A MDPH Message from Karen Robitaille: 
Greetings from the School Health Unit!
I don’t know about you, but I am definitely channeling the energy of marathon runners at this point of any school year, but especially this one. Congratulations to anyone who ran the Marathon last week, and congratulations to every school nurse for making it this far in the year. We are “in the home stretch” now, but I know that this last stretch is so incredibly busy for you, especially in a year when so much of your regular work has been disrupted and delayed. Here are a couple of resources that I hope can help you make it through:
This is a handy reference tool developed by Shanyn Toulouse (Northeast Regional School Nurse Consultant), which lays out which screenings happen in which grades and with which tools. The new vision screening protocols are located here and the full screening handbook can be found here. We will have our screening training updated to reflect the new vision protocols sometime in June, and will have a “shopping list” for vision screening ready for you very soon. A reminder that there is an audit version of the screening course if you have screeners that do not require nursing CE’s. Also, check out this article regarding the new vision screening protocols in MA in this month’s MCAAP newsletter!
The last set of Regional Nurse Leader meetings are coming up and are open for registration here, and our last CSHS convening of the year happens May 12th; registration is open here.
The annual NASN school nursing conference is live and in person this year, but there is also a virtual option if you can’t make it:
 More information and registration can be found here and early bird rates have been extended through May 2nd.
And finally, Wednesday, May 11th, is National School Nurse Day! NASN has a wonderful toolkit which includes downloadable posters, social media bytes and other resources to help your schools recognize and celebrate the extraordinary accomplishments of school nurses this past year….and every year! As a nurse leader, I used the social media materials to promote the day within my district and also sent them to building principals and the Superintendent’s office so they could do the same!
I’m thinking of all of you all of the time, and hopefully I’ll see many of you, whether at a site visit or at a meeting, soon. I’m going to dig deep over the next two months to find those energy reserves and I hope you can find ways to do the same. We’ve got this!
With great respect,
Karen
Karen Robitaille, MBA, MSN, RN, NCSN
<she, her, hers>
Director of School Health Services
Division of Child/Adolescent Health and Reproductive Health
Massachusetts Department of Public Health
250 Washington St. 5th floor, Boston, MA 02108
karen.robitaille3@mass.gov
Cell: 781-675-0463
Personal Webex room: https://statema.webex.com/meet/Karen.Robitaille3
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Sports Concussion Reporting Information
The Year End Reporting Form for Schools is required for all public schools and other schools subject to the rules of the Massachusetts Interscholastic Athletic Association (MIAA) with extracurricular athletic activities for grades 6-12. The deadline to submit the 2021-2022 Year End Report to the Department of Public Health (DPH) is August 31, 2022. Schools can complete either the online form or paper form of the Year End Report. Completing the online form is strongly encouraged. Please complete the Year End Report for 2021-2022 using the following links:
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School Health Unit Focus Groups
The MDPH School Health Unit will be holding focus groups of school nurses to learn about the needs and opportunities available to student nurses in school health offices. The School Health Unit will be partnering with the MA Dept of Higher Ed to facilitate placements of student nurses. We are interested in learning if and how nursing students can be of assistance in completing screenings, immunization entry, among other activities. Please join Assistant Director, Caitlin Pettengill, on Thursday, April 28th at 3:00pm. Click here to join the meeting.
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Naloxone in Schools Update
The memo titled The Administration of Naloxone in Schools is now available on the School Health Services website here and on the BU SHIELD website here.
To order naloxone from the MA State Office of Pharmacy Services (SOPS), your school/district will need a Massachusetts Controlled Substance Registration for Schools (MCSR for School) which covers naloxone. The process for obtaining a MCSR for School is registering with the MDPH School Health Unit for medication delegation/epinephrine training. Please see this MDPH School Health guidance document for details on how to register. Schools do NOT need a separate naloxone MCSR.
Your school/district is welcome to take advantage of the Commonwealth’s negotiated Public Interest Pricing for name brand Narcan. The current public interest price for a unit (2 doses) of Narcan Nasal Spray is $71.06. There are generic formulations which are a bit cheaper. These products are available for sale to municipal, state, and health and human services programs through the SOPS, all of which will require a MCSR for School.
There are free overdose prevention trainings available in MA through Praxis and through Health Resources in Action (HRiA). Please reach out to either agency to request a training. The MDPH Bureau of Substance Addiction Services also has a naloxone FAQ website.
Please feel free to reach out to the Assistant Director of School Health Services, Caitlin Pettengill caitlin.pettengill@mass.gov, with any questions.
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CSHS Site Visits Update
The School Health Unit staff will continue to conduct site visits throughout the end of the school year by request. Public school nurse leaders can use this link to request a site visit from Karen Robitaille and non-public school nurses can use this link to schedule a visit with Janet Guertin-Moruzzi. Visits can be virtual or in person, and funded districts who have not had a recent visit, as well as new nurse leaders, will be prioritized.
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School Nurses in the News:
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Conversations and Conundrums - Current Clinical Pediatrics 2022 Conference
Friday, April 29th | Virtual
This program will present clinically relevant, evidence-based cases and mini-lectures in a conversational format based on real-world scenarios encountered by today’s busy pediatrician. For more information, view the event page here.
Those who have remaining SHIELD credit can use it to attend this conference. Please email BU SHIELD at shieldbu@bu.edu if you are interested!
Defusing Tense Situations Workshop
Tuesday, May 3rd | 3:30 - 5:00 pm EST | Zoom
The defusing tense situations workshop is back! These sessions are free and we offer PDPs. Register here.
Commonwealth Challenges: Conversation Between Public Health & School Nurses Webinar
Thursday, May 5th | 6:00 - 7:30 pm EST | Zoom (1.5 contact hours will be awarded)
While the pandemic has emphasized the critical roles of the Public Health Nurses in improving population health, it also identified the need for the nursing population to better understand the impact of and more highly value these specialty practices. COVID-19 added additional responsibilities to these roles and a broader understanding of the complexity and continue value they bring to the profession and public health is needed. This nursing continuing professional development activity is being offered by American Nurses Association Massachusetts. To learn more, view the event page on SHIELD's website here and register here.
Gender Affirming Surgery Series
Gender Spectrum and the Gender Confirmation Center are hosting two (2) upcoming online events focused on gender affirming surgery. You can learn more and register using the following links:
Every Pediatrician is a School Physician - Lessons Learned from the Pandemic
Tuesday, May 10th | 3:30 pm - 7:30 pm EST | Waltham, MA
The Massachusetts Chapter of the American Academy of Pediatrics (MCAAP) will be hosting the MCAAP Annual CME Edward Penn Lecture and Business Meeting at the Massachusetts Medical Society (MMS) in Waltham, MA. To learn more and register, view the event details here.
Cultural Humility as a Methodology for Collaborating with Massachusetts Native Communities
Friday, June 3rd | 9:30 am - 3:30 pm EST | Zoom (4.5 contact hours offered)
The training team will present an interactive program that integrates best practices and principles regarding training for cultural humility, while communicating essential knowledge and nuanced understanding regarding Native communities in Massachusetts. To learn more and register, view the event page here.
Racial Trauma and Youth: Assessment and Treatment Across the Lifespan
Thursday, June 16th | 10:00 am - 12:30 pm EST | Zoom (2.5 contact hours offered)
This workshop will present current scholarship highlighting the interpersonal, institutional, and systemic race-related experiences of youth. Strategies for assessing racial stress and the potential for trauma will be presented. The workshop will conclude with recommendations for treatment and fostering healing. Learn more and register here.
BU CME/CNE Office Conference
In July, the Mindfulness in the Age of Anxiety - Helping Kids, Teens and Families program will be offered. This hands-on, practical workshop will focus on adapting mindfulness for a range of people and settings. We will discuss the most recent brain science, building buy-in and engagement, and strategies for starting mindfulness programs in larger institutions such as schools and hospitals. You can register here.
Community Education Initiative Pediatric Health Assessment
August 10th - 11th | 8:00 am - 4:00 pm EST | Norwood, MA
Registration for the Community Education Initiative Pediatric Health Assessment event is now open! To learn more, view the new event flyer here and register here.
Recurring Support Group for School Nurses
There is a weekly virtual support group for school nurses happening every Monday night at 7 pm. Jennifer Caprio, a mental health clinician from Eliot Community Human Services (ECHS), will be hosting the sessions. The support group is open to all school nurses from the Commonwealth of Massachusetts and will remain active through May 2023. This group is a safe place to discuss how you are feeling, receive support, and get wellness tips. The flyer with the Zoom link can be found here. Please email Jennifer with any questions or concerns at jcaprio@eliotchs.org.
For even more upcoming events,
you can view the calendar on SHIELD's website here!
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New Resources & Training Updates
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MA Mandated School-Based Screenings Reference Tool
Shanyn Toulouse, Northeast Regional Consultant, created a lovely
screening guidelines "cheat sheet" that can be found on SHIELD's website here.
Audit Version of "Vision Clinical Update 2021" Now Available
The audit version of the course "Vision Clinical Update 2021: Addressing Health Inequities and Implementing New Protocols" is now available on SHIELD's website here. This course is free and only offers participation credit.
For learners seeking credit, CNEs are available for the standard version found here - fee applies.
SHIELD Training Update: BinaxNOW
The BinaxNOW training has just been added to SHIELD’s website as a self-paced course. Learners can review material on their own time and then register to participate in a return demonstration with a BinaxNOW trainer. Additional BinaxNOW resources and updates can be found on SHIELD's website here.
SHIELD continues to add new trainings to its website; for a summary of all courses and upcoming events, see this one-page listing.
Recorded Webinar Now Available From NEPHTC
NEPHTC recently hosted a Transgender Introductory Primer webinar and the recording is now available here.
After viewing the recording, participants will be able to:
- Understand basic terminology and theory as they relate to transgender health.
- Describe health disparities facing the transgender community.
- Identify resiliency factors, gender transition paths and support needs, and targeted best practices for serving the transgender community.
SBIRT Training Updates
M.G.L Chapter 71 Section 97 (Verbal screening tool for substance abuse disorders) of AN ACT RELATIVE TO SUBSTANCE USE, TREATMENT, EDUCATION AND PREVENTION (the STEP Act), mandates that each public school, charter school and vocational school utilize a verbal screening tool to screen pupils for substance use disorders annually. The STEP Act makes no determination as to which school professionals perform the screening. The only requirement is that each screener complete the Massachusetts Department of Public Health (MDPH) Screening, Brief Intervention and Referral to Treatment (SBIRT) training, which is offered through Boston University School Health Institute for Education and Leadership Development (BU SHIELD). Please review school professionals’ workloads to determine who is best equipped to complete the substance use screening this year. If you have any questions on who can complete the screening in your school, please contact the MDPH Assistant Director of School Health Services, Caitlin Pettengill, at Caitlin.pettengill@mass.gov.
BU SHIELD offers a free two-part SBIRT training. The first part is online, self-paced and can be taken at any time. The second part is a live online session which is offered multiple times a month, year-round, on a continuous basis. If the posted dates will not work for your district, please reach out to Caitlin Pettengill directly. The MDPH School Health Unit is also offering an optional supplement training on vaping/nicotine. If you have taken the SBIRT course in the past, please know the optional course is not required.
Mental Health Series for School Health Professionals
This SHIELD training series now includes five self-paced courses with more to be released in March. For more information, visit SHIELD’s website here.
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Community Education Initiative
Professional Development Programming
For any school districts looking for professional development options, please consider the Community Education Initiative at Boston Children's Hospital (BCH). For more information, you can view the informational packet here. If you need any programming early on in the 2022-2023 school year, please send in your requests by the end of June in order to secure your topics/speakers. The Professional Day Request Form (page 4 of the informational packet) needs to be submitted to BCH in order to get on the calendar.
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EpiPen4Schools® Program Announcement
The EpiPen4Schools ordering website is currently under maintenance. However, you can call 1-973-845-7600 to speak with a live representative. They will verify your school and contact information so they can email you an order form and instructions. If you are unfamiliar with this program, more information can be found on their website here.
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School Food Allergy Protocol Survey
Dear School Nurses,
My name is Dr. Lisa Bartnikas and I am an Allergist at Boston Children's Hospital. I am conducting a research study on school food allergy policies to help us better understand how food allergies are managed in schools.
We are conducting a survey of Massachusetts school nurses and your email address was provided by regional nurse consultants in collaboration with the Massachusetts Department of Public Health. I would really appreciate your participation in answering a survey about your school’s food allergy policies. The survey takes approximately 20 minutes to complete. We plan to administer this survey annually for the next 3 years, sending emails each spring, though you can start or stop participating at any time.
All information will be kept confidential and any information collected will be deidentified so that no nurse or school names or locations are made public.
The link to the survey can be found here. Please forward this message to any additional Massachusetts school nurses who might be able to provide information or who might be interested in completing this survey. Thank you very much for your time!
If you are interested in learning more or have any questions, please feel free to contact me at lisa.bartnikas@childrens.harvard.edu.
Sincerely,
Lisa Bartnikas, MD
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A Message From Your Medication Program Team:
The MA Department of Public Health (MDPH) School Health Unit (SHU) has made a few changes to the medication and epinephrine registration procedure. The changes are part of a quality improvement plan to make the application process less cumbersome. There are revised applications and an updated guidance document for medication delegation and epinephrine training registration which will be posted to the MDPH SHU website and the BU SHIELD website soon. They were also mailed out through your Regional Consultants this week. If you are currently collecting signatures on an older version of the application, please feel free to continue and submit the older application.
Before explaining the changes, I would like to reflect over the last two years of registration. Prior to the pandemic the MDPH SHU registration process was 100% on paper. As MDPH transitioned to remote work in March 2020 SHU shifted the registration process online. The new process required a legal review, which resulted in two changes to be in compliance the laws and regulations of the Commonwealth. They are listed below, as well as a rationale from M.G.L. 94c § 7(a).
- The school/district must obtain a Massachusetts Controlled Substance Registration (MCSR),
- The school/district must register annually.
M.G.L. 94c § 7(a)
"Except in the case of a pharmacy, wholesale druggist or outsourcing facility, every person who manufactures, distributes or dispenses, or possesses with intent to manufacture, distribute or dispense any controlled substance within the commonwealth shall upon payment of a fee, the amount of which shall be determined annually by the commissioner of administration under the provision of section three B of chapter seven, register with the commissioner of public health, in accordance with his regulations, said registration to be effective for one year from the date of issuance."
MDPH SHU has worked diligently to eliminate the required fee and additional process of applying for a MCSR. Please see the below changes listed in the new guidance document and reflected on the revised application:
- No school in the Commonwealth shall be charged a $300 fee to receive a MCSR.
- The MDPH SHU will act as a liaison for schools in registering for a MCSR. Schools/districts will no longer interface with the MDPH Drug Control Program or fill out a MCSR application. A school/district will submit an application to MDPH SHU, and MDPH SHU will approve the application via email with a MCSR attached. We have attached a sample MCSR to this email.
- The training requirement of Medication Managers will change from every 5 years to every 3 years starting in July 2022. BU SHIELD and MDPH SHU will continue to offer the course online. The two required courses have not changed; Medication Administration in a School Setting: School Nurse Practice in Massachusetts and Medication Administration in Schools: What School Nurse Managers Need to Know.
If you have any questions about the registration process, please reach out to Lauren Cosby at medication.delegation@mass.gov.
Thank you for everything you are doing for your students and school communities. We appreciate you all.
Warmly,
Caitlin & Lauren
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Mandated Reporting for CSHS Funded Schools/Districts
The link to the Monthly report survey is here and the end-of-year Status Report 21/22 survey is here. All reporting forms, worksheets and instructions were sent out to districts by Bob Leibowitz and worksheets for the monthly report can also be found here, and here is the CSHS end-of-year Status Report 21/22 worksheet. Questions related to CSHS mandated grant reporting should go to: DPH_ESHS_data@MassMail.State.MA.US.
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Mandated Reporting for Non-CSHS Districts (public school)
Concussion Report Form: Not yet available.
BMI report form: BMI report. CSHS-funded districts and nonpublic schools should NOT submit a separate BMI report, as these data are included in the Status Report. Non-funded districts will use the same link that is used to access the Status Report form.
SBIRT report. CSHS-funded districts and nonpublic schools should NOT submit a separate SBIRT report, as these data are included in the Status Report. Non-funded districts will use the same link that is used to access the Status Report form.
A worksheet for non-funded districts can be found here.
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Mandated Reporting for ALL Schools/Districts
Asthma and Diabetes Survey: This year’s survey will be sent out in February and it will be an electronic form again this year. You should be getting it by email directly from us if you are on the list of regional school nurse coordinators or, if not, you should get it through your regional network. If you have questions or if you do not receive the survey by late February, please use the following email address to contact us: ped.asthma@mass.gov.
Epinephrine administration report form.
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2021/2022 COVID-19 Protocols and
Testing Information on DESE Website
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"Be who you are and say what you feel,
because those who mind don't matter
and those who matter don't mind."
- Dr. Suess
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Regarding Vision Screening Protocols:
The November 2021 Vision Clinical Update is a synthesis of the most current evidence to date related to children's vision and eye health. This course is an optional precursor to the upcoming revision of the School Health Screening Training, which is currently being updated to include training on the new vision screening protocols that go into effect September 2022. The November 2021 Vision Clinical Update is an excellent review of the impact of children's vision on education, physical, social, and emotional development and compliments the upcoming training in the new protocols. Additionally, the course discussed the relevance to school nursing practice and the critical role of follow-up and completion of vision referrals as a primary prevention strategy. The November 2021 Vision Clinical Update provides substantial evidence that supports the revision of the new evidence-based MDPH Vision Screening Protocols. Look for the release of the updated School Health Screening Training that will include new vision screening protocol training to be released very soon.
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Vision Screening during COVID. The National Center for Children's Vision and Eye Health at Prevent Blindness has updated the Considerations for Conducting Children's Vision Screening Safely in Schools, Head Start, and Early Care and Education Programs During the Covid-19 Pandemic. The resources includes a downloadable guide and FAQ. Please share these documents with your colleagues.
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COVID-19 Vaccine Information for Youth and Young Adults
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COVID-19 Resources for Families of Children with Medical Complexity (CMC)
Families and providers can learn more about disability-friendly vaccination events across Massachusetts at www.VaxAbilities.com. These clinics support people with sensory and/or other accommodation needs to have the most positive and comfortable vaccination experience possible.
Lastly, this flyer on “Ways to Increase COVID-19 Vaccination” provides ways to partner with local primary care practices, schools, or boards of health to co-host family friendly vaccination clinics, disseminate information, or host a town hall to encourage vaccination for children and their parents/caregivers. There are several helpful resources that can be used to promote vaccination in our communities.
Please use these resources in your efforts to promote vaccination in the communities we serve. Thank you!
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You may be seeing student and staff COVID-19 vaccination records, including those from other countries. AN IMPORTANT NOTE IN REGARD TO FOREIGN VACCINATION RECORDS: Unlike other vaccinations where we accept whatever the foreign formulation is, the U.S. is currently only accepting WHO-approved COVID vaccination formulations. Here is the link to the list of COVID-19 vaccines within the WHO EUL/PQ evaluation process; any vaccine marked “finalized” is accepted in the U.S. Please note, nurses should check this information frequently, as it is subject to change.
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For key information about managing COVID-19 in Massachusetts, see these websites.
SHIELD COVID-19/BinaxNow Resources.
MDPH Website.
SHAH Family Foundation Pooled Testing Website.
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For additional resources surrounding COVID-19, visit these websites.
NASN COVID-19 Resources.
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