(A) A public school district or non-public school, as defined by the Massachusetts Department of Elementary and Secondary Education, may register with the Department for the limited purpose of permitting properly trained unlicensed school personnel to administer any available, FDA-approved, pre-dosed form of an emergency rescue opioid antagonist (hereafter, any available, FDA-approved, pre-dosed form of an emergency rescue opioid antagonist will be referred to solely as an emergency rescue opioid antagonist for the purposes of 105 CMR 210.011) in a life-threatening situation during regular school activities when a school nurse is not immediately available, including field trips, provided that the following conditions are met:

1. (1) the school committee or governing body approves policies developed by the medication program manager governing administration of an emergency rescue opioid antagonist. This approval must be renewed every year;
2. (2) the school committee or governing body provides an assurance to the Department that the requirements of 105 CMR 210.000 will be met through registration with the Department;
3. (3) in consultation with the school physician, the medication program manager oversees and has final decision-making authority about the emergency rescue opioid antagonist program;

4. (4) the unlicensed school personnel authorized to administer an emergency rescue opioid antagonist are trained by the school nurse, or a training provider designated by the school nurse, in accordance with standards established by the Department;

   1. (a) the training, at a minimum, shall include:

      1. 1. recognition of the symptoms of an opioid overdose; and
      2. 2. proper use of the administration method.
   2. (b) the medication program manager, or school nurses designated by this person, shall document the training and evaluation of competency.
   3. (c) the school shall maintain and make available upon request by caregivers or staff documentation of those unlicensed school personnel authorized and trained to administer an emergency rescue opioid antagonist when the school nurse is not immediately available.

5. (5) when an emergency rescue opioid antagonist is administered:

   1. (a) there shall be immediate notification of the local emergency medical services system (generally 911), followed by notification of a student's caregiver as appropriate, the school nurse, and other individuals as warranted and deemed appropriate by the school nurse; and
   2. (b) the medication program manager will report the administration of an emergency rescue opioid antagonist to the Department of Public Health as directed each time an emergency rescue opioid antagonist is administered during regular school activities, in accordance with 105 CMR 210.009(C).
6. (6) all school staff, regardless of licensure, should follow a medication order for the administration of an emergency rescue opioid antagonist; and

7. (7) identification of places where the opioid antagonist is to be stored, following consideration of the need for storage:

   1. (a) at one or more places students and visitors are most likely to be located;
   2. (b) in such a manner as to allow rapid access by trained persons, including possession by the student when appropriate; and
   3. (c) in a place that minimizes risk of unintended use. The storage location(s) should be secure but not locked.