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• When medicine is given at the child care program:
• When children need to be given prescription medicine during child care hours for a temporary illness (like strep) or a chronic condition (like asthma), caregivers need to have written authorization signed by a parent and the child's health care provider. They may also need a written health care plan, particularly in the case of a chronic condition such as asthma.



• You and your child's health care provider may decide that your child's discomfort in certain situations (like hay fever) justify the use of medicine that can be purchased without a prescription - "over the counter" medications. Your caregiver needs to have written authorization signed by the parent and specific instructions by the child's health provider.



• Caregivers need to be trained by a health professional to give medicine correctly in order to ensure the health and safety of the child receiving the medicine. Check with your health care provider about providing instructions to the caregiver or work with your child care program's health consultant regarding appropriate training.



• When talking with the prescribing health care provider, determine if the medications can be given before and after your child is at a child care program, eliminating the need for giving them in the child care setting.

• Legal/state regulatory issues surrounding giving medicines in child care programs
• In many states, there are different sets of rules and laws about giving medicine ("medication administration") that may conflict with each other. For example:


• Americans with Disabilities Act (ADA)
• The ADA is a federal law that states that businesses must make "reasonable accommodations" for people with disabilities and special needs.
• Child care facilities are considered public accommodations (businesses) that must comply with the ADA.
• Giving medicine may fall under the category of "reasonable accommodations."
• Contact the Child Care Law Center for more information on child care and the Americans with Disabilities Act. See also Children with Special Needs Section.


• State Child Care Licensing Rules and State Nurse and Pharmacy Practice Acts


• Many states have regulations that define giving medicine (by paid caregivers, not family members) as a task that only "licensed medical professionals" can do. However, some states do allow caregivers to give medication.


• For your state's licensing requirements see http://nrckids.org/STATES/states.htm.


• Very few child care programs have health professionals on staff. Some states allow the task of giving medicine to be delegated to a caregiver by licensed medical professionals. Some states allow licensed medical professionals to delegate the task of giving medicine to caregivers; other states consider teaching medical administration as a professional activity. In states where the task of giving medicine is delegated, most of the states require that licensed medical professionals directly train and/or supervise caregivers who give medicine. Talk to your caregiver about how they receive training on giving medicines.


• For your state's Nurse Practice Act, contact your State Board of Nursing:
https://www.ncsbn.org/515.htm


• For more information on your state's Pharmacy Practice Act contact the National Association of Boards of Pharmacy:
http://www.nabp.net/

• Labeling requirements for medicines brought to a child care program:
• Any prescription medication brought to a child care program must be dated and be kept in the original container. The container must be labeled by a pharmacist with:


• The child's first and last names.
• The date the prescription was filled.
• The name of the health care provider who wrote the prescription.
• The medicine's expiration date.
• The manufacturer's instructions or a prescription label with specific, legible instructions for administration, storage and disposal.
• The name and strength of the medicine.


• Over the counter medicines must be kept in their original container as sold by the manufacturer, labeled by the parent with the child's name and specific instructions for administration given by the child's health care provider.

• Storage requirements of medicine at a child care program:

• Child resistant caps must be on all medications.
• Medicines should be stored, locked and separate from food and maintained at the proper temperature (refrigerated if required).
• All medicines are inaccessible to all children.
• Caregivers should have access to medicines at all times including field trips and outdoor activities.



Note: A small lock box can be kept in the refrigerator to hold medications.