Health Services

Every Dedham school has a Health Office staffed by registered nurses trained to handle all of the day to day physical health needs of their school. As a key part of an interdisciplinary services team they closely with district and school teams to provide exceptional health services that support every student’s academic success and create a safe and healthy learning environment. A nurse leader supervises district-wide health office activities and assures compliance with regulatory standards set by the Massachusetts Departments of Public Health (MDPH) and Elementary and Secondary Education (DESE). A school physician serves as an adviser to the nurses.

Among their many duties, school nurses administer physical screenings and are responsible for overseeing the safe use of any medications students need. They regularly communicate with families and school administration about ongoing illness trends and maintain student health records, including ensuring that all student vaccinations are up to date.

Back To School Health Updates

All students should have up to date immunizations prior to attending school.

All incoming 4th, 7th, and 11th grade students are required to submit a new physical exam with up to date immunizations.

7th graders should have an updated Tdap and Meningococcal vaccine along with their physical exam that includes a vision screen and scoliosis screen.

11th graders should have an updated Meningococcal vaccine along with their physical exam.

SNAP Health Portal

DPS Health Offices use the SNAP Health Portal to manage student health records and communications with families. Using the SNAP portal, families can:

Enter or confirm your current contact information. Make sure we have your current cell phone and or home phone , and, very important, your current email address.
Upload a copy of your child’s physical exam form. You can scan the form from your doctor or take a picture of it with your phone (just make sure the text on the form is readable in the picture).
Give permission for your child to have Tylenol/Acetaminophen and Motrin/ibuprofen (OTC medications) at school. This permission must be given each school year and expires on the last day of school.
Update medical conditions and upload doctor’s notes. Check the current medical conditions and alerts to see if they are still applicable to your child. Contact your nurse if there is a new condition that must be managed in school.
Communicate directly with your school nurse!

You can also access the SNAP portal directly from your PowerSchool account.

When To Keep Students Home

Student Illness Guidelines

To minimize the spread of infectious disease and to provide for a safe environment, students should be kept home from school for:

Fever greater than 100° within the last 24 hours
Fever should be under 100° for 24 hours without the use of fever-reducing medications before returning to school
Vomiting-or-diarrhea within the last 24 hours
A communicable disease
Difficulty breathing or shortness of breath
New loss of taste or smell
Muscle aches or body aches not due to a known cause
An upper respiratory illness with significant coughing and/or nasal discharge
Pain that requires the use of narcotic medications

Dedham Health Policies

Medications

Medication Policy

The Dedham Public Schools Medication Policy complies with the state guidelines which are available for review at the Massachusetts Department of Public Health website. The following are some important highlights of our policy:

We encourage that medication be administered before and after school hours, if possible.
All medications, prescription or over‐the‐counter, require a physician’s order and a completed parental permission form.
Medication will not be administered until documentation is complete and received by the school nurse. A new medication order from the physician is required for all dose changes. All required forms are available on the Health Services website.
All medication orders expire at the end of each school year.
All medication must be delivered to the school nurse in a correctly labeled pharmacy or manufacturer’s medication container by a parent/guardian or responsible adult. Medications will not be accepted in containers such as plastic bags.
Students are not permitted to bring medication into school.
Medication must be picked up at the end of each school year. Medication not picked up by the close of the school year will be destroyed.

For short‐term medications, i.e., those requiring administration for ten school days or fewer, the pharmacy‐labeled container may be used in lieu of a licensed prescriber's order; if the nurse has a question, she may request a licensed prescriber's order.

After consultation with the school nurse and development of a plan, students who fall into the following categories may self‐administer medication:

• Students with asthma or other respiratory diseases may possess and self‐administer prescription inhalers

• Students with life‐threatening allergies may possess and administer prescription epinephrine via an auto‐injector.

• Students with cystic fibrosis may possess and administer prescription enzyme supplements

• Students with diabetes may possess and administer a glucose monitoring test and insulin delivery system.

Food Allergies

The Dedham Public Schools recognizes the increasing prevalence of food allergies and the life threatening nature of these allergies for many students.

The implementation of this policy aims to minimize the risk of exposure, to assist students with assuming more individual responsibility for their health and safety as they grow older, and to ensure full participation in their educational programs and school-sponsored activities. The management of students with food allergies requires the awareness, support and response of the entire school community.

If a student has a life-threatening allergy, he/she must have access to emergency medication (EpiPen) at all times. Parents/guardians must be responsible for the school nurse obtaining the necessary medical information about child’s emergency allergy action plan.

Key points of the DPS Life-Threatening Allergy policy include:

An individualized healthcare plan will be developed for each student with a medically diagnosed life-threatening allergy.
Our school programs are not declared as allergen-free and foods with known allergies are not banned from our schools.
Communication, planning, and education with staff, parents/guardians, and students will aim to minimize the risk of exposure to allergens that pose a threat to students.
DPS staff is not responsible for implementing the Food Allergy Policy during school-sponsored events beyond the school day that are open to the public (e.g. plays, concerts, athletic contests, ceremonies).
DPS staff is not responsible for implementing the Food Allergy Policy for programs or events on DPS property that are sponsored by various parent, community and private groups.

Specialized Medical Equipment

A medical order is mandatory if a student requires the use of crutches, wheelchair or any other medically necessary equipment. If a student comes to school without a note for this equipment, the student will be sent home for reasons of liability and the potential for further injury. It is imperative that the nurse be aware when students with crutches, etc. are in the building so that, in the event of an emergency, an evacuation plan can be developed.

Special Health Care Needs

When a student has asthma, allergies, diabetes, seizures, attention deficit disorder, or any other medical or mental health condition requiring special health services in the school and/or requires the assistance of medical technology, it is vitally important that the parent/guardian meet with the school nurse to develop an Individualized Healthcare Plan as soon as possible.

Individualized Health Plan (IHP)

Individual Health Plan (IHP) Overview

Who Does It Serve?

Students with non-curable or chronic medical conditions (i.e. Cystic Fibrosis, IBS).

What Does It Do?

An IHP is a legal document that ensures all parties provide consistency of care in the case of complex medical conditions.

An IHP does not change the standard, what the child learns, and in most (but not all) cases how the child learns.

An IHP may include accommodations so that the child can progress in the curriculum. For example, a child with diabetes who has to go to the clinic 3 times per day for blood sugar checks may need to have someone review what they missed.

Whom Do I Contact?

The school nurse.

Universal Precautions

When To Notify Your School Nurse

School Nurse Notifications

Every Dedham Public School building has a full-time nurse on duty during regular school hours. The nurse is responsible for maintaining accurate health records for all of our students, administering first aid and overseeing the general health needs of all our students while they are attending our schools.

No student may be dismissed from the school building without the approval of a parent or guardian.
Parents/guardians are asked to pick up, or arrange for their child to be picked up, within a half hour of notification, for the benefit of their child and other students coming into the health office.
Nurse dismissal or time spent in the nurse’s office is considered an absence from class. These dismissals are not considered ‘excused absences’.

The school nurse can be reached by telephone or email if you have any questions about guidelines for school attendance or if you are in need of any health-related information.

Health-related and emergency information must be completed and updated annually by parents/guardians online through Powerschool and SNAP. All communication with the school nurse will be held confidential.

The school nurse should be notified by the parent/guardian of any:

• Serious injury, illness or hospitalization

• Planned surgery

• Communicable diseases

• New diagnosis or change in your child’s health status

• Fracture, sprain, stitches, cast, or crutches

• New medication and/or dosing change.

• Need to be excused from Physical Education

Contact The Health Team

Maria Antonuccio

Director Health Services

Lynn Averill MHP, BSN, RN, NASN

Nurse

Sheila Bennett MSN, RN, NCSN

School Nurse

Marie DiAngelis

School Nurse DHS

Kathleen Duckworth

School Nurse, Greenlodge Elementary

Donna Farrar

School Nurse DMS

Kate Feeley

Nurse ECEC

Carol Laurino

School Nurse ECEC

Ann Sherman

Nurse/Case Manager

Important Document Links:

Food Allergy & Anaphylaxis Plan

MA Asthma Action Plan

DPS Over The Counter Medication Form

DPS Prescription Medication Form

Massachusetts State Mandates

Physical Exams

Screenings

Massachusetts General Law, chapter 71, section 57 with related regulations 105 CMR 200.000 mandates that school nurses do periodic screenings of vision, hearing, growth (height and weight), and posture. Bill H.4056, section 97 requires schools to conduct annual verbal screenings (SBIRT) for substance use. Pursuant to these regulations, MPS nurses screen students according to the following schedule:

Vision: Grades PK-5, 7, and 10
Hearing: Grades K-5, 7, and 10
Growth (Height and Weight/BMI): Grades 1, 4, 7, and 10
Postural (Scoliosis): Grades 5-9
SBIRT (Screening, Brief Intervention, Referral to Treatment, more information linked here): Grades 8 and 10

Parents/guardians will be notified if a vision, hearing, or postural screening requires further evaluation. Included in this notification will be a request for a report from your healthcare provider of their findings so that the nurses are aware of any problems which may interfere with learning and can accommodate any needs that are identified.

Parents may choose not to have their children participate in any or all screenings. Please notify your school nurse in writing if you wish for your student to opt-out of a screening. This must be done annually.

If your student is receiving treatment for a vision, hearing, or postural concern, please provide your school nurse with current medical documentation of their condition.

Immunizations

All students must present evidence of immunizations in compliance with the requirements of Massachusetts General Laws, Chapter 76, Section 15, which specifically prohibits admitting a student to school without a physician verifying that religious or medical exemptions apply. Medical and Religious exemptions must be submitted to the Health Office annually.

Children need to be immunized against Diphtheria/Pertussis/Tetanus, Measles/Mumps/ Rubella, Polio, Hepatitis B, Varicella and Haemophilus Influenzae type B (HIB-Preschool requirement only).

Children who are not fully immunized against these preventable illnesses are not allowed to attend school.

For more information, contact your health care provider or the MDPH Immunization Program (617-983-6800 or 888-658-2850, www.mass.gov/dph/imm)