105 CMR 210.006
Self-administration and Self-carry of Medications
Consistent with school policy, the school nurse maypermit self-carryand self-administration
of medication by a student provided that the following requirements are met:
(1) the student, school nurse and caregiver, where appropriate, enter into an agreement
which specifies the conditions under which medication maybe self-administered, which may
include the conditions under which a student may self-carry medication for the purpose of
administration by another, or whether the medication being self-administered is being taken
or applied by the student themselves or with an FDA-approved medical device;
(2) the school nurse, as appropriate, develops a medication administration plan pursuant to
105 CMR 210.005(E) which contains only those elements necessary to ensure safe self-
administration of medication;
the school nurse evaluates the student's health status and abilities and deems self-
administration safe and appropriate. As necessary, the school nurse shall observe initial
self-administration of the medication;
(4) the school nurse is reasonably assured that the student is able to identify the appropriate
medication, knows the frequency and time of day for which the medication is ordered, and
follows the school self-administration protocols;
(5) there is written authorization from the student's caregiver that the student may self-
administer medication, unless the student has consented to treatment under M.G.L. c. 112,
§ 12F or other authority permitting the student to consent to medical treatment without
caregiver permission;
(6) if requested by the school nurse, the licensed prescriber provides a written order for self
administration;
(7) the school nurse establishes a plan for the safe storage of self-administered medication
and, as necessary, consults with teachers, the student and caregiver, if appropriate, to
determine a safe place for storing the medication for the individual student, while providing
for accessibility if the student's health needs require it. This may include self-carry of the
medication and this information shall be included in the medication administration plan. In
the case of an inhaler or other preventive or emergency medication, whenever possible, a
backup supply of the medication shall be kept in the health room or a second readily
available location;
the school nurse develops and implements a plan to monitor the student's self-
administration, based on the student's abilities and health status. Monitoring may include
teaching the student the correct way of taking the medication, and notifying the caregiver or
licensed prescriber of any side effects, variation from the plan, or the student's refusal or
failure to take the medication;
(9) with caregiver and student permission, if required by law, as appropriate, the school
nurse may inform appropriate teachers and administrators that the student is
self-administering and/or self-carrying a medication.