Policies Regarding Delegation of Medication Administration

(A) The School Committee, Board of Health, or governing body may develop a policy that allows the school nurse to delegate responsibility to unlicensed school personnel for medication administration. For the purpose of administering emergency medication to an individual student, including parenteral administration of medication pursuant to 105 CMR 210.004(A)(4), the school nurse may identify individual unlicensed school personnel who may be trained pursuant to 105 CMR 210.007 or 105 CMR 210.010, in the case of epinephrine, or 105 CMR 210.011, in the case of an emergency rescue opioid antagonist. Said unlicensed school personnel shall be listed on the medication administration plan developed in accordance with 105 CMR 210.005(E) and receive education in the administration of emergency medication to a specific student. (2) An individual selected by the school nurse may be authorized to administer medication if they meet the following criteria: (a) demonstrates sound judgment; (b) is able to read and write in the language in which the medication order is written; (c) is able to communicate with the school nurse orally and in writing; (d) is able to communicate with the student receiving the medication or has ready access to an interpreter when needed; (e) is able to meet the requirements of 105 CMR 210.000 and follow nursing supervision; (f) is able to respect and protect the student's confidentiality; and (g) has completed an approved training program pursuant to 105 CMR 210.007 or completed an approved training program pursuant to 105 CMR 210.010 in the case of epinephrine. (3) A school nurse shall be on duty while medications are being administered by designated unlicensed school personnel, and be available should consultation be required. The consultation may be in person or virtual (telephonic or web-based). Parenteral medications may not be delegated or administered by training, with the exception of epinephrine or injectable glucagon in an FDA-approved, pre-dosed autoinjector administered in accordance with the restrictions outlined in 105 CMR 210.000. (5) With the exception of emergency rescue medications, which may be administered under the delegation model according to the student's emergency medication plan without a separate nursing assessment, medications to be administered pursuant to p.r.n. orders may be administered by authorized unlicensed school personnel after an assessment by or consultation with the school nurse for each dose. (6) Neither prescription medication nor over-the-counter medications can be administered by delegation by unlicensed school personnel without student-specific medication orders from a licensed prescriber. (7) The name of the unlicensed school personnel administering medication by delegation must be identified in the student health record.