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Health Manager Orientation Guide

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Medication Administration

Young boy using a nebulizer.It is important to have clear steps when handling, giving, and storing medications in Head Start programs. This will ensure that all children, including those who need medication during the day, can participate in the program.

Common reasons children may need medication include:

  • Illnesses that require medication for a limited time (e.g., ear infection)
  • Chronic conditions that require long-term medications administered daily or on another regular schedule (e.g., eczema, cystic fibrosis)
  • Emergencies, where medications need to be available and administered only if needed (e.g., asthma episode, seizure, severe allergic reaction)

A collaborative statement from the leading health organizations emphasizes the important role schools play in supporting children with chronic conditions such as asthma, diabetes, dental disease, epilepsy, food allergies, mental health disorders, and obesity. Many children in Head Start programs may need this support, including support taking medication while in the program.

One of the most important responsibilities for a Head Start health services manager and the program’s health services staff is to provide clear steps on how medications should be organized and distributed. A successful process involves other staff and coordination with many Head Start management systems. Planning and ongoing communication with the child’s family and health care professionals are also required. This aligns with Head Start programs’ coordinated approach to quality services.

Setting up medication procedures helps reduce risks, which can be related to these factors:

  • Young children need help from adults and caregivers when taking medication.
  • A nurse or other health professional may not always be available to give all needed medications, making it necessary for other staff to be trained in safe medication administration.
  • When a child needs an adult’s assistance and attention to take a medication, staff still need to maintain adequate supervision of all other children in their care.
  • Medication dosing for young children is often based on weight and can result in different dosing for different children.

Head Start Health Services Competencies

CFH-21 Demonstrate safe methods that meet state and tribal requirements of administering medications, including consent, handling, labeling, storing, disposing, and recognizing possible side effects.

O-5 Understand the risk factors that make some people healthy, and other people unhealthy (e.g., determinants of health) that contribute to health disparities among culturally and linguistically diverse populations.

O-10 Share culturally, linguistically, and developmentally appropriate science-informed health education materials with children, families, and staff.

CFH-15 Help families identify and overcome barriers to completing further diagnostic testing, follow-up, and treatment.

CFH-16 Develop and implement Individual Health Care Plans (IHPs) for children with special health care needs, in collaboration with families, the medical home, and other related service providers.

CFH-29 Collect and use child and family health history, including current health needs, to help children and families achieve optimal wellness.

EF-1 Believe that families are experts about, and the primary decision makers for, their children’s health.

EF-2 Understand how the attitudes, beliefs, and traditions of individuals from diverse ethnic, cultural, religious, educational and socioeconomic backgrounds, sexual orientations, and genders affect health practices.

L-4 Understand adult learning principles.

L-10 Develop, disseminate, review, and update program health and safety policies and procedures.

L-11 Conduct ongoing monitoring activities to assure healthy and safe program practices and implement improvements as needed.

HSPPS Related to Medication Administration

State, Tribal, and Territorial Requirements

Besides following the mandates in the Performance Standards, Head Start programs must be familiar with and incorporate their own state, tribal, and territorial requirements for medication administration in early care and education.

Rehabilitation Act of 1973, Section 504, and Americans with Disabilities Act of 1990

The Americans with Disabilities Act is a federal law that requires a child with special health care needs to have reasonable accommodations when attending a publicly funded program such as a Head Start program. This includes children taking medications that are necessary for them to safely participate. It is important to note that children with medication needs may be eligible for services under the Individuals with Disabilities Education Act (IDEA).

Child Care and Development Block Grant Act of 2014 and the Child Care and Development Fund Program Final Rule (2016)

Head Start programs that use CCDF funding to supplement comprehensive services to children who qualify for both programs can refer to the CCDF Health and Safety Requirements Brief No. 2 for an overview of national guidelines and state requirements for CCDF when administering medication in child care

Caring for Our Children (CFOC) Standards

Social Determinants of Health and Equity Considerations

Chronic conditions that are not sufficiently under control can have a negative effect on a child’s attendance and academic success.

Social determinants of health that can affect the successful management of special health care needs, including medications, and then affect a child’s regular attendance and school readiness include:

  • Living in a community experiencing health care shortages
  • Not having access to a medical home that adequately manages and coordinates care
  • Not having health insurance or having insufficient coverage for accommodations, such as more medications or equipment while in the program
  • Experiencing homelessness, transitional housing, or housing insecurities
  • Having limited access to health information or education that is culturally or linguistically appropriate for the family to advocate for and manage their child’s health care needs

Helping staff understand inequities such as lack of health coverage or access to medical care, can make it easier for them to meet the needs of children and support their regular, safe attendance and participation.

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