News in school health

244 Pages·1992·17.2 MB·English

by  Massachusetts. Bureau of Family and Community Health. School Health Unit

Digitized by the Internet Archive
2014
in
https://archive.org/details/newsinschoolheal1992mass

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