# data[].attributes.headline
Local Public Health Consultation Program

# data[].attributes.subject
Local Public Health Consultation Program

# data[].attributes.attachment_link.title
Local Public Health Nurse Consultant Program : Elaine Marieb College of Nursing : UMass Amherst

# data[].attributes.attachment_link.description
The Public Health Nurse Consultant Program is designed to address the varying health challenges faced by communities across Massachusetts.

# data[].attributes.body
Important Note: The Massachusetts Controlled Substance Registrations (MCSRs) for schools have been renamed:

School Health Delegation MCSR (medication delegation) ~ formerly called the School Health MCSR

School Health Training MCSR (epinephrine training and emergency rescue opioid antagonist training) ~ formerly called the School Epinephrine MCSR

Updated Documents Required for MCSR Applications:

New MDPH Signature Page Please be sure to use this current MDPH Signature Page for both of your MCSR applications.

New MDPH School Health Services - Health Office Staffing Spreadsheet Please be sure to use this current spreadsheet for your School Health Delegation MCSR application.

RN Medication Manager MCSR Reminders:

If you are resigning, retiring, or no longer going to be the RN Medication Program Manager for your school entity, you need to send notification with your effective last day as the RN Medication Manager to medication.delegation@mass.gov.

MCSRs are valid for one year (365 days) from the date of approval. There is no option for renewal of the MCSR(s); a new application is required each year.

It is recommended to submit your application at least two (2) weeks prior to the expiration date to avoid a lapse in registration, as this is the average application processing/approval time frame.

MCSR applications can only be submitted by the RN applying for the MCSR(s) from their own Health Professions Licensing System account.  There is a legal electronic signature associated with the application submission. We do not accept MCSR applications from school staff other than the RN Medication Program Manager.

# data[].attributes.body
Karen Robitaille, MBA, MSN, RN, NCSN

Director of School Health Services

Margi Coggins, CNM, MSN, RN

Assistant Director of School Health Services

Janet Guertin-Moruzzi, MEd, BSN, RN, NCSN, MA SANE

Public Health Nursing Advisor to Non-Public Schools

Jill Connolly, MEd, BSN, RN, NCSN, MA SANE

Medication Administration Program Nursing Advisor

# data[].attributes.body
MCSR Registration Guidance Document

Updated 7.17.25

# data[].attributes.headline
Moratorium on electricity shutoffs during heat emergencies

# data[].attributes.subject
Moratorium on electricity shutoffs during heat emergencies

# data[].attributes.attachment_link.title
DPU Letter re Shut Off Moratorium_6.30.26

# data[].attributes.body
Lauren Augustin, BA
School Health Services Operation Coordinator

Pam Shuttle, AAS-HIT,RHIT(ret), ODS-C

Program Coordinator

Kathrine Mansfield, MPH
Epidemiologist

# data[].attributes.body
You may be receiving notices such as this regarding renewal of your medication registration (MCSR) for either epinephrine or medication delegation. PLEASE NOTE that this is an automated letter generated by the licensing system; the same system that you use to renew your nursing license. Therefore, the letter contains information about payment, but as a reminder, THERE IS NO FEE FOR YOUR MEDICATION REGISTRATION, so you may disregard that language.

# data[].attributes.body
Guidance from the MA BORN:

Nursing students participating in clinical learning experiences, including but not limited to community health, medical-surgical, pediatric, psychiatric, maternal-child, and other clinical settings, should be supervised by a qualified nursing faculty member.

When students are not directly supervised by nursing faculty, they must be assigned to a designated preceptor who is a registered nurse and who meets the program's established educational and experiential qualifications for preceptors.

In circumstances where neither direct faculty supervision nor an assigned qualified preceptor is available, students should be limited to an observational role only and shall not participate in direct patient care activities or assume responsibilities requiring clinical supervision.

*Each nurse will need to decide for themselves whether they have the capacity to serve as a preceptor and appropriately supervise a nursing student providing direct clinical care. It may also be prudent to have a system for notifying caregivers that a student may be providing care under a nurse's supervision. Other ways to provide a good experience for students outside of direct care include, health education projects and conducting screenings (after taking the required trainings and any other additional training deemed appropriate).

# data[].attributes.wish_content.attachment_props.alternative_text
student nurse caring for a child in school

# data[].attributes.attachment_link.readable_text
Boston - With summer approaching, the Massachusetts Department of Public Health (DPH) reminds residents to take common-sense precautions to keep everyone, especially young children, safe this summer.

"As residents and visitors start to make the most out of outdoor summer activities, I encourage everyone to remember some simple precautions to stay safe and healthy," said Public Health Commissioner Robbie Goldstein, MD, PhD. "Stay hydrated, use insect repellent, be mindful around bodies of water, and prepare for severe weather, including extreme heat, to help make for a fun and healthy summer for all."

Prevent tick bites

Some kinds of ticks can bite and make you sick with diseases like Lyme disease and Powassan virus, or allergies like alpha-gal syndrome. Ticks are most commonly found in damp, grassy, brushy, or wooded areas, including your own backyard. Follow these steps to help protect yourself from tick bites:

Use tick repellents with an EPA-registered active ingredient; always follow the directions on the label

Weather permitting, wear long-sleeved, light-colored shirts and long pants tucked into socks. This will help keep ticks away from your skin and make it easier to spot ticks on your clothing.

After spending time outdoors, taking a shower can help rinse off a tick before it becomes attached, and putting clothes in the dryer on high heat for 10 minutes can help kill ticks.

Check yourself for ticks once a day; if you find an attached tick, remove it promptly using fine tweezers or a tick removal tool.

Pets that spend time outdoors may bring ticks back inside. Talk to your veterinarian about the best ways to protect your animals from ticks and tick-borne disease.

Prevent mosquito bites

The risk for human infection of the mosquito-borne diseases West Nile virus (WNV) and Eastern equine encephalitis (EEE) starts to increase in mid to late summer in Massachusetts. DPH posts updates about local risk throughout the season on the Massachusetts Arbovirus Update page.

To prepare for mosquito season:

Drain standing water in and around your house or yard to prevent mosquito breeding.

Repair window and door screens to keep mosquitoes out of your home.

Use a mosquito repellent with an EPA-registered ingredient according to the directions on the label.

Wear long-sleeved shirts, long pants, and socks to reduce exposed skin when the weather permits.

For more information about preventing mosquito and tickborne illness, visit DPH's Mosquitoes and Ticks page.

Extreme heat safety

Climate change is increasing the number, as well as the intensity, of extreme heat events in Massachusetts. High temperatures and increased sun exposure mean that additional precautions should be taken when spending time outside, either recreationally or on the job, to reduce the risk of heat-related illnesses, such as heat cramps, heat exhaustion, and heat stroke.

Seek shade and take breaks from the sun throughout the day. Use air conditioning if available - otherwise, use fans, take cool showers, or visit public cooling centers.

Make sure to drink plenty of water throughout the day. Drinks like coffee and soda that contain caffeine may dehydrate, so they should be followed with water. Limit alcohol use, as it can reduce awareness of overheating while increasing the risk of heat-related illness through dehydration.

Wear sunglasses, apply sunscreen (SPF of at least 30) 15-20 minutes before going outside and reapply every two hours, and wear protective clothing to avoid sunburn.

When possible, limit outdoor activities during the hottest hours (10 a.m. - 4 p.m.), seek shade, and wear light, breathable clothing.

Check for Heat-Related Symptoms, including unusually heavy sweating, shortness of breath, and dizziness.

Avoid outdoor activity when air quality is low. An air quality monitoring map is available on the Massachusetts Department of Environmental Protection page.

To stay informed with real-time heat forecasts and community heat resources to help you plan, prepare, and respond to unhealthy heat in Massachusetts, visit the Unhealthy Heat Forecast Website and sign up to receive Unhealthy Heat alerts.

Additional extreme heat safety tips are available on DPH's Extreme Heat page, Heat and Health Tips for Watch Parties and Summer Events, and the Massachusetts Emergency Management Agency (MEMA) website.

Water and pool safety

Drowning is a leading cause of death among young children, nationally and in Massachusetts. To help prevent water-related injury and drowning:

Only swim at or within designated swimming areas. Swimming outside of the designated swimming areas or at waterfronts where swimming is prohibited can be dangerous.

Stay within arm's reach of younger children and keep a close eye on older children near the water. Parents and other guardians serve as the first and primary line of safety for their children.

Teach children to always ask permission before going near the water.

Do not dive headfirst into the water.

Do not swim during a storm or when there is thunder or lightning.

Do not swim beyond your skillset.

For those who cannot swim, keep to shallow areas or use a U.S. Coast Guard-approved life jacket. Information on proper fit testing of life jackets is available in this video created by DPH in cooperation with the USCG.

Do not use toys such as "water wings" or "noodles" in place of life jackets.

Enroll children in swimming lessons. Each year, the Massachusetts Department of Conservation and Recreation (DCR) provides free swimming lessons to children at select pools across the state in July and August through the Learn to Swim program.

In public swimming areas:

If caught in a rip current, do not swim against it. Swim parallel to the shoreline to escape it and then at an angle toward the beach.

If a person in your group goes missing, notify lifeguards and park staff immediately, then start your search.

Swimming at beaches with high levels of bacteria may cause illness. How to know if it is safe to swim:

Know before you go. Find out from your local health department or DPH if the beach you want to go to is monitored regularly and posted for closures. DPH maintains a beach water quality dashboard during the swimming season.

Look for signs posted at the beach. Check for any warnings or beach closures indicating that the water is not safe because of bacteria, riptides, or other hazards.

Swimming conditions can also vary throughout the day. Below are a few recommendations for deciding when and where to swim:

Check the weather.

Avoid swimming after heavy rain events - bacterial levels tend to rise due to runoff after heavy rains.

Watch for "signs" of water pollution, such as discolored, fast-flowing, and strong-smelling water.

Avoid swimming next to drainpipes, outlets, or other obvious sources of pollution.

Do not swim near trash or street litter floating in the water.

Avoid swallowing the water - when waterborne pathogens are present, most swimmers are exposed when they swallow the water.

Swim only in areas designated as "swim beaches." Do not swim in rivers or streams unless they are designated swim beaches.

Consider becoming a lifeguard: DCR is recruiting lifeguards to work at agency-managed inland and coastal beaches, as well as swimming pools. Positions are available in Boston, Revere, Lawrence, Cambridge, Somerville, Chelsea, Concord, Watertown, Everett, Malden, and Waltham. Candidates can earn from $22 to $27 an hour, with additional bonuses available for staff who work through the end of the season. For more information, visit DCR's lifeguarding website.

Food safety

Summer is peak season for foodborne illnesses when germs start to grow in food that is left out in the heat during outdoor activities like cookouts, picnics, or travel. Steps to prevent foodborne illnesses:

Wash hands and surfaces often. Do not handle or serve food while sick.

Do not cross-contaminate. Keep raw food separate from cooked foods. Wear gloves or use utensils when handling ready-to-eat foods.

Cook to proper temperatures and refrigerate promptly.

Hot foods must stay hot (above 140°F or 60°C) and cold foods must stay cold (below 40°F or 4°C). Perishable food left at room temperature for more than 2 hours, or more than 1 hour if temperatures are above 90°F, should be thrown away.

Bacteria can multiply rapidly if food is left at room temperature or in the "Danger Zone" between 40°F and 140°F. Throw away perishable foods that have been left at room temperature for more than 2 hours, or more than 1 hour if temperatures are above 90°F.

If you suspect you have become ill after eating food prepared outside of a private home (e.g., from a restaurant) or after attending a party or event, report it on the Report My Meal page.

Window safety

Falls from windows involving young children can cause serious injuries. Screens are not strong enough to protect children from falling out of windows. To prevent window falls, parents and caregivers should:

Keep furniture - and anything a child can climb on - away from windows.

Open windows from the top, not the bottom, when possible, and lock all unopened doors and windows.

Be sure children are always supervised.

Install quick-release window guards, which are available in most hardware stores.

To learn more about childhood injury prevention, visit the DPH Injury Prevention and Control Program website.

Car safety

Leaving children and animals inside a vehicle can be very dangerous. In the summer months in New England, the temperature in a closed car can rise quickly, and the vehicle can become a deadly place for a child or animal left in it, even for just a moment.

To keep young children and animals safe in and around cars:

Never leave children or animals alone in a parked vehicle, even when they are asleep or restrained, and even if the windows are open.

Always check inside the vehicle - front and back - before locking the door and walking away.

If a child is missing, check your vehicle first, including the trunk.

Do things to remind yourself that a child or animal is in the vehicle, such as placing your purse or briefcase in the back seat, so you will check there when you leave the vehicle.

Always lock your car and keep the keys out of children's reach.

If you see a child or animal alone in a hot vehicle, call the police. If they are in distress due to heat, get them out as quickly as possible and call 911 immediately.
All children ages 12 and under should always ride in the back seat, properly restrained. Infants and toddlers should remain in rear-facing car seats until they reach the highest weight or height allowed by their car safety seat manufacturer. More information on child passenger safety is available on DPH's Transportation Safety website.

Helmet safety

A helmet can help protect from serious injury, like concussions and skull fractures, and death when biking, rollerblading, skateboarding, using an e-bike, an e-moto, a scooter, or an all-terrain vehicle (ATV). Helmets should be worn at all times by all riders, regardless of age, ability, purpose, or duration of activity.

A helmet should fit properly and be worn consistently, be well-maintained, age-appropriate, and appropriately certified for use. Helmets designed for some activities, like skateboarding, may not be appropriate for others, like riding an e-bike.

Helmets should have a secure buckle to keep them from falling off on impact.

Cracked or damaged helmets, or those that sustained impact from a crash, should be replaced immediately.

Preventing rabies exposures

All mammals (animals with fur) can get rabies. People are most commonly exposed to the rabies virus when an infected animal bites them, or when the animal's saliva gets into an open cut or the person's eyes, nose, or mouth. People who are bitten or scratched by an animal, or who find a bat in a room where someone was sleeping, or with a young child or pet, should call their local board of health or the DPH Division of Epidemiology at 617-983-6800 for advice.

Other rabies prevention steps include:

Teach children never to approach animals they don't know - even if they appear friendly.

Report any animal that seems sick or injured to the local animal control official.

Enjoy wild animals from a distance and do not keep wild animals as pets.

Make sure pets are vaccinated against rabies. By law, all dogs, cats, and ferrets must be regularly vaccinated against rabies.

Do not leave food or water for pets outside. Even empty bowls will attract wild and stray animals.

Do not let pets roam freely. Keep them in a fenced yard or on a leash.

Keep garbage securely covered. Open garbage will attract wild or stray animals.

Keep chimneys capped and repair holes in attics, cellars, and porches to help keep wild animals like bats and raccoons out of the house.

###

# data[].attributes.attachment_link.title
Massachusetts Department of Public Health offers summer safety guidance

# data[].attributes.attachment_link.description
With summer approaching, the Massachusetts Department of Public Health (DPH) reminds residents to take common-sense precautions to keep everyone, especially young children, safe this summer. “As residents and visitors start to make the most out of outdoor summer activities, I encourage everyone to remember some simple precautions to stay safe and healthy,” said Public Health Commissioner Robbie Goldstein, MD, PhD. “Stay hydrated, use insect repellent, be mindful around bodies of water, and prepare for severe weather, including extreme heat, to help make for a fun and healthy summer for all.”Prevent tick bites Some kinds of ticks can bite and make you sick with diseases like Lyme disease and Powassan virus, or allergies like alpha-gal syndrome. Ticks are most commonly found in damp, grassy, brushy, or wooded areas, including your own backyard. Follow these steps to help protect yourself from tick bites: Use tick repellents with an EPA-registered active ingredient; always follow the directions on the label Weather permitting, wear long-sleeved, light-colored shirts and long pants tucked into socks. This will help keep ticks away from your skin and make it easier to spot ticks on your clothing. After spending time outdoors, taking a shower can help rinse off a tick before it becomes attached, and putting clothes in the dryer on high heat for 10 minutes can help kill ticks. Check yourself for ticks once a day; if you find an attached tick, remove it promptly using fine tweezers or a tick removal tool. Pets that spend time outdoors may bring ticks back inside. Talk to your veterinarian about the best ways to protect your animals from ticks and tick-borne disease. Prevent mosquito bitesThe risk for human infection of the mosquito-borne diseases West Nile virus (WNV) and Eastern equine encephalitis (EEE) starts to increase in mid to late summer in Massachusetts. DPH posts updates about local risk throughout the season on the Massachusetts Arbovirus Update page. To prepare for mosquito season: Drain standing water in and around your house or yard to prevent mosquito breeding. Repair window and door screens to keep mosquitoes out of your home. Use a mosquito repellent with an EPA-registered ingredient according to the directions on the label. Wear long-sleeved shirts, long pants, and socks to reduce exposed skin when the weather permits. For more information about preventing mosquito and tickborne illness, visit DPH’s Mosquitoes and Ticks page.Extreme heat safety Climate change is increasing the number, as well as the intensity, of extreme heat events in Massachusetts. High temperatures and increased sun exposure mean that additional precautions should be taken when spending time outside, either recreationally or on the job, to reduce the risk of heat-related illnesses, such as heat cramps, heat exhaustion, and heat stroke. Seek shade and take breaks from the sun throughout the day. Use air conditioning if available - otherwise, use fans, take cool showers, or visit public cooling centers. Make sure to drink plenty of water throughout the day. Drinks like coffee and soda that contain caffeine may dehydrate, so they should be followed with water. Limit alcohol use, as it can reduce awareness of overheating while increasing the risk of heat-related illness through dehydration. Wear sunglasses, apply sunscreen (SPF of at least 30) 15-20 minutes before going outside and reapply every two hours, and wear protective clothing to avoid sunburn. When possible, limit outdoor activities during the hottest hours (10 a.m. – 4 p.m.), seek shade, and wear light, breathable clothing. Check for Heat-Related Symptoms, including unusually heavy sweating, shortness of breath, and dizziness. Avoid outdoor activity when air quality is low. An air quality monitoring map is available on the Massachusetts Department of Environmental Protection page.To stay informed with real-time heat forecasts and community heat resources to help you plan, prepare, and respond to unhealthy heat in Massachusetts, visit the Unhealthy Heat Forecast Website and sign up to receive Unhealthy Heat alerts.Additional extreme heat safety tips are available on DPH’s Extreme Heat page, Heat and Health Tips for Watch Parties and Summer Events, and the Massachusetts Emergency Management Agency (MEMA) website. Water and pool safetyDrowning is a leading cause of death among young children, nationally and in Massachusetts. To help prevent water-related injury and drowning:Only swim at or within designated swimming areas. Swimming outside of the designated swimming areas or at waterfronts where swimming is prohibited can be dangerous. Stay within arm’s reach of younger children and keep a close eye on older children near the water. Parents and other guardians serve as the first and primary line of safety for their children.Teach children to always ask permission before going near the water.Do not dive headfirst into the water. Do not swim during a storm or when there is thunder or lightning. Do not swim beyond your skillset. For those who cannot swim, keep to shallow areas or use a U.S. Coast Guard-approved life jacket. Information on proper fit testing of life jackets is available in this video created by DPH in cooperation with the USCG. Do not use toys such as “water wings” or “noodles” in place of life jackets. Enroll children in swimming lessons. Each year, the Massachusetts Department of Conservation and Recreation (DCR) provides free swimming lessons to children at select pools across the state in July and August through the Learn to Swim program. In public swimming areas: If caught in a rip current, do not swim against it. Swim parallel to the shoreline to escape it and then at an angle toward the beach. If a person in your group goes missing, notify lifeguards and park staff immediately, then start your search. Swimming at beaches with high levels of bacteria may cause illness. How to know if it is safe to swim: Know before you go. Find out from your local health department or DPH if the beach you want to go to is monitored regularly and posted for closures. DPH maintains a beach water quality dashboard during the swimming season. Look for signs posted at the beach. Check for any warnings or beach closures indicating that the water is not safe because of bacteria, riptides, or other hazards. Swimming conditions can also vary throughout the day. Below are a few recommendations for deciding when and where to swim: Check the weather. Avoid swimming after heavy rain events - bacterial levels tend to rise due to runoff after heavy rains. Watch for “signs” of water pollution, such as discolored, fast-flowing, and strong-smelling water. Avoid swimming next to drainpipes, outlets, or other obvious sources of pollution. Do not swim near trash or street litter floating in the water. Avoid swallowing the water - when waterborne pathogens are present, most swimmers are exposed when they swallow the water. Swim only in areas designated as “swim beaches.” Do not swim in rivers or streams unless they are designated swim beaches. Consider becoming a lifeguard: DCR is recruiting lifeguards to work at agency-managed inland and coastal beaches, as well as swimming pools. Positions are available in Boston, Revere, Lawrence, Cambridge, Somerville, Chelsea, Concord, Watertown, Everett, Malden, and Waltham. Candidates can earn from $22 to $27 an hour, with additional bonuses available for staff who work through the end of the season. For more information, visit DCR’s lifeguarding website.Food safetySummer is peak season for foodborne illnesses when germs start to grow in food that is left out in the heat during outdoor activities like cookouts, picnics, or travel. Steps to prevent foodborne illnesses:Wash hands and surfaces often. Do not handle or serve food while sick. Do not cross-contaminate. Keep raw food separate from cooked foods. Wear gloves or use utensils when handling ready-to-eat foods. Cook to proper temperatures and refrigerate promptly. Hot foods must stay hot (above 140°F or 60°C) and cold foods must stay cold (below 40°F or 4°C). Perishable food left at room temperature for more than 2 hours, or more than 1 hour if temperatures are above 90°F, should be thrown away.Bacteria can multiply rapidly if food is left at room temperature or in the “Danger Zone” between 40°F and 140°F. Throw away perishable foods that have been left at room temperature for more than 2 hours, or more than 1 hour if temperatures are above 90°F. If you suspect you have become ill after eating food prepared outside of a private home (e.g., from a restaurant) or after attending a party or event, report it on the Report My Meal page. Window safetyFalls from windows involving young children can cause serious injuries. Screens are not strong enough to protect children from falling out of windows. To prevent window falls, parents and caregivers should: Keep furniture – and anything a child can climb on – away from windows. Open windows from the top, not the bottom, when possible, and lock all unopened doors and windows. Be sure children are always supervised. Install quick-release window guards, which are available in most hardware stores. To learn more about childhood injury prevention, visit the DPH Injury Prevention and Control Program website. Car safetyLeaving children and animals inside a vehicle can be very dangerous. In the summer months in New England, the temperature in a closed car can rise quickly, and the vehicle can become a deadly place for a child or animal left in it, even for just a moment.To keep young children and animals safe in and around cars:Never leave children or animals alone in a parked vehicle, even when they are asleep or restrained, and even if the windows are open. Always check inside the vehicle – front and back – before locking the door and walking away. If a child is missing, check your vehicle first, including the trunk. Do things to remind yourself that a child or animal is in the vehicle, such as placing your purse or briefcase in the back seat, so you will check there when you leave the vehicle. Always lock your car and keep the keys out of children’s reach. If you see a child or animal alone in a hot vehicle, call the police. If they are in distress due to heat, get them out as quickly as possible and call 911 immediately.All children ages 12 and under should always ride in the back seat, properly restrained. Infants and toddlers should remain in rear-facing car seats until they reach the highest weight or height allowed by their car safety seat manufacturer. More information on child passenger safety is available on DPH’s Transportation Safety website. Helmet safetyA helmet can help protect from serious injury, like concussions and skull fractures, and death when biking, rollerblading, skateboarding, using an e-bike, an e-moto, a scooter, or an all-terrain vehicle (ATV). Helmets should be worn at all times by all riders, regardless of age, ability, purpose, or duration of activity. A helmet should fit properly and be worn consistently, be well-maintained, age-appropriate, and appropriately certified for use. Helmets designed for some activities, like skateboarding, may not be appropriate for others, like riding an e-bike. Helmets should have a secure buckle to keep them from falling off on impact. Cracked or damaged helmets, or those that sustained impact from a crash, should be replaced immediately. Preventing rabies exposuresAll mammals (animals with fur) can get rabies. People are most commonly exposed to the rabies virus when an infected animal bites them, or when the animal’s saliva gets into an open cut or the person’s eyes, nose, or mouth. People who are bitten or scratched by an animal, or who find a bat in a room where someone was sleeping, or with a young child or pet, should call their local board of health or the DPH Division of Epidemiology at 617-983-6800 for advice.Other rabies prevention steps include:Teach children never to approach animals they don’t know – even if they appear friendly. Report any animal that seems sick or injured to the local animal control official. Enjoy wild animals from a distance and do not keep wild animals as pets. Make sure pets are vaccinated against rabies. By law, all dogs, cats, and ferrets must be regularly vaccinated against rabies. Do not leave food or water for pets outside. Even empty bowls will attract wild and stray animals. Do not let pets roam freely. Keep them in a fenced yard or on a leash. Keep garbage securely covered. Open garbage will attract wild or stray animals. Keep chimneys capped and repair holes in attics, cellars, and porches to help keep wild animals like bats and raccoons out of the house.

# data[].attributes.body
The medication administration courses are available on BU SHIELD’s website.

The courses have been updated to reflect regulatory changes to 105 CMR 210: The Administration of Medications in Public and Non-Public Schools.

Available Courses:

1. An Introduction to Medication Administration and Delegation in MA Schools (formally Medication Administration in a School Setting: School Nursing Practice in Massachusetts)

2. Managing a Medication Administration and Delegation Program in MA Schools (formally Medication Administration in Schools: What School Nurse Managers Need to Know)

Important Reminders:

School Nurse Medication Program Managers who are signatories on their public or non-public school's Massachusetts Controlled Substance Registration (MCSR) are required to complete both of the above training every three (3) calendar years.

Certificates of completion from the previous courses completed within the last three (3) calendar years will still be accepted for MCSR approval; however, School Health Services strongly recommends that all RN Medication Program Managers complete the updated courses, as they reflect revised regulations.

It is the responsibility of all Medication Program Managers and school nurses to stay informed about changes in laws and regulations to ensure continued compliance.

# data[].attributes.headline
MA School Immunization Requirements 26/27

# data[].attributes.subject
MA School Immunization Requirements 26/27

# data[].attributes.body
Updated Feb 2026

# data[].attributes.body
All schools in which a medication error occurred that resulted in serious illness/injury | https://redcap.link/SchoolMedError

# data[].attributes.headline
May 2026 Guidance for Schools and Childcare

# data[].attributes.subject
May 2026 Guidance for Schools and Childcare

# data[].attributes.body
It's that time of year again when we field (see what I did there?) many questions about sunscreen and insect repellant and 105 CMR 210.  In a nutshell, sunscreen is considered a drug and regulated by the FDA and thus is subject to 105 CMR 210.  Insect repellant is considered an insecticide, is regulated by the EPA, and is NOT subject to 105 CMR 210.  Combination formulations (sunscreen + repellant) are generally regulated by FDA and fall under 105 CMR 210.  Supporting documents will be posted up under this.

# data[].attributes.headline
COMBINATION PRODUCTS (SUNSCREEN + REPELLANT)

# data[].attributes.subject
COMBINATION PRODUCTS (SUNSCREEN + REPELLANT)

# data[].attributes.body
We've complied here a list of acts, statutes and regulations that school nurses should be familiar with, linked for your convenience!

# data[].attributes.headline
Guidance regarding K-12 Schools' obligations to protect students and their information

# data[].attributes.subject
Guidance regarding K-12 Schools' obligations to protect students and their information

# data[].attributes.headline
Statutes, regulations and advisories pertinent to school health

# data[].attributes.subject
Statutes, regulations and advisories pertinent to school health

# data[].attributes.headline
School Measles Transmission Simulation Tool

# data[].attributes.subject
School Measles Transmission Simulation Tool

# data[].attributes.body
MODEL: This dashboard uses a simple stochastic compartmental susceptible-exposed-infectious-removed-vaccinated (SEIRV) model. It assumes that vaccination reduces both susceptibility to infection and infectiousness when infected. The model includes only enrolled students and does not consider intervention measures. Public health interventions–such as exclusion from school, active case finding, quarantine, isolation, and vaccination campaigns–would likely result in shorter and smaller outbreaks compared to these projections.The default parameters are based on estimates that are widely used by public health agencies: (1) a basic reproduction number (R0) of 15 [ECDC’s Factsheet about measles], (2) an average latent period of 10.5 days [CDC’s Measles Clinical Diagnosis Fact Sheet], (3) an average infectious period of 5 days, derived from a total infectious period of approximately 8 days [CDC’s Measles Clinical Diagnosis Fact Sheet], assuming students remain home after symptom onset, (4) a vaccine efficacy of 99.7% in preventing infection [van Boven et al. 2010], and (5) a 95% reduction in infectiousness among vaccinated individuals [Tranter et al. 2024]. Parameter ranges are based on [ECDC’s Factsheet about measles] and [Bailey and Alfa-Steinberger 1970].The basic reproduction number is the expected number of people a single case will infect, assuming nobody has immunity from vaccination or prior infection. If prior immunity exists due to vaccination, the effective reproduction number at the start of an outbreak will be lower than the basic reproduction number. Individual schools may experience higher or lower R0 values depending on classroom structures, daily activities, and other contextual factors.

# data[].attributes.body
DPH’s central heat safety page offering prevention guidance, setting-specific resources, and planning tools for clinicians, local health departments, and community partners.

# data[].attributes.attachment_link.description
Explore guidance, tools, and resources to help you understand, prepare for, and stay safe during periods of extreme heat in Massachusetts.

# data[].attributes.headline
Unhealthy Heat Action Toolkit (NEW for 2026)

# data[].attributes.subject
Unhealthy Heat Action Toolkit (NEW for 2026)

# data[].attributes.body
A ready-to-use communications package with social media graphics, sample messaging, and outreach materials to help communities amplify consistent heat safety messaging throughout the season.

# data[].attributes.headline
Alpha-Gal Syndrome now reportable to MDPH

# data[].attributes.subject
Alpha-Gal Syndrome now reportable to MDPH

# data[].attributes.body
Common questions about childhood immunizations

(Under "Where can I get more information?")

Childhood vaccine information for parents and caregivers

(Under "Resources for parents and caregivers")

# data[].attributes.headline
DESE Guidance on AI and Deepfake Images and Videos

# data[].attributes.subject
DESE Guidance on AI and Deepfake Images and Videos

# data[].attributes.attachment_link.description
A message from Commissioner Pedro Martinez and the
Department of Elementary and Secondary Education

# data[].attributes.body
In Massachusetts, physical screening requirements are mandated by statute and regulation. Should schools/districts wish to request a waiver for selected screenings, please see the attached guidance on submitting a waiver request. Waiver requests must include information about screenings completed in the two school years preceding the waiver request and an alternative plan for targeted screening. Please email to karen.robitaille3@mass.gov. Requests will be reviewed by MDPH School Health Services staff.

The waiver process outlined in 105 CMR 200.620 ONLY applies to vision/hearing screening and height/weight measurement and BMI calculation. A waiver would NOT exempt public schools/districts from the requirements of M.G.L. c. 71, §§ 57 and 97 regarding postural screening and Screening, Brief Intervention and Referral to Treatment (SBIRT).

# data[].attributes.attachment_link.title
Guidance on Waivers of Health Screening Schedules in 105 CMR 200.docx (1)

# data[].attributes.headline
Guidance for Healthcare Settings on Immigration Enforcement

# data[].attributes.subject
Guidance for Healthcare Settings on Immigration Enforcement

# data[].attributes.headline
NEW Epinephrine Administration Report Guide

# data[].attributes.subject
NEW Epinephrine Administration Report Guide

# data[].attributes.attachment_link.title
Epinephrine Administration Report Guide for 3.11.26

# data[].attributes.body
iCARE is a new, free program for caregivers looking for self-paced education and tips about navigating adolescent substance use. This program is funded by the Massachusetts Department of Public Health and can be completed on a computer/tablet or phone.

# data[].attributes.attachment_link.title
ORI + AGO Q&A on Immigration Issues_February 2026

# data[].attributes.attachment_link.title
Great Healthcare is Possible - LGBTQ+ Healthcare Directory

# data[].attributes.attachment_link.description
The LGBTQ+ Healthcare Directory is a free, searchable database helping people find friendly and affirming doctors, medical professionals and providers.

# data[].attributes.body
The Department of Public Health (DPH) Data Library is your gateway to an array of data about the health of Massachusetts residents and communities. Here you will find a catalog of dashboards, reports, datasets, and more, ready to download or export. The Data Library is for residents, policy makers, grant writers, researchers, and anyone interested in the topics we address.

# data[].attributes.attachment_link.description
Your go-to source for Massachusetts public health data.

# data[].attributes.headline
Hosting A School-Located Vaccination Clinic: A Practical Guide 

# data[].attributes.subject
Hosting A School-Located Vaccination Clinic: A Practical Guide 

# data[].attributes.body
New resource developed by DPH's Immunization Division

Some Massachusetts families struggle to access critical immunizations. School-located clinics can be a powerful tool for increasing vaccination rates in your school community. This resource discusses the best practices for organizing and running your clinic. Supplemental resources are included.

Covered topics include:

Joining the DPH vaccine program (through which you can acquire vaccine for patients ages 0-18 at no cost)

Staffing/clinic roles

Obtaining patient consent

Using standing orders

Publicizing your clinic

Ensuring language access for English learners

Interpreting international vaccine records

Selecting a time and place for your clinic

Access the guide through the following link. Please reach out to Christophe.Stuck-Girard2@mass.gov with any questions.

# data[].attributes.headline
BCHAP Bullying Prevention Campaign Launch

# data[].attributes.subject
BCHAP Bullying Prevention Campaign Launch

# data[].attributes.body
Bureau of Community Health and Prevention's (BCHAP) Child Youth Violence Prevention Unit (with support from our Office of Youth Mental Health and Wellbeing — and CARH's YAB!) launched “Be the reason someone belongs” earlier this week. This is a bullying prevention campaign that aims to promote inclusion and belonging among middle school youth who report a high prevalence of experiencing bullying and cyberbullying.

The content aims to increase awareness of bullying, help young people understand their rights and options if they experience bullying, and to support both youth and adults in learning how to effectively intervene and prevent bullying.

The youth-oriented page can be found here: mass.gov/StopBullying

The page for adults is here: https://www.mass.gov/bullying-resources-for-adults

Community partners can order free materials from the Massachusetts Health Promotion Clearinghouse:

Posters (Multiple Languages): Be the Reason Someone Belongs Anti-Bullying Poster

Stickers (English): Be the Reason Someone Belongs Anti-Bullying Sticker

Each poster is English on one side and features your choice of an additional language on the reverse — Spanish, Brazilian Portuguese, Haitian Creole, Cape Verdean Creole, or Simplified Chinese.

View the short video advertisement: Stop Bullying - Be the Reason Someone Belongs

# data[].attributes.attachment_link.title
Stop Bullying - Be the Reason Someone Belongs

# data[].attributes.body
We wanted to share that a new series of webpages on norovirus were recently posted to mass.gov: mass.gov/norovirus (landing page). There’s now a comprehensive page for child care programs and K-12 schools to refer to which includes:

The norovirus fact sheet,

Guidance on reporting norovirus and GI illness outbreaks,

Prevention and control recommendations,

Exclusion requirements for ill children and staff (includes the GI Illness Symptom Checklist developed in February 2025), and

Additional resources.

# data[].attributes.attachment_link.readable_text
Learn what norovirus is, how it makes you sick, how it spreads, and how you can prevent yourself and others from getting sick.

A norovirus outbreak is defined as an increase in people experiencing diarrhea or vomiting above what is normal for a facility, with regard to time and place. This includes illness in both children and staff. There does not need to be a diagnosis or laboratory testing for a group of ill people to be considered an outbreak.

The following examples would be considered an outbreak and should be reported:

A child care program with 30 children has 10 children in the toddler and preschool classrooms call out sick with symptoms of vomiting and diarrhea over the course of two days. Two staff who work in the same classrooms also call out sick. This is an increase above what is normal for the program and should be reported as an outbreak.

An elementary school with 250 students has 100 students absent over the course of a week. Some are known to have been sick with a "stomach bug." Additionally, 15 students were seen by the school nurse with sudden vomiting. During a typical week, 25 students are absent and only 1 or 2 are seen by the nurse for vomiting. This is an increase above what is normal for the school and should be reported as an outbreak.

A high school with 800 students has 50 students absent in a single day. Most are athletes on the girls' varsity and junior varsity soccer teams. The coach reports that several have reported having diarrhea and vomiting that began Wednesday night, the day after a game. While 50 students absent is not unusual for the school, it is not typical for so many students to be sick among members of a sports team. This should be reported as an outbreak.

Suspected norovirus outbreaks should be reported by child care programs and schools as soon as they are identified by completing the following online form: Gastrointestinal Illness Child Care & K-12 School Cluster Reporting Form.

After submitting the online form, the local board of health or a DPH epidemiologist will call the submitter to provide guidance on outbreak management and control.

For any questions regarding the reporting, investigation, or control of suspected norovirus outbreaks, please contact your local board of health, or the DPH Division of Epidemiology at (617) 983-6800.

The following steps should be taken to stop the spread of norovirus in child care programs and K-12 schools:

Wash hands

Teach staff and students how to properly wash hands using soap and warm running water for 20 seconds. Hand sanitizer does not work well against norovirus.

In child care programs:

Monitor young children to make sure they are correctly washing their hands when they arrive, before eating or being fed, after going to the bathroom or receiving a diaper change, and before participating in shared sensory or water tables.

Teach staff to wash their hands frequently. Staff should wash hands after handling diapers, before preparing food or feeding children, before eating, and before taking or giving medicine.

In schools:

Make sure students and staff follow all handwashing policies. Hands should be washed after going to the bathroom or helping students go to the bathroom, before eating or touching food, and before taking or giving medicine.

Have staff supervise younger students washing their hands.

Environmental cleaning

Follow CDC and EPA guidance on cleaning and disinfection:

Check that cleaning products are effective against norovirus and are being used throughout the child care program or school.

Clean and disinfect areas immediately after someone vomits or has diarrhea.

Clean and disinfect surfaces and objects frequently touched like tables, desks, doorknobs, toys, faucet handles, etc. at least daily and when dirty.

Clean and disinfect bathroom toilets and sinks at least daily and when dirty.

In child care programs: Clean and disinfect diapering areas and potty chairs after each use, and bathroom toilets and sinks at least daily and when soiled.

Exclusions

Limit opportunities for transmission

Teach staff about the rapid onset of norovirus symptoms. Make sure leak-proof, washable or disposable containers are available in classrooms and other areas of the facility for anyone who suddenly needs to vomit.

Consider cancelling or delaying group activities, including those scheduled after normal hours.

Limit contact of children and staff across classrooms, especially classrooms with people sick and those without anyone sick.

In child care programs:

If possible, group staff who worked with sick children in the same classroom or area. This will help limit the spread to classrooms without anyone sick.

Limit sharing of items (e.g., toys or books) among children within a classroom, and across classrooms.

Don't share food among children and staff.

In schools:
Don't allow sharing of food, stop the use of self-service in cafeterias, and consider switching to single-use dining materials if reusable ones cannot be promptly and thoroughly cleaned.

Notify

In child care programs: Notify parents/guardians when cases of norovirus infection occur in children or staff. Licensed daycare facilities must notify all parents/guardians in accordance with DPH recommendations when any communicable disease or condition has been introduced into the program (606 CMR 7.11).

In schools: Consider notifying parents/guardians during suspected or confirmed outbreaks of norovirus. The local board of health or a DPH epidemiologist can help determine whether notification is recommended.

Staff and children ill with gastrointestinal illness symptoms such as vomiting or diarrhea should not attend programs or schools in accordance with the Gastrointestinal Illness Symptom Checklist for Children and Staff in Child Care Programs and K-12 Schools.

# data[].attributes.attachment_link.title
Norovirus information for child care programs and K-12 schools

# data[].attributes.attachment_link.description
Information about the reporting and control of norovirus outbreaks in child care programs and K-12 schools.

# data[].attributes.headline
NEW reporting form for GI illness clusters

# data[].attributes.subject
NEW reporting form for GI illness clusters

# data[].attributes.body
The Massachusetts Department of Public Health (DPH) provides dashboards used to visualize trends in COVID-19, influenza, and respiratory syncytial virus (RSV) disease activity and vaccination in Massachusetts. Information about COVID-19 and flu vaccines and resources to find vaccination locations are available at mass.gov/SeasonalVaccines. Residents who cannot get to a vaccination location can schedule an appointment for in-home COVID-19 and flu vaccination by visiting the In-Home Vaccination Program website or calling 833-983-0485.

# data[].attributes.headline
Medication Error Report Guide NOW AVAILABLE

# data[].attributes.subject
Medication Error Report Guide NOW AVAILABLE

# data[].attributes.body
You must download the form to your own computer and save it. To do this, click on the three dots at the top right of the post and click "download attachment".

# data[].attributes.body
A respiratory illness cluster is defined as one positive influenza test or 3 or more clients/students with influenza-like illness (ILI*). Submit one form per cluster at your facility. A new form should only be submitted if there is a new cluster and it has been greater than 14 days since your last case. (*ILI is defined as: Fever of >=100F and cough and/or sore throat.).

# data[].attributes.headline
UPDATED Information on Respiratory Diseases-for Healthcare Providers

# data[].attributes.subject
UPDATED Information on Respiratory Diseases-for Healthcare Providers

# data[].attributes.attachment_link.readable_text
Guidance

The Commonwealth of Massachusetts is updating this guidance for healthcare personnel (HCP) in health care settings with respiratory virus infection or exposure. HCP and health care settings are defined by the Centers for Disease Control and Prevention (CDC) and referenced at the end of this document. This guidance replaces Guidance for Health Care Personnel with SARS-CoV2 Infection or Exposure revision issued October 13, 2022, and further clarified on May 3, 2024.

Effective September 1, 2025, HCP are advised to use the standards outlined below, following a confirmed or suspected respiratory virus infection or exposure:

HCP who have either tested positive for a respiratory viral pathogen (i.e., SARS-CoV2, Influenza, Respiratory Syncytial Virus, etc.) or who are exhibiting two or more symptoms of a respiratory viral illness (e.g., cough, shortness of breath, sore throat, runny nose, headache, myalgia, chills, fatigue, fever), even in the absence of a test, should isolate.

An isolating HCP who had respiratory viral symptoms may return to work:

after 3 days have passed since symptom onset; (Day 0 represents symptom onset, with return on Day 4) AND

if symptoms are improving, including being fever-free without the use of antipyretics for 24 hours; AND

if they feel well enough to work.

AHCP who has been asymptomatic but tested positive for a viral respiratory pathogen may return to work after 3 days; (Day 0 represents positive test date, with return on Day 4).

Any HCP who returns to work prior to 7 days since their symptom onset or first positive test was taken must wear a facemask until after 7 days have passed (Day 8 represents the first day masks may be removed).

HCP who have been exposed to someone who has a respiratory viral illness but are not themselves exhibiting any symptoms and have not tested positive for a respiratory viral pathogen, do not need to be restricted from work. HCP may continue to work after being exposed, provided they remain asymptomatic. Said HCP should wear PPE appropriate for their duties and must at least wear a facemask, or a surgical, medical procedure, dental, or isolation mask that is FDA-cleared, authorized by an FDA EUA, or offered or distributed as described in an FDA enforcement policy, and self-monitor for symptoms for 5 days after exposure.

HCP who are immunocompromised may shed viruses for prolonged periods of time. Consider consultation with occupational health to determine when HCP who are immunocompromised may return to work and discontinue use of source control (the use of a mask to cover a person's mouth and nose and to help reduce the spread of large respiratory droplets to others when the person talks, sneezes, or coughs). Occupational health may consider consulting with an infectious disease specialist and/or using a test-based strategy in making this determination.​

HCP and healthcare settings are also expected to follow Organizational Policies and Procedures for Mitigating Respiratory Illness and implement action steps to mitigate and prevent the transmission of respiratory illness during times of higher prevalence of viruses, which may include masking and increasing ventilation; adhere to infection prevention practices for patient care activities; and administer antiviral treatment and chemoprophylaxis when appropriate.

HCP should stay up to date with influenza and COVID-19 immunizations and follow CDC recommendations for adults who are at increased risk of RSV.

Definitions

Referenced definitions:
Healthcare personnel (HCP) refers to all paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials, including body substances (e.g., blood, tissue, and specific body fluids); contaminated medical supplies, devices, and equipment; contaminated environmental surfaces; or contaminated air.

These HCP may include, but are not limited to, emergency medical service personnel, nurses, nursing assistants, home healthcare personnel, physicians, technicians, therapists, phlebotomists, pharmacists, dental healthcare personnel, students and trainees, contractual staff not employed by the health care facility, and persons (e.g., clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted among from HCP and patients.

Healthcare settings refers to places where healthcare is delivered and includes, but is not limited to, acute care facilities, long term acute care facilities, inpatient rehabilitation facilities, nursing homes and assisted living facilities, home healthcare, vehicles where healthcare is delivered (e.g., mobile clinics), and outpatient facilities, such as dialysis centers, physician offices, and others.

School health offices are health care settings. School nurses and other health office staff should follow the guidance for health care settings. [1]

Respiratory viruses are viruses that cause illnesses in the respiratory system. These illnesses share similar symptoms, risk factors, and prevention strategies. Common examples include influenza, COVID-19, RSV, Adenovirus, Rhinovirus/Enterovirus (common cold), Parainfluenza and Parvovirus B19 (Fifth Disease).[1]

# data[].attributes.attachment_link.title
Guidance for Health Care Personnel with a Respiratory Viral Pathogen Infection or Exposure

# data[].attributes.attachment_link.description
The Commonwealth of Massachusetts is updating this guidance for healthcare personnel (HCP) in health care settings with respiratory virus infection or exposure. HCP and health care settings are defined by the Centers for Disease Control and Prevention (CDC) and referenced at the end of this document. This guidance replaces Guidance for Health Care Personnel with SARS-CoV2 Infection or Exposure revision issued October 13, 2022, and further clarified on May 3, 2024.

# data[].attributes.attachment_link.title
105 CMR 300.00: Reportable diseases, surveillance, and isolation and quarantine requirements

# data[].attributes.attachment_link.description
105 CMR 300.000 lists diseases dangerous to the public health as designated by the Department of Public Health and establishes reporting, surveillance, isolation and quarantine requirements. Download a PDF copy of the regulation below.

# data[].attributes.headline
CSHS NEW Budget Form (Affiliates in FY27)

# data[].attributes.subject
CSHS NEW Budget Form (Affiliates in FY27)

# data[].attributes.body
You must download the form to your own computer and save it. To do this, click on the three dots at the top right of the post and click "download attachment".

# data[].attributes.headline
CSHS Data Report Instructions and Templates 2026-2027 School Year NOW POSTED!

# data[].attributes.subject
CSHS Data Report Instructions and Templates 2026-2027 School Year NOW POSTED!

# data[].attributes.body
If you have any questions regarding reports, please send them to Kathrine Mansfield at kathrine.a.mansfield@mass.gov.

# data[].attributes.body
Regional Consultants and MDPH School Health Services have been receiving a large number of requests for surveys to be disseminated out to school nurses and school nurse leaders.

If you have a survey that you would like shared with school nurses, please complete the form linked above.

Surveys will be reviewed by the MDPH School Health Services team and, if approved, shared either in the Newsletter or regionally by your RC.

# data[].attributes.attachment_link.title
MDPH School Health Services Newsletter Survey Request Form

# data[].attributes.attachment_link.description
MDPH School Health Services Newsletter Survey Request Form

# data[].attributes.headline
Varicella (Chickenpox) Cluster Reporting Form

# data[].attributes.subject
Varicella (Chickenpox) Cluster Reporting Form

# data[].attributes.body
Use this form when 3 or more cases are identified

A varicella cluster is defined as 3 or more cases of varicella at the same facility within 42 days.

Submit one form per cluster at your facility.

A new form should be submitted if there have been greater than 42 days since your last case.

# data[].attributes.headline
School Health Data Monthly Reporting Instructions and Link for SY26/27

# data[].attributes.subject
School Health Data Monthly Reporting Instructions and Link for SY26/27

# data[].attributes.headline
NEW self-paced course: Navigating Care for Students with Medical Complexity

# data[].attributes.subject
NEW self-paced course: Navigating Care for Students with Medical Complexity

# data[].attributes.body
This program aims to help participants:

Assess Care Approaches – Reflect on how medical, educational, and social factors impact children with complex health needs.

Analyze Clinical Environments – Examine whether your own healthcare or school setting is accessible and appropriate for diverse families.

Collaborate & Apply Expertise – Integrate personal experience with expert guidance to begin shaping an Individual Health Care Plan (IHCP) that supports students with medical complexity.

Prioritize Equity & Accessibility – Understand the intersection of healthcare, education, and family circumstances to create plans that are realistic and culturally responsive.

# data[].attributes.attachment_link.title
Navigating Care for Students with Medical Complexity | Chobanian & Avedisian School of Medicine/CCE

# data[].attributes.attachment_link.description
Boston University Chobanian & Avedisian School of Medicine asks all individuals involved in the development and presentation of Accredited Continuing Education activities to disclose all financial relationships with ineligible companies. This information is disclosed to all activity participants prior to the start of the educational activity. Boston University Chobanian & Avedisian School of Medicine has procedures to mitigate all relevant financial relationships with ineligible companies. In addition, faculty members are asked to disclose when any unapproved use of pharmaceuticals and devices is being discussed.

# data[].attributes.body
Find your funding program and associated documents by school/district!

# data[].attributes.attachment_link.title
CSHS Responsibility Rubric- Model and Affiliate FY27

# data[].attributes.headline
LIFEVAC Update from our Medical Consultant

# data[].attributes.subject
LIFEVAC Update from our Medical Consultant

# data[].attributes.body
LifeVac, an anti-choking suction device that has recently  received FDA clearance for use in airway obstruction emergencies.

Choking remains a life-threatening emergency that requires immediate recognition and prompt intervention. The standard of care for managing foreign body airway obstruction in children and adults continues to be the evidence-based protocols established by the American Heart Association (AHA) and the American Red Cross.

These established measures must always be followed first and in accordance with current AHA and Red Cross guidelines, as they are supported by longstanding clinical evidence and national training standards.

LifeVac may be considered an adjunctive rescue device during an acute choking episode only after standard choking interventions have been attempted and have not successfully relieved the obstruction. It should not replace established first-line interventions.

If LifeVac is available within your school setting, staff should be properly trained in its use, and its role should be clearly incorporated into your existing emergency response protocols. Activation of emergency medical services (911) should occur promptly in any severe choking event and should not be delayed while attempting interventions.

# data[].attributes.headline
Annual Status Report Instructions and Link (for CSHS funded schools and districts) SY 26/27 *coming soon*

# data[].attributes.subject
Annual Status Report Instructions and Link (for CSHS funded schools and districts) SY 26/27 *coming soon*

# data[].attributes.headline
SBIRT Data Collection Instructions and Link (for non-funded schools and districts) SY 26/27 *coming soon*

# data[].attributes.subject
SBIRT Data Collection Instructions and Link (for non-funded schools and districts) SY 26/27 *coming soon*

# data[].attributes.body
For Public Schools and Districts WITHOUT CSHS FUNDING.

# data[].attributes.headline
BMI Data Collection (for non-funded school districts) Instructions & Link SY 26/27 *coming soon*

# data[].attributes.subject
BMI Data Collection (for non-funded school districts) Instructions & Link SY 26/27 *coming soon*

# data[].attributes.body
For public schools and districts WITHOUT CSHS FUNDING.

# data[].attributes.headline
LINKS to all data reports SY 26/27 *coming soon*

# data[].attributes.subject
LINKS to all data reports SY 26/27 *coming soon*

# data[].attributes.body
Resources for Parents with Uncertain Immigration Status: The Attorney General’s Office released an Emergency Planning Guide and an Emergency Planning Fact Sheet for parents with uncertain immigration status. These materials are available in English, Spanish, Portuguese, Haitian Creole, and Simplified Chinese on the AGO’s website.

Updated SHIELD Law Signed: Governor Healey signed an updated SHIELD law, strengthening protections for health care providers and patients in Massachusetts. Read more here.

LGBTQIA+ Health Resources Page: DPH launched a dedicated webpage offering health resources for LGBTQIA+ individuals. See page here.

Partnership with Fenway Institute: DPH announced a new collaboration with the Fenway Institute to provide education and training for health and social services staff caring for LGBTQIA+ patients and others. Learn more here.

# data[].attributes.body
CLIA waivers are necessary when doing any testing in schools, such as glucose or ketone monitoring. We have heard from many schools that they do not have diabetic students, so they do not need a CLIA waiver. But how will you manage if a current student is newly diagnosed? Or if a student with diabetes or some other health condition requiring a CLIA waived test moves into your school/district?

Clinical Laboratory Improvement Amendments (CLIA) Application Update

Information on CLIA waivers is located here:

https://www.mass.gov/how-to/apply-for-a-clinical-laboratory-improvement-amendment-clia-certificate

Applications should be submitted through the DPH Clinical Laboratory Program by e-mailing the completed CMS-116 CLIA application to CLIALab@mass.gov.

# data[].attributes.body
The Healthy Air Network is a collaboration of organizations and community members who work to improve air quality, increase climate resilience, and advocate for environmental justice in Massachusetts.

# data[].attributes.attachment_link.readable_text
Explore Air Quality in Western Massachusetts

Each circle on the map shows an air monitor located in the Healthy Air Network. The color will change based on measured air quality. You can click on each circle for more information about the monitoring site and what precautions to consider - if any. The grey moving lines show the current wind conditions.

The air monitoring network measures fine particulate matter in the air. Fine particulate matter (also called PM 2.5) small particles that are less than 2.5 µm in size. This small size lets these particles stay suspended in the air for an extend period of time. PM 2.5 is made up of many different chemicals that may be released from many sources like vehicles, factories, and wildfires. High levels of PM 2.5 in the air can reduce visibility and impact our health.

For each monitoring site in the network, PM 2.5 levels are reported together with the air quality index (AQI). The AQI is a national index of air pollution and provides information on how to avoid the health effects of poor air quality. AQI values range from 0 to 500 and is divided into six categories (good, moderate, unhealthy for sensitive groups, unhealthy, very unhealthy, and hazardous). Check this website regularly to see current air quality levels in your neighborhood.

# data[].attributes.attachment_link.description
Explore Air Quality in Western Massachusetts Each circle on the map shows an air monitor located in the Healthy Air Network. The color will change based on measured air quality. You can click on each circle for more information about the monitoring site and what precautions to consider - if any.

# data[].attributes.headline
The Statewide Mental Health Resources for Youth and their Families flyer has been translated!

# data[].attributes.subject
The Statewide Mental Health Resources for Youth and their Families flyer has been translated!

# data[].attributes.body
Direct padlet links to all the languages:

English

Spanish

Brazilian Portuguese

Vietnamese

Haitian Creole

Chinese (simplified)

Chinese (traditional)

# data[].attributes.headline
Site Visits: FUNDED PUBLIC SCHOOLS/DISTRICTS

# data[].attributes.subject
Site Visits: FUNDED PUBLIC SCHOOLS/DISTRICTS

# data[].attributes.body
MEET WITH THE ASSISTANT DIRECTOR!

I can help you with your budget, or otherwise answer questions about the grant and how it can be most useful to your school/district.

Book time to meet with me!

# data[].attributes.body
PurpleAir provides affordable air quality sensors and real-time data, empowering a wide range of people to make big and small steps towards advancing air quality knowledge. While the applications are diverse, some of the most common uses include creating detailed air quality maps, monitoring pollution levels across communities, and supporting scientific research. By making air quality data accessible to individuals, organizations, and researchers alike, PurpleAir plays a vital role in improving environmental awareness and driving informed decision-making. Below, we'll dive deeper into who some of these groups are, and what they do.

Real-Time Air Quality Maps

PurpleAir sensors contribute to real-time air quality mapping by integrating with platforms like the EPA’s AirNow Fire and Smoke Map and Environment and Climate Change Canada’s AQHI map. These maps help individuals and organizations track pollution levels and make informed decisions, particularly in areas affected by wildfires and other environmental hazards.

# data[].attributes.attachment_link.description
The US EPA PM2.5 Air Quality Index (AQI) is a number used by US government agencies to communicate to the public how polluted the air currently is or how polluted it is forecast to become.

# data[].attributes.body
https://redcap.link/MA_School_Opioid_Antagonist_Admin

# data[].attributes.headline
REGIONAL SCHOOL NURSE CONSULTATION Simulation Equipment Loan Program

# data[].attributes.subject
REGIONAL SCHOOL NURSE CONSULTATION Simulation Equipment Loan Program

# data[].attributes.body
The Regional Consultants (RC) of the Massachusetts School Nurse Consultation Program are dedicated to improving the health and well-being of all school children and youth, and promoting inclusive and equitable access to schools, including for those students living with complex health care needs.

Many students with complex health care needs require skilled nursing services to safely attend school. To assist school nurses in creating professional development aimed at the practice and improvement of these nursing skills, the Regional Consultants have established the Simulation Equipment Loan Program to make simulation equipment available to school nurses to be used in conjunction with other educational resources, many of which are available on the Boston University School Health Institute for Education and Leadership Development (BU SHIELD) Special Health Care Needs (SHCN) Library Pilot Site.

Simulation equipment, including task trainers, manikins and supplies, were selected to practice skills such as:

Tracheostomy care

Ostomy care

Tube feedings

Suctioning

Catheterization

Diabetes care

Urgent/Emergent events (EpiPen, Narcan Trainers), Stop the Bleed

And more...

Note: School districts are responsible for developing their own competencies and trainings associated with the equipment.

# data[].attributes.body
To order naloxone from the MA State Office of Pharmacy Services (SOPS), your school/district will need a Massachusetts Controlled Substance Registration (MCSR).

Due to recent and ongoing shifts in the funding and reimbursement landscape for naloxone, BSAS has revisited our policy and eligibility requirements for programs and other entities to receive fully subsidized naloxone.

DPH Naloxone Bulk Purchasing Program: The overdose crisis remains a significant public health concern for Massachusetts communities. Public K-12 schools in Massachusetts are eligible for the DPH Naloxone Bulk Purchasing Program. This program allows municipalities and state agencies to purchase naloxone at the state-negotiated public interest price of $23.51 per two dose unit (pricing subject to change). To purchase naloxone from DPH, please reach out to Scott Brody at the State Office of Pharmacy Services at scott.brody@mass.gov. Products ship upon receipt of payment.

Please review all relevant school health regulations (105 CMR 210.011) regarding administration of emergency rescue opioid antagonists for your school setting.

Please see the medication resources on BU SHIELD here to access free trainings for staff on the use of opioid antagonists.

# data[].attributes.attachment_link.readable_text
Please do not include personal or contact information. You will not get a response

The feedback will only be used for improving the website. If you need assistance, please contact the Bureau of Substance Addiction Services.

# data[].attributes.attachment_link.description
Naloxone distribution programs in Massachusetts (MA) include Overdose Education and Naloxone Distribution (OEND) programs and Community Naloxone Purchasing Program (CNPP) affiliate programs. These programs provide naloxone at no cost to community members.

# data[].attributes.body
TRAIN Massachusetts is a gateway to a comprehensive catalog of public health training opportunities, available as part of the TRAIN Learning Network.

You'll find an array of courses developed by the Massachusetts Department of Public Health — as well as other providers in the network — to help you advance your skills and knowledge regarding a variety of public health topics.

Our goal: making sure you have the tools you need to support optimal health and well-being for all people in Massachusetts.

First time to TRAIN? Select "Create Account" on the left menu to register for TRAIN. You only need one TRAIN account to access multiple TRAIN sites. Be sure to opt-in to emails so that you receive important messages.

# data[].attributes.body
The overhaul makes finding what you need easier and more intuitive. Check it out!

# data[].attributes.headline
REVISED 11/2024 SBIRT DATA COLLECTION WORKSHEET

# data[].attributes.subject
REVISED 11/2024 SBIRT DATA COLLECTION WORKSHEET

# data[].attributes.body
Please consider that the Excel form is a WORKSHEET, meant to assist you in collecting the data that will be submitted using the annual report RedCap link.

# data[].attributes.headline
Vision Screening Resources to Send Home to Caregivers

# data[].attributes.subject
Vision Screening Resources to Send Home to Caregivers

# data[].attributes.headline
School Behavioral Health Workforce and Services Expansion Grantees 

# data[].attributes.subject
School Behavioral Health Workforce and Services Expansion Grantees 

# data[].attributes.headline
Grant orientation resources including a self-paced course on budgeting.

# data[].attributes.subject
Grant orientation resources including a self-paced course on budgeting.

# data[].attributes.body
Go directly to the budgeting course by clicking here.

# data[].attributes.attachment_link.title
► CSHS and Regional Meetings | Chobanian & Avedisian School of Medicine/CCE

# data[].attributes.attachment_link.description
MenuGrant OrientationPrevious Meeting RecordingsCSHS Meeting DatesRegional Meeting DatesNeed to file a report to MDPH? Requirements and links to reports are here.Grant OrientationThis program introduces nurse leaders to CSHS grant management and requirements. Please complete the pre-work, watch the video of this training recorded in 2020, and download and review the tools

# data[].attributes.body
Does your non public school receive the CSHS Affiliate or CSHS Non Public Grant ?

Book a 30 Minute CSHS Virtual Site Visit Meeting here

This time is intended to create connection, answer questions, and assess progress toward grant objectives for those schools receiving Comprehensive School Health Services (CSHS) grant funding.

Are you new to school nursing? Do you just want to connect? I invite you to Book time to meet with me

Looking forward to connecting soon!

Janet Guertin-Moruzzi, MEd, BSN, RN, NCSN, MA SANE
Public Health Nurse Advisor, Non Public Schools
Pronouns: she/her/hers
Janet.Moruzzi@mass.gov

# data[].attributes.body
You can watch all all RESPECTfully videos or follow RESPECTfully MA on Instagram and TikTok!

# data[].attributes.attachment_link.readable_text
Healthy relationships start with us.

Healthy relationships are built on respect, honesty, and open communication. They make people feel good about themselves and each other. Learn what makes a relationship healthy or unhealthy, signs to look out for, and how to talk about these issues with people you care about.

RESPECTfully Pledge

February is Teen Dating Violence Awareness Month.
Pledge to respect your limits and help encourage healthy behavior.
It starts with us -let's end teen dating violence together.

Identifying healthy and unhealthy relationships

Resources for teens

# data[].attributes.attachment_link.description
Healthy relationships start with us. Healthy relationships are built on respect, honesty, and open communication. They make people feel good about themselves and each other. Learn what makes a relationship healthy or unhealthy, signs to look out for, and how to talk about these issues with people you care about.

# data[].attributes.headline
Supporting All Students, Including LGBTQ Students

# data[].attributes.subject
Supporting All Students, Including LGBTQ Students

# data[].attributes.attachment_link.authors[].name
Massachusetts Department of Elementary and Secondary Education

# data[].attributes.attachment_link.title
Supporting All Students, Including LGBTQ Students - Office of the Commissioner of Elementary and Secondary Education

# data[].attributes.attachment_link.description
The goal of the Massachusetts public K-12 education system is to prepare all students for success after high school. Massachusetts public school students are leading the nation in reading and math and are at the top internationally in reading, science, and math according to the national NAEP and international PISA assessments.

# data[].attributes.body
You will need your FEIN (tax ID number) to look up payments from the Massachusetts Department of Public Health.  Most likely, payments from MDPH are yours (but could also be the local health department's) and sometimes get stuck on the municipal side of things and need to get moved to the school side of things.

# data[].attributes.attachment_link.readable_text
New to VendorWeb? Please see the " How to Use VendorWeb " job aid for a description of system features and instructions.

Welcome to the VendorWeb site: Using this web site, vendors to the Commonwealth of Massachusetts can easily and quickly access their payment information - view scheduled payments, view payment history, and read news and updates of interest to vendors.

# data[].attributes.attachment_link.description
New to VendorWeb? Please see the " How to Use VendorWeb " job aid for a description of system features and instructions. Welcome to the VendorWeb site: Using this web site, vendors to the Commonwealth of Massachusetts can easily and quickly access their payment information - view scheduled payments, view payment history, and read news and updates of interest to vendors.

# data[].attributes.headline
Guidance for School Committees and Districts: Upholding the Rights of Immigrant Students to Enroll in School

# data[].attributes.subject
Guidance for School Committees and Districts: Upholding the Rights of Immigrant Students to Enroll in School

# data[].attributes.body
Upholding the Rights of Immigrant Students to Enroll in School

# data[].attributes.body
https://padlet.com/nicolebarnaby/school-behavioral-health-resource-board-quzwicovtr6tg0pc

# data[].attributes.headline
Massachusetts School Nursing-Yesterday and Today

# data[].attributes.subject
Massachusetts School Nursing-Yesterday and Today

# data[].attributes.body
Compiled from records from the MA Public Health Archives and the written histories of actual school nurses, this video presents the long history of school nursing in Massachusetts, a well-known national leader for School Health Services.

# data[].attributes.attachment_link.title
Massachusetts School Nursing: Yesterday and Today

# data[].attributes.headline
School Health Services Behavioral Health Infographic

# data[].attributes.subject
School Health Services Behavioral Health Infographic

# data[].attributes.body
Connecting Massachusetts Students to Behavioral Health Services

# data[].attributes.headline
Guidance on Schools’ Legal Obligations Regarding Hate and Bias Incidents

# data[].attributes.subject
Guidance on Schools’ Legal Obligations Regarding Hate and Bias Incidents

# data[].attributes.body
The Office of the Attorney General has partnered with the Executive Office of Education and Department of Elementary and Secondary Education to issue updated Guidance on Schools’ Legal Obligations to Prevent and Address Hate and Bias Incidents.

https://www.mass.gov/doc/09252024addressinghatebiasschools-qa/download

https://www.mass.gov/doc/09112024addressinghatebiasschoolsspanishpdf/download

https://www.mass.gov/doc/09252024combatting-hate-in-our-schools/download

https://www.mass.gov/doc/09112024combatting-hate-in-our-schoolsspanish/download

# data[].attributes.body
The Department of Public Health’s (MDPH) regulation, 105 CMR 210.000: The Administration of Prescriptions Medications in Public and Private Schools, authorizes the administration of medications in primary and secondary school settings. This regulation relates to the administration of FDA-approved medications in Schedules II through VI and FDA-approved over-the-counter medications.

Massachusetts follows the federal controlled substances schedules, which still classify marijuana as a Schedule I controlled substance.  By contrast, cannabidiol (CBD) is primarily marketed and sold as a supplement, not a medication, and thus is not scheduled.

105 CMR 210.000 does not authorize the administration of either medical marijuana or CBD, as neither are FDA-approved medications.  Each district will need to seek its own legal counsel to ascertain whether there are other authorizations to manage the use of medical marijuana and CBD on its campus.

If you would like to learn more about the medical marijuana law, please visit the Cannabis Control Commission’s website at https://masscannabiscontrol.com/.

# data[].attributes.headline
Change in Fluticasone HFA Coverage for MassHealth Members

# data[].attributes.subject
Change in Fluticasone HFA Coverage for MassHealth Members

# data[].attributes.headline
Alternatives to discontinued asthma medication

# data[].attributes.subject
Alternatives to discontinued asthma medication

# data[].attributes.body
With respiratory season arrival, DPH reminds patients and providers of alternatives to discontinued asthma medication | Mass.gov

# data[].attributes.attachment_link.readable_text
Issued February 1999
Revised June 2021

603 CMR 28.03(3)(c)

1. What is the Intent of the Massachusetts Regulations on Educational Services in the Home or Hospital?
The Massachusetts regulation requiring educational services in the home or hospital is 603 CMR 28.03(3)(c). It reads as follows:

Upon receipt of a physician's written order verifying that any student enrolled in a public school or placed by the public school in a private setting must remain at home or in a hospital on a day or overnight basis, or any combination of both, for medical reasons and for a period of not less than fourteen school days in any school year, the principal shall arrange for provision of educational services in the home or hospital. Such services shall be provided with sufficient frequency to allow the student to continue his or her educational program, as long as such services do not interfere with the medical needs of the student. The principal shall coordinate such services with the Administrator for Special Education for eligible students. Such educational services shall not be considered special education unless the student has been determined eligible for such services, and the services include services on the student's IEP.

The intent of this regulation on home or hospital instruction is to provide a student receiving a publicly funded education with the opportunity to make educational progress even when a physician determines that the student is physically unable to attend school. While it is impossible to replicate the total school experience through the provision of home/hospital instruction, a school district must provide, at a minimum, the instruction necessary to enable the student to keep up in his/her courses of study and minimize the educational loss that might occur during the period the student is confined at home or in a hospital.

Although the regulation on home/hospital instruction is included in the Special Education Regulations (603 CMR 28.00), home/hospital instruction is not considered "special education" unless the student has been found eligible for special education. In other words, home/hospital instruction typically is considered a regular education service, since it is in the interest of both the individual student and the school to make it possible for the student to keep up with schoolwork while s/he is unable to attend school for medical reasons.

The Special Education Regulations also include a provision relating specifically to students who are likely to be confined to home or hospital for medical reasons for more than 60 school days in any school year. Please see regulation 603 CMR 28.04(4), discussed in 603 CMR 28.04(4) Question #1, below.

Please note that the requirements and guidance discussed in this Question and Answer Guide are separate and distinct from those relating to the approval of parent requests for "home education" or home schooling programs, which are governed by General Laws Chapter 76, § 1. The Department of Elementary and Secondary Education's Home Education Advisory provides guidance on the Massachusetts law governing home schooling programs.

2. Who is Entitled to Educational Services in the Home or Hospital?
Public school students. A public school student who, due to documented medical reasons, is confined to home or a hospital for not less than fourteen (14) school days during the school year, is entitled to receive home/hospital educational services as described under 603 CMR 28.03(3)(c). In this context "public school student" means a student who is enrolled in a public school district or a charter school, or a student who is being educated with public funds in an educational collaborative or an approved private day or residential special education school. (Please see Question #7, below, for more detail about students in approved private day and residential special education schools.) The requirement for a school district to provide home/hospital instruction to a public school student who is being educated at public expense is not dependent upon the student's eligibility for special education.

Private school students. A student who is enrolled in a private school at private expense ("private school student") is entitled to receive publicly-funded home/hospital instruction as a special education service if s/he has been found to be a student with a disability who requires special education. Mass. General Laws Chapter 71B, § 1defines "school age child with a disability" as follows:

a school age child in a public or non-public school setting who, because of a disability consisting of a developmental delay or any intellectual, sensory, neurological, emotional, communication, physical, specific learning or health impairment or combination thereof, is unable to progress effectively in regular education and requires special education services, including a school age child who requires only a related service or related services if said service or services are required to ensure access of the child with a disability to the general education curriculum. G.L. Chapter 71B, § 1 (emphasis added).

A private school student who has been evaluated and has been found eligible for special education is entitled to receive home/hospital educational services as outlined in Question #8, below. For both public school students and private school students, the justification for any needed home or hospital instruction must be documented by a student's personal physician. A school district that receives a request for home instruction from someone other than a physician, or from a physician who is not personally responsible for a student's care, is not obligated to provide instruction under 603 CMR 28.03(3)(c). In this case, the responsible school district should inquire further with the student's parent or guardian to determine the student's status and any additional information or action that is needed. For example, the school district may need to proceed under the compulsory attendance law if it determines that a student between ages 6 and 16 is not attending school, is not being otherwise educated in a manner approved by the school district, and is not medically unable to attend school.

Determining eligibility. As required under M.G.L. c. 71B, § 2, if a parent of a private school student requests an evaluation to determine the student's eligibility for special education and presents the school district with a physician's statement, then the school district must immediately review the physician's statement to determine if there is sufficient information available to consider if the student has a "health impairment" according to the definition provided under 603 CMR 28.02(7)(i). If there is sufficient information in the physician's statement, then the school district should convene the Team within 15 days to make an expedited determination of eligibility and begin provision of services. Please refer to Administrative Advisory SPED 2003-1 for additional information about these requirements.

3. How Can Home or Hospital Education Services Be Accessed?
Once the student's personal physician (for example, a pediatrician, internist, medical specialist, psychiatrist or nurse practitioner) determines that a student's medical condition will require either hospitalization or home care for not less than 14 school days, the physician must notify the school district responsible for the student in order to begin the home/hospital instruction process. The student's physician must complete a Department of Elementary and Secondary Education form 28R/3 (or equivalent signed statement) and submit it to the student's building principal or other appropriate program administrator. At a minimum the physician's signed notice must include information regarding:

the date the student was admitted to a hospital or was confined to home;

the medical reason(s) for the confinement;

the expected duration of the confinement; and

what medical needs of the student should be considered in planning the home or hospital education services.

Students with chronic illnesses who have recurring home/hospital stays of less than 14 consecutive school days, when such recurrences have added up to or are expected to add up to more than 14 school days in a school year, are also eligible for home or hospital educational services if they are requested and the medical need is documented by the physician.

Home and hospital educational services under 603 CMR 28.03(3)(c) must begin without undue delay after the school district receives written notice from the student's physician that such services are necessary. Please note that there is no required 14-day waiting period before home or hospital instruction can commence if it is likely that the student will be absent from the school-based program for 14 school days or more in the school year.

Whenever a student is likely to miss 14 school days or more for health-related reasons, the Department strongly recommends that the school district expedite the delivery of educational services as well as any evaluation or Team meetings that may be necessary, in order to minimize the negative impact on the student's educational progress. (See also Question #9, below.)

4. How Should Home or Hospital Services Be Delivered?
School districts may provide home/hospital services in a number of ways, including:

providing the services directly to the student using district employees;

contracting with the hospital to provide the needed services;

contracting with another school district to provide the services;

contracting with another agency to provide the services; or

providing the services via live streaming and/or remote instruction.

Home/hospital instruction is typically one-to-one or small group instruction that is provided on an individualized schedule, for less than a full school day or a full school week. The school district should determine the number of instructional hours per day or per week based on the educational and medical needs of the individual student. School districts may not preset the number of instructional hours per week provided to students who must remain at home or in the hospital; the decision must be individualized. Based on the student's medical status, the student's physician may determine that the number of instructional hours should be reduced. In addition, the amount of instructional time deemed necessary by a district may be guided by the instructional approach used in a one-to-one home or hospital setting as compared to the instructional approach normally implemented in the student's school-based program. However, such a reduction in instructional time must be based on the educational benefit received by the student given the reduced teacher-student ratio. Service delivery, including the time of day the services are to be delivered, should be determined in the best interests of the student and in consideration of the medical circumstances of the student.

When planning and delivering home or hospital educational services, the school district should carefully consider all aspects of a student's educational program while attending school, including any current IEP services, Section 504 plans and instructional accommodations, as well as the student's general education services.

5. Is the Academic Content of Instruction and the Certification of Staff Any Different for Home or Hospital Instruction Than for School-Based Instruction?
Instruction that is provided in the home or hospital for public school students under 603 CMR 28.03(3)(c) must include the same academic content as that provided in the student's regular school-based program. While teacher certification requirements apply to the teachers who are providing the instruction, the teachers do not have to be certified in all subject areas. However, in all cases the school district must be able to demonstrate that the assigned staff member effectively provides the necessary instruction to the student. Teachers who provide home/hospital instruction to public school students must coordinate the instructional content, approach and student progress with the student's teachers at school.

For both public school students and private school students, special education and/or related services that are provided in a home or hospital setting under this provision must be delivered (or closely supervised) by staff certified or appropriately licensed to deliver such services.

6. May A School District Require That a Parent or Other Responsible Adult be in the Home While the District's Instructor is Working With the Student?
If a district requires that an adult is present during homebound instruction, the district should take reasonable steps to ensure that this policy does not conflict with its obligation to provide instruction. A district could likely avert a potential conflict by arranging for instruction at a time (such as late afternoon or evening) when an adult would be at home with the student. If a district were unable to send an instructor at a time when an adult was at home, it would be permissible for the district to send a staff member to accompany the instructor. If a district is unable to arrange for instruction during hours when an adult will be at the home or to send a staff member to accompany the instructor, the district should propose a reasonable alternative to the student's parent that would ensure that the student receives instruction while satisfying the district's legitimate concerns about safety and liability.

7. Under what Circumstances are Educational Collaboratives and Public and Private Day and Residential Special Education Schools Approved Under 603 CMR 28.09 Required to Provide Home or Hospital Instruction? Under Review

8. How Do These Requirements Apply to a Student Who is Enrolled in Private School at Private Expense and Needs Home/Hospital Instruction for Medical Reasons?
As is stated above in answer to Question #1, although the regulation requiring home/hospital instruction is included in the Special Education Regulations (603 CMR 28.00), home/hospital instruction is not considered "special education" unless the student has been found eligible for special education. State law (G.L. Chapter 71B) requires school districts to provide special education to eligible students who are attending private school at the parent's expense or other private expense ("private school students"). Since home/hospital instruction can be a regular education or special education service, this has led to some confusion about the appropriate provision of home/hospital instruction for private school students.

If the private school student already has an IEP under which the school district is providing special education services, then during the 14+ school days that the physician says the student will be out of school for medical reasons, the school district must provide the specially designed instruction and/or related services described on the student's current IEP, modified as necessary to accommodate the student's medical needs. If the student's medical condition is likely to affect the ability of the student to maintain effective school progress, the student's parent may request that the Administrator of Special Education convene a Team meeting to consider further evaluation of the student and, if appropriate, to amend the existing IEP or develop a new IEP. Modifications to the IEP can include home or hospital instruction. The Administrator of Special Education is required to convene a Team meeting without undue delay for any student with an IEP who, in the judgment of the student's physician, is likely to remain at home or in a hospital for more than 60 school days in any school year. This requirement is found in the Special Education Regulations at 603 CMR 28.04(4) and is discussed in 603 CMR 28.04(4) Question #1.

If the private school student does not have an IEP and will be confined to home or a hospital for medical reasons, s/he may be eligible for special education services if the student's medical condition is determined to be a health impairment that adversely affects the student's educational performance. Under these circumstances, the parent is entitled, at any time, to request and receive an evaluation of the student by the public school district to determine if the student's medical condition meets special education eligibility requirements. If a physician indicates to a school district that the student has a medical or health condition that is likely to lead to extended school absence(s) or an inability to maintain effective educational progress, the school district shall treat such information as a referral for an evaluation to determine eligibility for special education. In such case, the school district shall, within five school days, send written notice to the student's parent seeking consent for such evaluation to occur (603 CMR 28.04(1)(a)). A Team may find a student eligible for special education based on a chronic or acute health impairment or other disability, as defined in 603 CMR 28.02(7), that adversely affects the student's educational performance. Please see Question #9, below.

Under Massachusetts law, a private school student who has been determined to be a "school age child with a disability" as defined in G.L. Chapter 71B, § 1, is entitled to receive publicly-funded special education services in accordance with an IEP developed by the school district of residence. The school district may not refuse to evaluate the student because s/he is enrolled in private school or because s/he is currently out of school for medical reasons. The Department recommends that the Administrator of Special Education make every effort to expedite assessment(s) and the Team meeting so that services may be provided in a timely fashion. If the student is evaluated and determined to be a student who is eligible for special education, the student will be entitled to receive home/hospital instruction according to the IEP.

If the private school student does not have an IEP and the parent does not wish to refer the student for a special education evaluation, the parent may contact the school district of residence, providing documentation from the student's physician that the student is confined to home or hospital for medical reasons for not less than 14 school days during the school year. The school district may, at its discretion, provide home/hospital instruction to the student, using the district's resources to provide the instruction, but it is not required to do so unless the student is evaluated and found to be eligible for special education. Please see Question 2 above for additional information on determining eligibility of private school students based on a physician's statement.

Please note that the public school district is under no obligation to be familiar with nor to use the private school's curriculum, textbooks, or related education materials, but shall provide home or hospital services designed to maintain the private school student's progress in general curriculum areas when such services have been included on the IEP. Consequently, if a private school student will be absent from school for medical reasons for an extended period of time, the student's parent should always contact the private school to find out what tutoring services or other home/hospital instruction the private school will provide to help the student keep up with his or her schoolwork. The administrators and teachers in the private school are most knowledgeable about the private school's curriculum and the coursework that the student is covering in class, and they are in the best position to design and provide tutoring or other home/hospital instruction that will enable the student to keep up with school assignments. Depending on the circumstances, the private school itself may have an obligation to provide accommodations or services to the student under federal civil rights laws, Section 504 of the Rehabilitation Act and the Americans with Disabilities Act, or under the contract of enrollment between the school and the parents.

9. Are Students With Chronic or Acute Health Issues Always Eligible for Special Education?
The answer depends on the facts of the individual case. Any student with a medical or health condition that is likely to lead to extended school absence(s) or inability to maintain effective educational progress is a reasonable candidate to be referred to the public school district for initial evaluation to determine special education eligibility. Such referrals should take place as soon as it is known that a student's health condition is chronic or acute and is likely to have a negative educational impact, rather than delaying referral or action until the student is absent for significant periods of time or has begun to experience educational failure.

If assessment information indicates that the student's educational progress will be adversely affected as a result of a chronic or acute medical condition that is not temporary in nature, then the Team will likely determine that the student is eligible for special education. An eligibility determination is an individualized decision that depends on the facts of each case. In most cases, if the Team determines the student is eligible, the type of disability as recognized by federal and state special education law will be a "health impairment" (see 603 CMR 28.02(7)(i)). In some cases, the assessments may indicate other types of disability, such as "emotional impairment" or "neurological impairment."

If the student has been evaluated and found eligible for special education, the Team will write an IEP describing the special education and related services that the student needs and the school district will provide. If the student will be out of school for medical reasons for an extended period of time, it is appropriate to include on the IEP educational tutoring as a related service that the student needs in order to access the general curriculum while s/he is in the home or hospital setting. The IEP may be tailored to address expected time periods when the student is unable to attend school, if that is deemed appropriate to meet the unique needs of the individual student.

603 CMR 28.04(4)

What Requirements Apply if the Student is Likely to Be Confined to Home or a Hospital for More Than 60 School Days?
If, in the judgment of the student's physician, a student with an IEP is likely to remain at home, in a hospital, or in a pediatric nursing home for medical reasons and for more than sixty (60) school days in any school year, the Administrator of Special Education is required, without undue delay, to convene a Team meeting to consider evaluation needs and, if appropriate, to amend the existing IEP or develop a new IEP suited to the student's unique circumstances. (See 603 CMR 28.04(4).) The Department recommends that the Administrator of Special Education convene the Team meeting within 10 school days after the school district is notified that the student is likely to remain at home or in the hospital for more than sixty days. This provision applies to all eligible students, including private school students who have been determined to need special education.

Additional questions or concerns about the provision of home or hospital educational services for students who are unable to attend school should be directed to the Department of Elementary and Secondary Education, Problem Resolution System Office, at (781) 338-3700.

# data[].attributes.attachment_link.keywords[]
massachusetts department of elementary and secondary education

# data[].attributes.attachment_link.authors[].name
Massachusetts Department of Elementary and Secondary Education

# data[].attributes.attachment_link.title
Question and Answer Guide on the Implementation of Educational Services in the Home or Hospital

# data[].attributes.attachment_link.description
The goal of the Massachusetts public K-12 education system is to prepare all students for success after high school. Massachusetts public school students are leading the nation in reading and math and are at the top internationally in reading, science, and math according to the national NAEP and international PISA assessments.