Advocacy
Puerto Rico: State Honor Roll Score
Overall, meets 5 of 27 AAFA’s policy standards and 0 of 6 extra credit indicators. Below are the standards that Puerto Rico meets.
The 2025 State Honor Roll of Asthma and Allergy Policies for Schools rates the U.S. states and territories 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
| 1. Requires schools to have medication administration policies for school personnel to give prescription medication to students. |  |
| 2. Policy ensures students’ right to self-carry and self-administer prescribed asthma medication. |  |
| 3. Policy ensures students’ right to self-carry and self-administer prescribed anaphylaxis medication. | |
| 4. Policy protects school personnel from liability for unintended injuries related to medication administration. | |
| 5. Requires anaphylaxis medicine – epinephrine – stocking and authority to administer in schools. | |
| 6. Allows and/or requires asthma quick-relief medicine stocking and authority to administer in schools. | |
| 7. Requires schools to update and maintain records/health histories for identified students with chronic conditions including asthma and anaphylaxis. | |
| 8. Requires schools to maintain asthma/ allergy incident reports for reactions attacks and medications administered. | |
| 9. Requires schools to have emergency protocols for asthma. | |
| 10. Requires schools to have emergency protocols for anaphylaxis. | |
| 11. Has adopted policy that each school will have at least 1 full-time nurse. | |
| 12. Has adopted policies that address the development of comprehensive school-based health services. | |
| A. Has or is preparing an explicit asthma program with policies procedures and resources for schools to manage students with asthma. | |
| B. Has or is preparing an explicit anaphylaxis program with policies procedures and resources for schools to manage students with allergies. | |
| C. Recommends each school stock at least 2 doses of easily administered epinephrine. | |
| D. Provides funding for stock medications. | |
Awareness Policies
| 13. Sponsors or provides funding for staff training in asthma awareness covering school asthma program/policy and procedures. | |
| 14. Sponsors or provides funding for staff training for the prevention recognition and treatment of allergic reactions to food. | |
School Environment Policies
| 15. Requires schools to have indoor air quality (IAQ) management policies. | |
| 16. Makes funding or other resources such as training available for technical IAQ assistance to schools. | |
| 17. Requires schools to inspect and maintain heating ventilation and air conditioning (HVAC) systems. | |
| 18. Requires schools to develop a plan to identify sources of mold and if necessary a plan to clean and remediate mold and mold sources in public school buildings. | |
| 19. Recommends standards and programs to promote IAQ for school construction and renovation. | |
| 20. Requires schools to develop a cleaning program that promotes healthy IAQ. | |
| 21. Requires schools to use integrated pest management (IPM) techniques including limiting use of pesticides inside schools and on school campuses. | |
| 22. If pesticide use is necessary state requires schools to notify parents of upcoming pesticide applications. | |
| 23. Limits school bus idling time and/or establishes proximity restrictions. | |
| 24. Has implemented zero-emission school bus transition incentives or mandates. | |
| 25. Prohibits all smoking and vaping in school buildings and on school grounds. | |
| 26. Prohibits all smoking and vaping on school buses and at school-related functions. | |
| 27. Requires tobacco-use and vaping prevention in health education curriculum. | |
| E. Requires school facility design and operation standards that address IAQ. | |
| F. Requires districts or schools to provide tobacco-use-cessation and e-cigarette-use-cessation services and resources to students. | |
Notes
Puerto Rico prohibits all smoking and vaping in school buildings.
Puerto Rico prohibits all smoking and vaping on school buses.
