[MaineSchoolNurse] Follow up to Office Hours 3/5/25

Thu Mar 6 08:55:14 EST 2025

Thanks to those who were able to join us for office hours yesterday afternoon. This follow up email is very long as it contains a lot of information about Biohazard Medical Waste. The take home message about that is—don't panic about this. It isn't an emergency, but it is something we should be aware of and bring to administrators for their awareness.
Browntail Moth Notice went out to all School Integrated Pest Management coordinators last week. I am sharing this information with all nurses as well. Action by school facilities now can prevent those nasty itchy rashes later! https://content.govdelivery.com/accounts/MEDACF/bulletins/3d37413
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Biohazard Medical Waste https://www.maine.gov/dep/waste/biomedical/index.html
Sharing this information is not intended to make it another job for nurses. But I want to make sure you are aware of it.
This information is from Eric.P.Hamlin at maine.gov<mailto:Eric.P.Hamlin at maine.gov> in the Department of Environmental Protection.  I’ll summarize the key points first and the additional information is from Eric Hamlin with details. Please contact him with any questions.

  *   The Department’s Chapter 900 biomedical waste rules require generators of biomedical waste to register with the Department and to store, package, label, and dispose of their waste in accordance with specific requirements.

  *   Residents generating their own biomedical waste such as needles used for medication injections are not required to register and are not subject to the Chapter 900 rules.  A recommended method of managing their used sharps is to place them in a purpose-specific or other sturdy, puncture-resistant container like a plastic laundry detergent jug, seal it up (labeling it if not prelabeled as “sharps – do not recycle”, and placing in their trash.

  *   Non-residential entities like hospitals, medical or dental offices, needle exchange programs, veterinary clinics, body artists, schools, and businesses that have people on site who generate even small amounts of sharps from tattooing, microblading, electrolysis, or administration of medications or vaccinations are required to register and must manage their waste in accordance with Chapter 900.  Each location where biomedical waste is generated will need to registered, but a billing address can be shared.

 Here is the general information along with some links related to registration and fee payment:
Registration:
Our Chapter 900 rules<http://www.maine.gov/sos/cec/rules/06/096/096c900.doc> for biomedical waste require facilities generating biomedical waste such as used sharps to register with the Department and to arrange for proper packaging, storage, and disposal of biomedical waste.

Here is a link to our Biomedical Waste Generator Registration Form<https://www.maine.gov/dep/waste/biomedical/documents/2018-bio-waste-form.pdf>.   If your company or organization has multiple locations where waste is generated each one will need its own registration number, so please send in one registration form for each physical location.  The “Registrant Information” section of the form is typically used for the “parent” organization or company information, and the “Generator Information” section of the registration form is for the address, name, contact information, etc. for each specific location you register.

Payments can be made by check or electronically (electronic payment is preferred) via our online Payment Portal<https://www.maine.gov/dep/paymentportal>.  The initial registration fee is $50 for any biomedical waste generator regardless of how much waste they produce.  If you use the payment portal, please keep a copy of the electronic payment confirmation you receive and send that with your registration form to Geraldine (Gerry) Travers at Geraldine.Travers at maine.gov<mailto:Geraldine.Travers at maine.gov> (I have copied Gerry on this email).  Once you have registered, you will receive (typically by email) a letter with your biomedical waste generator registration number for each physical location that you register.  Please note that you will only receive a letter when you initially register; that same number will remain in effect as long as you continue to pay your annual fees.

Annual Fees:
After you have registered, you will receive an invoice for your annual fee in January of each year regardless of when you first registered (this will probably change to billing on the registration anniversary date soon).  Annual fees can also be paid by check or via our Payment Portal<https://www.maine.gov/dep/paymentportal>, and are based on the amount of waste you generate each month.  The annual fees are: $25 for small quantity generators (less than 10 lbs./month), $50 for medium quantity generators (between 10 and 50 lbs./month), and $500 for large quantity generators (more than 50 lbs./month).  If you use the Payment Portal<https://www.maine.gov/dep/paymentportal> you will be able to enter your invoice number and the form should fill in automatically.  Once you have made your payment, you will receive a confirmation of payment.  Please email a copy of your payment confirmation along with your invoice to Heidi Dennis at Heidi.m.dennis at maine.gov<mailto:Heidi.m.dennis at maine.gov>.

Changes, updates, and modifications:
If any of your information changes or you want to change your generator size category, please update your information using our Biomedical Waste Generator Modification Form<https://www.maine.gov/dep/waste/biomedical/documents/2018-bio-waste-modification-form.pdf>.  This should be sent to me and to Geraldine.Travers at maine.gov<mailto:Geraldine.Travers at maine.gov>.

Biomedical waste management plan:
We don’t currently have templates for this purpose, but you can find the relevant standards in Sections 11 and 12 of the Chapter 900 rules<https://www.maine.gov/sos/cec/rules/06/096/096c900.doc>.  The use of purpose-specific, prepaid sharps accumulation mail-in boxes will nicely handle the packaging requirements and most of the labeling requirements with the exception of the sender address and information.  The rest is pretty much common sense and can be written specifically for your facilities and procedures.  It may be helpful to think of this document as something you would have a new employee look at or refer to in order to understand how the waste is stored and managed.
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Introducing the Lending Library Pilot Program!
We have heard from some of you that you wish you could more easily provide various training to staff or other people in your school community, but you don’t have the right equipment. We heard you and we took action. We have set up a system to offer a lending library as a pilot program! We are starting simple with but may expand to include other items if there is a need and this process is successful.
Inventory Includes: STOP THE BLEED® Training Kit, AED Trainers, CPR Manikin Set (adult/infant).
In order to borrow equipment from this lending library there are some assurances that we require:
(1) The request is being made by an RN working in a Maine PreK-Grade 12 school.
(2) The RN has knowledge and skills required to utilize equipment.
(3) The equipment will be kept in a secure location.
(4) The equipment will be cleaned with wipes provided prior to returning them to storage space.
(5) All borrowed equipment will be returned within the agreed time.
The request form will go out with the March newsletter--so watch for that in the coming weeks.
Leadership Cohort presented on their experiences. The overall objective of the Northeastern University<https://neusha.org/leadership/> program is to strengthen leadership confidence, values, and competencies in order to improve student health and achievement. Below are a few of the highlights shared today by the Maine participants in 2024.
*Hearing from other nurses across the nation and our similarities and differences. It really highlighted the importance of data collection to assist with requests for supplies or staffing. A cost-benefit analysis of school health services article was shared. Link below.
Wang LY, Vernon-Smiley M, Gapinski MA, Desisto M, Maughan E, Sheetz A. Cost-benefit study of school nursing services<https://pubmed.ncbi.nlm.nih.gov/24840710/>. JAMA Pediatr. 2014 Jul;168(7):642-8. doi: 10.1001/jamapediatrics.2013.5441. PMID: 24840710; PMCID: PMC9255385.
*Identifying Your Compass<https://www.clee.org/resources/compass-points-north-south-east-and-west-an-exercise-in-understanding-preferences-in-group-work/> activity was shared by one of the nurses who found it helpful to learn how best to communicate with her colleagues.
*Amazing program! There was so much to learn. Data is what drives action! This nurse created a survey for parents to complete asking if they felt that the 1:1 consultation time was helpful during PreK and K screenings. 89% said it was a good use of time. Because of this data collection and advocacy she was asked to be part of the planning team for the registration days this year.
*Creating meeting norms for nurse team meetings helped to give the meetings more structure and respect. The team now jointly create an agenda that is based on the School Nursing Practice Framework<https://www.nasn.org/nasn-resources/framework>.
*Created a goal that all students with a chronic health condition were connected with a medical home and with MaineCare if eligible which led to learning more about state resources, electronic health record reporting functions, and improved access to healthcare for students.
We ended the meeting today by sharing books that we are reading or have read recently. It was such a great way to connect with each other. I tried to capture the books that were shared. If you are looking for a suggestion, maybe choose one of these!

The Anxious Generation Book by Jonathan Haidt
Secret Life of Bees by Sue Monk Kidd
The President is Missing by Bill Clinton and James Patterson
The Covenant of Water by Abraham Verghese
Junie by Erin Crosby Eckstine
Outlive: The Science and Art of Longevity by Bill Gifford and Peter Attia
Braiding Sweetgrass by Robin Wall Kimmerer
The Stars are Fire by Anita Shreve

Thank you for all you do to keep Maine students healthy and safe.
-Emily

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Emily Poland, MPH, RN, NCSN (she/her)
School Nurse Consultant
Coordinator – Coordinated School Health
Office of School and Student Supports
Maine Department of Education
23 State House Station
Augusta, Maine 04333-0023
Email: emily.poland at maine.gov<mailto:emily.poland at maine.gov>
Phone: 207-592-0387
Maine DOE<http://www.maine.gov/doe> | Facebook<https://www.facebook.com/MaineDepartmentofEducation1/> | Twitter<https://twitter.com/mdoenews> | Instagram<https://www.instagram.com/mainedepted/?hl=en> | Maine DOE Newsroom<https://mainedoenews.net/> | School Health Services<https://www.maine.gov/doe/schools/safeschools/healthed/nurseresources/guidelines>

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