A MDPH Message from Karen Robitaille: 
Greetings from the School Health Unit!
HAPPY SCHOOL NURSE DAY 2022!
Some of the best moments of my life have been school nursing moments. Almost nothing compares to knowing that something you did or said made a difference for a young person.
As a high school nurse, I used to always tell my school nursing colleagues that I would likely never know the impact I had, as my students were far beyond handwritten class cards or other such recognitions of my work. But one spring I received a wedding invitation from one of my former students. She and her fiancé actually began dating in high school and I knew them both, but she spent most lunch periods with me for four years, and eventually became a nurse (coincidence?!). When I arrived at the venue, I noted that all of the tables had names, and I was seated at the “Karen” table. Everyone at the table was trying to figure out what the names meant; I thought maybe it was some sort of party game. When the bride came over to greet the “Karen” table guests, one of them asked about the table name. She said that each of the tables was named after someone influential in either her or her new husband’s lives. Y’all, she NAMED A TABLE FOR ME. AT HER WEDDING. Never, ever doubt that your work goes unnoticed. I see you, your colleagues see you, your families see you, and most of all your students see you. Thank you for bringing your brilliant minds and loving hearts to this work every day.
I hope your day is filled with good things. I’m so looking forward to celebrating with many of you this week at our CSHS meeting, but please know, whoever you are, wherever you are practicing, you are part of something bigger and, in the words of Aibileen from The Help, “you is smart, you is kind, you is important”.
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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MA School Nurse Day
Proclamation From Governor Baker
Governor Charlie Baker recently issued a proclamation for MA School Nurse Day!
You can read the proclamation in full here.
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The School-Based Health Center Program Is Expanding!
Please see below for a graphic that displays the new round of MDPH-funded SBHCs and where they are located. New SBHC’s are noted. Please direct any questions or ideas for collaboration to the new SBHC Program Director, Máireád Day Lopes, contact information below. Máireád will be joining a few of our Regional School Nurse Leader meetings and is looking forward to forging new partnerships with School Health Services!
Máireád Day Lopes, BSN, RN, NCSN
Director, School-Based Health Center Program
Pronouns: She/her/hers
Email: mairead.daylopes@mass.gov | Phone: 781-559-9869
________________________________________________________
Division of Child/Adolescent Health and Reproductive Health
Massachusetts Department of Public Health
250 Washington St. 5th floor, Boston, MA, 02108
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Now Available! - New Sample Vision Tool List
Reminder: the new MA Vision Screening Protocols come into effect September 2022. A sample vision, equipment, and supplies "shopping list" is now available! Additional screening resources, guidelines, checklists, and more can be found on SHIELD's Health Screenings resource page.
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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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From Margret Cooke, MDPH Commissioner:
"This week we observe National Nurses Week which began May 6th and ends on the 12th, Florence Nightingale’s birthday. This is an opportunity to recognize the more than 600 DPH nursing professionals who advise, inform, and assist our hospitals, bureaus, and offices with a wide variety of clinical matters. Our nurses have been vital to the state’s COVID-19 response, and they deserve our recognition and appreciation for the essential roles they play every day. Please visit the DPH Staff Spotlight: Nurses webpage to read about someone we all know and respect for their hard work over the last two years!"
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 Milestones Day School and Transition Program, located in Waltham MA, released a statement regarding a recent visit from Governor Charlie Baker.
An excerpt from the statement reads:
"Governor Baker had the opportunity to tour the school and talk with Lyn Ross, RN, Milestone’s School Nurse, regarding the intense work done by school nurses across the  state in disseminating information to students, staff, and families to help mitigate the spread of COVID... Throughout the pandemic, Milestones not only safely remained open for onsite instruction, but significantly expanded our facility, adapted and created new programming, increased staffing to meet students’ complexity and the needs of public districts, and embraced initiatives to retain and recognize our most important asset to students’ success - our dedicated faculty."
You can read the statement in full here.
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Gender Affirming Surgery Series
Gender Spectrum and the Gender Confirmation Center are hosting an upcoming online event focused on gender affirming surgery. You can learn more and register using the following link:
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.
2022 New England Summer School of Addiction Studies Programs
June 6th - 10th | Virtual
The MDPH BSAS Office of Youth & Young Adult Services is excited to share the announcement for the second annual Adolescent Track at the New England Summer School of Addiction & Prevention Studies.
This is a New England regional (virtual) conference for professionals working in the substance use field and the Adolescent Track focuses on content and presenters relevant to the youth and young adult serving workforce. Topics are broad and cover introductory material such as the neurobiology of addiction on a developing brain to innovative approaches, family work, and youth-focused recovery. Scholarships are available and we encourage anyone wanting to attend to apply for the OYYAS scholarship. You can register and access the scholarship form 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.
Mental Health Series for School Health Professionals
The SHIELD Mental Health Series now includes 8 recordings. CNEs & PDPs available. For more information, visit SHIELD's website. The following recordings are now open:
Statewide Regional Meetings Courses Now Available
Two courses delivered during statewide regional meetings are now available online:
- Responding to Disclosures of Sexual Assault/Abuse: Considerations for School Nurses (ACCNE Credit or Audit)
- Welcoming refugee students: An introduction to refugee student health for MA school nurses (ACCNE Credit or Audit)
Additional online learning opportunities can be found on SHIELD's website here.
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.
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.
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Massachusetts School Wellness Coaching Program
In response to the Massachusetts School Wellness Needs Assessment, this program provides training and technical assistance by way of a School Wellness Coach to districts that have both an active wellness committee and a written Local Wellness Policy (LWP). To apply for the program, please complete the Initial Interest Survey. For more information, please view the flyer here. If you have any questions about the program, please feel free to reach out to Nicole Good, School Wellness Specialist, at nicole.good@mass.gov.
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Free Telehealth for COVID-19 Treatment With Paxlovid
Massachusetts has launched a new free telehealth program to help residents easily access COVID-19 treatment. The COVID-19 telehealth program is a quick, easy and free way for individuals to see if Paxlovid is an appropriate treatment for them. Paxlovid is a COVID-19 treatment pill taken orally that can reduce the risk for severe symptoms and hospitalization by nearly 90 percent.
This program is available to all COVID-19 positive Massachusetts residents 18 years or older who are experiencing COVID-19 symptoms. The telehealth visit consists of a short health intake survey and, if eligible, a video consultation with a health care clinician. During the telehealth visit, the clinician will review symptoms and risk factors, and determine if Paxlovid treatment is appropriate. If an individual is eligible for the treatment, the clinician will send a prescription to a local pharmacy or, if necessary, arrange for free overnight delivery to the resident's home. This program can be accessed at mass.gov/COVIDtelehealth and is available in English, Spanish, Haitian Creole, and Portuguese.
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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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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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"Life is not a problem to be solved,
but a reality to be experienced."
- Søren Kierkegaard
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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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