Guidance for School Staff: Applying EPA- Approved Mosquito Repellent to Prevent EEE

Greetings (again) from the School Health Unit!


Reducing Risk of Mosquito-borne Illness While Outdoors

Guidance for School Staff: Applying EPA- Approved Mosquito Repellent to Prevent EEE


Mosquito Bite Prevention OnePager - Caregivers - SPA

Mosquito Bite Prevention OnePager - Caregivers

Mosquito Bite Prevention Poster - Kids - SPA

Mosquito Bite Prevention Poster - Kids

Massachusetts is in the second year of an EEE outbreak cycle, and there is a risk that people may be infected. However, children can continue to spend time outdoors for recess and other activities during the day with the use of repellent—as well as wearing long-sleeves, long pants, and socks when possible. Outdoor activities should be avoided between dusk and dawn, when mosquitoes are most active.

EEE (Eastern equine encephalitis) is a rare but serious disease that is generally spread to people through the bite of an infected mosquito. EEE can cause severe illness and possibly lead to death in any age group; however, people under age 15 are at particular risk.

To reduce the chance of becoming infected, the Department of Public Health (DPH) recommends always applying an EPA-approved mosquito repellent to children before they go outside. EPA approved repellents contain DEET, permethrin, picaridin, or oil of lemon eucalyptus.

Attached is the full guidance document, as well as several items that can be put up in schools, go home with students, go up on websites, and otherwise be disseminated widely.  There are materials for both caregivers and students in English and Spanish, and soon a Portuguese translation will also be available.  Additional materials regarding mosquito-borne illness prevention can be found here.  The guidance document can also be found on the MDPH Local Public Health page.

I hope this provides some helpful information, as well as clarity around the use of insect repellent in the school setting.

Take good care,


MA Travel Order Effective August 1st, 2020

By Andree EntezariJuly 30th, 2020in SHIELD Updates

Dear School Nurse Colleagues,

Here are school reopening updates posted this morning on the CDC website:

Also, here is the link to the new COVID-19 Travel Order announced by Governor Baker during today's press conference that goes into effect on August 1, 2020,

DESE Transportation and Facilities Guidance

By Andree EntezariJuly 24th, 2020in SHIELD Updates

Transportation and Facilities Guidance

Dear Superintendents, Charter School Leaders, Assistant Superintendents, Collaborative Leaders, and Leaders of Approved Special Education Schools,

The attached transportation and facilities and operations guidance documents supplement DESE’s Initial Fall School Reopening Memo. The initial memo put forth the goal of the safe return of as many students as possible to in-person school settings, and the safe transportation of students to and from school and the carefully considered use of school facilities are critical parts of achieving this goal. In developing this guidance, the health and safety of students and staff were our top priorities.

The Transportation Guidance is focused on supporting districts as they develop a transportation strategy that provides safe conditions for all students and staff traveling by bus while also maximizing in-person learning. Districts strategies should:

  1. Follow the medically-advised health and safety requirements for school bus transportation;
  2. Address bus capacity challenges created by the physical distancing requirements by considering strategies such as adding bus routes, staggering schedules, and pursuing a waiver for student learning time requirements if needed; and
  3. Take proactive steps to promote safe alternative transportation options for students, including family-provided transportation, walking, and biking, as appropriate.

The Facilities and Operations Guidance provides details and considerations for schools’ physical plants and grounds, as well as operational protocols based on the most recent information we have about COVID-19 and related mitigation practices. The document has three main sections:

  1. Preparing spaces,
  2. Making systems and other space-use modifications, and
  3. Developing operational protocols

Please note that both guidance documents are subject to change depending on the COVID-19 trends and as we learn more about the virus from medical research.

Transportation and Facilities Guidance

Fall Reopening K-12 Transportation Guidance vF

Fall Reopening Facilities and Operations Guidance vF




Jeffrey C. Riley



2020 Medication Delegation Application Process & Forms

By Andree EntezariJuly 24th, 2020in SHIELD Updates

This email is to communicate the process for applying for medication delegation for your school or district, including training of unlicensed staff for administration of epinephrine by auto-injector.  Circumstances have required us to rethink and redesign our process, keeping in mind every step of the way the balance of collecting the information that we need to make informed decisions, with a process that is also clear, concise, and lessens the burden on you as the applicant. I am going to highlight some key changes here, and detailed guidance is also included with the applications:

Med Del Epi Registration Guidance Final

Med Del Epi Registration Guidance Final

Epinephrine Application Final

  • We are beginning the transition to electronic record-keeping for this program now.  Therefore, we are eliminating the need to send the paper application in.  The applications are now fillable PDF’s, which you are able to save and print.  Only signatures need to be done in ink.  Completed applications may be scanned and emailed per the guidance.
  • You will no longer need to request an application unless you are leaving your position and can give us contact information for your replacement or interim manager.  The application is attached and you could save a “clean” copy for reuse in subsequent years.  If we update it, we will send out a new version.  We will also post this on the DPH School Health Services website ASAP.
  • Registrations are now renewable annually in line with the MCSR requirement.  Your renewal date is the date on your MCSR.  You may re-apply at any time up to your renewal date, but make sure you leave yourself enough time for processing on our end.
  • If you do not have a current MCSR, you must reapply now.  Even if your current registration is still in effect, we are asking all those without an MSCR to reapply so we can make sure everyone is in compliance with the law.  If you have sent in an application since February 2020, please check in with Caitlin Pettingill (, Medication Delegation Program Manager, to see if your application has been processed and your MCSR imminent.
  • Public day, private day, public residential, and private residential have all been collapsed into one application.  Please make sure you read the instructions carefully when filling out the staffing/building profile grid.  You will fill out a profile for each school building; large districts may attach a spreadsheet as long as it contains all of the data elements in the grid.
  • The application for training of unlicensed staff on the administration of epinephrine by an auto-injector is still separate, allowing districts who do not practice delegation of routine medication to simply fill out the epinephrine application.
  • You still need to send in copies of training certificates, but no longer need to send a copy of your nursing license.  We will be looking this up on our end.

We hope that we have captured as much information on this revamped process as possible in both this email and the attached guidance.  However, we know there may still be questions or concerns, and please feel free to communicate those to myslef and or Caitlin.  We are here to help every school/district across our Commonwealth practice safe medication delegation and it is our responsibility to try to make this process as smooth as possible for all of you.


Take good care,




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



Medication Administration and Epinephrine Training Registration Guidance Document

National School Nurse Day – May 6th, 2020

To our amazing school nurse friends and colleagues:

On this School Nurses Day, we celebrate your skill, dedication, and service. Even in the midst of a pandemic that has shuttered businesses, closed schools, and forced us to isolate in our homes, you continue to step up to do what it takes to keep your students safe, healthy, and ready to learn. From delivering food, to contact tracing, preparing training videos, and beginning to plan for school reentry, you are stepping outside of your usual comfort zones, providing leadership in your communities and compassion to your families. These are historic times and we are in awe of all of you.

Thank you for all you do. We celebrate your contributions and look forward to the day that we can again be together. Be safe and be well.

With warmest regards,