Advocacy

Maryland

Overall, meets 17 of 23 core policy standards and seven of 13 extra credit indicators. Below are the standards that Maryland meets.

The 2019 State Honor Roll of Asthma and Allergy Policies for Schools ranks the states with the best public policies for people with asthma, food allergies, anaphylaxis and related allergic diseases in U.S. elementary, middle and high schools.

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Medication and Treatment Policies

Meets 10 of 12 core policy standards in this category:

1. State requires physician’s written instructions to be on file to dispense prescription medication to students.checkmark
2. State policy ensures students’ right to self-carry and self-administer prescribed asthma medication.checkmark
3. State policy ensures students’ right to self-carry and self-administer prescribed anaphylaxis medication.checkmark
4. State policies or procedures shield school personnel from liability for unintended injuries.x
5. State requires local school districts to create asthma and anaphylaxis medication policy and provides resources, guidelines and parameters.checkmark
6. State policy mandates schools to identify and maintain records for students with chronic conditions including asthma and anaphylaxis.checkmark
7. State requires a procedure updating health records periodically.checkmark
8. State requires that schools maintain asthma/allergy incident reports for reactions, attacks and medications administered.checkmark
9. State requires a student health history form that includes asthma/allergy information to be maintained for each student.checkmark
10. State requires schools to have emergency protocols for asthma.checkmark
11. State requires schools to have emergency protocols for anaphylaxis.checkmark
12. Nurse-to-student ratio is 1:750 or better.x

Meets four of six extra credit indicators in this category:

A. State requires anaphylaxis medicine – epinephrine – stocking and authority to administer in schools.checkmark
B. State allows and/or requires asthma quick-relief medicine – albuterol – stocking and authority to administer in schools.x
C. State has or is preparing an explicit asthma program with policies, procedures and resources for schools to manage students with asthma.checkmark
D. State has or is preparing an explicit anaphylaxis program with policies, procedures and resources for schools to manage students with allergies.checkmark
E. State has adopted policy that each school will have one full-time nurse.x
F. State has adopted policy that school districts provide case management for students with chronic health conditions such as asthma.checkmark
Awareness Policies

Meets both core policy standards in this category:

13. State recognizes problem of asthma in schools and has begun to address it.checkmark
14. State recognizes problem of allergy in schools and has begun to address it.checkmark

Meets zero of two extra credit indicators in this category:

G. State sponsors or provides funding for staff training in asthma awareness covering school asthma program/policy and procedures.x
H. State sponsors or provides funding for staff training in food allergies.x
School Environment Policies

Meets five of nine core policy standards in this category:

15. State has mandated that all schools must have indoor air quality (IAQ) management policies.x
16. State has adopted a policy requiring that districts and schools conduct periodic inspections of heating, ventilation and air conditioning (HVAC) system & other items important in asthma/allergy management.checkmark
17. State has IAQ policies that include specific components important in asthma/allergy management (HVAC, HEPA, carpeting, pesticide use).x
18. State recommends/requires that districts or schools use Integrated Pest Management (IPM) techniques OR ban use of pesticides inside school.checkmark
19. State requires schools to notify parents of upcoming pesticide applications.checkmark
20. State limits school bus idling time and establishes proximity restrictions.x
21. All smoking is prohibited in school buildings and on school grounds.checkmark
22. All smoking is prohibited on school buses and at school-related functions.x
23. Tobacco-use prevention is required in health education curriculum.checkmark

Meets three of five extra credit indicators in this category:

I. State makes funding or resources available for technical IAQ assistance to schools.x
J. State recommends standards and programs to promote environmentally preferable materials for school construction, maintenance and cleaning.checkmark
K. State requires school facility design standards that include low emission construction materials, pollutant source controls, durable and easy to clean surfaces and floors, moisture/mold controls.x
L. State has implemented or actively promotes diesel school bus engine retrofitting program.checkmark
M. State requires districts or schools to provide tobacco-use-cessation services to students.checkmark
Policy Gaps
Nurse-to-Student Ratio
Noteworthy
Asthma and Allergy Medication in School: Maryland addresses planning and documenting the needs of students who require medication and self-administration of medication. Maryland requires schools to allow students to carry an asthma inhaler, provided that (a) the student’s physician writes a prescription and completes the state medication form, and (b) the school nurse reviews the student’s technique. The state requires local boards of education, with the local health department, to formulate writ10 policies regarding the storage and administration of medication during school hours and school-sponsored activities.

All persons other than registered nurses (RNs) or licensed practical nurses (LPNs) who administer medication in schools on a routine basis, regardless of position, do so under the supervision of the RN. To meet this requirement, personnel administering medication must successfully complete a 20-hour medication administration training program course that is approved by the Maryland Board of Nursing (MBON). Medication technicians are certified by the MBON. The certification must be renewed every two years.

In MD, all levels of emergency medical technicians, are allowed to carry and are trained to use epinephrine auto-injectors.

Epinephrine in School: A 2012 Maryland law requires counties to implement policies allowing school personnel to acquire and use epinephrine auto-injectors for emergency use on students whether or not they have a prescription. SB 621 Frequently Asked Questions