105 CMR, § 700.003 - Registration of Persons for a Specific Activity or Activities in Accordance with M.G.L. c. 94C, Section 7(g)
(A)
(1) A Paramedic or a Paramedic student, as
part of their participation in a Department-approved Paramedic training
program, may administer only those controlled substances, in quantity and kind,
that are necessary for the performance of their duties in accordance with 105
CMR 170.000: Emergency Medical Services System and the STPs,
or in accordance with their duties as authorized by clinical protocols in a
Department-approved MIH program or community EMS program pursuant to M.G.L. c.
111O;
(2) An Advanced EMT, Advanced
EMT student as part of their participation in a Department-approved training
program, EMT or EFR may administer only those controlled substances for which
they have been approved by the Department and that are necessary for the
performance of their duties in accordance with 105 CMR 170.000:
Emergency Medical Services System and the provisions of the
Statewide Treatment Protocols, or in accordance with their duties as authorized
by clinical protocols in a Department-approved MIH program or community EMS
program pursuant to M.G.L. c. 111O;
(3) Administration of controlled substances
by EMTs at all levels, and EMT students at all levels, is also subject to the
following conditions:
(a) The ambulance
service, EFR service, or Department-approved MIH or community EMS program for
which the individual serves, shall be registered in accordance with
105
CMR 700.004 for the appropriate controlled
substances;
(b) The ambulance
service, EFR service, or Department-approved MIH or community EMS program shall
maintain a current listing of names of its employees and volunteers who are
authorized to administer controlled substances;
(c) The EMT, Paramedic student, Advanced EMT
student or EFR shall perform only those functions for which they are authorized
by, and trained in accordance with 105 CMR 170.000: Emergency Medical
Services System;
(d)
Administration of controlled substances shall be conducted:
1. pursuant to the order of a practitioner
and the STP; and
2. in accordance
with 105 CMR 170.000: Emergency Medical Services System and
the provisions of the STP.
(4) A Paramedic may dispense by
administration influenza vaccine and other immunizations designated by the
Department to persons 18 years of age or older, as authorized by clinical
protocols in a Department-approved MIH program or community EMS
program.
(B) Dental
hygienists and fluoride program monitors employed by or affiliated with a
registered school may administer fluoride tablets or fluoride mouth rinse to
school children three through 18 years old provided that:
(1) The school has registered with the
Department by sending a letter of intent to administer fluoride treatments to
the Division of Dental Health and by providing whatever further information the
Commissioner may require; and
(2)
The child's parent or guardian has been informed in writing of the nature, dose
and effects of fluoride tablets and mouth rinse, and has consented in writing
to the administration of fluoride tablets or mouth rinse on behalf of the
child; and
(3) The tablets or mouth
rinse is administered in accordance with the order of a physician or dentist
employed by or associated with a local Board of Health or school; and
(4) The fluoride program monitor has been
trained to administer and store fluoride tablets and mouth rinse in accordance
with a training program designed by the Commissioner; and
(5) All fluoride mouth rinse and tablets
possessed by the registered school are stored securely under lock and key;
and
(6) The registered school shall
maintain such records and files such reports concerning the fluoride program
for a period of two years or for such longer period as the Commissioner may
require.
(C) Persons
specified in
105
CMR 700.003(C) may
purchase, distribute, possess and administer rescue medications in a life
threatening emergency, where medical professionals are not readily available,
in accordance with any applicable Department protocols and the following:
(1) Any administration is pursuant to the
order of a practitioner and, in the case of first responders, the STP, except
as provided in
105
CMR
700.003(C)(6)(d);
(2) The rescue medication is:
(a) dispensed by a pharmacy pursuant to the
order or prescription of a practitioner or other authorized
prescriber;
(b) obtained by a
municipality or agency in accordance with
105
CMR 700.003(C)(4);
(c) obtained by a registered facility or
program funded, operated or licensed by a municipality or agency in accordance
with 105 CMR
700.003(C)(5).
(3) The rescue medication is
packaged in a prefilled, automatic delivery device intended for
self-administration, and the opioid antagonist is in the manufacturer's
original packaging;
(4) A
municipality or an agency, department or authority of the Commonwealth, through
a public official or law enforcement officer, may purchase and distribute
rescue medications without obtaining registration, and may train its employees
or volunteers to administer the same in accordance with Department
guidance.
(5) A facility or program
funded, operated or licensed by a municipality or agency of the Commonwealth
may register in accordance with
105
CMR 700.003(C)(7) to
purchase and possess naloxone or other opioid antagonist approved by the
Department for the purpose of training its employees and volunteers to
administer in accordance with Department guidance
(6) To the extent authorized by
105
CMR 700.003(C), the
following persons may administer rescue medications:
(a) a first responder may administer rescue
medication approved by the Department in accordance with 105 CMR 171.000:
Massachusetts First Responder Training, and the STP;
(b) an employee of or volunteer to a
municipality or agency who is trained to administer in accordance Department
guidance;
(c) an employee of or
volunteer to a facility or program funded, operated or licensed by a
municipality or agency who is trained to administer in accordance with
Department guidance;
(d) A
non-licensed staff member of a health facility, health care entity, community
program, or practitioner's office may administer rescue medications to an
individual the staff person reasonably believes to be experiencing a
life-threatening emergency, provided that:
1.
for naloxone and other Department approved opioid antagonists, the person
responding to the emergency is in possession of the rescue medication;
or
2. the individual experiencing
the emergency is in possession of the rescue medication to be administered;
or
3. the facility, entity,
community program or practitioner's office is in possession of the rescue
medication in accordance with all applicable laws and regulations and policies
and procedures for storage and security; and
4. the rescue medication is administered
pursuant to a prescription or practitioner's order, which may include a
standing order issued by the Department, and in accordance with the directions
in the manufacturer's package insert.
(7) A facility or program funded, operated or
licensed by a municipality or agency of the Commonwealth and registered
pursuant to
105
CMR 700.003(C)(5) may
approve administration of epinephrine or opioid antagonist approved by the
Department, or nerve agent antidotes by persons designated in 105 CNR
70.003(C)(6)(c), and a municipality or agency may approve administration of
rescue medications by persons designated in
105
CMR 700.003(C)(6)(b), in
accordance with Department guidance;
(8) The person registered pursuant to
105
CMR 700.003(C)(5) shall
Designate a qualified, licensed practitioner as medical director for purposes
of 105 CMR
700.003(C).
Such medical director shall:
(a) be the responsible person named on the
registration application;
(b)
authorize administration of rescue medication, as appropriate, and oversee
compliance with
105
CMR 700.003(C);
(c) establish and enforce written protocols
and procedures to ensure that individuals administering rescue medication are
properly trained, evaluated for competence, and up to date in their skills and
knowledge.
Training shall include, but not be limited to:
1. procedures for risk reduction;
2. recognition of the symptoms of an opioid
overdose or a severe allergic or nerve agent reaction;
3. proper use of an inhaler, auto-injector
for epinephrine or nerve agent antidote, and other acceptable method of
administration for opioid antagonists approved by the Department;
4. procedures for notification of emergency
medical services and other appropriate persons following
administration;
(d)
establish and enforce written protocols and procedures to ensure:
1. proper storage, handling and return or
disposal of rescue medication;
2.
review and evaluation of an emergency response;
3. reporting of adverse events to the medical
director;
4. monitoring of program
compliance with
105
CMR 700.003(C);
and
(e) establish and
enforce written protocols and procedures to ensure that a municipality or
agency, or a facility or program funded, operated or licensed by a municipality
or agency and registered in accordance with
105
CMR 700.003(C)(5), maintains
current and readily retrievable records of:
1.
the authorized employees or volunteers who may administer rescue
medication;
2. individual trainings
and evaluations;
3. receipt and any
return or disposal of rescue medication; and
4. administration of rescue
medication;
(9)
Each person registered pursuant to
105
CMR 700.003(C)(5) shall:
(a) comply with the policies and procedures
established pursuant to
105
CMR 700.003(C)
(b) designate a licensed health care
practitioner, whenever possible, or the program director or designee, to
oversee the program's implementation of said policies and procedures;
(c) in the case of minors served by the
program, obtain prior informed consent whenever possible from the minor's
parent or legal guardian for the administration of rescue medication;
(d) develop individualized medication
administration plans that address indications for administration of rescue
medication, any unique issues around storage or handling of the rescue
medication and persons to be notified in the event that rescue medication is
administered.
(e) immediately
notify emergency medical services and designated contact persons, including
those identified in the medication plan, in the event that rescue medication is
administered; and
(10)
The municipality or agency, and the Department shall have full access to all
pertinent records for monitoring purposes.
(D) A school district or private school shall
register in order to permit a school nurse to store and deligate administration
of patient specific controlled substances to trained school personnel in
accordance with 105 CMR 210.000: The Administration of Prescription
Medications in Public and Private Schools.
(E) An employee of a community program may
administer or assist in the administration of a controlled substance or other
prescription medication to a stable non-self-administering person as those
terms are defined in applicable Department guidance, provided that:
(1)
Registration.
The community program is registered with the Department in accordance with
105
CMR 700.004, and meets the following
requirements:
(a) Administration or assistance
in the administration of prescription medication to a non-self-administering
individual shall be carried out only by a duly licensed professional staff or
by an unlicensed program staff of a registered community program who has
successfully completed the training specified in
105
CMR 700.003(E)(2);
(b) The community program shall establish,
maintain, and operate in accordance with policies that ensure that only
properly trained and certified personnel administer medication;
(c) The community program shall maintain a
current written list of those staff members who have successfully completed a
training program meeting the requirements of
105
CMR 700.003(E)(2);
(d) The community program shall permit the
Department to inspect program and individuals' records pertaining to the use
and administration of prescription medications. The Department may make
announced or unannounced on-site visits or inspections of common areas and such
other inspections as the Department is authorized to make in order to monitor
the program's compliance with 105 CMR 700.000.
(e) The Drug Control Program within the
Department shall promptly be notified by the program of any suspected
shortages, tampering, or diversion of prescription medication;
(f) The community program shall document in
the individual's record any administration of prescription medication in a
manner inconsistent with the practitioner's prescription or order or in
violation of 105 CMR 700.000. The program must also promptly report to each
community program sponsor which funds, licenses or operates such community
program, in accordance with procedures and on a form approved jointly by the
Department and said community program sponsors, any administration of
prescription medication in a manner inconsistent with the practitioner's
prescription or in violation of 105 CMR 700.000. Such form shall be provided,
upon request, to the Department;
(g) The community program shall provide or
arrange for technical assistance and advice to be provided as needed by a
registered nurse, registered pharmacist, or other licensed practitioner when
questions arise regarding appropriate administration practices or the effects
of medications. The program shall establish policies and procedures that ensure
reasonable access to such assistance and advice;
(h) The community program, professional staff
and program staff shall comply with all applicable requirements of M.G.L. c.
94C: The Controlled Substances Act, as well as 105 CMR 700.000
and all pertinent regulations of the community program sponsor which funds,
licenses or operates such community program, as appropriate, including those
pertaining to storage, labeling, administration and documentation of
prescription medication, medical back-up, review of medication, and emergency
procedures.
(i) Community program
and professional staff may not engage in other duties or obligations while
performing documentation and medication administration tasks under
105
CMR 700.003 and shall comply with applicable
Department guidance.
(2)
Training. No unlicensed staff person may administer or
assist in the administration of a prescription medication without successfully
completing a training program that meets the specifications for a training
curriculum and examination process established jointly by the Department and
any community program sponsor which funds, licenses or operates such community
program, as well as the following requirements:
(a) The training program shall be taught by a
registered nurse, certified nurse practitioner, physician assistant,
pharmacist, or physician who meets applicable requirements for a trainer
established jointly by the Department and the community program
sponsors;
(b) The Department and,
as appropriate, the community program sponsors shall have the authority to
monitor the training program for compliance with established
standards;
(c) The training program
shall keep records of all persons who have successfully completed the training
program which shall be made available to the Department and, as appropriate, to
community program sponsors upon request;
(d) Each person who successfully completes
the training program must be certified by one or more of the community program
sponsors, and shall be provided with such documentation of completion of the
training program as approved by said community program sponsors. Documentation
of certification shall be provided to and maintained by the community
program;
(e) No person shall
continue to administer or assist in the administration of prescription
medication beyond two years from the completion of the initial certification
unless such person has met standards for retraining and/or retesting
established by the community program sponsors and approved by the
Department.
(3)
Storage. The community program meets all applicable
regulations of the community program sponsors, and of the Department regarding
storage and handling of prescription medications as well as the following
requirements:
(a) All prescription medications
that are consumed by individuals who are non-self administering shall be
appropriately secured in a locked container or area. The community program
shall have a written policy on which persons may have access to such container
or area, how access to the key or combination and container or area is to be
restricted, and under what conditions authorized persons may have access to the
container or area;
(b) Prescription
medications for individuals who are self-administering shall be stored in a
locked container or area unless the community program director makes a
determination that unlocked storage of the prescription medication poses no
threat to the health or safety of the individual or other individuals;
provided, however, that all controlled substances in Schedules II through V
shall be appropriately secured in a locked container or area;
(c) Outdated prescription medications and
prescription medications that have not been administered shall be disposed of
and the disposal documented in accordance with policies established by the
community program, provided that disposal occurs in the presence of at least
two witnesses and in accordance with any policies of the Department.
(4)
Labeling. All medications shall be properly labeled in
accordance with M.G.L. c. 94C, § 21 and the following requirements:
(a) Community program staff shall not repack
or relabel prescription medications. If an individual needs to bring
prescription medication for administration at a location or program regularly
or frequently attended, such prescription medications shall be packed and
labeled by a pharmacist or, in the case of prescription medication dispensed
for immediate treatment, by the dispensing practitioner;
(b) Where prescription medication is consumed
by an individual at two or more locations on a regular or frequent basis, the
prescription medication shall be stored in a separate, properly packaged,
labeled, and appropriately secured medication container at each location. In
circumstances in which this is not practical or feasible, the community program
sponsor which funds, licenses or operates the site shall establish an
alternative procedure approved by the Department;
(c) The community program shall have policies
for obtaining a properly labeled container where there is a change in
prescription or where the individual frequently or regularly receives
prescription medication in two or more locations.
(5)
Administration.
All prescription medications shall be administered in accordance with M.G.L. c.
94C, the appropriate regulations for any community program sponsor which funds,
licenses or operates such site, and the following requirements:
(a) All prescription medications shall be
administered in accordance with the prescription of a practitioner;
(b) Prescribed medications shall only be
administered to or taken by the individual for whom the prescription has been
issued;
(c) The community program
shall have a policy that specifies the administrative procedures to be followed
when there is a medical emergency relating to medication. Such policy shall
include a list of staff persons and medical personnel to be contacted which is
up to date, readily available to staff and clearly indicates who is to be
contacted on a 24-hour a day, seven days a week basis. The medical personnel to
be contacted shall include the prescribing practitioner or, if unavailable,
another licensed practitioner or appropriate emergency room
personnel;
(d) Certified staff
employed by community programs registered with the Department may only
administer prescription medications that are oral, topical, ophthalmic, otic,
internasal, suppository, or products that are administered by inhalation,
without additional training as authorized by
105
CMR
700.003(E)(5)(e);
(e) Parenteral drugs generally intended for
self administration, or drugs administered via a
gastrostomy/jejunostomy tube may be administered by certified staff members who
have successfully completed a specialized training program in such technique
taught by a physician, physician assistant, pharmacist, registered nurse, or
certified nurse practitioner, approved by the Department and the comminoty
program sponsor which funds, licenses or operates such site;
(f) Whenever possible, a prescription for
medication shall be limited to a 37-day supply and one refill. The prescribing
practitioner shall be notified by community program staff of this
requirement;
(g) Where an
individual who is non-self-administering receives prescription medication at a
location other than a community program site (off-site), the community program
whenever possible shall identify the individual who will be responsible for
administering the medication at the off-site location, and make available to
that person instructions as to how the medication is to be
administered;
(h) An
over-the-counter drug may be consumed or applied by a non-self administering
individual who is already receiving prescription medication only:
1. with the prior approval of a practitioner;
or
2. after consultation with a
pharmacist or registered nurse; or
3. in accordance with applicable guidelines
established by the community program sponsors, with the approval of the
Department.
(6)
Documentation. All prescriptions and administration of
prescription medications must be documented in accordance with applicable
regulations of the community program sponsor which funds, licenses or operates
such site, and the following requirements:
(a)
All prescriptions for medication shall be documented in the individual's
record. Such documentation shall specify for each individual the name and
dosage of medication, the indication for which the medication is prescribed,
and contraindications or possible allergic reactions, possible side effects and
appropriate staff response, and special instructions, including steps to be
taken if a dose is missed. The community program shall establish appropriate
policies and procedures to address how community program staff shall obtain
relevant prescription information in accordance with the requirements of
105
CMR 700.003(E)(6). In
addition, such policy and procedures shall ensure that medication changes are
received from practitioners and properly documented in the individual's
record;
(b) The community program
shall ensure that staff have ready access to such information as listed in
105
CMR 700.003(E)(6)(a), by
maintaining on site either an appropriate reference approved by the Department
or, for each drug administered, a copy of the pertinent section of such
reference or a medication-specific drug information sheet that states in plain
language generally why the drug is used, when it is to be administered, how it
should be administered, any special instructions or precautions, proper storage
conditions, possible side effects and what is to be done if a dose is
missed;
(c) The taking or applying
of medications for non-self-administering individuals, including
over-the-counter drugs, shall be documented in the individual's record;
1. the time that the medication is taken or
applied shall be noted in the record;
2. the record shall indicate any off-site
taking or applying of medication by a non-self-administering individual that
would normally occur at the program site;
3. individuals who are self-administering
shall not be required to document their own self-administration of
medication;
(d) Any
change in medications or dosage levels of a medication shall be treated as a
new health care provider order for the purposes of documentation;
(e) A non-self-administering individual's
residential community program shall notify the individual's day community
program of any prescription medications that the individual is taking and must
provide the day community program with a copy of the health care provider order
for each prescription medication that the individual receives. Where a
non-self-administering individual receives prescription medication solely at
the day community program, the day community program must have responsibility
for notifying the residential community program and providing it with a copy of
the health care provider order;
(f)
The community program must establish procedures to document the date that any
individual's prescription is filled and the quantity of medication dispensed by
the pharmacy;
(g) Except for
persons who are self-administering, the community program must maintain a
documented accounting of the quantities of all controlled substances in
Schedules II through V, stored by the community program, which must be
reconciled at the end of each shift or as otherwise approved by the
Department.
(F)
Notwithstanding any other Department regulation, a health care professional
duly licensed or certified by the Department, or a student duly enrolled in an
approved or accredited program for licensure as a health care professional and
acting in accordance with the policies of that program, may possess and
administer any vaccine designated by the Commissioner for the prevention of a
pandemic, novel, or other vaccine-preventable disease, provided the
Commissioner determines that there are or will be insufficient health care
professionals available for timely vaccine administration and issues an order
authorizing such administration.
(1) To the
extent authorized by
105
CMR 700.003(F), a health
care professional duly licensed or certified by the Department, or a student
duly enrolled in an approved or accredited program for licensure as a health
care professional and acting in accordance with the policies of that program,
may administer vaccine if:
(a) authorized to
administer vaccine by order of the Commissioner;
(b) administration is in accordance with the
Commissioner's order and the order or prescription of a duly registered
practitioner authorized to issue an order or prescription for a vaccine
pursuant to 105 CMR 700.000; and
(c) with respect to a student administering
vaccine pursuant to
105
CMR 700.003(F), authorized
and supervised by a licensed and qualified health care professional.
(2) In accordance with the
Commissioner's order, a person administering vaccine shall:
(a) receive proper training and supervision
in the administration of the vaccine;
(b) comply with written protocols to ensure
proper storage, handling and return of vaccine, recordkeeping regarding
administration, response to adverse events, and safe and appropriate
administration of vaccine.
(G) A pharmacist may issue, modify or
discontinue a prescription or medication order as authorized in a collaborative
practice agreement meeting the requirements of 247 CMR 16.00:
Collaborative Drug Therapy Management,
243
CMR 2.12: Collaborative Drug Therapy
Management (CDTM) with Authorized Pharmacists, and M.G.L. c. 112,
§ 24BL, provided the following requirements are met:
(1) the pharmacist meets all applicable
requirements of the Board of Registration in Pharmacy established in accordance
with M.G.L. c. 112, § 24, and 247 CMR 1.00 through 16.00;
(2) the pharmacist registers with the
Department, in accordance with
105
CMR 700.004, and the DEA, if applicable, in
accordance with 21 CFR 1300, for the purpose of prescribing under 105 CMR
700.000;
(3) the pharmacist issues,
modifies or discontinues a prescription or medication order in accordance with
M.G.L. c. 112, §
24B1/2105 CMR 700.000, 247 CMR 16.00:
Collaborative Drug Therapy Management,
243
CMR 2.12: Collaborative Drug Therapy
Management (CDTM) with Authorized Pharmacists, and the collaborative
practice agreement between the pharmacist and supervising physician established
in accordance with 247 CMR 16.00 and
243
CMR 2.12;
(4) the pharmacist, if practicing in a retail
setting, may issue a prescription for a controlled substance in Schedule VI
only, in accordance with
105
CMR 700.003(G)(3);
(5) the pharmacist may dispense a controlled
substance for immediate treatment in accordance with M.G.L. c. 94C, § 9,
provided the pharmacist is authorized by
105
CMR 700.003(G) to prescribe
such controlled substance;
(6) the
pharmacist may order from a drug wholesaler, manufacturer, laboratory or
distributor, for purposes of dispensing for immediate treatment, those
controlled substances in Schedule VI which the pharmacist is authorized by
105
CMR 700.003(G) and the
collaborative practice agreement to prescribe. For the purposes of dispensing
controlled substances in Schedules II through V for immediate treatment in
accordance with
105
CMR 700.003(G)(5), the
pharmacist may obtain such controlled substances only as supplied by the
supervising physician or obtained through a prescription or medication order
for the patient;
(7) the pharmacist
may issue a prescription in accordance with M.G.L. c. 94C, § 20, provided
that the prescribing pharmacist clearly identifies their name and professional
designation to the dispensing pharmacist and provides their registration
number, work address, phone number, and the name of the supervising
physician.
(8) the pharmacist may
prescribe a controlled substance for a patient in a licensed health facility,
including a hospital, long term care facility, ambulatory care clinic or
hospice, through the use of a written medication order entered on the patient's
medical record maintained at the facility, provided that such a written order
meets all applicable provisions of 105 CMR 700.000;
(9) the pharmacist maintains a record of any
controlled substance maintained for the purpose of dispensing for immediate
treatment or administering pursuant to 105 CMR 700.000 and any related
Department guidelines;
(10) the
pharmacist provides a copy of an initial prescription or a modification or
discontinuation of a prescription to the supervising physician within 24 hours
of its issuance, unless more urgent notification is required under the
circumstances.
(H)
Notwithstanding any other provision of 105 CMR 700.000, a registered physician,
physician assistant, certified nurse practitioner, or nurse midwife may provide
expedited partner therapy (EPT) for the treatment of chlamydia infection, which
is the prescribing or dispensing for immediate treatment of an appropriate
therapeutic agent in Schedule VI for the treatment of a sex partner or partners
of a patient diagnosed with chlamydia infection, provided that:
(1) The prescribing or dispensing is in
accordance with
105
CMR 700.003 (H,) 243 CMR 2.00:
Licensing and the Practice of Medicine, 263 CMR 5.00:
Scope of Practice and Employment of Physician Assistants, 244
CMR 4.00: Advanced Practice Registered Nursing, as well as any
applicable guidelines of the Department, Board of Registration in Medicine,
Board of Registration of Physician Assistants, Board of Registration in
Nursing, and U.S. Centers for Disease Control and Prevention;
(2) In a case in which the patient is
provided with a therapeutic agent for immediate treatment of the patient's sex
partner, the therapeutic agent shall be provided to the patient in a separate,
properly labeled container for the sex partner to be given the therapeutic
agent;
(3) In a case in which the
patient is provided with a prescription for the patient's sex partner, there
shall be a separate prescription for the sex partner, which includes on the
prescription form, where the name and address of the patient is to be noted,
either the name of the sex partner or the words "Expedited Partner Therapy,"
"E.P.T." or "EPT"; and
(4) The
physician, physician assistant, certified nurse practitioner, or nurse midwife
counsels the patient about EPT and whenever possible provides the patient with
an information sheet provided by the Department, or comparable to that provided
by the Department, for the sex partner. Such information sheet shall include
pertinent information about procedures for taking the medication, avoiding
sexual activity as required during treatment, possible allergic reactions, and
avoiding future infection. As appropriate, patient counseling may also include
suggested ways of notifying and providing the medication or prescription to the
sex partner.
(I) A
non-licensed individual authorized by a practitioner registered pursuant to 105
CMR 700.000 may administer topical fluoride varnish or comparable fluoride
agent approved by the Department for topical administration to prevent dental
caries, provided that:
(1) the non-licensed
individual administering the fluoride varnish or other approved fluoride agent
has successfully completed a Department approved training and any Department
mandated refresher courses in proper administration, storage, handling, record
keeping, and reporting of adverse reactions;
(2) the fluoride varnish or other approved
fluoride agent is administered in accordance with the order of a practitioner;
and
(3) the non-licensed individual
administering the fluoride varnish or other approved fluoride agent is
supervised by a practitioner.
The requirements of 105 CMR 700.003(I)(1) do not apply to any individual subject to 234 CMR: Board of Registration in Dentistry.
(J) A medical device manufacturer may
register solely for the purpose of purchasing and storing specific controlled
substances which are to be used solely as part of the manufacturing and quality
control processes.
(K) A medical
specialty camp shall register as required by St. 2020, c. 227, § 90, in
order to permit unlicensed personnel to administer diabetes medication in
accordance with 105 CMR 430.000: Minimum Standards for Recreational
Camps for Children (State Sanitary Code Chapter IV). Supervision of
persons administering diabetes medication pursuant to this section must be as
outlined in regulation or specified in guidance issued by the
Department.
(L) A non-licensed
staff member of a health facility, health care entity, community program, or
practitioner's office may administer rescue medications, without registration,
to an individual the staff person reasonably believes to be experiencing a
life-threatening emergency, provided that:
(1)
the individual is in possession of the rescue medication to be administered;
or
(2) the facility, entity,
community program or practitioner's office is in possession of the rescue
medication in accordance with all applicable laws and regulations and policies
and procedures for storage and security; and
(3) the rescue medication is administered
pursuant to a prescription or practitioner's order and in accordance with the
directions in the manufacturer's package insert.
(M) Licensed nurses employed at Massachusetts
correctional facilities may delegate medication administration, pursuant to
existing patient prescriptions and administration orders, to unlicensed
personnel, identified and trained and deemed competent by the nurse, as
outlined in Department guidance.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.