As used in 105 CMR 210.000, the following words, unless the context clearly requires otherwise, shall have the following meanings:

Administration of Medication means the direct application of a medication by inhalation, ingestion, or by any other means to the body of a person.

Caregiver means a parent or guardian of a student.

Controlled Substance shall have the meaning as defined in M.G.L. c. 94C, § 1.

Cumulative Health Record means the collection of an individual student's medical documentation relevant to the health of the student maintained by a school or school district which may include historical and ongoing medications, applicable diagnosis information, allergies and other relevant medical conditions, immunization records, health screenings, health office visits notes, and contact information for the student's health care providers. The records may be maintained in a paper or electronic format or a combination of both.

Delegation shall have the meaning as defined in 244 CMR 10.01: Definitions. The delegating nurse must provide adequate supervision of all nursing activities delegated to unlicensed persons. Delegation is the most common model under which unlicensed school personnel can administer medications in schools.

Department means the Massachusetts Department of Public Health.

Drug shall have the meaning as defined in M.G.L. c. 94C, § 1.

Emergency Rescue Medication means a schedule II-VI medication which is administered in the event of an allergic reaction, hypoglycemia, apparent opioid overdose, asthma or other loss of consciousness and/or acute respiratory event, in order to prevent imminent death or serious injury or illness. Examples may include, but are not limited to:

1. (1) epinephrine in an FDA-approved, pre-dosed auto-injector or FDA-approved, pre-dosed forms that are administered through the mucous membranes of the nose, digestive tract, or lungs;
2. (2) opioid antagonists in an FDA-approved, pre-dosed auto-injector or FDA-approved, pre-dosed forms that are administered through the mucous membranes of the nose, digestive tract, or lungs;
3. (3) glucagon in an FDA-approved, pre-dosed auto-injector or FDA-approved, pre-dosed forms that are administered through the mucous membranes of the nose, digestive tract, or lungs;
4. (4) atropine, pralidoxime chloride or other designated nerve agent antidotes that are in an FDA-approved, pre-dosed form;
5. (5) rescue inhalers; and
6. (6) other medications in FDA-approved, pre-dosed forms that are administered through the mucous membranes of the nose, digestive tract, or lungs.

Investigational New Drug means any medication with an approved investigational new drug (IND) application on file with the Food and Drug Administration (FDA) which is being scientifically tested and clinically evaluated to determine its efficacy, safety and side effects and which has not yet received FDA approval.

Licensed Practical Nurse means an individual who is a graduate of an approved practical nursing program, and who is currently licensed as a practical nurse pursuant to M.G.L. c. 112.

Licensed Prescriber means a health care provider who is legally authorized to prescribe medication pursuant to M.G.L. c. 94C and applicable federal laws and regulations.

Medical Device means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component, part, or accessory for use as outlined in 21 U.S.C. § 321.

Medication means any controlled substance in schedules II-VI or FDA-approved over-the-counter medication with a drug fact sheet.

Medication Program Manager means a School Nurse that has assumed responsibility for a school or district medication program by registering with the Department of Public Health.

Parenteral Medication means any medication administered in a manner other than by the digestive tract or topical application, as by intravenous, intramuscular, subcutaneous, or intradermal injection.

Physician means a doctor of medicine or osteopathy licensed to practice medicine in Massachusetts or in another state.

Pro re nata (abbreviated p.r.n.) means "as needed."

Regular School Activities means all instructional/academic activities, as well as all activities organized or sanctioned by the school including, but not limited to, day and overnight field trips, school-provided transportation, interscholastic sporting events, after school or extracurricular clubs or organizations, and proms or other social events organized as part of the instructional/academic portion of the school.

School Nurse means a nurse practicing in a school setting, who is:

1. (1) a graduate of an approved school for professional nursing;
2. (2) currently licensed as a Registered Nurse pursuant to M.G.L. c. 112; and
3. (3) appointed by a School Committee or a Board of Health in accordance with M.G.L. c. 71, §§ 53, 53A, and 53B or, in the case of a non-public school, by the governing body.

School Physician means a physician appointed by a School Committee or Board of Health in accordance with M.G.L. c. 71, §§ 53, 53A, and 53B or, in the case of a non-public school, by the governing body.

Self-administration shall have the meaning as defined in 105 CMR 700.001: Definitions.

Self-carry means storage of limited quantities of medications including, as appropriate, multi-dose medications on a student's person, at the discretion of the school nurse, as outlined in 105 CMR 210.006.

Supervision means guidance by a qualified school nurse, provided through any communication medium, to accomplish a task, with initial direction and instruction concerning the task and periodic inspection and oversight of activities related to the task.

Unlicensed School Personnel means any individual employed by or through contract with the school committee or in the case of a non-public school, by the governing body, who does not hold a healthcare license in Massachusetts that authorizes the licensee to administer medications.