HB 131 - mental health education programs

Bill Title: Establishing a commission on mental health education programs.

Summary: This bill establishes a commission to develop and promote mental health programs in kindergarten through grade 12.  The bill has a list of professions that should be included on the commission.  Nurses are not listed.

Full Bill Text:  https://legiscan.com/NH/text/HB131/2019

Bill Sponsors:  Patricia Cornell, HIllsborough, District 18
Connie Van Houten  Hillsborough, District 45
Donovan Fenton  Cheshire, District 8
Joelle Martin  Hillsborough, Milford, District 23
Mary Heath  Hillsborough  District 14
Skip Berrien  Rockingham  District 18
Tamara Le  Rockingham  District 31
Timothy Smith  Hillsborough  District 17

Bill Status:  
1/02/2019:  Introduced in the House and assigned to House Education Committee
1/16/2019:  Public Hearing 10:15 am in LOB 207 - 
Laurie Fleming from NHSNA attended and testified to the importance of having a nurse, more specifically a school nurse, on the commission
2/14/2019: Passed the House with amendment.  Amendment included " One school nurse, appointed by the New Hampshire School Nurses' Association, appointed by the association."  

Next steps:  The  bill will move over to the Senate.   

HB 719 - establishing the position of school nurse coordinator

Bill Title: establishing the position of school nurse coordinator in the department of education and making an appropriation therefor

FULL BILL TEXT

Summary:  To establish within the division of learner support the position of school nurse coordinator who shall be a classified employee qualified to hold such position by reason of education and experience. The school nurse coordinator shall coordinate and guide school nurses and other school personnel responsible for student health care in the areas of student health and wellness, safety, behavioral and mental health, and alcohol and substance misuse. The school nurse coordinator shall be a resource for administrators, professional development, parental education, and legislators.

This position currently is vacant.  This bill would fund the position withing the NHDOE.  NHSNA strongly supports this bill and helped craft it with Representative Polly Campion.

Sponsors:  Polly CampionLinda TannerMary HeathSkip BerrienJoelle MartinShannon Chandley

Bill Status:  1/03/2019  Introduced in the House
1/18/2019:  Referred to House Education Committee   
1/30/2019  Hearing before the House Education Committee,  Legislative Office Building   33 N State St, Concord, NH 03301 Room 207
Results of hearing: A public hearing before the Education Committee was held on 1/30/2019.  Several NHSNA members were in attendance and testified for the bill.  In addition NHSNA presented the committee with:

  • Copies of 27 letters of support from School Nurses and Stakeholders
  • A copy of the Online Petition. 164 people had responded, 100% supported the bill.  
  • Supporting documents of what a School Nurse Coordinator would do
  • Supporting documents of other states which have Coordinators / Consultants

2/27/2019 Passed the House, 198-146 

Next Step:  Passed onto the Finance Committee

NHSNA has drafted a sample letter for you to communicate with legislators.


Sample letter to Legislator that School Nurses could use
 

-- SB 137 -- To amend current school nurse certification

Senate Bill 137  Title: relative to the certification of school nurses   Full Bill Text

Current RSA 200:29     Current Rules on implementing RSA 200:29

Summary: This bill provides for the application of education and certification requirements for school nurses.  This bill would make changes to the current certification requirements in the following ways:

  • ADD a grandfathering clause to include school nurses hired before July 1, 2019   Note that the grandfathering clause was written into the rules, but the law should also include it.  This bill would also extend the number of nurses who quality for grandfathering
  • ADD:   All school nurses appointed after the effective date of this paragraph and before July 1, 2022 holding an associates' degree in nursing, and all nurses hired before the effective date of this paragraph who did not meet the application deadline in subparagraph (a), shall be enrolled in a registered nurse to bachelor of science in nursing program and shall complete such program within 6 years of the date of this paragraph.
  • ADD:  All school nurses appointed on or after July 1, 2022, shall meet the certification requirements in paragraph II, pursuant to rules adopted by the state board of education.

Bill Sponsors:  
Senator Jay Kahn  District 10
Senator Ruth Ward  District 8

Bill Status:  
This bill has been assigned to the Senate Education and Workforce Development Committee
Hearing wasMarch 12th @ 9:45 AM
Four people testified in favor, none against.
Executive session was held the same day.  VOTE:  4 to 1 in favor,  will not go to the full senate for a vote.  Probable date of 3/14/19 or 3/21/19. 

-- HB 275 -- to repeal school nurse certification

Bill Title: relative to repealing school nurse certification

Summary:  To amend RSA: 200:29 and repeal school nurse certification

Full Bill Text

Bill Sponsors:  Josh Yokela, Rockingham District 33
Dennis Acton, Rockingham  District 10
Timothy Lang  Belknap- District 04
Carol McGuire Merrimack- District 29
Sean Morrison Rockingham- District 09  
Max Abrahamson  Rockingham- District 20
Rick Ladd  Grafton- District 04
Ralph Boehm  Hillsborough- District 20
Russell Ober   Hillsborough- District 37
Chris True Rockingham- District 04

Bill Status: 

01/02/2019 Introduced and assigned to Education Committee

1/8/2019 Public Hearing Scheduled for 01/22/2019 01:00 pm LOB 207
NHSNA members will be present and testify to kill this bill.
NHNA members will be present and testify to kill this bill.
Kent Street Coalition will have parents testify to kill this bill.
Children's Behavioral Health Coalition and New Futures will submit written testimony to kill the bill.

2/5/19: Executive Session of the The Education Committee  Split vote 10 to 10

3/07/2019:   This bill was Tabled on the floor of the house.  This means that the bill will NOT move forward.

2018 Year: SB 322:  Bronchodilator/spacer/nebulizer

Asthma Action Plan Form          Fact Sheet on SB322          Download SB322 here

Senate Bill 322, passed in May 2016, allows school nurses to maintain a stock bronchodilator for the emergency treatment of asthma.  The use of the bronchodilator is limited to those students with a diagnosis of asthma, have a current Asthma Action Plan, and whose own inhaler is not available.  The inhaler can be used for multiple students but each student must be provided with a separate spacer.  The spacers cannot be shared.  The Office of Student Wellness website has is a powerpoint module that school nurses are welcome to use or adapt for staff training.  Each school year the use of the stock bronchodilator is to be reported; the form is also posted on the website.

The New Hampshire School Nurses Association has been collaborating with the New Hampshire Department of Education, the New Hampshire Public Health Association, the New Hampshire Asthma Collaborative, Acelleron and Convenient MD to find bronchodilator, spacer and nebulizer resources.

2018 Year: DOE School Nurse Certification

House Bill 1193 on School Nurse Certification

HISTORY:  The board of the New Hampshire School Nurses' Association is collaborating with the New Hampshire Department of Education to develop a certification process for School Nurses. It is the postion of NHSNA that  certification would establish a standard of practice to ensure that all children are receiving the highest level of health care that will allow them to reach their full educational potential.  This certification will be separate from teacher certification and school nurses will not be expected to teach.

NOTE:  It is not the position of the New Hampshire School Nurses' Association to interpret the rules.  Any questions on how the rules apply to you should be asked of the NH DOE Credentialing Office.

History/Context:
There are approximately 500 school nurses in New Hampshire, serving 618 public and private schools.  The role of the professional school nurse is currently defined by New Hampshire School Nurse Certification Law (RSA 200:29, II), with the current rules approved by JLCAR (Ed 306.12).  Certification ensures a professional level of qualification for the position of school nurse, which will support a minimal standard of care for students with acute and chronic health needs in school. 

New Hampshire school nurses are members of a unique discipline of professional nursing and are often the sole healthcare providers in their districts.  They are both an independent clinician and manager of school health services.  It is imperative that school nurses are prepared for and practice at the same level as their colleagues, such as teachers who are certified, as well as other adjunct therapists who are prepared with Masters Degrees, for example occupational therapists, physical therapists, and speech therapists.  


2016 Year: Senate Bill 25 FN-Relative to Epinephrine

HISTORY: This bill was introduced lin 2016 by Senator D’Alessandro of the Education Committee and was referred to committee.  This bill allows schools to acquire and maintain a supply of epinephrine auto-injectors with the intent of making them available to ANY student showing symptoms of anaphylaxis, and for the school nurse to train designated school personnel to receive training in the administration of an epinephrine auto-injector to any student with symptoms of anaphylaxis.
 FULL BILL FOUND HERE

CURRENT STATUS:  
Completed Legislative Action
Spectrum: Partisan Bill (Democrat 1-0)
Status: Passed on May 4 2016 - 100% progression
Action: 2016-05-04 - Signed by the Governor on 05/03/2016; Chapter 0039; 

Effective 07/02/2016
Text: Latest bill text (Chaptered) [HTML]

UNH STUDENT TRAINING RESOURCES     The school nurse has the authority to possess and administer epinephrine as a stock medication to use in the event of anaphylaxis, a severe and life threatening allergic reaction. There are students who experience their initial allergic episode during the school day and having access to epinephrine has prevented serious life threatening results. An EpiPen provides a safe and easy delivery system of epinephrine that can be used by an unlicensed person. This module has been developed as a training tool for school staff and includes essential information about anaphylaxis and the use of an EpiPen. Each school nurse maintains a list of those staff members trained. We would like to thank the senior nursing students from the University of New Hampshire for participating in this project.

Epinephrine Training Certificate

Epinephrine Auto Injector Training Evaluation Form

Epinephrine Auto Injector Training PPT

2015 Year: Glucagon injections
HISTORY: Sponsor: Senator Stiles District 4   This bill passed without input from NHSNA. This bill allows parents to train and delegate school staff on glucagon administration.  

CURRENT STATUS: Effective Date: July 4, 2015   FULL TEXT HERE

Glucagon Administration Training for Non-Medical School Personnel

A joint project project of NHSNA, Office of Student Wellness and Senior UNH Nursing Students

In an effort to provide the highest quality information and training in an accessible manner, the Office of Student Wellness is please to provide the following information on the administration of Glucagon to students by non-medical personnel. School nursing staff are encouraged to utilize the documents below and to contact our office with questions. We would like to thank the senior nursing students from the University of New Hampshire for participating in this project.

Glucagon Training PowerPoint       Please be aware that the slides will advance after one minute, your arrow buttons will work to advance or back up.

Glucagon Pre-Test and Answer Key
Post-Test and Answer Key
Glucagon Administration Checklist
Training Program Evaluation
Program Certificate of Completion

Naloxone

The New Hampshire School Nurses' Association formed a study committee in October 2015 to look at the issue of Naloxone in the schools.  Their work is now complete and the board of the NHSNA approved the a position statement for distribution.

Opioid related  overdose kills hundreds in New Hampshire every year. Many of these deaths are preventable with the timely use of an opioid antagonist (naloxone) as well as the quick summoning of EMS and the initiation of care. NH school nurses, as allowed by local administration and policy, are in the position to administer life-saving measures in the event of an opioid overdose. In addition, as an integral part of the interdisciplinary team, school nurses are also in the unique position to provide prevention awareness and support to students, family, faculty, and staff-- a critical step in the on-going management of substance abuse and misuse.

In response to the opioid crisis in New Hampshire, the state has created the campaign "Anyone. Anytime." to educate the public and professionals about addiction, emergency overdose medications, and support services for anyone experiencing opioid addiction. 

NH Naloxone laws and resources: 
NHSNA Position Statement
Anyone, Anytime  DrugfreeNH
House Bill 270 - Good Samaritan Law
House Bill 271 - Friends & Family Access to Naloxone

NH Board of Nursing Position Statement: RN Role in Off Label Medication UsePosted March 16th, 2016
The board determined that an off label medication can be administered or delegated with an appropriate provider order. The nurse should be familiar with the drug purpose and side effects in relation to the client that is receiving the medication.

FULL TEXT HERE

Vaccine Registry
HISTORY:  
New Hampshire is the only state without a centralized immunization registry. The NH Legislature in 1998 ordered the creation of a “single repository of accurate, complete and current immunization records to aid, coordinate and promote effective and cost-efficient disease prevention and control efforts.” But the initiative was never funded. 

The NH  Executive Council on in April 2014 approved a $1.3 million contract with an Arizona company to get a registry up and running. Everyone who administers vaccinations will enter information into the system, but only designated DHHS personnel would have the passwords needed to access the information on an aggregate or individual basis.
Massachusetts became the 49th state to adopt an online vaccination registry in 2011, leaving New Hampshire as the only state without one

CURRENT STATUS:
Years in the making, N.H. immunization registry hits snag during rulemaking
By CASEY McDERMOTT,   Concord Monitor Staff:  January 4, 2015


ENDS = Electronic Nicotine Delivery SystemsSince 2010, it has been illegal (RSA 126 K) for NH youth under 18 year of age to buy and/or use ENDS. ENDS are also included in the indoor clean air act (Indoor Smoking Act, RSA 155:64-77), making it illegal to use them in all the same places as combustible (tobacco) cigarettes. 

Download Flyer from Tobacco Free NH network

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