Legal Rights of Children with Epilepsy in School & Child Care

Legal Rights of Children with Epilepsy in School and Child Care
7.3Q:
Does the Epilepsy Foundation have a position about the administration of
emergency antiepileptic medication?
A: Yes. The Epilepsy Foundation’s position states, in part:
Federal and state laws guarantee every child/student the right to participate
in a free, appropriate public education in the least restrictive setting.
Schools, camps, and day care providers are also required to provide many
health-related services, including administering medicine, if needed, to
students with disabilities, as either a reasonable accommodation or a related
service. The purpose of these laws is to ensure that children with chronic
health conditions like epilepsy can be educated in the least restrictive
environment and participate in recreational activities, camp and day care
programs with their peers. Because medicines, including rectally
administered diazepam, can be administered by non-medical personnel who
have received proper instruction, lack of access to a doctor or full-time
nurse is not an acceptable reason to refuse to administer the medication onsite
or to deny a child or student access to the program. The Epilepsy
Foundation wholly supports these principles as being in the best interest of
the child.
The Epilepsy Foundation urges providers of child care and educational
services to work with the child, his or her parents and the child’s treating
physician to learn how and when to administer the appropriate treatment.
Schools and service providers should, along with the child’s parents and, as
appropriate, the treating physician, develop a plan for ensuring that
adequate measures are taken to administer the treatment and that the
appropriate staff is properly trained to do so.
7.4Q: Who is allowed to administer emergency antiepileptic medication to
students in schools?
100
A: This depends on state law. State nurse practice acts and education codes govern
the tasks that are reserved for licensed nurses and the tasks that may be
delegated by nurses to unlicensed assistive personal (UAPs) such as health
aides. Most states do in fact authorize school nurses to delegate the authority to
administer certain medications to UAPs. Louisiana is an example of a state
where nurses apparently freely delegate the authority to administer diazepam,
and in that state a detailed clinical protocol on diazepam administration has been
developed.
However, in a number of states, it is unclear whether the authority to delegate
extends to the administration of diazepam or other emergency antiepileptic
medications. The reason for this lack of clarity is that many state education
codes or nurse practice acts prohibit delegation of nursing duties that require the
exercise of “professional nursing knowledge or judgment or complex nursing