Advocacy

MA Legislation: Creditable Service for School Nurses update- May 2023

Medicaid  Bill Update March 2023

Postural Screening Bill Update March 2023

If this Bill is passed, Postural Screening would only need to be performed in schools annually for one grade instead of all grades 5-9.

MSNO supports this legislation to reduce postural screening frequency in schools because:

• The U.S. Preventive Services Task Force concluded there is insufficient evidence to recommend routine postural screening,
• Critical time on learning is lost over 5 grades,
• Many parents/guardians opt-out each year (school nurses report up to 60% opting out of the screening)
• Primary Care Pediatric Providers perform postural screening as part of the physical exam,
• School Nurse time is better used for other screenings, such as the universal SBIRT substance use screening in two grades as required by the 2016 STEP Act, and
• 93-97% of MSNO members polled in December 2018 (42% of all members, 365 school nurses) support filing this postural screening legislation.

• This bill with the same language was originally filed in 2016, and again in 2018 and 2020.  Each time the bill has moved further; in 2021, the bill made it to the House Ways and Means Committee.

There are only 7 states, including Massachusetts, that require Postural Screening by law. Please visit US Preventative Services Task Force for more information.

Attention School Nurses:

Please spend just a few valuable moments to help influence the direction of the postural screening bill. We need your help to make a difference! Even if you have already called or emailed, we need you to do it again!

Please email your legislators ASAP to ask them to contact the Chair of the House Ways and Means Committee, Representative Aaron Michlewitz, or the Speaker of the House, Representative Ronald Mariano, and ask them to move the postural screening bill out of the House Ways and Means Committee to Senate Ways and Means.

Emails are needed as soon as possible!

At the close of the formal legislative session on July 31st, the Postural Screening bill (H.2335 and S.1401) remained in the House Ways & Means Committee and did not go to study. It is still there and can be moved forward during this informal session. Legislators continue to meet during this time and work on some of these remaining bills.

This week we met with Representative Kay Khan, who filed the bill in the House for us, to discuss getting this bill passed. She recommended emailing your representative, identify that you are their constituent, and ask them to move the bill forward. 

It is also imperative that any school nurse who is a constituent of Chair Michlewitz or Speaker Mariano reach out to them personally and ask them to move it forward as one of their constituents. Your contact will have an impact!

As this bill is in the House, we are focusing our efforts on emailing Representatives (not Senators) at this time. 

Sample Email for Postural Screening Call to Action

Written Testimony regarding the Postural Screening Bill by Jenny Gormley

Update regarding the Postural Screening Bill

• The Postural Screening Bills (Senate Bill, S1401, filed by Sen. Cyr; House Bill, H2335, filed by Rep Khan; same language in each bill) have moved to the Joint Committee on Health Care Financing where it will be reviewed by legislators on this Committee.
• MSNO has sent a letter to the Co-Chairs of the Committee, Sen. Cynthia Friedman and Rep. John Lawn, Jr., to ask them to favorably review the bill.
• In January, we will reach out to you to call your legislators for their support to move the postural screenings bills through remaining committees for a legislator vote before this legislative cycle ends Dec. 2022.

Update regarding Medicaid Reimbursement Bills Coming Soon

SB1401 An act to update postural screening in schools
filed by Senator Julian Cyr

The Massachusetts School Nurse Organization has filed 2 Bills related to Postural Screening in the MA House and Senate with the same title and language.

These are the same bills that MSNO filed in the last legislative cycle starting 2019 when 71 MA legislators signed up to co-sponsor them. Here is a summary of the postural screening bills and reasons for filing. We are asking to decrease the state requirement of postural screening to once for students in grades 6, 7, 8, or 9 from the current requirement to screen all students in grades 5
through 9 (MGL Section 57 of Chapter 71).

We support this legislation to reduce postural screening frequency in schools because:
● Routine postural screening is not recommended by the U.S. Preventive Services Task Force,*
● Critical time on learning is lost over 5 grades,
● Many parents/guardians opt-out each year,
● Most Primary Care Pediatric Providers oversee postural screening as part of the physical exam,
● School Nurse time is better used for other screenings, such as the universal SBIRT
substance use screening in two grades as required by the 2016 STEP Act, and
● 93% of MSNO members polled in December 2018 (42% of all members, 365 school
nurses) support filing this postural screening legislation.
● There are only 7 states, including Massachusetts, that require Postural Screening by
law and in 1 grade only.
For more information, please contact a member of the MSNO Advocacy Team:
Doreen Crowe, MSNO President, president@msno.org
Jenny Gormley, MSNO Immediate Past President, pastpresident@msno.org
Cathryn Hampson, MSNO President-elect, president-elect@msno.org
Carilyn Rains, NASN Director for MSNO, nasndirector@msno.org

References:

Jakubowski T, Alexy A (2014). Does School Scoliosis Screening Make the Grade? NASN School Nurse , 29(5), 258-265.
Jinn J (2018). Screening for Scoliosis in Adolescents. Journal of the American Medical Association (JAMA) , 319(2),202.
Magee J, Kenney D, Mullin E (2012). Efficacy of and Advocacy for Postural Screening in Public Schools .Orthopaedic Nursing , 31 (4), 232-235.* https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/adolescent-idiopathic-scoliosis-screening1

Find your legislator here: https://malegislature.gov/Search/FindMyLegislator

Sample Postural Screening Letter to Ask for Legislator Co -sponsorship

School Nurses’ Script to Call Legislators to Co-Sponsor MSNO’s Postural Screening Bill. March 26, 2021

2. Call and introduce yourself: “Hi, I’m __ name_ ___, a school nurse from town or city, resident of___ town you live in, and I wish to speak with the Representative/Senator about co-sponsoring a bill.” Your legislator may not be available, and you should ask for the legislative aide, and if this person is not available,give the information to the person answering the phone.

3. Say that you are calling to request that the Senator or Representative co-sponsor the Postural Screening bills,An Act to update postural screening requirements in schools, filed by Senator Julian Cyr in the Senate
(SB#1401) and Representave Kay Khan in the House (HD #2355) on behalf of the MA School Nurse Organizaon (MSNO).
HB2335 An act to update postural screening in schools
filed by Representative Kay Khan
SB1401 An act to update postural screening in schools
filed by Senator Julian Cyr

4. Share that these bills were filed by the same legislators in 2019 with a total of 71 legislators (senators and representatives) signing on to co-sponsor the bills in the House and Senate.

5. Explain that MSNO and school nurses are asking to decrease the state requirement of postural screening to once for students in grades 6, 7, 8, or 9 from the current requirement to screen all students in grades 5 through 9 (MGL Secon 57 of Chapter 71).

6. As time allows, you can explain to the legislative aide, why you are joining MA school nurses in asking for this change in the law:
● Routine postural screening is not recommended by the U.S. Preventive Services Task Force,
● Critical time on learning is lost with screening students in 5 grades,
● Many parents/guardians opt-out each year,
● Most Primary Care Pediatric Providers oversee postural screening as part of the physical exam,
● School Nurse time is better used for other screenings, such as the universal SBIRT substance use screening in two grades as required by the 2016 STEP Act, and
● 93% of MSNO members polled in December 2018 (42% of all members, 365 school nurses) support filing this postural screening legislation.
● only 7 states, including Massachusetts, that require Postural Screening by law for 1 grade only.

7. You may offer to email the legislative aide and Senator or Representative your request for them to co-sponsor the bills.

8. Thank the aide and Senator or Representative for considering co-sponsorship. Share your contact info if they have follow-up questions.

9. After your call, please email Jenny Gormley, MSNO Immediate Past President, pastpresident@msno.org, to share who you called and what their response was to your request. We are keeping track so that we can better
advocate for reducing the legal requirement for postural screening for students in 5 grades to students in 1 grade annually.

• Postural Screening.
  Senate Bill #1233, An Act to update postural screening in schools, is still under consideration by legislators in the Joint Committee on Health Care Finance, chaired by Senator Cindy Friedman and Representative Dan Cullinane.  The deadline for review was extended until June 19, 2020.  Please call your legislators to ask them to request this bill move favorably out of this committee.  See MSNO letter [linked] sent to the Committee Chairs with talking points about why MSNO is supporting the reduced frequency of annual postural screening from 5 grades to 1 grade.
• School-Based Medicaid Reimbursement for school nursing services.
  The House and Senate Bills went to study in early 2020, meaning they are no longer being considered by legislators, and MSNO can consider filing again in the next legislative session, which starts in January 2021.

MSNO request Postural Screen bill move favorably out of HCF 6.12.2020

MSNO Bills Assigned to Committees for Review

• Return school nursing billed Medicaid funds directly back to School Health Services programming, including behavioral health assessment, case management, health education, social emotional learning and health support, and other related school health services. The House and Senate version language is the same; only the title is different.
  • House bill #465: An act relative to the reimbursement of school-based care
  • Senate bill #676: An Act relative to MassHealth provider reimbursement
• Update the MA postural screening law to decrease the frequency of postural screening in public school from all students in grades 5-9 every year to all students in one of the following grades every year: 6, 7, 8 or 9. The House and Senate version language is the same.
  • House bill #1946: An Act to update postural screening requirements in schools
  • Senate bill #1233: An Act to update postural screening requirements in schools

PDF of Summary of Bills

Thank You to our MA Legislators in support of co-sponsoring our bills of concern!

For the list of legislator support please click the link:

Legislature Co-Sponsorship

Action Needed on 2 Bills Filed in the MA House & Senate

Medicaid bills

• Senate bill #1966, An Act relative to MassHealth provider reimbursement, filed by Sen. deMacedo
• House bill #2904, A Act Relative to the reimbursement of school-based care, filed by Rep. Garlick

Postural Screening bills

• Senate bill #1995, An Act to update postural screening requirements in schools, filed by Sen Cyr
• House bill # 2899, An Act to update postural screening requirements in schools, filed by Rep Khan

All letters can be copied and pasted to MS Word or Google Docs and changed for your needs

• SUMMARY OF BOTH BILLS: Postural and Medicaid Reimbursement bills
• SCRIPT OF SAMPLE CALL–Postural Screening: to representative to request that representative place a call to the Co-Chair and ask that they release the bill favorably out of committee – suggested by MSNO

• Senator Jon Tester (D-MT) and Rep. Dina Titus (D-NV) introduced the Nurses for Under-Resourced Schools Everywhere (NURSE) Act in both the Senate and House.
• The bills numbers respectively are S 2532 and HR 5251.

More info on the NURSE Act