School Health Services Update: May 1, 2019

Dear Colleagues,

This year, National School Nurse Day is next Wednesday, May 8th (it’s always the Wednesday during National Nurses Week). Since 1972, School Nurse Day has been set aside to recognize school nurses. National School Nurse Day was established to foster a better understanding of the role of school nurses in the educational setting.  This is truly an opportunity to  honor school nurses everywhere and all that they do!!  But what if no one knows who you are and the credentials you have worked hard to obtain? What if no one knows the advance skills you possess to deliver nursing care in schools?  Or no one understands what complex services can be provided to children by the school nurses in your school?  What if parents, physicians, and others can’t find you on the school’s website nor easily identify what you can do for their child in need of services?  What if physicians can’t find how to reach you when attempting to communicate with a school nurse concerning a child in their care?  What if other healthcare providers, collaborators from other agencies and individuals who are looking for your expertise and education to contribute to a program or project in your community don’t even know you exist in the school?

A recent article in the Journal of School Nursing by Moss, Bergren and Maughan, “School Nurse Websites:  What do they tell us about School Nurses?” provided the research for what has been noted among some of the district websites for school health services in Massachusetts.  The article includes an audit tool by which the authors assessed a sample of websites and the content of each.  The results are similar to what we have found when searching district websites for contact information for school health services in our state. Just as the authors cite, we see the missed opportunity for school nurses who are not maximizing the use of the website to promote their practice. Content related to the role of school nurses, especially in areas beyond managing injuries and episodic illnesses, is lacking from most websites. Little mention is given to the role of the nurse in improving attendance, school performance, and case management for students with chronic health conditions. Data that demonstrates these outcomes is almost non-existent on webpages and visitors to the website are given no information as to the vital role of school nurses in improving the overall health and academic success of students in the district. Many times, even the school nurses’ credentials are not provided as required by law!  We ask you to take a look at a few of the selected website that describe the mission, identify the nurses, along with their credentials, and the services provided:

Brockton Public Schools Health Services:

Fitchburg Public Schools Health Services:

Hampden-Wilbraham Regional School District health Services:

Lexington Public Schools Health Services:

Newburyport Public Schools Health Services:

Plymouth Public Schools Health Services:

In order to providing the lasting recognition that all school nurses deserve on National School Nurse’s Day and beyond, we hope you will be sure that you’re visible on the school and district website, that it promotes your practice and enhances the professionalism of the school nurses in the district.  And we hope you’re celebrated in a special way as well for all you do – every day!

Please note some of the announcements in the email below including information on the re-opening of the CSHS Affiliated Program application process, School-based Medicaid trainings for school nurses, and research on SBIRT as an effective prevention program.

THANK YOU for a job well done!

Mary Ann and the School Health Team

“Remember that the happiest people are not those getting more, but those giving more.” –H. Jackson Brown Jr., author


Our congratulations to the following school nurses on achieving national certification!

Pam Ciborowski, MPH, RN, NCSN, Barnstable Public Schools Coordinator of Nursing and Wellness

Jill Connolly, RN, NCSN, Metrowest Regional Consultant

Mary Ellen Reed, RN, NCSN, School Nurse, Orleans Elementary School Nurse

The following opinion piece written by Jonathan Haines, MEd, BSN, RN, a school nurse at the McKinley Elementary School and the McKinley Prep High School in Boston, appeared in the Thursday, April 25th edition of the Bay State Banner:

Congratulations to Rita Bailey, MEd, BSN, RN, Coordinator Health Services for the Quincy Public Schools and her daughter, Jordan, both who recently completed the Boston Marathon!! Rita ran the Marathon in 4 hrs. 38 mins. 13 sec. and  Jordan’s time was 4hrs. 2 mins. 10 secs.  Well done!!

The following opinion piece written by Jonathan Haines, a school nurse at the McKinley Elementary School in Boston, appeared in the Thursday, April 25th edition of the Bay State Banner:

A collaboration between the Plymouth Public Schools, Brigham &Women’s Hospital and the American College of Surgeons for a “Train the Trainer ” Program led to a Stop the Bleed Training for our Plymouth 10 grade Biomedical students. Plymouth school nurses were trained as trainers by the Brigham &Women’s trauma team which then allowed them to later roll this training initiative out to students – which happened to be televised nationally by CBS news on the day of the Boston Marathon! Plymouth Public Schools now has a sustainable training program to provide the school community as part of their MERP!  Here’s the link:


Please be sure to put your request in writing and either mail or fax this request to:

Janet Burke
MA Department of Public Health/ School Health Services
250 Washington Street – 5th Floor
Boston, MA 02108
FAX:  617-624-6062

And be sure if you have not attended the Medication Administration program through the BU SHIELD program within the past five years, that you have attended the required courses (both the online and the in-person workshop) before submitting your school’s or district’s application.


As a part of the Department’s efforts to educate the public about the dangers of vaping for youth, DPH recently launched a public information campaign for middle and high school aged youth titled  Vapes & Cigarettes: Different Products. Same Dangers.  The campaign links the dangers of vaping to cigarette smoking, and was developed with the input of middle and high school students across the state.

Different Products. Same Dangers. will feature online and social media ads (Instagram, Snapchat, Spotify, and YouTube). The campaign sends youth to for basic information and resources on the dangers of vaping and encourages them to follow the campaign on Instagram (@GetTheVapeFacts).

Detailed guidance on how schools and organizations who work with youth can utilize the campaign and its resources is available through a Toolkit for schools and community based organizations at  If you are already familiar with the Toolkit from the Department’s first campaign, The New Look of Nicotine Addiction, to educate parents and adults about the dangers of youth vaping, we encourage you to take another look as the Toolkit has been updated with new resources and information.

Different Products. Same Dangers also includes posters, handouts and mirror clings for schools and organizations.  Materials are available free of charge at the Massachusetts Health Promotion Clearinghouse.


The Department has re-opened the bid for RFR #123029 Comprehensive School Health Services (CSHS) Affiliated Program.  The bid closing date and time is: May 21, 2019 at 12:00 PM.   For more information, please click on the link to view on the Commbuys website at:


Last week at the Governor’s Council meeting, Secretary of EOHHS, Mary Lou Sudders  announced $7.5M in DPH grants to 123 public school districts, intended to strengthen  comprehensive school health, including behavioral health services throughout the Commonwealth.


MassHealth, in conjunction with UMass Medical School will offer a series of specialty-specific trainings with support from MassHealth’s clinical teams. These trainings will share critical information related to Reimbursable Services billed through interim claiming and moments marked as “in accordance with program guidelines” in the Random Moment Time Study. The trainings will build upon information shared in the recently published “Direct Service Interim Claiming Guide” and the materials covered in the April 4th training by digging deeper into specialty-specific clinical topics. The topics discussed in the May trainings will focus on clinical coverage guidelines, health indicators, evaluation requirements, treatment plans and service authorizations, medical necessity and practice standards as applicable to each specialty and includes time for questions addressed to the program and clinical staff.

Each LEA should identify an appropriate “leader” for each clinical specialty to attend a session in their field of practice. The leader should then share the critical information learned at the training with other practitioners at the LEA.  Please keep in mind that with the expansion of the program to include services provided to students not in Special Education, each LEA may wish to include “leaders” outside of Special Education as their clinical representatives.

These sessions will be available in person or via livestream, however, in-person attendance is encouraged as possible to have the best possible conversation and to take full advantage of the clinical experts supporting the trainings. These trainings will discuss services claimable under expansion in greater depth.

5/13:  Occupational Therapy/Physical Therapy:

          • When: 8:30AM – 12:00PM
          • Where: UMass, Shrewsbury campus

5/14: Mental/Behavioral Health (incl. DESE-licensed psychologist services):

          • When: 8:30AM – 11:30AM
          • Where: UMass, Shrewsbury campus

Personal Care (Required for LEAs that plan to or are considering seeking reimbursement for personal care services):

  • When: 1:30PM – 4:00PM
  • Where: UMass, Shrewsbury campus

5/21:  Applied Behavior Analysis (Strongly encouraged for LEAs exploring opportunities to claim for ABA services):

          • When: 8:30AM – 11:30AM
          • Where: UMass, Worcester campus

5/23:  Nursing (covering pre-planned services, 1-on-1 nursing, unplanned visits, and health screenings):

          • When: 8:30AM – 11:30AM
          • Where: UMass, Worcester campus

Speech-Language Pathology Services:

  • When: 1:00PM – 4:00PM
  • Where: UMass, Worcester campus

To register for any of the above trainings, please complete one online registration form per LEA, indicating which session(s) each individual will attend. As in the past, there are both in-person and livestream options available. Registrations are due no later than May 6th and confirmation emails will be sent out as the training dates approach.

Registration Link:

Date:  Thursday, May 16, 2019
Description:  This 6-hour training is designed for direct care providers as well as new to mid-level experienced clinicians to improve their skills concerning their engagement with adolescents who struggle with a trauma history as well as substance use issues.
The core content involves defining trauma, emotional and behavioral traits displayed by those exposed to traumatic events, latency age and adolescent development (social, emotional and cognitive), the relationship of trauma, substance use and mental health issues, trauma-informed and trauma-specific best practices within the milieu, strategies in working with traumatized teenagers and coping with secondary trauma and burnout. Participants will also have opportunities to practice these trauma-informed principles via role-plays and audience members will be able to support and encourage the use of appropriate interactions to enhance safety, understanding and emotional regulation skills.
Presented by: Christopher Green
Time: 9:00 Am- 4:00 Pm
Registration: 8:30 Am – 9:00 Am
Please remember breakfast and lunch will not be provided, please plan accordingly by bringing lunch or planning to run out and grab something. There will be an hour break for lunch.
Training: 9:00 AM – 4:00 PM
Location: Double Tree by Hilton
99 Erdman Way., Leominster, Massachusetts 01453
Registration Fee: $35 payable to Adcare Educational institute, Inc.
Mail payment to: 5 Northampton Street, Worcester, MA  01605
**if you are paying with a personal check or company check, please include a copy of your registration confirmation email with the payment.**
continuing education credits: 5.00 Click here for the event summary<>
TO REGISTER: click the “register’ button on the summary link page above ^^

Please be advised that you will need to select the appropriate tab at the top of the page to view each page of the brochure(i.e. summary, agenda, fees & other, etc.). Click on each tab to view the details pertaining to this event.  If you are deaf or hard of hearing, or are a person with a disability who requires accommodation, please contact Gina Colon at Adcare Educational Institute, Inc. At (508) 752-7313; fax: (508) 752-8111; tty: (508) 754-0039 or email:<> as soon as possible to secure accommodations.


Researchers at Kaiser Permanente health group have found long-term benefits for patients and health organizations that employ screenings, interventions, and referrals. The new study, published in the journal Pediatrics, suggests that the benefits can last for many years and can include sustained reductions in mental health conditions.

Lead author Stacy Sterling, Dr.P.H., M.S.W., of Kaiser Permanente’s Division of Research in Northern California, found that adolescents with access to SBIRT — short for “screening, brief intervention, and referral to treatment” — were less likely to have mental health or chronic medical conditions after 1 year.

Substance abuse is “closely associated with the top three causes of mortality and morbidity among adolescents — injuries, suicide and homicide,” write the authors. And, they note, adolescent substance use often goes hand-in-hand with other medical and mental health conditions and can lead to higher use of health care services. Investigators found that those with access to SBIRT services had fewer psychiatry visits over 1 and 3 years, and fewer total outpatient visits at 3 years. This evidence suggests improvements in mental health leading to lower costs and utilization of health services.

“The fact that we saw a difference in substance use problems even 3 years out was surprising,” said Sterling. “It suggests that providing access to SBIRT may plant a seed for patients and their care teams, creating awareness about substance use that may help kids avoid future problems.” The study used data from electronic health records to examine how much health care was used among adolescents with access to SBIRT services. The randomized clinical trial compared usual care to 2 other methods of delivering SBIRT in pediatric primary care, delivered by a pediatrician or by an embedded behavioral clinician.

The research was conducted at Kaiser Permanente in Northern California, an integrated health care delivery organization. The sample was taken from the pediatrics department in Oakland, California, and consisted of 1,871 adolescents ages 12 to 18. “We found that adolescents with access to SBIRT services, regardless of whether it was through their pediatrician or an embedded behavioral health clinician, were less likely to have mental health or chronic medical conditions after 1 year,” Sterling said. “We also found that SBIRT likely leads to lower health care utilization.”

The authors suggest that pediatric primary care and adolescent medicine clinics should consider implementing SBIRT, whether through training pediatricians or embedding SBIRT-trained behavioral health clinicians (or both) into the care team. Increased attention, training and capacity to address substance use and other behavioral health problems can have a significant impact on future health problems and health care use. “We need to increase resources and focus on the role of behavioral health on the overall health and well-being of children and teenagers in our care,” added Sterling.“I think more research is needed on SBIRT and these important, long-term health impacts.”

Source: Kaiser Permanente


Multiple winners to be awarded by NIH and the Calvin J. Li Memorial Foundation

The National Institutes of Health is inviting students ages 16 to 18 years old to participate in the “Speaking Up About Mental Health!” essay contest. Essays should explore ways to address the stigma and social barriers that adolescents from racial and ethnic minority populations may face when seeking mental health treatment.

The deadline for entries is May 31, 2019.

Learn more


State Epidemiologist 617-983-6800 For Calls Related to Infectious Disease and Immunizations ONLY.
Central Cynthia Tomlin 978-567-6250, ext. 10142 978-875-2009
Metrowest Jill Connolly 781-848-4000, ext. 7841 781-603-7697
Northeast Shanyn Toulouse 978-420-1919 978-761-2307
Southeast Ann Linehan 508-580-7363
West Diane Colucci 413-750-2511


Mary Ann Gapinski, MSN, RN, NCSN
Director of School Health Services
MA Department of Public Health
250 Washington Street – 5th Floor
Boston, MA  02108