A lack of outbreak reporting by nurses at Hopkinton Public Schools has resulted in responses and attention from both the Hopkinton Health Department and state agencies.
Health Director Shaun McAuliffe first brought the issue to the Board of Health’s attention during a meeting on Feb. 10. At that time, he detailed how he and public nurse Simone Carter had been monitoring an outbreak of a gastrointestinal (GI) illness at a “local establishment” in mid-January.
The Massachusetts Department of Public Health was notified of the outbreak, and soon realized there were a number of GI cases at both the Marathon and Elmwood elementary schools. As a result, the state “went back several years looking for evidence of reports and contact from school nurses,” McAuliffe said.
“They realized the nurses hadn’t submitted any reporting forms to the MDPH,” said McAuliffe. “[They] were very upset.”
According to McAuliffe, these reporting issues have been a consistent issue with the School Department. School nurses reportedly were failing to comply with contract tracing requirements during the COVID-19 pandemic, which resulted in the MDPH and the Massachusetts Department of Elementary and Secondary Education (DESE) becoming involved.
“The Hopkinton Public School Nurses have not submitted a form on their own to the MDPH since I started in 2017,” McAuliffe claimed in a later email to the Independent. “Kasey Mauro and I assisted them in submitting approximately 3 COVID-19 forms during the pandemic. ”
McAuliffe stated during the Board of Health meeting that the MDPH had issued a new state-wide protocol for outbreak reporting following the discoveries made at Hopkinton Public Schools. MDPH also sent out an online form to streamline outbreak reporting.
Reportedly, the state also has asked for coordination from the Health Department to monitor the School Department.
In an email to the Independent, an MDPH representative stated there had been no substantive policy change and that the existing rules on outbreak reporting had been in place for “quite some time.” Rather, the department had sent out a letter on Feb. 5 to inform school systems state-wide that a new online reporting tool was available.
“The process of creating the new reporting form for schools and childcare programs began two years ago and its deployment happened to coincide with the increase in norovirus activity this year,” the MDPH representative stated.
During a separate interview with the Independent, McAuliffe noted that Hopkinton was not the sole reason the MDPH put out its response. He also acknowledged that the School Department had been quick to respond to the situation.
One of the complicating factors with determining if an outbreak report is necessary are issues with parents and guardians informing the school nurses when a child is out of school with an illness.
“If they’re not getting a complete report on school absences from parents, they just know the kid’s absent,” said McAuliffe.
Another circumstance that compounded this most recent reporting issue is the nature of the illness itself. MDPH and the Health Department had identified the outbreaks at the school to be cases of norovirus, which is a chronically underreported communicable disease.
“With norovirus, the main problem is that the doctors’ offices don’t want kids with norovirus coming in, because they’ll put the whole office at risk,” said McAuliffe. “They tell [the parents] to keep the kids at home, so no one’s reporting it.”
Hopkinton High School head nurse and district nurse leader Sarah Patterson echoed these concerns.
“When parents report their child’s absence, they are encouraged to provide a reason,” said Patterson. “However, in many cases, the information provided is vague or not reported at all. Since school nurses can only document the information they receive, incomplete or missing details hinder accurate illness tracking and reporting.”
She went on to note that the school nurses lack access to certain diagnostic tools and databases such as the Massachusetts Virtual Epidemiologic Network (MAVEN) — a platform that town health departments use to track and monitor communicable diseases.
“School nurses rely on the Board of Health to inform them of any outbreaks or significant health concerns once such information is available through MAVEN,” Patterson said. “This collaboration is essential for schools to take appropriate measures in response to public health concerns.”
This is in contrast to claims from McAuliffe. “We really need the nurses to be collecting this data and communicating unusual rates of absenteeism so that we can look in the MAVEN records,” he said. “Then we can call the MDPH and we can do further investigations if necessary.”
Both sides agree that more communication between departments is essential to resolving issues with outbreak reporting, especially because there are legal obligations involved. School health services are responsible for “managing communicable disease outbreaks in the schools,” per MDPH.
“At the end of the day, they have a legal responsibility to be following up with suspected cases of communicable diseases,” said McAuliffe. In his report to the Board of Health, McAuliffe claimed the School Department could be fined $1,000 per incident of unreported outbreak if it did not meet its legal obligations.
Getting parents to be more communicative about child absenteeism and illness is another focus both sides agree on. “Strengthening [parent] communication will support a more informed and proactive approach to managing health concerns within the school community,” Patterson said.
The school district and the Health Department now are in the process of collaborating to ensure future compliance. Per emails to the Independent from McAuliffe, the school nurses have been supplied with the latest MDPH and Centers for Disease Control and Prevention regulations on outbreak reporting. His department will be monitoring MAVEN records weekly to keep track of any new outbreaks.
This Director McAuliffe seems to lack the understanding of what a school nurse does and the tools and information available. He seems to care more about counting blindly events as communicable diseases without having to true evidence. He should be ashamed at blaming nurses for this assumed problem. School nurses have a very hard job and see and care for a whole school of children. They are not Doctors, they do not have labs , and should not be expected to diagnose a vomiting issue as norovirus. He needs to look at himself and how to better support those in his district verse blaming those around him! That is not leadership!
Same old, same old .. amusing. One blames another. Dumping the blame from one department to another department.
With no results. But only more red tape and burocracy. What else is new on the municipal government?!! Lol honestly…
My only hope that Trump Administration will crack down on every municipal government in MA
Underworked and overpaid. Waste of Tax Payers money! Hopkinton is more corrupted and mismanaged then most people realize!
This is really simple you have neuro virus and stay home . Return to school after you are asymptomatic.
District leaders, nurses, and educators in the Hopkinton Public Schools want to clarify and correct several inflammatory remarks and accusations made by Shaun McAuliffe, Hopkinton’s Public Health Official in this article.
In this response, we will point out that much of what Mr. McAuliffe alleges are falsehoods.
On Thursday, January 30, 2025, Shaun McAuliffe sent an email to Tim Persson, Director of Facilities for HPS, inquiring if the schools were in possession of cleaning agents that were effective against Norovirus. He recommended that staff be advised to “take precautions at Marathon School” because he had been “notified by parents and MDPH of an outbreak.” The email was sent to the Marathon building principal, school nurses, and custodial staff, and countermeasures, including a deep clean, were taken. The school nurses and administrators had no data supporting the claim, but acted accordingly in compliance with Mr. McAuliffe’s request. In light of this, it is important for readers to note that according to Lindsey, an Epidemiologist at MDPH, the MDPH has no documented outbreaks in any of the Hopkinton Public Schools, per a telephone conversation on February 26, 2025.
On February 5, 2025, MDPH sent out a public notification of the new online reporting form to all school districts, which included the reporting guidelines. The nurses were asked by Sarah Patterson, Nurse Leader for the District, to review the data that they were now required to collect and to report any increases in absenteeism rates in any of the buildings. The collected data did not indicate that there was an excessive increase in absenteeism for that time of year, namely the winter months, in any school. Further, because the alleged but never substantiated outbreak at Marathon was reported to the District by Mr. McAuliffe (who reported that it was the MDPH who originally identified the “outbreak”), there was not a need for the nurses to file a report with the MDPH because (1) we did not have any substantiating data in our possession and (2) the alleged outbreak should have already been known to MDPH, if Mr. McAuliffe was being honest. It remains confounding that today, the MDPH has no recorded outbreaks in any of the Hopkinton Public Schools in MAVEN, the database that stores records of outbreaks of contagious illnesses across Massachusetts.
None of this made any sense.
Then, on Tuesday, February 11, 2025, Mr. McAuliffe sent an email to Sarah Patterson and Dr. Cavanaugh regarding outbreak reporting. He stated, “Hopkinton Public School Nurses (and nurses in several other communities) had not been reporting outbreaks of any communicable diseases to the local board of health or [the Massachusetts] DPH.” Again, it was hard to know what he was referring to, given that the nurses had not seen increased absences, nor was there any record of an outbreak in MAVEN, which again, is the state database that stores records ofoutbreaks across Massachusetts. How could nurses report what did NOT exist? Why didn’t the public health officials at the State level have any record of an outbreak?
In Mr. McAuliffe’s email of February 11th was an attached letter addressed to Sarah Patterson. It stated, “Under 105 CMR 300.200, healthcare providers, including school nurses, who fail to report a reportable communicable disease within 24 hours can face legal consequences. The penalty for non-compliance can include: 1. Fines: A fine of up to $1,000 for each violation. 2. Additional Penalties: In some cases, individuals may face additional administrative penalties depending on the nature of the violation and any previous history of non-compliance. The Hopkinton School District and School Nurses are hereby put on notice that further violations will result in fines and administrative actions”. THE FALSEHOOD: In checking the legislation, there are no such fines or penalties that Mr. McAuliffe is authorized to impose on public school nurses. In essence, he was making threats to the nurses that he had no authority to carry out. Ultimately, these unfairly lodged threats were inflammatory and had no legal basis.
Shaun McAuliffe reports that he and the former health nurse filed reports during COVID on the district’s behalf. THE FALSEHOOD: Shaun McAuliffe had access to test results in MAVEN that would reflect any COVID outbreaks at that time and therefore he would be the one to report that information to the state, not the nurses. School nurses do not have access to this information in MAVEN and again rely on their local BOH or parent reports for information. This is not limited to Hopkinton’s school nurses; rather, this is true of all school nurses, who must rely on their Public Health partners. It’s unfortunate that Mr. McAuliffe paints the nurses as being either lazy or lacking competence when COVID reporting to the state belonged to him and his former nurse. All school-based COVID cases were shared with Mr. McAuliffe during the pandemic.
Mr. McAuliffe alleges that “School Nurses reportedly were failing to comply with contract tracing requirements during the COVID-19 Pandemic”. THE FALSEHOOD: School nurses worked 12-hour days, 7 days a week, including weekends, holidays, and school vacations during that time. The system in place was so effective that HPS was one the first schools to open for students and faculty to resume in-person instruction for ESY education in the summer of 2020, after the initial shutdown. Neither the MDPH nor the Department of Elementary and Secondary Education involved themselves in the Schools’ approach to COVID.
Mr. McAuliffe’s attempt to denigrate the work of the HPS nurses during the pandemic is inexcusable and also insulting to the school nurses who came back to work in the fall of 2020 without complaint.
Mr. McAuliffe consistently references the Massachusetts Department of Public Health or MPDH throughout the aforementioned article as well as in the correspondences he sent to Dr. Cavanaugh and Sarah Patterson, but he will not state specifically who at MDPH identified clusters or who is giving him directives to verify this information. THE FALSEHOOD: Given that the state has reported that there are no known clusters or outbreaks in Hopkinton Public Schools, Mr. McAuliffe likely cannot cite his source. Because there simply isn’t one.
Mr. McAuliffe reported that the state also has asked for coordination from the local Health Department to monitor the School Department. THE FALSEHOOD: The MDPH knows that schools cannot be monitored by local public health officials, and that local health officials have no access to the schools’ student health records, as that is a violation of FERPA.
Sarah Patterson, the HPS lead nurse, and Simone Carter, the public health nurse who works for the health department, have been working together closely to ensure that necessary information is being shared while adhering to confidentiality requirements. School nurses must rely on the Board of Health to inform them of any confirmed outbreaks or significant health concerns once such information is available through MAVEN, which, again, the nurses have no access to. This collaboration is essential. It’s a good thing these two nurses share an excellent and collaborative working relationship. It’s unfortunate that Hopkinton’s Public Health Official, Mr. McAuliffe, does not.
Sincerely,
Hopkinton Public Schools Administrators and Sarah Patterson, HPS District Nurse Leader, on behalf of the Hopkinton Teachers Association