Digitized by the Internet Archive 2014 in https://archive.org/details/newsinschoolheal1992mass Selected School Health Mandated Programs Much of this newsletter will be devoted to a are beginning to occur after a lengthy period of summary of the state-mandated requirements for limited revisions in statutes and regulations school health programs and related laws because governing school health. Examples include the there have been so many questions concerning recent requirement for lead screening, the them. It is important to emphasize that the state requirement for a measles booster at entry into the mandates form one component of a comprehensive seventh grade, and the amendment to the statute school health program, albeit an important one for governing the use of psychotropic medications in the health of large numbers of children. Mandates school settings. As increasing attention at all levels governing infectious disease control, e.g., of society is being focused on the health needs of immunizations, are key public health strategies to today's youth, these may be just the beginning of ensure that the necessary disease prevention the change process.... safeguards are in place forchildren at critical times, such as school entry. Mandates requiring vision, Special recognition goes to the school nurses who hearing and postural screening are designed for have developed, implemented and evaluated the early detection of potential problems, before they mandated programs-including the follow-up with interfere with the learning process and/or result in parents and providers to ensure that the child's serious medical complications. Mandates requiring healthneedsare met Despite increasing workloads physical examinations at scheduled intervals are and the time-consuming nature of many of the aimed at ensuring that children receive a health requirements, these professionals have certainly met review on an ongoing basis—a process which the intent of the mandates. Also, recognition goes assumes even greater importance when more to school physicians who have performed physical children are uninsured and denied access to examinations when needed, to physical education ongoing health evaluations. teachers who have completed initial postural screenings, to trained volunteers and health aides Mandates relating to school health are found in who have assisted the school nurses in certain other education law, public health law and otherlaws and screenings and to teachers and administrators who regulations such as those applicable to professional have facilitated the implementationof the programs. practice, e.g., the Nurse Practice Act. As in any legal requirements, they are subject to change Thank you. through the legislative process. Changes may occur because of new research, changing public health needs and/or risks, and improved understanding of Anne H. Sheetz, R.N., M.P.H., C.N.A.A. the relationship of health and education. Changes Director of School Health "...early detection ofhealth problems or needs is only a beginningstep toiuard improved health; the ultimate outcome depends on what Imppens after the actual screening. " - School Nursing - A Framework (or Practice, hy Susan S. Wold, (C. V. Mosby, Co. 1981). MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH/BUREAU OF FAMILY AND COMMUNITY HEALTH/DIVISION OF PREVENTION: YOUTH, ADULT AND ELDER HEALTH Guest Contributor I've been told the mark of a resilient professional is to you if you find yourself in settings with your the ability to adjust to new demands without totally eyes peeled for information in the papers, and come short-circuiting. It seems as if this may be the year to one of our trainings on how to interpret and use for many of us to test this hypothesis! The 1992-93 the data, to be held through the Training Center in school year brings many challenges to all of us, and February. school nurses and other health services personnel are no exception. Many teachers are being asked to Another great resource for powerful statements in learn how toidentifyand referstudents withhealth- support of health services delivery and health related problems, and a growing number of school education is a report published by the Harvard nurses can be found in classrooms and corridors, as School Health Education Project. "Creating an well as clinics and in family homes. Part of the Agenda for School-Based Health Promotion" trickofmaintaining resiliency is, orcourse, knowing summarizes 25 national publications and provides how to set limits and part is picking from arfarray an eloquent argument for the necessity of all-too- of new skills to learn and practice with an eye often under recognized work you do. Call (617) towards mastery. We are fortunate in 432-3936 for more information. Massachusetts to have a spectrum of opportunities for professional development in the arena ofschool- You may be interested in knowing we are trying based health service delivery. One such resource something different this year in the Drug-Free lies in the Department of Education. Schools Program. School districts can apply for up to S5000 in a competitive grant program to enhance This is the second year of the Comprehensive their alcohol and other drug prevention efforts in Health Education and Human Services (CHEHS) specific ways. Ifyou have been after your school to Training Center, housed in the Bureau of Student do more youth<entered activities such as student Development and Health in the Quincyoffice of the assistance teams, peer programs, identification and Department of Education. With support from the referralsystems, advisor/advisee programs, conflict Drug-Free Schools, Comprehensive Health resolution/mediation programs or mentoring Education and Human Services and HIV/AIDS programs as well as family involvement and school Education Projects, all located in the same bureau, restructuring, you may be able to help bring more the Training Center offers free or low cost training, funds into yoursystem this fall. Contact your local oftenco-sponsored withotheragencies, forteachers, Drug-FreeSchools Coordinatorformore information nurses, and otherschool-based personnel in needed on this Discretionary Grant. areas of health education and human services. As one of 40 networked centers across the country, we We are also offering training grants through the are in touch with the latest ways to increase Commonwealth Inservice Institute (CII) for learner- competencyand skillsofschool-based health-related generated trainings at the local level in health and personnel. Perhaps you were one of the 1000 substance abuse prevention areas. This is one of the educators who attended a training event last year. great unsung resources in our agency, and we want A calendar of events is published free of charge every penny from this fund spent, so start designing twice a year. To receive your copy, just drop me a your trainings now! For more information on how line with your name and address. to apply to CII, call Dot Earle at (617) 770-7243. Another new role nine school districts will Finally, I invite you to become involved in a experience is that of "mentoring" the recipients of a statewide promotional effort to support new round of CHEHS grants. Twenty-nine first Comprehensive School Health Education. The year grantees can look to their "buddies," schools Massachusetts Division of the American Cancer that previously received similar funds, for support Society is coordinating a coalition to lobby for and sound, practical advice on how to implement a activities that support comprehensive health comprehensive health education program. Anearly education. This is an exciting new group that is October showcase introduced the mentors to the very diverse, growing bigger weekly, and there's conveners of the first year grants. For more plenty of room for you! If you have any inclination information about the CHEHS grants and mentors, to throw in your two cents' worth, please contact contact Nancy Coville (617) 770-7579. Kathy O'Connor at the Cancer Society's Boston office, (617) 267-2650. Last spring we conducted another Youth Risk Behavior Survey (YRBS) to determine the degree to By my count, that's five acronyms in one article, if which adolescents in Massachusetts engage in you count HIV and AIDS. Somebody's got to keep activities that put them at risk for serious problems. the jargon alive... The results, while similar to our first survey data, have some eyeopening surprises which we will be publishing and discussing with all interested Pam Chamberlain persons in January. These statistics may be useful Massachusetts Department of Education On The Agenda HIV ADOLESCENT PEER EDUCATION PROGRAMS: TheHIV/AIDS Bureau atthe Massachusetts Department of Public Health is beginning itssecond year of supportforscores ofteenagepeereducationAIDSpreventionprograms. Lastyear more than40Qteenagers weregivenintensive traininginpreventingHIV and STD infections anci paid stipends to conduct educational presentations to other m teenagers in their communities. The programs are based twelve of the largest urban areas and administered by seven of the Regional Prevention Centers. The adolescent teams can be called upon to do presentations at schools, community agencies, recreation centers, etc FormoreinformationcallMelidaCampos at (617) 727-0368. ADVISORY ON DISPOSAL OF INFECTIOUS AND DANGEROUS MEDICAL WASTES IN SCHOOL SETTINGS: The advisory is designed to clarify the school's responsibilities foridentification, handling and disposal ofinfectious and dangerous medical waste. Ithas been distributed to school superintendents, local boards ofhealth and school nurses. STATUS OF DRAFT REGULATIONS GOVERNING PRESCRIPTION MEDICATION ADMINISTRATION IN PUBLIC AND PRIVATE SCHOOLS: On October 8, 1992 the Public Health Council gave permission to hold public, hearings to receive testimony on the proposed regulations. The dates of the hearings wereDecember 1 and December 7, 1992. Both written and oral testimony was received. SCHOOL NURSE ORIENTATION: On October 1,1992 the staff of the School Health Unit presented the first group orientation for new school nurses. The program was designed to share standards of school nursing practice, review the responsibilities of the Massachusetts school nurses and emphasize the activities and collaboration needed to develop and maintain an effective comprehensive school health program. Thirty-one nurses representing all regions of the Commonwealth attended. The School Health Unit win conduct follow-up evaluations in the spring of 1993. STATEWIDE CONFERENCE ON COMMUNICATION SKILLS FOR SCHOOL NURSES: On November 18, 1992, the Department of Public Health presented a conference designed to enhanceschool nurses' communication skills with a variety of audiences such as parents, administrators and school committees. Brenda Millette, Ed.D., R.N., from the University of Massachusetts, Amherst, School of Nursing was the key presenter. Seventy school nurses representing all regions of the Commonwealth attended. 3 Additional Resources for School Health VIOLENCE PREVENTION INFORMATION: For information about violence prevention, including a curriculum for adolescents on preventing family violence, call Selena M. Respass, Director, Office of Violence Prevention, Massachusetts Department of Public Health, Bureau of Family and Community Health, Division of Prevention: Youth, Adult and Elder Health, (617) 727-1246. ADOLESCENT HEALTH PROGRAM: Forinformation concerning, School-Based Health Centers, call Richard Tafel, Director of Adolescent Health, Department of Public Health, Bureau of Family and Community Health, Division ofPrevention: Youth, Adult and Hder Health, (617) 727-0941. PLAYGROUND SAFETY CHECKLIST: This is a useful tool which is in compliance with the new Consumer Product Safety Commission Guidelines. Also available are varieties of articles concerning materials, signage and liability issues regarding playgrounds. These may be obtained from Steve Shuman, Health Education Planner, Statewide Injury Prevention Program, Injury Control, MA Department of Public Health, 150 Tremont St, Third floor, Boston, 02111. SMOKING CESSATION PROGRAMS: For information on resources for smoking cessation programs, please call the Massachusetts Department of Public Health, bureau of Family and Community Health, Office for Non-Smoking and Health Hotline 1-800-562-0102 or (617) 727-0731 DENTAL CERTIFICATES (formerly called the "orange cards"): These certificates may be used by the School Nurse to send to the child's dentist when screening reveals that there is a dental problem. The certificate is then completed by the local dentist and returned to the school where it becomes part of the student's health record. School health personnel may obtain the certificates free of charge from Carole Roy, Massachusetts Department of Public Health, Bureau of Famflv and Community Health, Office of Dental Health, (617) 727-0732. SAFE TRANSPORTATION FOR CHILDREN WITH SPECIAL NEEDS: The Massachusetts Passenger Safety Program of the Massachusetts Department of Public Health has a wide variety of audiovisual and print resources on this subject. Program staff will provide technical assistance to educators, transportation specialists, health care providers and parents. Call 1-800-CAR-SAFE or (617) 727- MERRIMACK VALLEY REGIONAL PEER LEADERSHIP CONFERENCE: The third annual conference will be held March 26, 1993 in Tyngsboro - Boston University Corporate Education Center and will be sponsored oy the Regional Prevention Center - Prevention Network. Merrimack Valley Regional Peer Network meeting occurs monthly. Sites will rotate to different schools each month. For additional information call Michael Rivera, Peer Leadership Coordinator at (508) 688-2323. PEER LEADERSHIP ACTIVITIES IN THE NORTH SHORE: Youth Conference sponsored by the Regional Prevention Center in the North Shore area will be held 1/29/93. The Regional Prevention Center in the North Shore area is administered by the Centers for Addictive Behaviors. For additional information about the peer leadership conference, cal' l-(800) 334-5512. SUMMARY OF SELECTED LAWS IN SCHOOL HEALTH PROGRAM/SERVICES Definitions Law or Statute Enacted by legislature, • M.G.L. c.71. s.54A Requires : : either codified into the General Laws or assignment or a physician or a person exists as a special law. trained in emergency medical care to interscholastic football games played Mandate A legal responsibility established by teams representing public : by statute. secondary schools. Regulation: Promulgated by an • M.G.L. c.71, s.54B (as amended by administrative agency such as the c.133, s.433, Acts of 1992): Governs Ivlassachusetts DepartmentofPublic Health the administration of medications to under statutory authorization. Assists in children in the school setting. the implementation of statutes and has the Requires the Department of Public force of law. Health to adopt regulations governing the administration of prescription M.G.L., c, s.: Massachusetts General Laws, medications in schools. Hearings to chapter, section. receive public comment have been held. The following represents a summary of selected laws regarding school health to • M.G.L., c.71, s.55 Requires : which schools are held legally accountable. student with a dangerous It is important to note that 'this listing of disease, as defined by the statutes and regulations is not intended as Department of Public Health, to a comprehensive review of all legislation be excluded from school. affecting school health programs or services but rather as a brief summary of certain • M.G.L., c.71, s.55A Requires child : selected laws which tend to generate who becomes sick to be sent home or requests for consultation or advice from referred to school physician. Exempts representatives of the department's School from liability a teacher, principal, Health Unit. Please consult the statute or nurse or others who give emergency regulations or the legal counsel for the first aid or provide transportation to school if further information is needed. the child in an emergency. Also, it should be noted that many of the mandates represent minimum • M.G.L. c.71, s.55B Prohibits person : requirements. with communicable tuberculosis from- working in school. Requires a one- M.G.L. c.71, s.l: Requires health time certification of all public and education in the public schools and private school employees (and defines general subjects such as volunteers) in contact with students cardio-pulmonary resuscitation, to ensure that thev are free of active effects of alcohol and tobacco, tuberculosis. All new employees prevention and detection of breast must be screened by a Mantoux'test cancer, etc. within 90 days prior to school employment. M.G.L. c.71 s.2A Prohibits :- student use of tobacco on school • M.G.L. c.71, s.57 (and related CMR grounds. regulations - 105 200.000 - 200.920): M.G.L. c.71, s.53 Requires each : school committee to appoint one or • Require physical examinations of more school physicians and registered school children within six months nurses, assign (hem to public schools prior to entrance into public schools within its jurisdiction, and provide all or during the first year after,^ proper facilities for the performance entrance and at intervals of either of tneir duties. The physicians and three or four years thereafter. In registered nurses must be currently addition, an annual physical exam licensed in Massachusetts. is required before participation in 5 A competitive sports. Exams are M.G.L. cllL S.190-199A (and CMR also required for: related regulations - 150 • 14-16 yr. old youths 460.050 and .060): Require that requesting workpermits; childrenpresent evidence ofhaving m • any child a private school been previously screened for lead when requested by parents; poisoning as a condition for entry • any child when requested into kindergarten. by teacher in consultation with a school nurse. M.G.L. c.112. The Nurse Practice Act (and related regulations - 244 Require vision and hearing CMR): Defines nursing practice. screening annually; Require annual measurement of REPORTING SUSPECTED ABUSE heights and weights; AND/OR NEGLECT OF CHILDREN Require annual postural M.G.L. c.119, s. 51 mandates the screening in grades five through Department of Social Services to receive nine; reports of possible child abuse and neglect. It also lists the mandated reporters and Require examination of feet. defines their responsibilities. The following school staff are mandated reporters: Waiver Procedure: Permits physicians, dentists, nurses, public or school systems to apply for a private school teachers, educational waiver of certain examination administrators, psychologists, guidance or regulations and, under certain family counselors, and social workers. circumstances, the department to (Refer to the statute for the complete list of allow schools to develop alternative mandated reporters.) health service programs designed to most effectively meet the needs of The statute requires that mandated their students. Granting the waiver reporters contact the Department of Social does not mean deletion of a Services when they have reasonable cause requirement but rather, the to believe that a cnild under the age of 18 substitution of one method of is suffering from abuse or neglect. Each health assessment for another. area of the Commonwealth has local offices to which all questions should be referred. M.G.L. c.71B (and related Call your local Department of Social regulations): Require Services for (1) more information about a child witn special health care what constitutes abuse and/or neglect, (2) needs to be referred for evaluation information as to how and where to report, and education. and (3) assistance with • individual situations. Your local Department of Social M.G.L. c.76, s 15 and 15C (and Services will also provide educational related amendments and programs upon request. CMR regulations - 105 220.000 to 220.500): Defines immunization We would suggest that you obtain the requirements for entry into following informational pamphlets from school. The regulations were vour local Department of Social Service revised last year to require a Office: "Child Protective Services" and measles booster for entry into "Child Protective Services: A Parent's seventh grade. Guide", both published by the Massachusetts Department of ' Social M.G.L. c.94C The Controlled Services. You mav call your local Substances Act (and related Department of Social Services for reporting regulations 105 CMR 700.000): cases from 9:00 A.M. to 5:00 P.M. - Monday Specifies those professionals who through Friday. can administer medications. Permits fluoride programs in A "Hot Line" for reporting cases outside the schools. Sets standards for the usual office hours is also available. This manufacture, distribution, number is 1-800-792-5200. In the Worcester dispensing and possession of area, call 1-800-922-8169. controlled substances.