StrongSchoolsNC K-12 COVID-19 Testing Program

An opt-in form was emailed to school administrators on Aug. 1, 2022. If your school did not receive the link to the opt-in form, please contact K12COVIDTesting@dhhs.nc.gov. Schools are encouraged to complete the opt-in form by Aug. 24, 2022.

School districts will opt-in and make decisions about which schools they want to include in the program.

School students and staff are eligible for both diagnostic and screening testing. Staff should include teachers, substitute teachers, bus drivers, food service, and custodial staff.  

Family members will not be eligible for routine screening testing or diagnostic testing by the state-contracted vendors or by school staff when using state-supplied test kits. However, districts and schools may include family members in testing for special event screening, such as before athletic events, using tests received from the state. 

Please continue with your existing program if it is working for your school or district. If you will be requesting tests from the state for an independent testing program, you must still complete the COVID-19 testing program opt-in registration form choosing the Independent Testing Option. 

A link to the opt-in form was recently emailed to school administrators and may be requested from K12COVIDTesting@dhhs.nc.gov. Districts/schools are encouraged to complete the opt-in form by Aug. 24. The opt-in form helps us better understand the approach all schools are taking to COVID-19 testing, and the form will let us know if your school or district: 

• already has a testing program; or 
• would like to request additional support, resources, or to make changes to your testing program.  

NCDHHS strongly encourages schools and districts to implement a COVID-19 testing program for the 2022-23 school year. Testing remains a crucial mitigation measure to prevent the spread of COVID-19 and schools are being asked to opt-in to the voluntary StrongSchoolsNC K-12 COVID-19 Testing Program. We encourage schools that do not conduct testing to provide their community with a list of free COVID-19 testing locations near them. Additionally, schools can request at-home tests from the state for distribution to students and staff.

Funding is currently set to expire on July 31, 2023.

If your district or school has already submitted the opt-in form and would like to change your program option selection, please email K12COVIDTesting@dhhs.nc.gov for assistance. 

Flexibility is a key part of the testing program – both when opting in and as the school year progresses. When schools or districts opt into the testing program, they identify a testing option that meets their needs at the present time and, if applicable, discuss a testing plan with the assigned vendor. Testing needs may change over the school year as community and state levels of COVID-19 spread changes, as discussed in NCDHHS K-12 Testing Program Guidance. Having a testing plan in place allows you to access state resources and be prepared as conditions evolve in the upcoming school year. Since testing programs respond to current conditions there is no opt-out protocol required. 

If working with a state-contracted testing vendor (Option 1), PPE is included in the end-to-end services for testing purposes. If a school is doing Independent Testing (Option 2), schools must maintain an adequate supply of PPE to perform tests. PPE is an allowable expense under ELC-ROS additional funding for public schools. 

Request Masks

StrongSchools.nc.gov is an online resource for school staff and parents. The webpage includes links to key resources, including parent FAQs about school testing, school resources, and an online communications toolkit with downloadable flyers, posters, and social media graphics. The materials are in the process of being updated for the 2022-2023 school year. 

Each school or district will make decisions regarding how to implement their testing program and who will be asked to participate.

Funds are intended to support K-12 student testing. NC Pre-K program students on LEA campuses may be included. 

No, program participation does not require a specific type of COVID-19 testing.​ The program is designed to support local flexibility in building a testing plan that meets local testing needs and CDC guidance.

CDC funding requirements and NCDHHS testing program implementation include a strong focus on ease of access, equity, and keeping students in school. To meet these programmatic values, routine K-12 screening, and diagnostic testing provided through the StrongSchoolsNC K-12 COVID-19 Testing program must be provided on the school campus that a student being tested attends.  

A positive feature of K-12 testing programs for parents is the ability to access a COVID-19 test without needing to take their student elsewhere, which helps minimize disruption for both the parent’s workday and the child’s school day. School-based testing can be critical for families who may experience transportation and other challenges that limit access to COVID-19 testing. A program that is not accessible on campus may then create a situation of inequity among students. It is expected that NC K-12 testing programs funded through the DHHS program will be equitably accessible to all students on the school campus and seek to minimize school day disruptions. 

Off-campus COVID-19 testing options currently exist in most counties supported through other resources. For more information on non-school-based testing options, visit ncdhhs.gov/GetTested. 

Schools should use a designated space to isolate students needing a diagnostic test. Refer to the Handling Possible, Suspected, Presumptive, or Confirmed Positive Cases of COVID-19 and Potential Exposures document for additional guidance.

In partnership with local schools, the state-contracted vendors are available to provide end-to-end services for screening testing, including: acquiring testing supplies, receiving parent or guardian consent for a student to be tested, administering COVID-19 tests, interpreting test results, and communicating results to individuals, parents and guardians, and local and state health departments, as applicable. 

If the state-contracted vendors do not meet a district or school’s needs, the district/school may independently partner with another entity to perform testing. A district/school may want to contact the local health department to see if they have any testing vendor partners that can be recommended or consider universities or medical centers in the area that may be interested in partnering for a school’s testing program. NCDHHS will not be able to reimburse schools for the cost of independently contracted vendors. 

Schools do not need a new CLIA certificate of waiver; however, schools do need to modify their existing certificate of waiver to include any tests that they may be using. The CMS form 116 should be used to report any change of information on the current CLIA certificate. If you have any questions, please contact DHSR at DHSR.CLIA@dhhs.nc.gov or via phone at (919) 855-4620. 

Any site that performs laboratory testing, including antigen testing, must follow applicable regulatory requirements including federal, state, and local mandates for testing, as well as requirements for the safety and confidentiality of personal information, as mandated by CLIA regulations. Some tests, such as COVID-19 antigen tests, may be performed under fewer CLIA regulations for labs and are classified as “waived” tests. However, sites performing these tests must apply for a CLIA Certificate of Waiver. A district or school may choose to apply for or utilize its own CLIA Certificate of Waiver or partner with an entity that has a CLIA certificate that can be extended to include the district or school if the entity has oversight for the testing. More information may be found at CLIA Information for Schools. Get the application for a CLIA Certificate (CMS Form 116) of Waiver here.

If applicable, an LEA/charter school may apply for one CLIA Certificate of Waiver that would include all schools in the district. For your convenience, we are sharing information that may help you fill out your CLIA application if your facility does not already have one. The below language uses the state-supplied Abbott BinaxNOW test as an example, but this language may be replaced with the names of the waived tests your district or school has elected to use.  

• In section I, select “Other Changes (Specify)” and fill in “COVID 19” to alert our program that your application is a part of this distribution effort. 
• In section II, select “Certificate of Waiver”. 
• In section III, select “26-School/Student Health Service”. 
• In section V, select “Yes” if you are applying as a school district and have more than one school in your district.   
• In #1 in section V, select “No” as each school may act as a temporary testing location should there be a need to test students, teachers, or staff. 
• In #2 – “Yes,” and #3, “No”  
• In section V, select “No. If no, go to section V1” if you are applying as a school at a single site. 
• In section VI, enter “BinaxNOW COVID-19 Ag Card” or name of other test if used 
• Completely fill out the other sections, as applicable. 

Please also include information about other medical tests, including any other COVID-19 tests, you may be performing at this location and provide specifics on these test systems. Please send the completed application to NCDHHS Division of Health Service Regulation/CLIA Certification at DHSR.CLIA@dhhs.nc.gov or via fax to (919) 733-0176. If you have any questions, please contact DHSR at (919) 855-4620.

Individuals performing COVID-19 testing do not need to be medical professionals. Unlicensed staff performing tests MUST be under direct supervision of a licensed medical professional, such as an RN school nurse.   

Information regarding specimen collection, handling, transportation, and storage can be found on the test manufacturer's instructions. 

It is the responsibility of the entity holding the CLIA certificate of waiver (i.e., district, school, CLIA-certified partner) to ensure that all the staff administering tests have completed the necessary training requirements and are competent in performing the test. 

Documentation or records of satisfactory completion of training should be maintained by the school, district or partner organization performing tests.  

All staff administering the tests must follow the instructions provided on the test package insert regarding specimen collection, handling, transport and storage. All components of the tests should also be disposed of as medical waste. Please pay close attention to the expiration dates listed on test packaging. 

If your district or schools do not already have medical waste disposal processes in place, many sites participating in the pilot partnered with vendors such as SteriCycle to provide this service. 

Though testing outdoors may be ideal for social distancing and ventilation purposes, it also poses a number of challenges, temperature being one. Sites must assure testing supplies are maintained within the defined range and consider use of temperature control equipment outside. 

All staff should follow standard precautions when running each test and handling clinical specimens. For personnel collecting specimens or within 6 feet of individuals suspected to have COVID-19, the following PPE is required: 

• A surgical or procedural mask (a fit-tested N95 or higher-level respirator can be used if available)  
• Eye protection 
• Gloves 
• Gown, when collecting specimens  

Staff administering tests must change gloves between handling of specimens suspected of COVID-19. Additionally, when using patient swabs, minimize contamination of the swab stick and wrapper by widely opening the wrapper prior to placing the swab back into the wrapper. Visit the CDC website for PPE guidance or contact your school nurse or local health department for further information regarding the proper use of PPE. Schools and districts must be able to maintain an adequate supply of PPE as is required to administer tests as needed. 

Please refer to any requirements from your local health department. The state does not require at-home tests results to be reported. 

Yes, to be eligible for mental and behavioral health services through a school-state contract, schools will need to opt in to the StrongSchoolsNC testing program. 

For schools within a school district, the district will submit one opt-in form. Please reach out to your district office regarding interest in the program. 

Yes. All schools are asked to opt-in to the program for the 2022-2023 school year including those schools that school opted into testing last year and had a staffing contract. 

Schools have until Aug. 24 to complete the opt-in form and indicate preferences for add-on funding options. 

The overview of the program launch process is provided below: 

• Opt-in forms are due by Aug. 24. 
• Once schools have indicated their preferences, NCDHHS will begin the process of finalizing vendor contracts with the state and onboarding schools to the programs available to them.  Based on the number of schools that opt-into each initiative, it is possible that each school may not have access to all of the programs that they have selected. 
• We hope to have any required contracting with schools completed by mid-Sept and program implementation to begin as soon as possible. 
• Some program options will necessarily take longer than others to implement. 

The total amount available to each district or school will vary depending on expressed programmatic interests by North Carolina schools. The exact figures will be available during the onboarding and contracting process, which will begin after the opt-in form closes on Aug. 24. Based on the number of schools that opt-into each initiative, it is possible that each school may not have access to all of the programs that they have selected. 

We are working with the vendors to finalize details and working to have the options available as soon as possible.  The first two steps in the implementation process are critical:   

1. Submit your opt-in form where you indicate programmatic preferences. 
2. Be on the lookout for communications in late-August and early-September to draft and execute a contract with the state to formalize the program funding request. 

Allocation amounts will be set in early September as we work with schools who have opted into the program to draft and execute funding contracts. For schools that had a contract last year that was extended in June, the contract team will reach out to amend your current contract.  

This program is funded by the CDC’s ReOpening Schools grant, which was extended through July 31, 2023.  Therefore, all funds must be expended by July 31, 2023. 

School health staff hired with testing program funds must support COVID-19 testing programs, other COVID-19 mitigation and prevention activities as needed (such as oversight for the school’s contact tracing plan), and other school health program activities that support student health, including mental and behavioral health.  Activities performed must always be within the scope of practice for the staff person’s license level. 

For districts and schools using the state-contracted vendor program option, the vendor will be responsible for reporting test results.  

For districts and schools opting to conduct independent testing, all positive and negative test results must be reported daily as part of required reporting of COVID-19 diagnostic tests. The most current reporting requirements and methods of reporting of COVID-19 diagnostic tests are described in the NC Administrative Code Emergency Rule and the associated NCDHHS guidance for reporting results. NCDHHS offers regular training on its user-friendly COVID-19 testing reporting platform, called eCATR PTR. Please email cat@dhhs.nc.gov to be added to an upcoming training. 

NCDHHS provides four options for facilities to automate reporting results: Patient Test Result Portal (eCATR PTR), COVID-19 Laboratory Automation (CLDA), HL7-based Electronic Lab Reporting (ELR) and COVID-19 Centralized ELR Reporters. The information provided here will help facilities select an approach to automation that fits their needs and capabilities. 

For most districts and schools performing independent testing and reporting, eCATR PTR will be the best tool. eCATR PTR is a secure web-based portal with a user-friendly interface to input positive and negative COVID-19 test results and associated data. The online overview linked above provides more information about the eCATR PTR reporting tool. To be added to an eCATR PTR training session, please email CATR@dhhs.nc.gov. 

Data entry in the eCATR PTR system can be done by one person or multiple users on one account. Many of testing program pilot schools chose to use one centralized school account that all nurses and delegated staff had access to in order to enter test results, but each user has a separate sign on. To be added to an eCATR PTR training session, please email CATR@dhhs.nc.gov. 

All eCATR accounts have a Print Test Result capability.  A test record can be printed once the test has been recorded in the state database (usually the next day). Primary account holders also have the ability to download results entered into eCATR. Please contact catr@dhhs.nc.gov for more information. 

NCDHHS is not requiring that schools publish a COVID-19 case dashboard. Dashboards can provide helpful information to families and the public and be effective in managing incoming emails and calls to the school; however, regular dashboards do require maintenance and consistent updating. For example, one pilot district indicated that their dashboard worked in unison with contact tracing and increased transparency but required significant effort to keep up-to-date.