What to know
Chris McCord, assistant superintendent of operations for the district, told the board of trustees about the expected requirement change that would replace the district's requirement for dispensing medications that has been in place since 2006. He said the change is expected to come out in "a few weeks."
Campus medication administration policy allows designated district personnel, including licensed nurses, to administer prescription medications with up-to-date prescription labels and over-the-counter medications to students with parent permission, according to information presented at the meeting.
The change would require licensed school nurses in Texas to have a physician’s order to administer over-the-counter and prescription medication, including oral and topical medication.
The district has 80 registered nurses.
“I want you to know that no matter what happens, Health Services will be ready, and we’ll be ready [to] make it work for our students, our staff and our parents,” McCord said.
The conditions
If the change occurs, there may be an extra step needed for parents and guardians, requiring them to obtain signed physicians orders for both prescription and OTC medications if a nurse is dispensing them.
For families without a physician, obtaining Texas Board of Nursing requirements may mean additional expenses, time and effort, officials said. In addition, it could be an added burden for campus personnel, could raise issues for nurses involving their licensure, and instructional minutes could be impacted.
"I don't know what for sure is going to come down; it appears the board of nursing is going to say nurses are going to have to have orders to be able to do it; they have put out an edict through the nurse organization; we are waiting to see," McCord said.
According to discussion at the meeting, this is not the result of a new law, but it is a new interpretation that will be coming out.
"This has the potential of being a very big impact on ... everybody, and parents," Superintendent Curtis Null said.
Board members speculated on the possible results of the change, including an increased burden on parents' finances and time.
"Parents ... working hourly jobs don't have that time," board member Datren Williams said, regarding the need for parents to get physicians' notes for any kind of medication administration.
The outlook
McCord outlined possible options for the district under the new interpretation.
For prekindergarten through sixth grade students, those options include:
- All medications dispensed at school by a licensed nurse at the school would require a signed physician’s order.
- All medications administered by a licensed nurse at school would require a signed physician’s order, but OTC medications could be administered by designated personnel, who are not a licensed nurses, with parent/guardian permission rather than a physician’s note.
- Both OTC and prescription medications would be administrated by a designated person—not a licensed nurse—with parent/guardian permission.
Barbara Robertson, director of health services for the district, said the Texas School Nurses Organization recently spoke with the Texas Board of Nursing about the barriers this practice would introduce for students.
"Our understanding ... is the board of nursing heard that, and they will be sending out information in the coming weeks that better explains the legal framework for why a registered nurse or licensed vocational nurse is required to have a physician's order in order to administer medications," Robertson said.
Before you go
At the end of the meeting, the board also held a public hearing on the proposed fiscal year 2024-25 budget and tax rate of $0.9496 per $100 valuation, which is a $0.125 decrease from the FY 2023-24 tax rate, CISD Chief Financial Officer Karen Garza said.
