Schools - National Asthma Public Policy Agenda

Supporting Strategies:

• Establish laws to authorize stocking of asthma medication in schools.
• Provide funding to support school nurses in every school.
• Expand Medicaid programs to allow school districts to bill Medicaid for all Medicaid eligible services delivered to Medicaid enrolled students. 
• State Boards of Education should create and disseminate standards or recommendations for healthcare services and alternative methods for providing care in schools in the absence of school nurses. 
• State Departments of Health and State Departments of Education should coordinate activities to support asthma policies and practices in schools.
• States should use funding from and implement procedures recommended by ESSA to improve school buildings.

Supporting Strategies:

• Implement recommended strategies such as those outlined in CDC’s EXHALE Guide for Schools on coordination of care and educate all students with asthma and their caregivers on asthma self-management.
• Ensure that all students with asthma who are not well controlled are provided case management by a school nurse or another designated school personnel.
• Educate all educational personnel (especially health services, physical educators, coaches, and athletic trainers) about asthma, including how to identify and respond to students at risk for a respiratory emergency.
• Establish and implement emergency protocols for students in respiratory distress.
• Designated school health staff should identify and track all students with a healthcare provider diagnosis of asthma and assess and refer students who may be at risk for asthma or have asthma that is not well-controlled based on a nurse assessment for clinical diagnosis and treatment.
• Obtain and ensure the use of an asthma action plan for all students with asthma in all settings.
• Ensure students with asthma have immediate access to quick-relief medications by establishing protocols to define students’ assessment of readiness for self-carry and stock medication in school.
• Schools should identify alternative options for care when school nurses are not present, such as School-based Health Centers (SBHCs), community health workers or telehealth.

Supporting Strategies:

• Communities should educate and train personnel from after-school programs, youth serving organizations and licensed childcare systems about effective asthma friendly policies and practices to improve childhood asthma.
• After-school programs, youth serving organizations and licensed childcare systems should implement emergency protocols for students in respiratory distress.

Supporting Strategies:

• Develop, implement and sustain an indoor air quality program as detailed in U.S. Environmental Protection Agency’s Indoor Air Quality Tools for Schools.
• Educational systems should strive to have ventilation systems that meet the minimum guidelines of American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE).
• Educational systems should follow work practices to reduce exposure to cleaning agents and disinfectants that cause or aggravate asthma as recommended by EPA’s “Safer Choice” program.
• Require schools, grounds, facilities, vehicles and sponsored events to be 100% tobacco-free, including e-cigarettes.
• Schools should minimize students’ exposure to outdoor air pollutants on days with unhealthy levels of air pollution, including using ventilation/filtration and other strategies to reduce exposures while inside school buildings.
• Schools should adopt zero-emission technology for school buses, and policies to prevent school bus and personal car idling on school grounds.
• Schools should develop and implement a disaster response plan that addresses exposure to indoor and outdoor pollutants (e.g., mold, wildfires), access to asthma medication and cleaning up schools.