Medications at school
Students BP 5141
Page 1 of 1
Health Care and Emergencies
The Governing Board recognizes the importance of taking appropriate action whenever an
accident or illness threatens the safety, health or welfare of a student at school or during school sponsored
activities. To facilitate immediate contact with parent/guardians on such occasions,
the Board requires parent/guardian to furnish the schools with the current information specified
below:
1. Home address and telephone number.
2. Parent/guardians business address and telephone number.
3. Name, address, and telephone number of a relative or friend who is authorized by the
parent/guardian to care for the student in cases of emergency when the parent/guardian
cannot be reached.
4. Local physician to call in case of emergency.
5. Health problems (examples: diabetes, bee sting allergy, asthma, heart problems, cerebral
palsy, food allergies, etc.)
Under Education Code 49407, no school district shall be held liable for the reasonable treatment
of a student without the consent of the parent/guardian when the student requires reasonable
medical treatment and the parent/guardian cannot be reached, unless a written objection to
medical treatment has been filed with the school district (other than first aid).
The Fremont Unified School District and its employees have a legal duty to take measures to
protect the health and safety of its students while in school. The District provided First Aid
Reference Guide contains guidelines for care and treatment of students. The information is
compiled from American Red Cross and American Heart Association Standards, and reflects
OSHA and Public Health policies. Further, it is the responsibility of the school district and its
staff to ensure a free, appropriate, public education for individuals with disabilities.
In the event that students become ill at school,
CPR and/or other appropriate life-saving steps or
interventions will be made to revive the student while emergency services (911) are sought.
Legal Reference
California Education Code
49407 Liability for Treatment
49408 Information for use in emergencies
Policy Adopted: November 13, 1996
Policy Revised: June 8, 2005
Policy Revised: August 23, 2006
Students
Accidents, Illness, and Injury BP 5141.1
Page 1 of 1
Every reasonable effort is made by the District to prevent accidents involving students.
The Superintendent or designee shall develop regulations and procedures which will
make sure that prompt action be taken to minimize the effects of injury, to provide first
aid and/or medical attention as quickly as possible, and to take whatever other steps are
deemed necessary in the interest of the student, should an accident occur.
A complete accident report shall be made by the certified staff member under whose
supervision the accident occurs.
Legal Reference
California Education Code
32040-32044 First aid equipment
49300-49307 School safety patrols
49408 Emergency Information
49409 Athletic events; physicians and surgeons;
emergency medical care; immunity
49470 Medical and hospital services for athletic programs
49471 Medical and hospital services not provided or
available
49472 Medical and hospital services for pupils
49474 Ambulance services
51202 Instruction in personal and public health and safety
Policy Adopted: November 13, 1996
Policy Revised: May 24, 2005
Students BP 5141.21
Page 1 of 2
Administering Medication
The Governing Board recognizes that students sometimes will need to take prescribed and/or
over-the-counter medication during the school day in order to be able to attend school without
jeopardizing their health. In such cases, when the District has received written statements from
the student's authorized health care provider and parent/guardian, the school nurse or other
qualified trained designated personnel may administer the medication or otherwise assist the
student in taking the medication or the student may self-administer the medication provided
specific conditions are met in accordance with administrative regulations.
With the approval of the students authorized health care provider and the students parent/legal
guardian, a student will be allowed to carry medication and/or to self-administer medication
under the supervision of trained school personnel as stated in the IEP, 504 Plan, or Individual
Student Health Plan (ISHP) and as indicated in the Self-Administration of Medication Contract.
Student privacy and confidentiality will be maintained when medications are administered and
documented.
Injections
The Board recognizes that some students have medical conditions (e.g., severe allergic reactions,
diabetes) that may or will require injections during the course of the school day. In such cases,
when the District has received written statements from the student's authorized health care
provider and parent/guardian, the school nurse or other qualified trained designated personnel
may administer the injection or otherwise assist the student in taking the medication or the
student may self-administer the medication provided specific conditions are met in accordance
with administrative regulations.
Insulin injections may be administered by the student, the parent/guardian, the parent/guardians
designee or licensed nurses provided the appropriate forms are completed annually by the
physician, the parent/guardian and when needed, by the student.
School staff who consent to administer injections shall become CPR certified and receive
appropriate training from licensed medical personnel. They will be authorized to administer the
injections as stated in the ISHP, 504, or IEP and within the provisions of law, and they will be
afforded appropriate liability protection by the District.
Injections that are single dose manufacturer prefilled may be administered at school by a student
who has an approved Self-Administration of Medication Contract on file, a parent/guardian, a
parent/guardian designee, a non-licensed trained FUSD staff or a licensed nurse. Injections that
are not single dose manufacturer prefilled may be administered by a student who has an
approved Self-Administration of Medication Contract on file, a parent/guardian, a
parent/guardian designee, or a licensed nurse.
Students BP 5141.21
Page 2 of 2
Administering Medication
Legal Reference
Board Policy
BP/AR 3500 Environmental Health and Safety Policy, Exposure Control Plan
for Bloodborne Pathogens, page 14 of 20
BP/AR 5141 Health Care and Emergencies
BP/AR 5141.24 Specialized Health Care Services
BP/AR 6153 Field Trips
BP/AR 6170 Section 504 of the Rehabilitation Act of 1973
California Education Code
49407 Liability for Treatment
49408 Emergency information
49414.5 Voluntary Emergency Medical Training
49423 Administration of prescribed medication for pupil
49423.1 Inhaled Asthma Medication
49423.5.1 Specialized Physical Health Care Services
49423.5 Specialized health care services
49423.6 Administration of Medication
49426 School nurses
49480 Continuing medication; regimen; notice
Business and Professions Code
2700-2837 Professional Nursing
2726 Authority not conferred
2727 Exceptions in general
California Code of Regulations Title 5 Section 3051.12
Family Educational Rights and Privacy Act of 1974 (FERPA)
Health Information Portability and Accountability Act of 2003 (HIPAA)
Policy Adopted: August 24, 1983
Policy Revised: November 13, 1996
Policy Revised: June 8, 2005
Policy Revised: August 23, 2006
Students AR 5141.21
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Administering Medication
1. Students requiring medications at school shall be identified to the school by
parents/guardians and their authorized health care provider. All required forms must be
submitted to the principal or the principals designee at least seven school days prior to the
administration of medicine so that the assigned nurse, principal and related staff have
reasonable time to review and be provided with required training as needed.
Parents/Guardians may also consent to have their student identified by name and photo to
school personnel to insure that they can identify a student who may be in need of medical
interventions at school. Students observed by school personnel possessing, administering, or
sharing unauthorized medications will be reported to their parents/guardians and site
administrator. (Discipline per Ed. Code 48900)
2. Once the forms are received, medication will be administered according to an authorized
health care providers written order and with the parents
/guardians written consent by:
a. A school nurse or other licensed health care provider as allowed by law and in keeping
with applicable standards of professional practice for their license.
b. Other trained designated school personnel as allowed by law and negotiated employee
agreement. Designated school personnel are defined as persons who have consented to
administer medication and have received appropriate training by a licensed professional.
c. An individual designated to do so by the parent or legal guardian may or will be
permitted to as allowed by law. This person must be clearly identified, willing to accept
the designation, and be permitted to be on the school site. Any limitations on the
persons authority as a designee must not be inconsistent or in conflict with his/her
District employment responsibilities.
d. Students who have a Self-Administration of Medication Contract in place.
Parent/guardians are permitted to administer medication to their student without forms on
file.
3. Before a nurse or other trained designated personnel administers any prescribed or over-the counter
medication to any student, the District shall have received:
a. A written statement from the student's authorized health care provider detailing the name
of, dosage of, method of administration, and time(s) when the valid or non-expired
medication is to be taken. The statement may be made on the FUSD form, Medication
at School (W26 0946) or in a document written by the authorized health care provider
that includes all of the information required on the form as well as the license number and
telephone contact information for the authorized health care provider.
Students AR 5141.21
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Administering Medication
b. A written statement from the student's parent/guardian requesting the District to assist the
student in taking the medication as prescribed by the authorized health care provider.
This requirement is met when the parent/guardian signs the FUSD Letter for Medication
at School. (Education Code 49423)
c. For students on a continuing medication regimen, both parent/guardian and authorized
health care provider must annually submit the necessary consent statements as described
here in a and b before the first day of student attendance each school year. The same
forms must be resubmitted at any time there is a change in the students authorized health
care provider, or a change in the medication, dosage, method by which the medication is
required to be taken, or date(s) or time(s) the medication is required to be taken. Forms
must be filed seven school days prior to the first day of student attendance or the day of
the administration of medication. The seven day notice assures that the needs of the
student are met and allows reasonable time to provide appropriate training and
communication prior to the students first day of attendance.
4. A student may be allowed to carry medication on their person when authorized by the health
care provider, but may only self administer when written permission from the health care
provider is granted.
5. Except as outlined in 4 above, all medications shall be kept in a locked drawer or cabinet or
refrigerated (if required) in a locked refrigerator or in a refrigerator placed where there is no
student access, unless the student has a medically-documented, life-threatening condition
requiring authorized health care providers prescribed approved medication to be kept on the
students person at all times. Location of the key should be taped in a marked sealed
envelope and attached to any locked cabinet or refrigerator.
a. In such cases, the school must receive an authorized health care providers statement as
to medical need.
b. With the written approval of the authorized health care provider and parent/guardian,
students will be permitted to carry approved medication and/or self-administer (such as
asthma inhaler, insulin or epi-pen) under the supervision of school personnel provided
the following conditions are met: (1) the student is physically, mentally, and
behaviorally capable, in the collective written opinions of the parent/guardian
authorized health care provider and credentialed school nurse, to assume that
responsibility and has been adequately instructed at home by the authorized health care
provider and the parent/guardian; (2) the current medication is necessary to the
students health and must be taken during school hours; (3) the student has successfully
demonstrated the safety standard associated with self-administration of the medication
to the credentialed school nurse; and (4) with respect to the self-administration of
asthma medication or the self-administration of auto-injectable epinephrine, if the
student uses the medication in any manner other than prescribed, the student is subject
to specified discipline actions. (AB2132, SB 1912 January 2005)
Students AR 5141.21
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Administering Medication
c. Each student who self-medicates must have the FUSD form
, Self-Administration of
Medication Contract approved on file
.
d. A record shall be kept at the school site of all students who are allowed to carry and/or
self-administer medication. The record will include:
the students name;
the name of the medication the student is permitted to administer;
the correct dosage;
the method by which the student is required to take the medication;
time the medication is to be taken during the regular school day;
date(s) on which the student is required to take the medication (if applicable);
authorized health care providers name and contact information;
and a space for daily recording of medication administration, such as date,
time and amount.
e. Carrying medication on a student's person may be revoked by the principal if it poses a
risk to the health and safety of any student. The principal or designee must make a
parent/guardian contact followed by a written notice requesting attendance at a
parent/guardian conference to discuss any dangerous practices affecting the health and
safety of any student or staff member around self-medicating. Safety standards will be
reviewed. If dangerous practices continue after this conference, the principal will hold
the appropriate meeting to discuss revoking permission to self-medicate, and the IEP,
504, or ISHP will be amended to reflect that the student can no longer self-medicate.
For students who are approved to self-medicate, a log entry will be made by school
personnel each time the student needs assistance with medication or related specialized
physical health care procedure.
f. In addition to the above, in order for a student to carry and self-administer prescription
inhaled asthma medication or to carry and self-administer prescription auto-injectable
epinephrine, the statement from the authorized health care provider must confirm that
the student is able to self-administer the inhaled asthma medication or auto-injectable
epinephrine, and the parent/guardian must consent in writing to the self-administration,
provide a written release for the school nurse or other designated school personnel to
consult with the child's health care provider, and provide a written release of the
District and school personnel from civil liability should the self-administering student
suffer an adverse reaction as a result of self-administering the inhaled asthma
medication or auto-injectable epinephrine.
6. The parent or guardian may terminate consent for administering medication to the student or
other wise assist the student in the administration of medication by providing a signed and
dated statement to the principal who will then notify relevant staff and the school nurse.
Students AR 5141.21
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Administering Medication
7. Under no circumstances are school personnel to provide aspirin or any other patent medicine
to students without consent statements as described in 5a and 5b.
All medication must be delivered to school by a parent/guardian or an adult parent/guardian
designee with the exception of a student who is allowed to self-administer medication, or
authorized to carry medication to be administered by trained designated staff.
8. The school medication supply shall be in an original pharmacy-labeled container. The label
shall include the name and telephone number of the pharmacy, the students name, name of
the authorized health care provider, name of medication, dosage, expiration date, time, and
frequency of administration. Over-the-counter medications should be in the original
manufacturer-labeled container. Additional medication should be brought to school in a
current pharmacy-labeled container. All medication for injections shall be labeled with the
student's name, medicine name, and expiration date. It shall be stored in a locked cabinet or
secure refrigerator if necessary with easy access/removal by authorized staff for an
emergency/disaster.
9. Medications under jurisdiction of the Federal Controlled Substance Act (e.g., Ritalin and
Phenobarbital) must be brought to the designated trained school personnel by a
parent/guardian or an adult parent/guardian designee. Controlled drugs shall be counted,
upon their arrival in school, by the designated trained school staff in the presence of the
parent/guardian. The date, number of pills, and the signature of the designated school staff
shall be entered into the log/medication card.
10 The designated trained personnel shall maintain a log/medication card recording:
the students name;
the name of the medication
the correct dosage;
the method by which the student is required to take the medication;
the time the medication is to be taken during the regular school day;
the date(s) on which the student is required to take the medication (if applicable);
the authorized health care providers name and contact information;
and a space for daily recording of medication administration.
For students who are approved to self-medicate, a log entry will by made be school
personnel each time the student needs assistance with medication or related specialized
physical health care procedure. Errors occurring that involve the administration of
medication or discrepancies in the amount of available medication must be reported to
the principal and an Incident Report must be completed. Parents/guardians will be
immediately informed of errors or discrepancies by the principal or the principals
designee
.
Students AR 5141.21
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Administering Medication
11. Parent/guardian has the responsibility to have medication at the site and to restock it when
used, consumed, empty or expired. Parent/guardian shall supply a hard, enclosed sharps
container for use at school and make arrangements for proper disposal.
12. Unused, discontinued and outdated medication should be returned to the students parent or
guardian where possible. The school administrator or designee shall notify the parent or
guardian to pick up unused medication at the end of the school year. Such medication that
cannot be returned to the parent or guardian must be disposed of at the end of the school year
under the supervision of a school nurse and in accordance with applicable law.
13. Annual Notice: The Superintendent or designee shall inform all parents/guardians through the
Parent/Guardian and Student Handbook and Notice of Rights and Responsibilities of the
following requirements: (Ed Code 49480)
a. The parent/guardian of a student on a continuing medication regimen from a non-episodic
condition shall inform the school nurse or other trained designated personnel of the
medication being taken, the current dosage, and the name of the supervising authorized
health care provider, including information regarding medication not taken during the
school day if knowledge of this medication affects or impacts the medication to be
administered at school.
b. With the consent of the parent/guardian, the school nurse, IEP case manager/team member
or 504 Plan administrator may communicate with the authorized healthcare provider and
may counsel with school personnel regarding the possible effects of the drug on the child's
physical, intellectual, and social behavior, as well as possible behavioral signs and
symptoms of adverse side effects, omission, irregular usage, or overdose.
14. Field Trips:
a. Prior to approving any field trip, the principal has the responsibility to coordinate all
components related to the field trip including compliance with Board Policies and
Administrative Regulations directing services for students with medical needs.
b. The principal or designee will notify the school nurse four weeks in advance when a
student needing assistance with medication or any health care accommodations as
delineated in an IEP, 504 or ISHP is participating in any field trip.
Students AR 5141.21
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Administering Medication
c. The principal will ensure that designated school personnel authorized in a students 504,
ISHP, or IEP are in place to administer medication or perform specialized physical health
care services to student while on the field trip.
d. The school nurse is responsible to train the designated employee to administer medication
and follow procedures written in the students Individual Student Health Plan.
e. The trained designated personnel will administer required medications for students on
field trips according to a completed Medication at School form (W26 0946). The
qualified designated personnel will perform other health procedures as indicated in the
ISHP.
f. The Field Trip Worksheet for Students with Health Needs form will be completed and
kept on file at the school site for regular education students and be submitted to the
Director of Special Services for students with an IEP.
15. Disaster/Emergency Preparedness: Each school shall include in its Comprehensive
School Safety Plan a section on medications or other health procedures, which will
provide for the implementation of this BP/AR during an emergency/disaster.
Administration of Medication by Injections, Auto Injector, Syringe, Infusion Method, and
Intravenous Methods
1. Insulin injections may be administered by the student, the parent/guardian, the
parent/guardians designee, or licensed nurses provided the appropriate forms are
completed annually by the physician, the parent/guardian, and by a self administering
student. Parents/guardians of students who may or will require injections must complete
the required FUSD form(s). Students who meet the criteria for self-medication must also
complete the Self- Administration of Medication Contract. In addition, if the
parent/guardian desires the student to be assisted by the school nurse or other qualified
designated school personnel, the District must receive: (1) a written statement from an
authorized health care provider detailing the method, amount, and time schedules by which
such medication is to be taken, and (2) a written statement from the parent or guardian of
the student indicating the desire that the District assist the student in the matters set forth in
the authorized health care providers statement.
Students AR 5141.21
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Administering Medication
2. School personnel who agree to administer medication by injections used for emergency
situations such as glucagon and auto-injectable epinephrine, (i.e. Epi Pen,) will receive
training from the school nurse. The school personnel who have consented and been trained
in the administration of injections shall be known as qualified designated school personnel
provided they perform the services under the supervision of a school nurse, public health
nurse, or licensed physician and surgeon. (See Education Code 49423.5 (a)(2)).
a. When the injections are administered at school, the procedure must adhere to Universal
Precaution standards. (See also BP/AR 3500.)
b. School personnel who consent to administer medication by injections will be required
to be CPR certified before the employee may administer injections. CPR may be
required for other medical procedures.
c. In the case of the administration of glucagon, the trained qualified school personnel
must receive training in the recognition and treatment of hypoglycemia, the
administration of glucagon, and basic emergency procedures. Procedures include
calling 911 and the attempt to contact the students parent or guardian. When the
employee administers glucagon, she or he must notify the credentialed school nurse
assigned to the school site, or, if unavailable, the Superintendent of the District or
Superintendents designee.
d. In the case of the administration of auto injectable epinephrine (i.e. Epi-Pen,) the
trained qualified school personnel must receive training in the recognition and
treatment of allergic reactions, the administration of epinephrine, and basic emergency
procedures. Procedures include calling 911 and the attempt to contact the students
parent or guardian. When the employee administers epinephrine, he/she must notify
the principal, the credentialed school nurse assigned to the school site, or, if
unavailable, the Superintendent of the District or the Superintendents designee.
3. The principal or designated staff will schedule in-service meetings to inform trained
designated staff about the prescribed emergency medications and their location before the
first day of school or within five school days of receiving an order.
4. The school nurse will:
a. train and qualify designated personnel in injection procedures.
b. designate which school staff the site administrator has identified to contact with
questions in case of an emergency.
Students AR 5141.21
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Administering Medication
a. provide sufficient information to school personnel regarding a basic understanding of the
disease/condition, the students needs, how to identify medical emergencies, how to
recognize the signs and symptoms requiring medication, and related side effects.
5. The principal, nurse or designee shall prepare a list naming the students who may need
injections, as well as a list of qualified designated personnel trained to administer
injections. Lists shall be maintained under confidentiality laws. Lists are shared on a need
to know basis. Parent/Guardian signature authorizing the sharing of health information with
FUSD staff as needed is located on the District Residency and Emergency Information
Form (W26-0380.)
6. The principal or designee shall post in the school health office a list of symptoms usually
associated with anaphylactic reactions, as well as a list of the symptoms of diabetic
reactions pertaining to hyperglycemia and hypoglycemia, and a clear, specific procedure
for administering injections in case of emergency. In the event of an emergency, 911 will
be called.
7. The parents/guardians of students who carry their own medication for the purpose of self administration
of medication shall complete and file the district form Self- Administration
of Medication Contract [AR 5141.21 (3) (b-c)]
8. Health procedures related to the administration of medication by injections, auto-injector,
or syringe are to be written into the students ISHP, 504, or IEP.
Students AR 5141.21
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Administering Medication
Legal Reference
Board Policy
BP/AR 3500 Environmental Health and Safety Policy, page 14 of 20 for
Universal Precautions
BP/AR 5141.24 Specialized Health Care Services
BP/AR 6153 Field Trips
BP/AR 6170 Section 504 of the Rehabilitation Act of 1973
California Education Code
48900 Grounds for Suspension or Expulsion
49407 Liability for Treatment
49408 Emergency information
49414.5 Voluntary Emergency Medical Training
49423 Administration of prescribed medication for pupil
49423.1 Inhaled Asthma Medication
49423.5 Specialized health care services
49423.6 Administration of Medication
49426 School nurses
49480 Continuing medication; regimen; notice
Business and Professions Code
2700-2837 Professional Nursing
2726 Authority not conferred
2727 Exceptions in general
Cal. Code Regs. Title 5, 3051.12
Regulation Established: August 24, 1983
Regulation Revised: March 15, 1989
Regulation Revised: February 20, 1990
Regulation Revised: November 13, 1996
Regulation Revised: July 28, 1999
Regulation Revised: June 8, 2005
Regulation Revised: August 23, 2006
Students AR 5141.21.1
Page 1 of 2
Health Procedures Related to Management of Serious Health Conditions, including Diabetes,
Asthma and Life Threatening Allergies, at School
In order to safely and successfully meet the health care needs of students, a set of guidelines
will be used to determine the appropriateness of assigning direct health care tasks to school
personnel, including medication administration. Assigned tasks must: (a) be routine for the
student; (b) pose little potential harm for the student or staff; (c) involve little variation from
student to student; (d) have a predictable outcome for the student; and (e) not require nursing
assessment, interpretation or decision-making.
School personnel will be assigned to provide student care after successful completion of
training in Fremont Unified School Districts health care procedures. Verification of
competency will be determined as necessary to ensure student safety.
1. The following completed forms: Physicians Written Authorization and Parent Consent:
Management of Diabetes at School, Parent Request/Physician Authorization for
Specialized Physical Health Care Services at School, Medication at School, and
Agreement for Health Care Procedure Performed by Student, will permit students to
carry medical supplies and perform health procedures at school under the following
conditions:
a. The student must adhere to Universal Precaution Standards .
b. Parents/Guardians will supply and maintain all necessary equipment, including a sharps
container for contaminated materials. Parents/Guardians will make arrangements for
proper disposal.
c. Accommodations are to be written in the students ISHP, 504, or IEP.
d. The student acts in a responsible manner when performing the health procedure. If the
student does not act responsibly, the parent/guardian will be contacted by the
principal/designee and be sent a written notice allowing for remediation. If the student
continues to act irresponsibly, the procedure will be confined to an office. If the
stipulation for the health procedure is authorized by an ISHP, 504, or IEP, the
appropriate school team will meet to review the practice.
2. At least two school personnel shall be trained to assist with the healthcare needs of the
student.
3. School personnel trained to assist with the serious healthcare needs of the student will be
provided on field trips, if indicated in the students 504, ISHP, or IEP and as written in AR
5141.21
Additionally, please review BP/AR 5141.24 Specialized Physical Health Care Services.
Students AR 5141.21.1
Page 2 of 2
Health Procedures Related to Management of Serious Health Conditions, Including Diabetes,
Asthma and Life Threatening Allergies, at School
Legal Reference
California Education Code
49407 Liability for Treatment
49408 Emergency information
49414.5 Voluntary Emergency Medical Training
49423.5 Specialized health care services
49423.6 Administration of Medication
49480 Continuing Medication; Regimen; Notice
Cal. Code Regs. Title 5, 3051.12
California Board of Registered Nursing: NPR-B-16 11/94
California School Employees Association/Fremont Unified School District January 2005
Article 6.9
Regulation Established: August 24, 1983
Regulation Revised: March 15, 1989
Regulation Revised: February 20, 1990
Regulation Revised: November 13, 1996
Regulation Revised: July 28, 1999
Regulation Revised: June 8, 2005
Regulation Revised: June 7, 2006
Regulation Revised: September 26, 2007