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Board warned replacing physician of record could cost $20,000–$40,000 and change medication procedures
Summary
Ms. Soares told the board the division’s longtime physician of record retired and staff have estimated replacement costs between about $20,000 and $40,000; the physician provided standing orders that let nurses administer medication (such as Tylenol) without calling parents, and board members asked about EpiPens, liability and alternatives such as piggybacking on EMS medical direction.
Ms. Soares informed the board that the division’s prior physician of record has retired and that staff have been searching for a replacement. She said a standing medical directive from that physician previously allowed school nurses to administer over-the-counter medications under parental permission forms and provided medical direction for nurses.
"If the student comes with their own doctor prescribed prescription, we can administer it," Ms. Soares said, but she cautioned that without a physician of record the division would likely revert to relying on parent-supplied medications and individualized physician orders.
Staff reported early cost estimates in the range of about $20,000 to $40,000 to secure physician-of-record services, and noted the practice had historically been provided pro bono by the retiring physician. Board members asked for a clearer list of what services are included in the estimated price — whether it covers only standing orders, on-call direction, insurance for medical direction, or periodic review — and asked staff to consult neighboring localities and the county health department for options. One member suggested leveraging existing EMS medical oversight protocols where feasible.
Ms. Soares said staff would return with a clarified scope of services and a cost breakdown so the board could evaluate whether to budget for the service or require parents to provide medications under individual physician orders.
The board did not vote on the matter; staff indicated they would bring detailed options back for further consideration.
