seq.), shall issue rules to implement the provisions of this act.

“(b) The Mayor may establish, by regulation, additional types of medication a student may self-administer and potentially life-threatening illnesses for which a student may self-administer medication other than those provided in this act.”

Section 11(b) of D.C. Law 17-52 provided that the act shall expire after 225 days of its having taken effect.

Delegation of Authority

Delegation of Authority to the Student Access to Treatment Act of 2007, see Mayor’s Order 2008-85, June 11, 2008 ( 55 DCR 9362).

Subchapter V. School Health Innovations Grant Program.

§ 38–671.01. Definitions. [Repealed]

Repealed.

§ 38–671.02. School Health Innovations Grant Program. [Repealed]

Repealed.

§ 38–671.03. Application process. [Repealed]

Repealed.

§ 38–671.04. Evaluation of health care clinic operations. [Repealed]

Repealed.

§ 38–671.05. Ownership of health records. [Repealed]

Repealed.