We are absolutely OPPOSED to these DMAS changes.  For those of us working directly with these children and their parents, these changes will increase bureaucracy without improving services to students.  We spent enough time with this paperwork, we do not need another step in this tedious process.  School nurses (Occupational Therapist, Physical Therapist, Speech, etc.)  have no control over Healthcare Providers timelines and willingness to review, sign and return our POC.  We are professional nurses, we can write and implement a POC without a Healthcare provider approving it. While waiting on POCs to be signed and returned, the school division not only loses billable services but also bears the impact on its cost reimbursement (or NO reimbursement).  It is unreasonable to school divisions to bear the fiscal consequences for a delayed/unmet requirement that is beyond our control.