Massachusetts - Referrals: Program requirement

Program Requirement
Policy Type: 
statute; regulation

State law addresses providing referrals to private physicians or community health partners.

General Laws of Massachusetts Chapter 111. Section 223: Nutrtional standards for sale or provision of foods or beverages in public schools

(b) The department, in consultation with the department of elementary and secondary education and the department of mental health, shall establish, and periodically review, guidelines for:

  • (i) the training of all public school nurses in behavioral health and appropriate screening and resources for the treatment of childhood obesity and behavioral health disorders, including eating disorders;

  • (ii) the recognition, treatment and availability of resources for children at risk for and diagnosed with childhood obesity and type 2 diabetes;

  • (iii) professional development and training of public school nurses and aid staff to gain the most up-to-date knowledge on childhood obesity, eating disorders and type 2 diabetes so that they can become more effective at screening for these conditions and making appropriate referrals for treatment; and

  • (iv) the establishment of a referral program where medical resources in the community shall collaborate with public schools to identify children in need of nutritional services, and provide these resources through in-school, outpatient and inpatient settings, where appropriate.

Code of Massachusetts Regulations 105 CMR 200.400: Vision and Hearing Screenings

(E) For any student who does not pass a vision or hearing screening, a written plan shall be developed by the school nurse, in consultation to the extent possible with a student's parent or legal guardian, for appropriate follow up of the student. With the consent of the parent or legal guardian, the student's primary care provider shall be furnished with a copy of the record of screening tests performed in the school.
Massachusetts Department of Public Health

General Laws of Massachusetts Chapter 71. Section 57: Physical examination of pupils

Section 57. The committee, or the board of health in those municipalities where school health services are the responsibility of the board of health, shall cause every child in the public schools, and at the individual request of a parent or guardian of a pupil in a private school which has been approved under section one of chapter seventy–six, and which does not discriminate in its entrance requirements on the basis of race or color cause such pupil to be separately and carefully examined in such manner and at such intervals, including original entry, as may be determined by the department of public health after consultation with the department of education and the medical profession, to ascertain defects in sight or hearing, postural and other physical defects tending to prevent his receiving the full benefit of his school work, or requiring a modification of the same in order to prevent injury to the child or to secure the best education results, and to ascertain defects of the feet which might unfavorably influence the child’s health or physical efficiency, or both, during childhood, adolescence and adult years, and shall require a physical record of each child to be kept in such forms as prescribed by the provisions of section one hundred and eighty–five A of chapter one hundred and eleven. Tests ascertaining postural defects shall be administered at least once annually in grades five through nine. Tests of sight and hearing and postural defects shall be performed by teachers, physicians, optometrists, nurses or other personnel who are approved by the department of public health for the purpose, and the examination of feet shall be made by the school physicians or by podiatrists, in accordance with regulations set up by the department. Upon entering kindergarten or within 30 days of the start of the school year, the parent or guardian of each child shall present to school health personnel certification that the child within the previous 12 months has passed a vision screening conducted by personnel approved by the department of public health and trained in vision screening techniques to be developed by the department of public health in consultation with the department of education. For children who fail to pass the vision screening and for children diagnosed with neurodevelopmental delay, proof of a comprehensive eye examination performed by a licensed optometrist or ophthalmologist chosen by the child’s parent or guardian indicating any pertinent diagnosis, treatment, prognosis, recommendation and evidence of follow–up treatment, if necessary, shall be provided. Any child shall be exempt on religious grounds from these examinations upon written request of parent or guardian on condition that the laws and regulations relating to communicable diseases shall not be violated.

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