Health Services
About
School Nurse Directory
Director of Health Services, Barnstable Public Schools
Alicia Bryant MSN, RN, NCSN
bryant_alicia@mybps.us
phone: 508-790-6445, ext 1038
Barnstable High School
phone: 508.790.6448
ext. 1195 | ext. 1060 | ext. 1720
Patricia Tucker MS, RN
tucker_trish@mybps.us
Caitlin Dumas BSN, RN
dumas_caitlin@mybps.us
Ricki Balestri BSN, RN
balestri_ricki@mybps.us
Barnstable Intermediate School (Gr. 6-7)
Sabrina Losapio BSN, RN
losapio_sabrina@mybps.us
phone: 508.790.6460 ext. 1565
Emily Hill BSN, RN
hill_emily@mybps.us
phone: 508.790.6460 ext. 1347
Barnstable Grade 4-5 School (Gr. 4-5)
Susan McLaughlin BSN, RN, NCSN
mclaughlin_susan@mybps.us
phone: 508.420.2272 ext. 1328
Kathleen Powell MSN, RN (e/o Wed., Thurs., Fri.)
powell_kathleen@mybps.us
phone: 508.420.2272 ext. 1323
Karen Pulit MSN, RN (Mon., Tues., e/o Wed.)
pulit_karen@mybps.us
phone: 508.790.6460 ext. 1323
Barnstable Community Innovation School
Ann Marie Melley MEd, BSN, RN
melley_annmarie@mybps.us
phone: 508.790.6495 ext. 1710
Barnstable-West Barnstable Elementary
Julianne Angiolillo BSN, RN, NCSN
angiolillo_julianne@mybps.us
phone: 508.362.4949 ext. 1
Meg Crocker BSN, RN
crocker_meghan@mybps.us
phone: 508.790.6480 ext. 1781
Julia Pachico DNP, RN, CPNP
pachico_julia@mybps.us
phone: 508.420.1100 ext. 1169
Colleen Santos BSN, RN
santos_colleen@mybps.us
phone: 508.790.9890 ext. 1645
Paige Gale, LPN
gale_paige@mybps.us
phone: 508.790.9890 ext. 1645
Enoch Cobb Early Learning Center
Patricia O'Hara BSN, RN
ohara_patricia@mybps.us
phone: 508.790.6493 ext. 1515
Float Nurse
Ann Agurkis BSN, RN
agurkis_ann@mybps.us
Float Nurse
Care Coordinator - Family and Community Engagement Center
Jackie Martinho, MA
marthinho_jaqueline@mybps.us
508.790.6345 ext. 134
Health Forms
Wellness Newsletter – Winter Edition
School Health Information
- Mandatory Screenings
- School Entry Requirements
- Fall/Winter Respiratory Illness Guidance
- When to Keep Your Child Home From School
Mandatory 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, the Barnstable Public School nurses screen students according to the following schedule:
- Vision: Grades PK-5, 7, and 10
- Hearing: Grades K-3, 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): Grades 7 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 health care 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 child participate in any or all screenings. Please notify your school nurse in writing within the first two weeks of school if you wish for your child to opt out of a screening. This must be done annually.
If your child is receiving treatment for a vision, hearing, or postural concern, please provide your school nurse with current medical documentation of his/her condition.
School Entry Requirements
Students must be compliant with vaccination and physical exam requirements to enter school
MEDICAL REQUIREMENTS FOR ENROLLMENT IN SCHOOL 2024-2025 School Year The Massachusetts Department of Public Health (105 CMR 200.00 and 220.00) specifies minimum immunization and physical examination requirements before admission to school.
Fall/Winter Respiratory Illness Guidance
As we move through fall and into winter, it is important to note that many respiratory illnesses are on the rise both in our schools and in the general population. Please see the links below for guidance and updates on some commonly seen illnesses. Please contact your child's school nurse with any questions and to report any absences.
As a reminder, students should not be sent to school if they have had a fever, vomiting or diarrhea within the last 24 hours. Please encourage good hand hygiene, covering coughs and sneezes, and to not share cups, bottles, utensils, etc. with others. Illness related absences should be reported to the school nurse.
English.pdf | Portuguese.pdf | Spanish.pdf
Additional Resources
- Pertussis Advisory (Whooping Cough)
- MA Dept. of Public Health - Staying home to prevent the spread of respiratory viruses
- Acute Respiratory Illness on the Cape & Islands
- Your Guide to Respiratory Season
- CDC: Mycoplasma Pneumoniae Infections Have Been Increasing (October 2024)
When to Keep Your Child Home From School
- Temperature 100.4 degrees or higher in the past 24 hours. Students may return when 24 hours fever free without the use of fever-reducing medications
- Vomiting or diarrhea in the past 24 hours
- Untreated infections such as strep throat, ringworm, bacterial conjunctivitis, or impetigo. These are contagious infections and must be treated with medication for at least 24 hours before returning to school.
- Rash of unknown origin. Rashes may indicate many different things and should be checked out by a healthcare provider.
Health Services Protocols
Concussions
This protocol is designed to provide standardized procedures for persons involved in the prevention, training, management, and return to activity decisions regarding students who incur head injuries while involved in extracurricular athletic activities, including, but not limited to, interscholastic sports and Marching Band. It is effective upon date of approval by the Barnstable School Physician as indicated on page 3.
This protocol is established pursuant to Code of Massachusetts Regulations 105 CMR 201.000. All definitions used herein are as found in those regulations. The latest version of the regulations on effective date of this protocol is as of August 1, 2014; should the regulations be amended by the Massachusetts Department of Health after that date, any such amendments are incorporated automatically into this protocol. If any portion of this Protocol conflict with the regulations, now or hereafter, the regulations shall govern.
- Section 1 – What is a Concussion?
- Section 2 – Education and Information for Parents/ Guardians/Students
- Section 3 – Education and Information for Staff, Students, and Families
- Section 4 – Reporting a Head Injury
- Section 5 – School Accommodation
- Section 6 – Guidelines for Returning to an Activity after a Concussion
Section 1 – What is a Concussion?
A concussion is a brain injury, and all brain injuries are serious. They may be caused by a bump,
blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works.
All concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. You can’t see a concussion and in most sports/extracurricular activity, concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child/player/student reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away.
Symptoms may include one or more of the following:
- Headache.
- Nausea/vomiting.
- Balance problems or dizziness.
- Double vision or changes in vision.
- Sensitivity to light or sound/noise.
- Feeling of sluggishness or fogginess.
- Difficulty with concentration, short-term memory, and/or confusion.
- Irritability or agitation.
- Depression or anxiety.
- Sleep disturbance
Signs observed by teammates, parents, band director, coaches, or others include:
- Appears dazed, stunned, or disoriented.
- Forgets plays or demonstrates short-term memory difficulties (e.g. is unsure of the game, score, or activity)
- Exhibits difficulties with balance or coordination.
- Answers questions slowly or inaccurately.
- Loses consciousness.
- Demonstrates behavior or personality changes.
- Is unable to recall events prior to or after the hit.
Section 2 – Education and Information for Parents/ Guardians/Students
Before the start of each sports or marching band season, a student/family will receive the following documents from the Athletic Director or Marching Band Director:
- A Fact Sheet for Athletes (Available from the CDC or equivalent)
- A Fact Sheet for Parents (Available from the CDC or equivalent)
- Massachusetts DPH Form Pre-Participation Head Injury/Concussion Report
- Massachusetts DPH Report Form Report of a Head Injury During Sports
Each student and family will complete a current Massachusetts DPH Form Pre-Participation Head Injury/Concussion Report each season, and submit it to the Athletic Office or Marching Band Director as appropriate. This form, signed by parent and student, will contain up to date medical history information of any past concussions or any head and neck injuries the student has received in the past. Should any forms indicate past injury, copies will go to the School Nurse(s), Licensed Athletic Trainer, and as appropriate School or Team Physician for review.
Section 3 – Education and Information for Staff, Students, and Families
The following personnel must yearly take and successfully complete a Massachusetts Department of Public Health approved Sports Head Injury and Concussion Awareness course. Certificates of completion requirements will be the responsibility of Athletic Office for sports, the Marching Band Director for marching band, and the District Nurse Leader for the School nurses.
- Coaches
- Licensed Athletic trainers
- Parent volunteers for any extracurricular athletic activity and marching band
- Physicians employed by the school or who volunteer for any extracurricular athletic activity
- School nurses
- Athletic Directors
- School marching band directors
Parents or legal guardians of students who participate in any extracurricular athletic activity including marching band, and the students themselves, are required by 105 CMR 201.007 to acknowledge in writing that they have read and understood DPH approved training materials on Sports Head Injury and Concussion Awareness.
The Athletic office or Marching Band Director will provide to Parents or legal guardians of children who participate in any extracurricular athletic activity or marching band activity the Massachusetts Department of Public Health approved Sports Head Injury and Concussion Awareness course information, in handout form.
Section 4 – Reporting a Head Injury
During a school based athletic or marching band activity, any student athlete that has sustained or may have sustained a head injury must not return to any game that day and must not resume practice that day. The coach or licensed athletic trainer will complete the Massachusetts DPH Report Form Report of a Head Injury During Sports. The Athletic Trainer, Coach, or Marching Band Director will contact the parents of the student to verbally report the event and provide a copy to school nurses, school counselor and band director (if applicable) within the next school day. Should this injury occur outside of school hours during an athletic event and not at a Barnstable school, facility or field, the Parent or Guardian is responsible for completing the Massachusetts DPH Report Form Report of a Head Injury During Sports. This blank form will be provided to the student’s family at the start of each sports or marching band season. A copy of the completed form will go to the athletic trainer, school nurse, counseling, and marching band director (if applicable). All athletes or marching band members will be evaluated by an appropriate health care provider as provided in the Regulations and this protocol, and be performing at their pre-injury academic level before their full return to any form of physical education, sport, or band activity.
Section 5 – School Accommodation
Section 6 – Guidelines for Returning to an Activity after a Concussion
The medical provider giving medical clearance for returning to play must use the MDPH Medical Clearance Form, “Post Sports-Related Head Injury Medical Clearance and Authorization Form”, available on the MDPH website (www.mass.gov/dph/sportsconcussion), or a school based equivalent that includes the same information. The completed forms should be kept in the student’s medical record in the school health office as well as the athletic department office.
All students at BHS must be cleared to return to play/practice by a licensed medical professional (physician, NP in consultation with a physician, licensed athletic trainer in consultation with a physician, neuropsychologist in coordination with a physician managing the student’s recovery or physician assistant under the supervision of a licensed physician) after the graduated return to play has been completed. Sports activities include physical education class as well as sports practices and games:
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The student should be completely symptom free at rest and with physical (sprints, non-contact aerobic activity) and cognitive exertion (school work).
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Return to play should occur gradually
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Students should be monitored for symptoms and cognitive function during each stage of exertion, and should progress to the next level of exertion only if they are asymptomatic at the current level.
In a situation in which a student has been medically cleared but school staff has observed continuing symptoms, the school’s medical personnel will make the final decision regarding a student’s return to play. School staff should communicate to the physician or health care provider to allow for re-evaluation by the health care provider.
A health care provider as specified by the Regulations and this protocol will evaluate any student that has sustained or may have sustained a head injury. In cases of diagnosed concussion and when an approved Massachusetts DPH Post-Sports Related Medical Clearance and Authorization form is completed by an authorized provider, and the student is performing at their pre-injury academic level, a written, stepped, return to play plan will be created, outlining the progression for return to full athletic participation. The Post-Concussion Graduated Re-entry Plan for Return to Play will be used by athletics.
Head Lice
Head Lice Protocol for the Management of the Student with Head Lice
Students enrolled in the Barnstable Public Schools who are discovered to have an active case of head lice (nits or lice) during school hours will be promptly identified and the following actions taken.
- The school nurse will examine a symptomatic student’s head for lice and nits.
- If live lice or nits are found,
- the student may return to class for the remainder of the school day, based on nursing discretion.
- The student should be discouraged from close direct head contact with others.
- The school nurse will contact the parent/guardian upon identification of head lice or nits and will request prompt, proper treatment of the child’s head lice.
- Information regarding head lice and its treatment will be provided to the parents/guardians of the student found to have head lice or nits.
- The student may be dismissed if the school nurse’s assessment indicates that the student is uncomfortable due to the severity of the infestation.
- The school nurse will re-examine the student the next day (or when the child returns to school) for treatment efficacy.
- Students may attend class, regardless of the presence of lice/nits, based on the nurse’s discretion.
- If after initial treatment the infestation is unchanged, the school nurse may request that the parent/guardian come into the Health Office for instruction on identification and removal of nits/lice.
If a cluster of cases are discovered in the same classroom, a general informational notice regarding lice may be sent home to the parents/guardians of the students in the classroom, based on nursing discretion.
Protocol review and revision by the School Physician Consultant and the Director of Health Services shall occur as needed, but at least every two years.
Head Lice Information for Parents/Guardians
- What Are Head Lice and How Are They Spread?
- How Do I Know If My Child Has Head Lice?
- What Is The Best Way To Look For Head Lice?
- How Do I Get Rid of the Head Lice?
- When Can My Child Return To School?
What Are Head Lice and How Are They Spread?
Head lice are a common problem, especially among school-aged children and their families. It is important to know that head lice are neither a health hazard, nor are they a sign of uncleanliness, and they are not responsible for the spread of any disease.
Your school nurse will work with you and your child should head lice or nits be identified upon examination either at home or in school. Remember: the school nurse can only be of assistance and support when informed of the infestation. Below is information to help you understand the life cycle of head lice and the steps you can take to treat an infestation and prevent re-infestation.
What Are Head Lice and How Are They Spread?
Head lice are tiny, wingless insects that feed on the human scalp. The eggs of head lice are called nits. Head lice crawl very quickly, but do not fly or jump. Head lice are spread primarily by close, prolonged head-to-head contact. There is a very small chance that head lice will spread by sharing items such as combs, brushes, hats and sports helmets. Sleep-overs among friends and relatives are thought to be the most common method of spreading infestations.
How Do I Know If My Child Has Head Lice?
What Is The Best Way To Look For Head Lice?
Examine your child’s head under a bright light or near a sunny window. Examine small areas at a time (about 1 inch) by parting the hair with a comb. Look for eggs (nits), which can look like dandruff, but are difficult to remove. Hatched eggs are whitish to sandy color; intact eggs are harder to see and more tan in color. Both will be seen on the hair shaft within an inch of the scalp and are firmly attached to the hair. Live lice travel so quickly that they are difficult to see.
How Do I Get Rid of the Head Lice?
First, kill the live lice.
- Consult your child’s physician to determine the best treatment for your child. Carefully follow the directions.
Note: Some head lice have become resistant to common over-the-counter (OTC) treatments. While prescription preparations may be more costly than OTC preparations, they can be more effective and save time and money by not having to retreat the infestation. You can also talk to your school nurse about non-medicated treatment options.
Next, re-inspect the hair to remove ALL nits.
- After treatment, use a fine tooth comb to comb the hair thoroughly. It is best to do small (1 inch) sections at a time to remove all visible lice and eggs. Although tedious, this is a very important step and should not be rushed.
- If nits are still seen on the hair strands a solution of water and white vinegar may help loosen the nit “glue”. Once this is applied, recomb the hair in the same fashion: using the fine tooth comb, comb thoroughly small sections at a time.
- Some nits may still be attached and need to be removed individually by pulling them down and off the hair strand using your fingertips.
- Removing nits is very time consuming. Recombing with the fine tooth comb may need to continue daily for up to 4 weeks.
Next, clean the house and belongings.
- Wash your child's clothes, towels, hats, and bed linens in hot water and dry on high heat if they were used within 2 days before head lice were found and treated. You do not need to throw these items away. Items that cannot be washed may be sealed in a plastic bag for 2 weeks or dry-cleaned.
- Do not spray pesticides in your home. They can expose your family to dangerous chemicals and are not needed when you treat your child's scalp and hair properly.
- All household members and close contacts should be checked and treated for head lice if necessary.
Finally,
- Complete a second treatment 7-10 days after the first treatment to prevent a reinfestation. Hair should be rechecked daily for the next 7-10 days (the life cycle of head lice) to make sure the hair is free of head lice and reinfestation has not occurred.
- If reinfestation has occurred, retreat according to the product directions.
When Can My Child Return To School?
The most current research indicates that it is not necessary to keep a child with head lice out of school. No diseases are associated with head lice and in-school transmission is considered to be rare. Students may attend class regardless of the presence of lice or nits. However, students may be dismissed from school if the nurse’s assessment indicates that the student is uncomfortable due to the severity of the infestation. Treatment is required before the student returns to school after the initial identification of the infestation.
Upon return to school, your child must report to the health office so that the school nurse can examine your child’s head and assess the need for further treatment. If the infestation is unchanged and/or live lice are still present, the school nurse may request that the parent/guardian come into the health office for instruction on identification and removal of lice/nits.
Life Threatening Allergies
- District
- School Nurse & Physician
- Parent/Guardian
- Student with Allergies
- Food Service Staff
- Classroom Staff
- Before/After School Activities (Staff/Coaches)
- Field Trips
- Transportation
- Custodial/Environment
- Emergency Response
District
Managing Life-Threatening Allergies in School Protocol
While Barnstable Public Schools cannot guarantee that a student will never experience an allergy related event while at school, the district is committed to student safety, and therefore has created this protocol to reduce the risk that children with allergies will have an allergy related event. This protocol addresses: a) measures to reduce exposure to allergens, and b) procedures to treat allergic reactions.
Total avoidance of the substance to which the student is allergic is the only means to prevent allergic reactions. Adequate plans and staff who are knowledgeable regarding preventive measures and well prepared to handle severe allergic reactions can save the life of a child.
The school nurse will oversee development of an individual health care plan (IHCP) and emergency action plan (EAP) for each student with the diagnosis of a life-threatening allergy, which will be reviewed annually. The school nurse will be responsible for organizing and conducting a meeting with the student’s parent/guardian, the student, classroom teacher, school nutrition director/ manager, and other personnel as determined by the student’s needs. The IHCP will ideally be developed before the student begins school or immediately after diagnosis of a life-threatening condition. The school nurse will assess each student with severe allergies and depending on their needs will work collaboratively to create a safer environment.
Barnstable Public Schools ensure that all staff entrusted with the care of students receive basic education concerning life-threatening allergies and have training in the prevention and management of allergic conditions. All staff will be trained and know their roles in their school’s emergency protocol. Administration will ensure that adequate time is provided for this education.
An effective, life-threatening allergy plan needs the cooperation of parents, teachers, counselors, school nutrition staff, administrators, school nurses, school physicians, primary care physicians, extracurricular advisors, bus/transportation personnel, and any staff that might be present where children can be exposed to the allergens that can trigger their extreme reactions.
Barnstable Public Schools are prepared to manage an anaphylactic emergency by:
- Clearly identifying the student’s needs.
- Having responsible school personnel designated and trained to respond.
- Requesting parent/guardian to obtain current physician’s orders and medication(s).
- Maintaining a current supply of epinephrine auto-injector in secure but unlocked location(s) to allow for immediate availability and/or carried by the student, when appropriate. The school nurse assesses whether a student can self- carry and/or self-administer an epinephrine auto-injector. Even with students who self-carry/self-administer, staff is ultimately responsible for ensuring the anaphylaxis emergency care plan is being followed.
- Having available a municipal emergency response team prepared to respond to a 911 call with epinephrine. It is important to know what the local EMS can provide, as some ambulance services may not be permitted to administer epinephrine.
Barnstable Public Schools are ready to respond to severe allergic reactions in children with no history of anaphylaxis or no previously diagnosed allergies. Health offices will have stock epinephrine auto-injectors unlocked on a wall and in their emergency bags in cases of unknown allergy anaphylaxis emergencies. School personnel will contact the school nurse immediately when any allergic reaction is suspected. If the school nurse is not immediately available, staff will contact emergency services.
School Nurse & Physician
SCHOOL NURSES
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ICHP/EAP development: After a school nurse is made aware of a student with a life-threatening allergy, they will work with the parent/guardian to create an ICHP and EAP, ideally before the student enters school. For a student who is already in school, immediately after the diagnosis of a life-threatening allergic condition, the nurse will meet with the student’s parent/guardian (in person or via telephone conversation) and develop an ICHP and EAP.
- Classroom: For students Pre-K- 7th grades with severe peanut/tree allergies, classrooms will be designated as “peanut/tree nut safe”. Nurses will provide to teachers a letter to share with parents/guardians that the classroom is “peanut/nut safe” and a sign will be posted outside the door. For all other food allergies, the severity and need for strict avoidance will be assessed by the nurse in collaboration with the parent and physician, and a classroom plan made, as appropriate.
- Medications:
- Obtain from the parent/guardian the epinephrine auto injector order from the health care provider and an epinephrine auto injector for school.
- Complete a medication administration plan, in accordance with 105 CMR 210.000.
- Ensure access to unlocked medication at all times, per MA DPH regulations (105 CMR 210.000)
- Determine the appropriateness for the student to self-carry and/or administer his/her epinephrine
- Periodically check medications for expiration dates and arrange for them to be current.
- Notifications:
- Familiarize classroom teachers with their students’ anaphylaxis EAPs at the beginning of school year, or as soon as the plans are written. Other staff members who have contact with students with life-threatening allergies should be familiar with these plans on a need-to- know basis. Educate new staff as needed.
- Ensure that food allergy alerts are current in both SNAP and Aspen.
- Notify the main food service office of new students with life threatening allergies and provide the school kitchen manager with updates on student allergies.
- Education/Training by School Nurses
- Barnstable Public School nurses will provide education and training to school staff at the beginning of each school year, as well as to parents and students as needed, about life-threatening allergies.
- Staff should know the signs and symptoms of anaphylaxis, how to activate the medical emergency response plan, and be aware of bullying risk for students with allergies. The importance of not bullying or teasing those with allergies should be emphasized.
- Provide in-depth training to staff in frequent contact with students who have life-threatening allergies, as per nurse discretion. In this training, the school personnel may be trained to administer epinephrine by auto-injector in accordance with standards and a curriculum established by the Massachusetts Department of Public Health.
- Barnstable Public School nurses will provide education and training to school staff at the beginning of each school year, as well as to parents and students as needed, about life-threatening allergies.
The training, at a minimum, shall include:
- Procedures for risk reduction
- Recognition of the symptoms of a severe allergic reaction
- The importance of following the medication administration plan
- Proper use of the epinephrine auto-injector
- Requirements for proper storage and security, notification of appropriate persons following administration, and record keeping
All contracted staff (e.g., bus drivers/monitors and school nutrition staff) will receive the same general life-threatening allergy training as permanent school staff. The Director of Health Services will ensure the training is shared with the Director of Transportation, bus drivers/monitors, Director of Food Services and the school nutrition staff.
SCHOOL PHYSICIAN
- Participate in the multidisciplinary team to develop and implement the allergy management and prevention plan as requested.
- Sign standing orders for epinephrine auto injectors and diphenhydramine as needed in an emergency, to be administered by a school nurse in the case of anaphylaxis in an undiagnosed individual.
- Provide education and training to school nurses on any new updates and information related to life-threatening allergies.
Parent/Guardian
- Provide to the school nurse documentation of life-threatening allergy(s) from a licensed healthcare provider, individual anaphylaxis emergency care plan and a provider order for epinephrine, which need to be renewed at the beginning of each school year.
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Provide epinephrine auto-injector as well as other medications ordered.
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Provide parent consent for each medication ordered, renewed annually.
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Collaborate with the school nurse on student’s IHCP, including whether a peanut/tree nut safe table in the cafeteria is needed (grades K-7).
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Provide the Emergency Action Plan to the extracurricular coordinator, teacher or coach, if participating in before and/or after school activities (including sports, before/after care, school-sponsored enrichments, etc.)
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Inform bus drivers and/or transportation department of allergies.
Student with Allergies
Food Service Staff
FOOD SERVICE STAFF
- Annually food service staff will be trained on food allergies, including recognition and treatment (epinephrine auto-injector), and cross contamination, as organized by the Director Food Services.
- Schools with K-7 grade students will have Peanut/Nut safe tables available in the cafeterias that will be monitored by assigned school staff.
- Food service personnel or assigned staff will have the responsibility for cleaning the allergen free tables between each lunch period. Food service personnel will clean allergen free tables with soap and water and the district approved cleaner.
- The food service point of sale system will have food allergies noted in their NutriKids system and food service staff will look at student’s lunch tray and note any items that may cause allergies and address with students.
DIRECTOR OF FOOD SERVICES
- Will make appropriate food/meal substitutions for students with food allergies as requested by parents and documented by health care providers.
- Be prepared to make lists of all ingredients used in food production and service available.
- Understand the legal protections for a student with life threatening allergies.
- Read all food labels and recheck routinely for potential food allergens.
- Train all school nutrition staff and substitutes to read product food labels and recognize food allergens.
- Provide approved allergy awareness training and maintain documentation of training.
- Review and follow sound food handling practices to avoid cross-contact with potential food allergens.
- Following cleaning and sanitation protocols strictly to avoid cross-contact.
- Establish other cafeteria policies regarding students with food allergies as needed
- Have a functioning communication system to activate emergency services and call school nurse if needed.
Classroom Staff
- School staff will participate in annual training regarding allergies and epinephrine auto-injector administration as provided by the school nurse.
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Classroom staff will communicate with parents/guardians if a classroom is “peanut/tree nut safe”, (or other allergen, as indicated), utilizing a standard letter provided by the school nurse.
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A “peanut/tree nut safe” sign will be posted outside the classroom, if needed.
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Review student alerts in Aspen; develop a system to ensure substitutes have knowledge of health alerts including life-threatening allergies.
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Review and understand the EAP of any student(s) in your classroom with life-threatening allergies.
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Participate in a multidisciplinary team to develop and implement the allergy management and prevention plan, as requested by school nurse.
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If animals are present in the classroom, review the ingredients in their food, as many animal feeds contain peanuts.
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As appropriate, educate classmates to avoid endangering, isolating, stigmatizing, or harassing students with food allergies. Be aware of how the student with allergies is being treated; enforce school rules about bullying and threats.
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Never question or hesitate to act if a student reports signs of an allergic reaction. Implement the EAP, which includes alerting the school nurse.
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Prohibit students from sharing or trading any food.
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Encourage hand washing before and after eating.
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Per Wellness Guidelines/Policy, use non-food items for classroom activities.
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Staff should have a walkie-talkie, cell phone, or other device for emergency communication if they are bringing students outside of the building.
Before/After School Activities (Staff/Coaches)
- Before/after school staff, including coaches, should be notified by students’ parents/guardians regarding life-threatening allergies.
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Before and after-school activities sponsored by the school must be consistent with school protocols regarding life-threatening allergies.
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An epinephrine auto-injector is readily accessible, unlocked in the health office, and an adult staff member onsite should be trained on its use, for previously diagnosed students.
Field Trips
- Teachers must submit a field trip request form with a class list to the nurse, 30 days ahead of time.
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School nurses will communicate with the teacher regarding students with life threatening allergies and review the EAPs.
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Staff will be trained to administer epinephrine auto-injector and activate EMS as needed on a field trips.
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Individual student’s epinephrine auto-injectors will accompany them on all field trips, carried by a staff member, or self-carried (if permitted).
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No food should be eaten on the bus, except for students with medical conditions such as diabetes.
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School personnel will have a system for communicating (e.g., cell phone, walkie-talkies, etc.) any problems per the EAP.
Transportation
- Eating food is prohibited on school buses (except in the case of a documented medication condition, such as diabetes).
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School bus drivers will be trained by appropriate personnel on risk reduction procedures, recognition of allergic reaction, and implementation of bus emergency plan procedures, including the administration of epinephrine (per 540 CMR 8.00 [Registrar of Motor Vehicles] pursuant to M.G.L. c. 90, § 8A). Drivers with contracted bus companies should receive the same allergy training as permanent staff.
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There are no stock epinephrine auto-injectors on busses. 911 must always be called.
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The school bus driver must have a cell phone, walkie talkie or other means of communication for emergency calls.
Custodial/Environment
- All schools are LATEX-FREE.
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Cleaning procedures in areas of the school where allergens may be found include warm soapy water or approved district product, per department requirements.
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Each school has their own cleaning schedule.
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Building staff and/or nursing to notify principal and maintenance if there is an identified area of concern for students with bee/insect allergies. Prompt removal of any bee/insect nests in buildings or grounds.
Emergency Response
- The district will maintain a medical emergency response plan as required by DESE.
- The Director of Health Services registers annually with the Massachusetts Department of Public Health to train unlicensed personnel on administering epinephrine by auto-injector.
- All staff will be offered annual training on life-threatening allergies and administration of epinephrine by the school nurse in each building at the beginning of each school year.
- The Massachusetts Department of Public Health regulations require auto-injector training twice a year at a minimum.
- Stock epinephrine autoinjectors will be on the wall in each nurse’s office, unlocked. Student epinephrine autoinjectors will be unlocked in the nurse’s office.
Wellness Guidelines & Policy
Wellness Policy
District Wellness Advisory Committee
The district-wide Wellness Advisory Committee is an essential component of a successful, comprehensive, coordinated school health program. The committee's collective knowledge, expertise, influence, and advocacy can be a powerful force on behalf of the program. As a district-wide advisory body, the committee can identify health and social problems related to the community's youth, develop viable solutions, and identify key resources.
The Committee participates in the development, review, updating, and implementation of the Local District Wellness Policy. The Wellness Committee members include school administration, school nurses, food services, teachers, members of the community, students and parents.
To learn more about the Wellness Committee or to join, please contact Alicia Bryant, Director of Health Services
District Wellness Guidelines
The Barnstable Public School district is committed to providing school environments that promote and protect children's health, well-being, and ability to learn by supporting healthy eating habits and physical activity. School districts are required by Section 223 of Chapter 111 of the Massachusetts Generals Laws to have a wellness policy. In an effort to create an environment that promotes healthy lifelong eating and exercise habits, the following guidelines (based upon have been established.
Nutrition standards for foods SOLD in school (signed into law 2010) |
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Foods Sold Nutrient Requirements:
Beverage Guidelines: Water without added caloric or artificial sweeteners or color; fruit and vegetable juices and fruit based drinks that contain 100% juice and no additional sugar; unflavored or flavored low fat (1%) or fat-free milk are permitted. Portion sizes: elementary schools may sell up to 8 ounce portions, while middle schools and high schools may sell up to 12 ounce portions of milk and juice. Resource: USDA’s Smart Snacks in Schools |
Snacks
Snacks served by the schools during the school day or during after-school care or enrichment programs will follow the nutritional standards and make a positive contribution to childrens’ diets and health, with an emphasis on serving fruits and vegetables as the primary snacks and water as the primary beverage. The district will make available a list of healthy snack items to teachers, after-school program personnel, and parents on health services websites, newsletters, or handouts.
We ask that everyone consider moderation as well as a thoughtful approach focused on wellness for all rewards, celebrations, fundraising activities, and events.
Rewards
If schools provide food or beverage rewards for academic performance or positive behavior, they shall utilize the USDA’s Smart Snacks in Schools guidelines (see above), or the district's food service provider catering menu through the teacher during the school day. Schools are highly encouraged to use other options besides foods for rewards. Food or beverages will not be withheld as a punishment.
Celebrations
Given the schools’ role to promote student health,principals and staff will promote non-food celebrations. Schools should limit celebrations that involve food during the school day to no more than one party per class per month. No outside food that is prepared at home for sharing will be allowed during the school day. Only products that are labeled, pre-packaged and purchased from a licensed vendor will be allowed or food can be ordered through the district's food service provider by a staff member.
Fundraising Activities
To support children's health and school nutrition goals, there will be no food fundraisers sold to students during the school day. These standards do not apply during non-school hours. Schools will encourage fundraising activities that promote physical activity and other non-food alternatives. The school district will make available a list of ideas for alternatives to food fundraising activities. PTOs will be notified of guidelines.
Foods/beverages sold in vending machines, school stores and concession stands/snack bars
Foods and beverages offered or sold at school-sponsored events during non-school hours (including, but not limited to, athletic events, dances, performances, presentations) will be encouraged to meet the nutritional standards for foods and beverages. During the school day, only foods that align with the school meal nutrition standards will be allowed, and no foods prepared in someone’s home can be shared with other students.
Communication with parents/guardians
The schools will provide nutrition guideline information to parents/guardians, through web sites, newsletters, or handouts. Schools should encourage parents to pack healthy lunches and snacks for their children. Ideas for healthy celebrations, rewards and fundraising activities can be provided by the school.
Physical activity opportunities and physical education
Physical activity and education is provided in grades K-7, and opportunities for physical activity and education are offered in grades 8-12. Whenever possible, schools should work to increase recess and physical activity times, including during inclement weather days by utilizing indoor spaces. Annual walk-a-thons are encouraged for all students and staff.
Physical activity opportunities before and after school
All schools are encouraged to offer extracurricular physical activity programs, including a range of activities that meet the needs, interests, and abilities of all students.
Physical activity and punishment
All schools will promote "reflective walking" rather than withholding recess/physical activity as punishment, as per the discretion of the Principal.
Health education
Health Education is provided in grades K-7, and opportunities for health education are offered in grades 8-12 that focus on healthy choices.
Staff wellness
Each school will promote and support staff wellness. This can be done through individual school Wellness Task Forces, and will utilize staff input to encourage healthy eating and physical activity among staff.
Monitoring
The superintendent (or designee) will ensure compliance with established district-wide nutrition and physical activity wellness policies.
In each school, the principal will ensure compliance with those policies and will report on the school's compliance to the school district superintendent (or designee).
All schools are highly encouraged to have a Wellness Task Force or, at a minimum, incorporate wellness into the agenda of at least two meetings at their school to address wellness related concerns in their building and to improve wellness policy compliance within their school.
School food service staff, at the school or district level, will ensure compliance with nutrition policies within school food service areas and will report on this matter to the superintendent, or if done at the school level, to the principal.
Each year, the District Wellness Advisory Council will review wellness practices and provide resource information to schools as needed and requested.
Revised October 2021