To our school communities,

The Learn to Return program partners extend our gratitude and admiration to schools for their countless hours and dedicated efforts to keep students safe and healthy throughout the pandemic. 

This program started as a pilot with 13 school districts in 2020 and now supports more than 830+ schools with access to customized COVID-19 testing solutions to fit their testing needs. Learn to Return was developed to assist schools in returning to in-person learning and to provide a safe environment for students and their families. 

Although many of the Learn to Return COVID-19 testing resources and funding sources have now concluded for the 2022-2023 school year, the work of this program has resulted in new partnerships that will continue to strengthen our collective service to schools.

As the new school year approaches, we want schools to have a clear understanding of what COVID-19 testing resources are still available and what is ending. Below is a detailed summary of current resources schools can expect.

• Schools will have access to free testing supplies that can be requested through the same ordering portal.
• Supplies will include over the counter (OTC) and point-of-care (POC) rapid antigen tests.
•  The BD “Triplex” test for COVID-19 and flu will still be available.
•  Supply ordering questions can be sent to COVIDtestingsupport@doh.wa.gov.
• Schools can still reach out for testing support from their Educational Service District Coordinators. Contact information can be found here. Resources and information for schools regarding COVID-19 testing will remain available at DOH Testing in Schools website.

• PCR testing supplies will no longer be available via the ordering portal.
• Labor Support Funding ended on Monday, July 31, 2023, and will not be available for the 2023-2024 school year.
• Schools will no longer have access to 1:1 technical assistance from Health Commons Program Managers. The schools@healthcommonsproject.org inbox will continue to be monitored but we encourage schools to contact your regional ESD coordinator for assistance.
• Learntoreturn.org website is no longer actively maintained as of 08/17/2023. For the most updated information, please visit the DOH Testing in Schools website for assistance.

As we close out of the Learn to Return program, we thank you for your participation and for your role in supporting COVID-19 testing in K-12 schools. This program would not have been possible without the ongoing collaboration among schools, school partners, and testing vendors, and the diligent implementation of school administrators, nurses, and staff.

With deep gratitude,

Learn to Return partners

Free COVID-19 tests are not as easy to find these days. Since the end of the Public Health Emergency (PHE), most community sites have closed, insurance providers are no longer required to cover testing costs, and stock piles of free tests are starting to dwindle. As access to COVID-19 testing becomes more challenging, your school community may look to you for free tests to help manage family health throughout the fall and winter. 

Related: New COVID-19 Hospitalizations Increase as EG.5 Spreads

Our testing menu has changed a bit since last school year, but we still offer a range of high quality rapid antigen tests (including BD Triplex for flu and COVID-19) that can be administered at point-of-care (POC) with appropriate personnel or distributed for use at home. 

A note on expiration dates: Many rapid antigen tests continue to receive extended shelf-lives from the FDA. In our menu below, we show you how to check shelf-life extensions for each test. Schools should use the most up-to-date shelf-life extensions to determine whether or not their inventories are okay for use.

The authorization that allowed expired tests to be used if they pass quality control tests is no longer valid. All tests must be within the printed expiration date or FDA-approved expiration extension date to be used for school testing. 

We recommend replenishing stocks as needed to make sure you have enough tests on-hand for two months at a time. All tests and testing supplies that are expired beyond their extended shelf-lives can be thrown out with the regular garbage.

With the end of the public health emergency (PHE), the authority (ability) of the Secretary of Health to provide standing orders for COVID-19 point-of-care testing in the community ended along with the ability of unlicensed personnel to perform these tests. 

The nursing commission has stated that it is within the scope of the registered nurse license to perform tests that are CLIA-waived without a specific order. Additionally, RNs may delegate these tests to unlicensed personnel (see letter from commission linked here).

The legal foundation for school nurse (RN) delegation is based on care of individual students and does not provide for delegation for populations or groups of individuals. The nursing commission, now known as the Board of Nursing, is continuing to work on defining legal parameters for the provision of tests in the school and community settings. Until we have more clarity on the legal foundation for testing by unlicensed personnel and delegation of these tests for groups of students by school nurses, it is advised that where there is no school RN or when the RN is not available, tests be provided to families for home use. 

Throughout the pandemic, our Impact Fund partners have worked to increase testing access and vaccine confidence in their communities. They’ve leveraged their existing programs and developed new approaches to reach populations that have been marginalized by the pandemic. 

Today, we launch a seven-part Spotlight series to showcase their work to bridge the gap in health disparities for diverse communities in Washington.  

We begin with the Pacific Northwest Black Business Coalition (PNWBBC), a community based organization in Seattle committed to economically empowering black-led businesses, combating systemic racism, and championing equitable engagement for underserved youth. With support from the Impact Fund, they used traditional and social media to channel the voices of young influencers who advocated for COVID-19 vaccinations in their communities. 

The DOH Testing in Schools website is now your go-to online resource for school testing. The Learn to Return website will still be live, but will no longer be maintained with up-to-date information and resources. 

The Testing in Schools website includes: 

• Latest guidance and recommendations for K-12
• Testing FAQs
• Updated expiration extensions for tests
• Contact information for DOH and ESD support staff

DOH’s K-12 Schools website has a new look and feel to make the site more engaging and easier to use. It is designed to be a “one-stop shop” highlighting new and relevant categories, including sections for What’s Happening Now and Key Resources.

Other resource areas include:

• Immunizations
• Mental and behavioral health guidance
• Enhancing safe and healthy environments
• Promoting healthy behaviors
• Managing health conditions
• Preventing injury and violence
• Promoting healthy decision making

Schools continuing point-of-care (POC) this year MUST renew their MTS license. An MTS license is not required for the distribution of at-home tests like iHealth.

• A Medical Test Site (MTS) license is a certification that allows a facility in Washington state to legally examine a person through waived tests for the purpose of diagnosis, treatment, or prevention of disease. 
• Schools with an MTS license are exempt from the Clinical Laboratory Improvement Amendments (CLIA waivers). In effect, an MTS license is a CLIA waiver. These terms have been used interchangeably over the course of the program, but schools will need to renew their MTS license if they continue to offer POC testing.

• Schools that wish to perform point-of-care testing for COVID-19 (or any other disease) MUST have an active MTS license. 
• Schools that choose to distribute over the counter (OTC) tests exclusively DO NOT need an MTS license.

• For schools to provide POC testing onsite, these conditions must be met: 
• • An RN or RN-delegated staff member must administer or supervise the self-administration of the POC test;
  • The school must have an active MTS license;
  • The school must have signed consent by parents or legal guardians to perform the POC test.
• The MTS license alone does not permit RN delegation. For more information about RN-delegation, see the May 18 statement from the Nursing Care Quality Assurance Commission (NCQAC): Authority of Registered Nurses to Administer and Delegate COVID-19 CLIA-Waived Tests in School Settings.

• If you have an active MTS license, you should have received a renewal notice in the mail in late April or early May 2023. Instructions for how to make a renewal payment are included in your renewal notice. If you did not receive the renewal notice, contact hsqafc@doh.wa.gov for assistance.
• Schools with an active MTS/CLIA waiver license should not need to submit a new application, just pay the renewal fee ($260). Schools seeking a new license should complete the Certificate of Waiver Medical Test Site (MTS) Application Packet. 
• If you are concerned about the renewal, please contact hsqafc@doh.wa.gov at least 2 weeks after the payment is processed (i.e., check is cashed) to check on the status. There is also a website where you can search to check for the processed renewal confirmation: https://fortress.wa.gov/doh/facilitysearch/
• MTS/CLIA waivers are valid for 2 years.

• No, you do not need an MTS license if you are only distributing OTC tests for use away from school grounds. 
• You only need an MTS license if you plan on having a registered nurse (RN), RN-delegated staff member, or RN-directed LPN administer POC tests on school grounds.

• All glucometers (glucose tests) are CLIA waived but must be added to your MTS license in order to be used onsite. 
• To add glucose testing to your MTS license, notify DOH Laboratory Quality Assurance (LQA) that you are adding glucose testing by completing the Test Menu Change Form 505-089 and returning it to hsqafc@doh.wa.gov.
• Questions on licensing can be submitted to LQA@doh.wa.gov.

In our last newsletter, we highlighted the contributions of each testing vendor that left the L2R menu this year. We included statistics about the number of tests performed or distributed, but some of these numbers have been revised since publication.

See the updated spotlight for the most accurate vendor data.