Health Office

A school nurse or program director might exclude a LABBB student from school or school-related activities for health reasons if that student has returned from a hospital visit— including an emergency room visit that did not result in hospital admission—without the required documentation unless that visit was for routine lab tests. Students may also be excluded during the infectious period of a variety of communicable diseases or for the following:

• A fever greater than 100°F unless that student has a documented temperature regulation issue and is otherwise asymptomatic. The student’s temperature must be below 100°F for 72 hours, without the use of medication, before returning to school.
• COVID-like symptoms or a known COVID exposure.
• Strep throat. Students may return to school 24 hours after beginning antibiotic therapy.
• Pending culture labs. (Exceptions can be made at the discretion of the school nurse.)
• Respiratory precautions due to a significant change in their respiratory status.
• Chickenpox or shingles with an active rash. All dry, non-weeping shingles rashes must be covered before returning to school.
• Significant seizure activity.
• Excessive sleepiness.
• Excessive bleeding, especially after a dental visit.
• Persistent vomiting or diarrhea. Students must be symptom-free for 24 hours before returning to school.
• A condition, like a broken bone, that requires immediate medical attention.
• A condition that requires ongoing medical supervision that cannot be provided in the school setting.
• Posing a significant health risk to the general school population. For example:
  • students in the infectious stage of an airborne illness or disease;
  • students unable to manage their bowel and bladder functions who are in the infectious stage of an oral-fecal transmitted disease such as Hepatitis A, Rotavirus, Giardia, Salmonella, or parasites;
  • or students with a disease that can be transmitted through body fluids whose developmental level makes it difficult for them not to touch lesions. Examples of such diseases include herpes, impetigo, hepatitis B, staph, strep, and conjunctivitis.

The SNAP Health Portal is an online platform that provides direct access to the health records of your student, like an electronic health record portal provided by your physician’s office. This web-based system provides an easy, secure, and green way for you to update and review important school health information and medical documents throughout the year. With 24-hour access over the web, you will be able to:

• Electronically sign and submit all health forms safely over the internet
• Review and update new health information such as vaccinations, health conditions, and screening results throughout the school year
• Receive immediate notifications when there are changes in your child’s health status
• Easily message the school health clinic to expedite communication

You can access the SNAP Health Portal here. 

FAQs: SNAP Parent Health Portal

• https://docs.google.com/document/d/1zosrxmh_6Z0cxY_hGSciuektbla90IKNa5a3Pru02t8/edit?usp=sharing

SNAP Portal Overview

• https://docs.google.com/document/d/1sDuyjhC2ckYF8CRbDhWrKc-MFuotz5JlL6m1i4ov9Sk/edit?usp=sharing
• https://youtu.be/mSVajSWVZ0M?si=sBn9Ui0cgNf5L3hx

In accordance with regulations set forth by the state of Massachusetts, LABBB students will participate in health screenings each school year. These screenings are performed by the school nurses and trained personnel. 

Please reach out to your student’s school nurse with any questions or to opt out of the screenings. More information can be found on the Massachusetts Department of Public Health School Health Services website.

Health Screenings by Grade

• Vision: 
• Grades K–5, once in grades 6–8, and once in grades 9–12
• If your child is already followed by a specialist, you may want to opt out here.
• A vision screening is a technique used by trained nurses to determine if an individual might have a vision problem. The screening uses a chart with letters or symbols at a specific distance away from the student and tests vision accuracy. A vision screening is different from a professional eye examination by a licensed optometrist or ophthalmologist. This specially trained optometrist or ophthalmologist looks at all aspects of your child’s vision and eye health and will establish a plan for a vision problem if one is detected.
•   If your child fails their screening, they will be referred to a specialist. 
• Hearing: 
• Grades K–3, once in grades 6–8, and once in grades 9–12
• If your child is already followed by a specialist, you may want to opt out here. 
• A  hearing screening is a technique used by specially trained school personnel to determine if an individual might have a hearing problem. It is usually a small tabletop machine with headphones for the student to wear to test for hearing accuracy. A hearing screening is different from a professional hearing examination which should be performed by a licensed audiologist and otolaryngologist/otologist. These specially trained providers look at all aspects of your child’s hearing and will establish a treatment plan if any problems are detected. 
• If your child fails their screening, they will be referred to a specialist. 
• BMI: 
• Grades 1, 4, 7, and 10
• You can opt out of the yearly BMI screening through this form. 
• What is Body Mass Index (BMI) Screening?
• BMI screening is a tool used to identify individuals who might be at risk for being underweight or overweight. BMI results are confidential and not shared. School BMI results are reported to MDPH in aggregate form, meaning student names and any identifying factors are not reported.
• Why Do We Do BMI in School?
• The purpose of BMI screening in all schools is to gather valuable data that can help MDPH monitor trends in childhood obesity and identify possible solutions. Its goal is to focus on supporting change at the system and environmental level, not at the individual level. 
• Postural: 
• Grades 5–9
• Postural screening is a procedure performed by a nurse to help determine the risk for a curvature of the spine. All students are given the option to decline the screening.
• Why Do We Do Postural Screenings in School?
• The purpose of postural screenings is to identify early signs of spinal curvatures and other issues. The first mild signs of curvature usually appear in early adolescence and because they almost always develop without any pain or discomfort, they often go unnoticed and untreated. Most curvatures and other spinal issues can be easily treated if detected early. 
• SBIRT: 
• Once in a middle school grade and once in a high school grade
• If you do not want your student screened for substance use risk behaviors, you can fill out this form. 
• If any positive results are determined at time of the screening, follow-up steps will be made between the screener and student. Per Mass Gen Laws c.71, §97(c): “All statements and disclosures made by the student during the screening shall be considered confidential information and shall not be disclosed without the prior written consent of the pupil, … except in cases of immediate medical emergency….”.

• What is an SBIRT Screening?

• SBIRT is a screening questionnaire tool used by specially trained school professionals to identify students who might be at risk for substance use disorders. At LABBB, school nurses and school counselors can conduct the SBIRT screenings using the CRAFTT-N screening questionnaire during a private, structured 1:1 conversation with students to help build trusting relationships around education, behavior, and support related to substance use.

• Why do we Screen for SBIRT in Schools?

SBIRT is intended to identify substance use risk behaviors and to improve the health, safety, resilience, and success in students. SBIRT screening provides a unique opportunity for the student to sit with a trusted adult on a 1:1 basis and receive personalized education about the risk of substance use on the young developing brain, to ask questions in a private setting, and to address any concerns. For more info, click on SBIRT in Schools and FAQs.

Guardians complete Annual Health Paperwork so that school nurses are able to safely care for children in the school setting. The school nurse should also be made aware of all important health conditions and any medications your child is taking, at home and in school. 

Activity Restrictions, Changes in Status, or New Conditions

• We understand the complex medical needs of LABBB students may evolve during their time with us. To best support them in school, we ask that you reach out to your school nurse anytime there’s a major change in your student’s medical conditions, a new condition, or a new restriction in their activity. 
• This information helps us make a supportive plan for your student and allows us to train our staff members using the most up-to-date information. 

Notify the School Nurse for Any of the Following Reasons:

• New medical diagnosis or any change in your child’s physical, behavioral or emotional health status.
• A change in seizure frequency, duration, or presentation.
• Recent serious injury or illness requiring emergency treatment, hospitalization or surgery.
• If absent for more than 3 days due to illness, injury, or mental health condition. 
• Updates to dietary needs or feeding protocols
• Any injury requiring sutures, casts, immobilizer boots, crutches, or wheelchair. 
• Any life-threatening allergy, such as peanuts, latex and/or insects, requiring Epipens.
• Any medication that may affect your child in school.
• Head injury or new concussion diagnosis.
• Upcoming scheduled surgeries or medical procedures
• Changes to medical devices or equipment

We want to make managing your child’s health needs at school as clear and seamless as possible. To help, our nursing team has put together answers to some of the most common questions we receive from families.

Every student is unique, so if you don’t see the specific information you are looking for below, please don’t hesitate to reach out to your student’s school nurse directly. 

We are always here to help!

• Do LABBB staff members undergo any health training?

1. Yes, we perform yearly training on allergies, seizures, and asthma. Additionally, many of our staff members are trained in CPR, the heimich maneuver, and basic first aid. With permission, we can provide specialized training on your student’s medical needs to pertinent staff members on your student’s team.  

• I’ve been referred out for a particular mandated health screening, but I’m not sure where to go! Do you have any suggestions?

1. Yes, we do! We keep a list of pediatric optometrists and audiologists. We made sure to include a few that had experience with the disabled population. Just ask your nurse. 

• My kiddo doesn’t like the dentist! Can you help with that?

1. Yes we can! We have a list of neurodivergent/disability-friendly dentists in the larger surrounding area. Just ask your nurse. 

• I’m having a hard time scheduling a physical without a long wait list. Can you help?

1. Yes! We have partnered with a local urgent care to provide free school physicals to our LABBB families. While this doesn’t completely replace a physical performed by a PCP, it improves your student’s access to healthcare until your next primary care provider appointment. Just ask your nurse for a voucher. 

• I need help with supplies/insurance/something else. Can you help? 

• We may not be able to help directly, but we may be able to refer you to someone who can. MASSTART is an incredibly helpful, publicly funded organization that works to connect families to resources.  

• How does the LABBB nursing department promote autonomy through health interactions?

• LABBB nurses are encouraged to counsel students on the name, dose, and reason for their medications. Students are offered privacy during health office visits and play an active role in their care.  Some students may be evaluated for self-administering and self-carrying their medication, as appropriate, to promote independence post-22. 

• May I send my child to school with a cold?

• Yes, but your child must be fever free without fever reducing medication for the past 24 hours. Your child should feel that they can get through the planned school day without exclusion from planned activities. If you have questions, please feel free to reach out to your school nurse. 

1. How do I send my child’s prescription or emergency medication (like Diastat, Valtoco, or an EpiPen) to school?
1.  All prescription medications must be delivered directly to the school nurse by a parent or responsible adult. Please do not send medications in your child’s backpack unless it’s in a locked bag and the code has been given to your nurse. Medications must be in their original, pharmacy-labeled container and unexpired. We must have a signed doctor’s order and parent consent form on file before we can accept them.
2. My child requires G-tube feedings or has a specialized pureed diet. How is this managed? 
1. We work closely with families to ensure feeding protocols are followed. Parents are responsible for supplying all daily formula, feeding bags, pump tubing, or specialized thickeners. We also require an updated physician’s order for any tube feedings or specific dietary modifications to ensure your child’s safety.

• Can the nurse give over the counter (OTC) medications?

• Acetaminophen and ibuprofen may be given to a student with written permission from the parent/guardian.  Permission available here through the SNAP Portal. 

•  What do I do if my child has been hospitalized or ill for a prolonged time?

• Re-entry is terminology used to signify the return of a student to the school environment after a medical hospitalization, a psychiatric evaluation or hospitalization, or a prolonged absence. We may request a written statement/discharge plan from the student’s physician for the team’s consideration in planning and coordinating appropriate services and in assessing health needs for the student. 

• How can I make sure that my child is protected with sunscreen and/or insect repellent?

• Parents are responsible for supplying sunscreen and/or insect repellent for students. We do not keep a stock supply. Parents are encouraged to apply sunscreen before students arrive at school, but it may be re-applied during school as needed. 

• What is medication delegation?

1. To help a student maintain their independence or access their-community-based schedule, nurses may delegate medication administration or certain treatments to trained, specialized staff members on a case-by-case basis. Parents will be informed of any plans for medication delegation. 

• I’m new to LABBB, what do I need for paperwork?

• We need a physical signed by the doctor within the last year and all updated vaccines. We also need all emergency action plans and medication orders signed by the doctors. All emergency action plans, treatments, and medication orders need to be renewed in August. All medications need to be picked up at the end of the summer program, or they will be destroyed.

1. What is an Individualized Health Care Plan (IHCP), and does my child need one? 
1. An IHCP is a formal, written document created by the school nurse in collaboration with you. It outlines exactly how your child’s specific medical needs (like seizure management, severe allergies, or diabetes) will be handled during the school day. If your child has a complex medical condition, emergency medication, or requires specific nursing interventions, we will work with you to develop an IHCP. 

• Is there someone I can contact to discuss my child’s special health care needs?

• Parents are encouraged to call or email their child’s school nurse. The nurse on your student’s team will be happy to support you. 

• LABBB Community Resources
• MASS DPH
• Food Allergy Resources
• Epilepsy Foundation
• Healthy Children
• Association for Autism and Neurodiversity
• Federation for Children with Special Needs
• Autism Alliance
• MASSTART