                                 CODE OF VIRGINIA

PROFESSIONAL USE BY PRACTITIONERS (§ 54.1-3408)

A. A practitioner of medicine, osteopathy, podiatry, dentistry, or veterinary
medicine, a licensed advanced practice registered nurse pursuant to &#xA7;
54.1-2957.01, a licensed certified midwife pursuant to &#xA7; 54.1-2957.04, a
licensed physician assistant pursuant to &#xA7; 54.1-2952.1, or a TPA-certified
optometrist pursuant to Article 5 (&#xA7; 54.1-3222 et seq.) of Chapter 32 shall
only prescribe, dispense, or administer controlled substances in good faith for
medicinal or therapeutic purposes within the course of his professional
practice. A licensed midwife pursuant to &#xA7; 54.1-2957.7 shall only obtain,
possess, and administer controlled substances in good faith for medicinal or
therapeutic purposes within the course of his professional practice.

B. The prescribing practitioner&#8217;s order may be on a written prescription
or pursuant to an oral prescription as authorized by this chapter. The
prescriber may administer drugs and devices, or he may cause drugs or devices to
be administered by:

   1. A nurse, physician assistant, or intern under his direction and
   supervision;

   2. Persons trained to administer drugs and devices to patients in state-owned
   or state-operated hospitals or facilities licensed as hospitals by the Board
   of Health or psychiatric hospitals licensed by the Department of Behavioral
   Health and Developmental Services who administer drugs under the control and
   supervision of the prescriber or a pharmacist;

   3. Emergency medical services personnel certified and authorized to administer
   drugs and devices pursuant to regulations of the Board of Health who act
   within the scope of such certification and pursuant to an oral or written
   order or standing protocol;

   4. Persons who are employed or engaged at a medical care facility, as defined
   in &#xA7; 32.1-3, who have a valid emergency medical services provider
   certification issued by the Board of Health as a requirement of being employed
   or engaged at the medical care facility within the scope of such
   certification, pursuant to an oral or written order or standing protocol to
   administer drugs and devices at the medical care facility; or

   5. A licensed respiratory therapist as defined in &#xA7; 54.1-2954 who
   administers by inhalation controlled substances used in inhalation or
   respiratory therapy.

C. Pursuant to an oral or written order or standing protocol, the prescriber,
who is authorized by state or federal law to possess and administer
radiopharmaceuticals in the scope of his practice, may authorize a nuclear
medicine technologist to administer, under his supervision, radiopharmaceuticals
used in the diagnosis or treatment of disease.

D. Pursuant to an oral or written order or standing protocol issued by the
prescriber within the course of his professional practice, such prescriber may
authorize registered nurses and licensed practical nurses to possess (i)
epinephrine and oxygen for administration in treatment of emergency medical
conditions and (ii) heparin and sterile normal saline to use for the maintenance
of intravenous access lines.
			Pursuant to the regulations of the Board of Health, certain emergency medical
services technicians may possess and administer epinephrine in emergency cases
of anaphylactic shock.
			Pursuant to an order or standing protocol issued by the prescriber within the
course of his professional practice, any school nurse, school board employee,
employee of a local governing body, or employee of a local health department who
is authorized by a prescriber and trained in the administration of epinephrine
may possess and administer epinephrine.
			Pursuant to an order or standing protocol that shall be issued by the local
health director within the course of his professional practice, any school
nurse, licensed athletic trainer under contract with a local school division,
school board employee, employee of a local governing body, or employee of a
local health department who is authorized by the local health director and
trained in the administration of albuterol inhalers and valved holding chambers
or nebulized albuterol may possess or administer an albuterol inhaler and a
valved holding chamber or nebulized albuterol to a student diagnosed with a
condition requiring an albuterol inhaler or nebulized albuterol when the student
is believed to be experiencing or about to experience an asthmatic crisis.
			Pursuant to an order or a standing protocol issued by the prescriber within
the course of his professional practice, any employee of a school for students
with disabilities, as defined in &#xA7; 22.1-319 and licensed by the Board of
Education, or any employee of a private school that is accredited pursuant to
&#xA7; 22.1-19 as administered by the Virginia Council for Private Education who
is authorized by a prescriber and trained in the administration of (a)
epinephrine may possess and administer epinephrine and (b) albuterol inhalers or
nebulized albuterol may possess or administer an albuterol inhaler or nebulized
albuterol to a student diagnosed with a condition requiring an albuterol inhaler
or nebulized albuterol when the student is believed to be experiencing or about
to experience an asthmatic crisis.
			Pursuant to an order or a standing protocol issued by the prescriber within
the course of his professional practice, any nurse at an early childhood care
and education entity, employee at the entity, or employee of a local health
department who is authorized by a prescriber and trained in the administration
of epinephrine may possess and administer epinephrine.
			Pursuant to an order or a standing protocol issued by the prescriber within
the course of his professional practice, any employee of a public institution of
higher education or a private institution of higher education who is authorized
by a prescriber and trained in the administration of epinephrine may possess and
administer epinephrine.
			Pursuant to an order or a standing protocol issued by the prescriber within
the course of his professional practice, any employee of an organization
providing outdoor educational experiences or programs for youth who is
authorized by a prescriber and trained in the administration of epinephrine may
possess and administer epinephrine.
			Pursuant to an order or a standing protocol issued by the prescriber within
the course of his professional practice, and in accordance with policies and
guidelines established by the Department of Health, such prescriber may
authorize any employee of a restaurant licensed pursuant to Chapter 3 (&#xA7;
35.1-18 et seq.) of Title 35.1 to possess and administer epinephrine on the
premises of the restaurant at which the employee is employed, provided that such
person is trained in the administration of epinephrine.
			Pursuant to an order issued by the prescriber within the course of his
professional practice, an employee of a provider licensed by the Department of
Behavioral Health and Developmental Services or a person providing services
pursuant to a contract with a provider licensed by the Department of Behavioral
Health and Developmental Services may possess and administer epinephrine,
provided such person is authorized and trained in the administration of
epinephrine.
			Pursuant to an order or standing protocol issued by the prescriber within the
course of his professional practice, any employee of a place of public
accommodation, as defined in subsection A of &#xA7; 2.2-3904, who is authorized
by a prescriber and trained in the administration of epinephrine may possess and
administer epinephrine.
			Pursuant to an oral or written order or standing protocol issued by the
prescriber within the course of his professional practice, such prescriber may
authorize pharmacists to possess epinephrine and oxygen for administration in
treatment of emergency medical conditions.

E. Pursuant to an oral or written order or standing protocol issued by the
prescriber within the course of his professional practice, such prescriber may
authorize licensed physical therapists to possess and administer topical
corticosteroids, topical lidocaine, and any other Schedule VI topical drug.

F. Pursuant to an oral or written order or standing protocol issued by the
prescriber within the course of his professional practice, such prescriber may
authorize licensed athletic trainers to possess and administer topical
corticosteroids, topical lidocaine, or other Schedule VI topical drugs; oxygen
and IV saline for use in emergency situations; subcutaneous lidocaine for wound
closure; epinephrine for use in emergency cases of anaphylactic shock; and
naloxone or other opioid antagonist for overdose reversal.

G. Pursuant to an oral or written order or standing protocol issued by the
prescriber within the course of his professional practice, and in accordance
with policies and guidelines established by the Department of Health pursuant to
&#xA7; 32.1-50.2, such prescriber may authorize registered nurses or licensed
practical nurses under the supervision of a registered nurse to possess and
administer tuberculin purified protein derivative (PPD) in the absence of a
prescriber. The Department of Health&#8217;s policies and guidelines shall be
consistent with applicable guidelines developed by the Centers for Disease
Control and Prevention for preventing transmission of mycobacterium tuberculosis
and shall be updated to incorporate any subsequently implemented standards of
the Occupational Safety and Health Administration and the Department of Labor
and Industry to the extent that they are inconsistent with the Department of
Health&#8217;s policies and guidelines. Such standing protocols shall explicitly
describe the categories of persons to whom the tuberculin test is to be
administered and shall provide for appropriate medical evaluation of those in
whom the test is positive. The prescriber shall ensure that the nurse
implementing such standing protocols has received adequate training in the
practice and principles underlying tuberculin screening.
			The Health Commissioner or his designee may authorize registered nurses,
acting as agents of the Department of Health, to possess and administer, at the
nurse&#8217;s discretion, tuberculin purified protein derivative (PPD) to those
persons in whom tuberculin skin testing is indicated based on protocols and
policies established by the Department of Health.

H. Pursuant to a written order or standing protocol issued by the prescriber
within the course of his professional practice, such prescriber may authorize,
with the consent of the parents as defined in &#xA7; 22.1-1, an employee of (i)
a school board, (ii) a school for students with disabilities as defined in
&#xA7; 22.1-319 licensed by the Board of Education, or (iii) a private school
accredited pursuant to &#xA7; 22.1-19 as administered by the Virginia Council
for Private Education who is trained in the administration of insulin and
glucagon to assist with the administration of insulin or administer glucagon to
a student diagnosed as having diabetes and who requires insulin injections
during the school day or for whom glucagon has been prescribed for the emergency
treatment of hypoglycemia. Such authorization shall only be effective when a
licensed nurse, an advanced practice registered nurse, a physician, or a
physician assistant is not present to perform the administration of the
medication.
			Pursuant to a written order or standing protocol issued by the prescriber
within the course of his professional practice, such prescriber may authorize
the possession and administration of undesignated glucagon as set forth in
subsection F of &#xA7; 22.1-274.2.
			Pursuant to a written order or standing protocol issued by the prescriber
within the course of his professional practice, such prescriber may authorize an
employee of a public institution of higher education or a private institution of
higher education who is trained in the administration of insulin and glucagon to
assist with the administration of insulin or administration of glucagon to a
student diagnosed as having diabetes and who requires insulin injections or for
whom glucagon has been prescribed for the emergency treatment of hypoglycemia.
Such authorization shall only be effective when a licensed nurse, an advanced
practice registered nurse, a physician, or a physician assistant is not present
to perform the administration of the medication.
			Pursuant to a written order issued by the prescriber within the course of his
professional practice, such prescriber may authorize an employee of a provider
licensed by the Department of Behavioral Health and Developmental Services or a
person providing services pursuant to a contract with a provider licensed by the
Department of Behavioral Health and Developmental Services to assist with the
administration of insulin or to administer glucagon to a person diagnosed as
having diabetes and who requires insulin injections or for whom glucagon has
been prescribed for the emergency treatment of hypoglycemia, provided such
employee or person providing services has been trained in the administration of
insulin and glucagon.

I. A prescriber may authorize, pursuant to a protocol approved by the Board of
Nursing, the administration of vaccines to adults for immunization, when a
practitioner with prescriptive authority is not physically present, by (i)
licensed pharmacists, (ii) registered nurses, or (iii) licensed practical nurses
under the supervision of a registered nurse. A prescriber acting on behalf of
and in accordance with established protocols of the Department of Health may
authorize the administration of vaccines to any person by a pharmacist, nurse,
or designated emergency medical services provider who holds an advanced life
support certificate issued by the Commissioner of Health under the direction of
an operational medical director when the prescriber is not physically present.
The emergency medical services provider shall provide documentation of the
vaccines to be recorded in the Virginia Immunization Information System.

J. A dentist may cause Schedule VI topical drugs to be administered under his
direction and supervision by either a dental hygienist or by an authorized agent
of the dentist.
			Further, pursuant to a written order and in accordance with a standing
protocol issued by the dentist in the course of his professional practice, a
dentist may authorize a dental hygienist under his general supervision, as
defined in &#xA7; 54.1-2722, or his remote supervision, as defined in subsection
E or F of &#xA7; 54.1-2722, to possess and administer topical oral fluorides,
topical oral anesthetics, topical and directly applied antimicrobial agents for
treatment of periodontal pocket lesions, and any other Schedule VI topical drug
approved by the Board of Dentistry.
			In addition, a dentist may authorize a dental hygienist under his direction
to administer Schedule VI nitrous oxide and oxygen inhalation analgesia and, to
persons 18 years of age or older, Schedule VI local anesthesia.

K. Pursuant to an oral or written order or standing protocol issued by the
prescriber within the course of his professional practice, such prescriber may
authorize registered professional nurses certified as sexual assault nurse
examiners-A (SANE-A) under his supervision and when he is not physically present
to possess and administer preventive medications for victims of sexual assault
as recommended by the Centers for Disease Control and Prevention.

L. This section shall not prevent the administration of drugs by a person who
has satisfactorily completed a training program for this purpose approved by the
Board of Nursing and who administers such drugs in accordance with a
prescriber&#8217;s instructions pertaining to dosage, frequency, and manner of
administration, and in accordance with regulations promulgated by the Board of
Pharmacy relating to security and record keeping, when the drugs administered
would be normally self-administered by (i) an individual receiving services in a
program licensed by the Department of Behavioral Health and Developmental
Services; (ii) a resident of the Virginia Rehabilitation Center for the Blind
and Vision Impaired; (iii) a resident of a facility approved by the Board or
Department of Juvenile Justice for the placement of children in need of services
or delinquent or alleged delinquent youth; (iv) a program participant of an
adult day center licensed by the Department of Social Services; (v) a resident
of any facility authorized or operated by a state or local government whose
primary purpose is not to provide health care services; (vi) a resident of a
private children&#8217;s residential facility, as defined in &#xA7; 63.2-100 and
licensed by the Department of Social Services, Department of Education, or
Department of Behavioral Health and Developmental Services; or (vii) a student
in a school for students with disabilities, as defined in &#xA7; 22.1-319 and
licensed by the Board of Education.
			In addition, this section shall not prevent a person who has successfully
completed a training program for the administration of drugs via percutaneous
gastrostomy tube approved by the Board of Nursing and been evaluated by a
registered nurse as having demonstrated competency in administration of drugs
via percutaneous gastrostomy tube from administering drugs to a person receiving
services from a program licensed by the Department of Behavioral Health and
Developmental Services to such person via percutaneous gastrostomy tube. The
continued competency of a person to administer drugs via percutaneous
gastrostomy tube shall be evaluated semiannually by a registered nurse.

M. Medication aides registered by the Board of Nursing pursuant to Article 7
(&#xA7; 54.1-3041 et seq.) of Chapter 30 may administer drugs that would
otherwise be self-administered to residents of any assisted living facility
licensed by the Department of Social Services. A registered medication aide
shall administer drugs pursuant to this section in accordance with the
prescriber&#8217;s instructions pertaining to dosage, frequency, and manner of
administration; in accordance with regulations promulgated by the Board of
Pharmacy relating to security and recordkeeping; in accordance with the assisted
living facility&#8217;s Medication Management Plan; and in accordance with such
other regulations governing their practice promulgated by the Board of Nursing.

N. Advanced medication aides registered by the Board of Nursing pursuant to
Article 7 (&#xA7; 54.1-3041 et seq.) of Chapter 30 may administer drugs that
would be administered by a registered medication aide pursuant to subsection M,
in addition to drugs determined permissible by the Board of Nursing, in a
nursing home licensed by the Department of Health. Advanced medication aides
shall administer drugs pursuant to this section in accordance with the
prescriber&#8217;s instructions pertaining to dosage, frequency, and manner of
administration; in accordance with regulations promulgated by the Board of
Pharmacy relating to security and recordkeeping; in accordance with the licensed
nursing home&#8217;s policies and procedures; and in accordance with such other
regulations governing their practice promulgated by the Board of Nursing.

O. In addition, this section shall not prevent the administration of drugs by a
person who administers such drugs in accordance with a physician&#8217;s
instructions pertaining to dosage, frequency, and manner of administration and
with written authorization of a parent, and in accordance with school board
regulations relating to training, security and record keeping, when the drugs
administered would be normally self-administered by a student of a Virginia
public school. Training for such persons shall be accomplished through a program
approved by the local school boards, in consultation with the local departments
of health.

P. In addition, this section shall not prevent the administration of drugs by a
person to (i) a child in a child day program as defined in &#xA7; 22.1-289.02
and regulated by the Board of Education or a local government pursuant to &#xA7;
15.2-914, or (ii) a student of a private school that is accredited pursuant to
&#xA7; 22.1-19 as administered by the Virginia Council for Private Education,
provided such person (a) has satisfactorily completed a training program for
this purpose approved by the Board of Nursing and taught by a registered nurse,
a licensed practical nurse, an advanced practice registered nurse, a physician
assistant, a doctor of medicine or osteopathic medicine, or a pharmacist; (b)
has obtained written authorization from a parent or guardian; (c) administers
drugs only to the child identified on the prescription label in accordance with
the prescriber&#8217;s instructions pertaining to dosage, frequency, and manner
of administration; and (d) administers only those drugs that were dispensed from
a pharmacy and maintained in the original, labeled container that would normally
be self-administered by the child or student, or administered by a parent or
guardian to the child or student.

Q. In addition, this section shall not prevent the administration or dispensing
of drugs and devices by persons if they are authorized by the State Health
Commissioner in accordance with protocols established by the State Health
Commissioner pursuant to &#xA7; 32.1-42.1 when (i) the Governor has declared a
disaster or a state of emergency, the United States Secretary of Health and
Human Services has issued a declaration of an actual or potential bioterrorism
incident or other actual or potential public health emergency, or the Board of
Health has made an emergency order pursuant to &#xA7; 32.1-13 for the purpose of
suppressing nuisances dangerous to the public health and communicable,
contagious, and infectious diseases and other dangers to the public life and
health and for the limited purpose of administering vaccines as an approved
countermeasure for such communicable, contagious, and infectious diseases; (ii)
it is necessary to permit the provision of needed drugs or devices; and (iii)
such persons have received the training necessary to safely administer or
dispense the needed drugs or devices. Such persons shall administer or dispense
all drugs or devices under the direction, control, and supervision of the State
Health Commissioner.

R. Nothing in this title shall prohibit the administration of normally
self-administered drugs by unlicensed individuals to a person in his private
residence.

S. This section shall not interfere with any prescriber issuing prescriptions in
compliance with his authority and scope of practice and the provisions of this
section to a Board agent for use pursuant to subsection G of &#xA7; 18.2-258.1.
Such prescriptions issued by such prescriber shall be deemed to be valid
prescriptions.

T. Nothing in this title shall prevent or interfere with dialysis care
technicians or dialysis patient care technicians who are certified by an
organization approved by the Department of Health Professions or persons
authorized for provisional practice pursuant to Chapter 27.01 (&#xA7;
54.1-2729.1 et seq.), in the ordinary course of their duties in a
Medicare-certified renal dialysis facility, from administering heparin, topical
needle site anesthetics, dialysis solutions, sterile normal saline solution, and
blood volumizers, for the purpose of facilitating renal dialysis treatment, when
such administration of medications occurs under the orders of a licensed
physician, an advanced practice registered nurse, or a physician assistant and
under the immediate and direct supervision of a licensed registered nurse.
Nothing in this chapter shall be construed to prohibit a patient care dialysis
technician trainee from performing dialysis care as part of and within the scope
of the clinical skills instruction segment of a supervised dialysis technician
training program, provided such trainee is identified as a &#8220;trainee&#8221;
while working in a renal dialysis facility.
			The dialysis care technician or dialysis patient care technician
administering the medications shall have demonstrated competency as evidenced by
holding current valid certification from an organization approved by the
Department of Health Professions pursuant to Chapter 27.01 (&#xA7; 54.1-2729.1
et seq.).

U. Persons who are otherwise authorized to administer controlled substances in
hospitals shall be authorized to administer influenza or pneumococcal vaccines
pursuant to &#xA7; 32.1-126.4.

V. Pursuant to a specific order for a patient and under his direct and immediate
supervision, a prescriber may authorize the administration of controlled
substances by personnel who have been properly trained to assist a doctor of
medicine or osteopathic medicine, provided the method does not include
intravenous, intrathecal, or epidural administration and the prescriber remains
responsible for such administration.

W. A physician assistant, nurse, dental hygienist, or authorized agent of a
doctor of medicine, osteopathic medicine, or dentistry may possess and
administer topical fluoride varnish pursuant to an oral or written order or a
standing protocol issued by a doctor of medicine, osteopathic medicine, or
dentistry.

X. A prescriber, acting in accordance with guidelines developed pursuant to
&#xA7; 32.1-46.02, may authorize the administration of influenza vaccine to
minors by a licensed pharmacist, registered nurse, licensed practical nurse
under the direction and immediate supervision of a registered nurse, or
emergency medical services provider who holds an advanced life support
certificate issued by the Commissioner of Health when the prescriber is not
physically present.

Y. Notwithstanding the provisions of &#xA7; 54.1-3303, pursuant to an oral,
written, or standing order issued by a prescriber or a standing order issued by
the Commissioner of Health or his designee authorizing the dispensing of
naloxone or other opioid antagonist used for overdose reversal in the absence of
an oral or written order for a specific patient issued by a prescriber, and in
accordance with protocols developed by the Board of Pharmacy in consultation
with the Board of Medicine and the Department of Health, a pharmacist, a health
care provider providing services in a hospital emergency department, and
emergency medical services personnel, as that term is defined in &#xA7;
32.1-111.1, may dispense naloxone or other opioid antagonist used for overdose
reversal and a person to whom naloxone or other opioid antagonist has been
dispensed pursuant to this subsection may possess and administer naloxone or
other opioid antagonist used for overdose reversal to a person who is believed
to be experiencing or about to experience a life-threatening opioid overdose.
Law-enforcement officers as defined in &#xA7; 9.1-101, employees of the
Department of Forensic Science, employees of the Office of the Chief Medical
Examiner, employees of the Department of General Services Division of
Consolidated Laboratory Services, employees of the Department of Corrections
designated by the Director of the Department of Corrections or designated as
probation and parole officers or as correctional officers as defined in &#xA7;
53.1-1, employees of the Department of Juvenile Justice designated as probation
and parole officers or as juvenile correctional officers, employees of regional
jails, employees of any state agency, school nurses, local health department
employees that are assigned to a public school pursuant to an agreement between
the local health department and the school board, school board employees who
have completed training and are certified in the administration of an opioid
antagonist for overdose reversal by a program administered or authorized by the
Department of Health, other school board employees or individuals contracted by
a school board to provide school health services, resident assistants in a
student housing facility at a public institution of higher education who have
completed training in the administration of an opioid antagonist for overdose
reversal pursuant to &#xA7; 23.1-802.2, and firefighters may also possess and
administer naloxone or other opioid antagonist used for overdose reversal and
may dispense naloxone or other opioid antagonist used for overdose reversal
pursuant to an oral, written, or standing order issued by a prescriber or a
standing order issued by the Commissioner of Health or his designee in
accordance with protocols developed by the Board of Pharmacy in consultation
with the Board of Medicine and the Department of Health.
			Notwithstanding the provisions of &#xA7; 54.1-3303, pursuant to an oral,
written, or standing order issued by a prescriber or a standing order issued by
the Commissioner of Health or his designee authorizing the dispensing of
naloxone or other opioid antagonist used for overdose reversal in the absence of
an oral or written order for a specific patient issued by a prescriber, and in
accordance with protocols developed by the Board of Pharmacy in consultation
with the Board of Medicine and the Department of Health, any person may possess
and administer naloxone or other opioid antagonist used for overdose reversal,
other than naloxone in an injectable formulation with a hypodermic needle or
syringe, in accordance with protocols developed by the Board of Pharmacy in
consultation with the Board of Medicine and the Department of Health.

Z. Notwithstanding any other law or regulation to the contrary, a person who is
acting on behalf of an organization that provides services to individuals at
risk of experiencing an opioid overdose or training in the administration of
naloxone or other opioid antagonist for overdose reversal may dispense naloxone
or other opioid antagonist, provided that such dispensing is (i) pursuant to a
standing order issued by a prescriber and (ii) in accordance with protocols
developed by the Board of Pharmacy in consultation with the Board of Medicine
and the Department of Health. If the person acting on behalf of an organization
dispenses naloxone or other opioid antagonist in an injectable formulation with
a hypodermic needle or syringe, he shall first obtain authorization from the
Department of Behavioral Health and Developmental Services to train individuals
on the proper administration of naloxone or other opioid antagonist by and
proper disposal of a hypodermic needle or syringe, and he shall obtain a
controlled substance registration from the Board of Pharmacy. The Board of
Pharmacy shall not charge a fee for the issuance of such controlled substance
registration. The dispensing may occur at a site other than that of the
controlled substance registration provided the entity possessing the controlled
substances registration maintains records in accordance with regulations of the
Board of Pharmacy. No person who dispenses naloxone or other opioid antagonist
on behalf of an organization pursuant to this subsection shall charge a fee for
the dispensing of naloxone or other opioid antagonist that is greater than the
cost to the organization of obtaining the naloxone or other opioid antagonist
dispensed. A person to whom naloxone or other opioid antagonist has been
dispensed pursuant to this subsection may possess naloxone or other opioid
antagonist and may administer naloxone or other opioid antagonist to a person
who is believed to be experiencing or about to experience a life-threatening
opioid overdose.
			AA. A person who is not otherwise authorized to administer naloxone or other
opioid antagonist used for overdose reversal may administer naloxone or other
opioid antagonist used for overdose reversal to a person who is believed to be
experiencing or about to experience a life-threatening opioid overdose.
			BB. Pursuant to a written order or standing protocol issued by the prescriber
within the course of his professional practice, such prescriber may authorize,
with the consent of the parents as defined in &#xA7; 22.1-1, an employee of (i)
a school board, (ii) a school for students with disabilities as defined in
&#xA7; 22.1-319 licensed by the Board of Education, or (iii) a private school
accredited pursuant to &#xA7; 22.1-19 as administered by the Virginia Council
for Private Education who is trained in the administration of injected
medications for the treatment of adrenal crisis resulting from a condition
causing adrenal insufficiency to administer such medication to a student
diagnosed with a condition causing adrenal insufficiency when the student is
believed to be experiencing or about to experience an adrenal crisis. Such
authorization shall be effective only when a licensed nurse, an advanced
practice registered nurse, a physician, or a physician assistant is not present
to perform the administration of the medication.
			CC. . Pursuant to a written order or standing protocol issued by the
prescriber within the course of his professional practice, such prescriber may
authorize, with the consent of the student&#8217;s parents as defined in &#xA7;
22.1-1, an employee of (i) a school board, (ii) a school for students with
disabilities as defined in &#xA7; 22.1-319 licensed by the Board of Education,
(iii) a private school accredited pursuant to &#xA7; 22.1-19 as administered by
the Virginia Council for Private Education, (iv) a local governing body, or (v)
a local health department who is trained in the administration of seizure rescue
medications for the treatment of seizures resulting from a condition causing
seizures to administer such medications to a student diagnosed with a condition
causing seizures when the student is believed to be experiencing or about to
experience a seizure. Such authorization shall be effective only when a licensed
nurse, an advanced practice registered nurse, a physician, or a physician
assistant is not capable of reaching the student within the amount of time
necessary to effectively perform the administration of the medication.

HISTORY: Code 1950, § 54-497; 1956, c. 225; 1970, c. 650, § 54-524.65; 1973,
c. 468; 1976, cc. 358, 614; 1977, c. 302; 1978, c. 224; 1980, cc. 270, 287;
1983, cc. 456, 528; 1984, cc. 141, 555; 1986, c. 81; 1987, c. 226; 1988, c. 765;
1990, c. 309; 1991, cc. 141, 519, 524, 532; 1992, cc. 610, 760, 793; 1993, cc.
15, 810, 957, 993; 1994, c. 53; 1995, cc. 88, 529; 1996, cc. 152, 158, 183, 406,
408, 490; 1997, cc. 272, 566, 806, 906; 1998, c. 112; 1999, c. 570; 2000, cc.
135, 498, 861, 881, 935; 2003, cc. 465, 497, 515, 794, 995, 1020; 2005, cc. 113,
610, 924; 2006, cc. 75, 432, 686, 858; 2007, cc. 17, 699, 702, 783; 2008, cc.
85, 694; 2009, cc. 48, 110, 506, 813, 840; 2010, cc. 179, 245, 252; 2011, c.
292; 2012, cc. 787, 803, 833, 835; 2013, cc. 114, 132, 183, 191, 252, 267, 328,
336, 359, 617; 2014, cc. 88, 491; 2015, cc. 302, 387, 502, 503, 514, 725, 732,
752; 2016, c. 144; 2017, cc. 3, 55, 107, 168, 174, 182, 294, 304, 713; 2018, cc.
62, 247; 2019, cc. 87, 212, 221, 431; 2020, cc. 39, 302, 459, 460, 556, 560,
853, 860, 861, 924, 927, 1095; 2021, Sp. Sess. I, cc. 181, 200, 201, 508; 2022,
cc. 695, 696, 733, 774; 2023, cc. 115, 116, 183, 267, 569, 631, 673, 674, 729;
2024, cc. 37, 150, 440, 451, 465, 466, 519; 2025, cc. 59, 65, 277, 341, 370,
386, 446.