Schools look to widen student medication and restraint policies

Schools Superintendent Laurie Hunter presented new policy changes at the last School Committee meeting that would broaden when school officials are responsible for student medication and when physical restraint may be used.

Hunter said the revisions largely mirror updated state regulations and guidance from the Massachusetts Association of School Committees.

Medication policies

OLD | NEW

Covers medication administered “while at school.” | Expands to all “regular school activities,” including field trips, buses, sports, extracurriculars, and school-sponsored events.

Does not outline records kept. | Requires daily logs, medication administration records, documentation of omissions, adverse reactions, quantities received, and more.

Does not outline an administration plan. | Defines in detail what the plan must include, including medication orders and allergies, storage conditions, monitoring, and field trip planning.

The proposed medication policy broadens in scope to cover all “regular school activities,” including field trips, school transportation, athletic events, and extracurricular programs. Previously, the policy covered only school hours.

It also would create more detailed requirements for medication administration plans, mandating documentation that ranges from physician orders and parent authorization to storage conditions, side effects, and monitoring procedures.

Exceptions for students with asthma, cystic fibrosis, diabetes, and life-threatening allergies still exist. These students can carry and administer their own medication when they need it. 

“The short version is the nurses are going to be able to train more broadly and delegate medication administration for certain types of medications beyond what they’ve been able to do, which up till now has been pretty much EpiPens,” Hunter said at the June 16 committee meeting.

The policy also would give the school nurse or a designated “medication program manager” final authority over medication administration plans for field trips and other short-term school events.

Hunter said the district is still determining who will fill that position and expects to know before the School Committee approves the policy. 

Restraint policies

OLD | NEW

Focused primarily on physical restraint. It prohibited seclusion and mentioned timeout only briefly. | Expanded to cover timeout, seclusion, and physical restraint in detail. It adds formal definitions, standards for timeouts, and extensive language governing seclusion.

Seclusion prohibited. | Seclusion may be used in extremely limited emergency circumstances when numerous conditions are met, including an imminent threat of serious physical harm, documented history, physician and mental health approval, and parent consent.

Included general requirements for training, reporting, and notifying parents after restraints. | Creates stricter procedures for monitoring, documentation, and administrative review of incidents.

Physical restraint

The committee also reviewed a rewritten policy governing timeout, seclusion, and physical restraint. 

Although the district already has a physical restraint policy, the proposed version would add detailed definitions and procedures for timeout and seclusion. It also would expand documentation and oversight requirements.

Hunter said the goal is to rely on other strategies whenever possible.

“The direction is to use other de-escalation strategies, so that kids are not confined,” she said at the meeting.

Under the proposed policy, seclusion could be used only as a last resort when a student poses an imminent threat of assault or serious physical harm and multiple safeguards have been met. 

Those include written principal approval, parent consent, documentation from medical and mental health professionals, and staff training requirements.

The district has three years to fully implement the updated requirements.

The committee took no action on the medication and restraint proposals and is expected to revisit them in August when the School Committee returns to regular meetings.