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.
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.
|2. State policy ensures students’ right to self-carry and self-administer prescribed asthma medication.
|3. State policy ensures students’ right to self-carry and self-administer prescribed anaphylaxis medication.
|4. State policies or procedures shield school personnel from liability for unintended injuries.
|5. State requires local school districts to create asthma and anaphylaxis medication policy and provides resources, guidelines and parameters.
|6. State policy mandates schools to identify and maintain records for students with chronic conditions including asthma and anaphylaxis.
|7. State requires a procedure updating health records periodically.
|8. State requires that schools maintain asthma/allergy incident reports for reactions, attacks and medications administered.
|9. State requires a student health history form that includes asthma/allergy information to be maintained for each student.
|10. State requires schools to have emergency protocols for asthma.
|11. State requires schools to have emergency protocols for anaphylaxis.
|12. Nurse-to-student ratio is 1:750 or better.
Meets two of six extra credit indicators in this category:
|A. State requires anaphylaxis medicine – epinephrine – stocking and authority to administer in schools.
|B. State allows and/or requires asthma quick-relief medicine – albuterol – stocking and authority to administer in schools.
|C. State has or is preparing an explicit asthma program with policies, procedures and resources for schools to manage students with asthma.
|D. State has or is preparing an explicit anaphylaxis program with policies, procedures and resources for schools to manage students with allergies.
|E. State has adopted policy that each school will have one full-time nurse.
|F. State has adopted policy that school districts provide case management for students with chronic health conditions such as asthma.
Meets both core policy standards in this category:
|13. State recognizes problem of asthma in schools and has begun to address it.
|14. State recognizes problem of allergy in schools and has begun to address it.
Meets both 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.
|H. State sponsors or provides funding for staff training in food allergies.
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.
|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.
|17. State has IAQ policies that include specific components important in asthma/allergy management (HVAC, HEPA, carpeting, pesticide use).
|18. State recommends/requires that districts or schools use Integrated Pest Management (IPM) techniques OR ban use of pesticides inside school.
|19. State requires schools to notify parents of upcoming pesticide applications.
|20. State limits school bus idling time and establishes proximity restrictions.
|21. All smoking is prohibited in school buildings and on school grounds.
|22. All smoking is prohibited on school buses and at school-related functions.
|23. Tobacco-use prevention is required in health education curriculum.
Meets two of five extra credit indicators in this category:
|I. State makes funding or resources available for technical IAQ assistance to schools.
|J. State recommends standards and programs to promote environmentally preferable materials for school construction, maintenance and cleaning.
|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.
|L. State has implemented or actively promotes diesel school bus engine retrofitting program.
|M. State requires districts or schools to provide tobacco-use-cessation services to students.
Epinephrine in Schools: In 2013, Oregon amended prior law by requiring schools to create a process to allow parents to request that epinephrine auto-injectors be kept in a secure location in the student’s classroom if a licensed health care professional confirms in writing that lack of immediate access may be life threatening. The amendment also protects the school, administrators, nurse, teacher, or other school employee from liability if they, in good faith, assist the student’s self-administration of the medication. H.B. 2749
Also in 2013, Oregon passed a bill requiring the state education department to adopt policies allowing school personnel to acquire and use pre-measured doses of epinephrine for emergency use on students whether or not they have a prescription. The bill also requires training on recognizing symptoms of anaphylaxis and properly administering epinephrine. S.B. 611
Liability Shield: The law referenced above also addresses liability for asthma/anaphylactic medication use and shield school personnel from liability for unintentional injury in situations where a student self-administers bronchodilator or epinephrine medication and where school personnel administer these medications. S.B. 611
School Emergency Protocols: In Oregon, all levels of emergency medical technicians are allowed to carry and trained to use epinephrine auto-injectors.
Air Quality: In 2018, Oregon amended Minimum Standards for School Buses (581-053-0240) to require retrofitting for older diesel school buses. Further details are contained in the 2018 Minimum Standards for Oregon School Buses guidance document.