Barriers and Solutions to Implementing Stock Asthma Medication in Schools

Asthma is one of the most common reasons children miss school. So, ensuring that schools are equipped with emergency asthma medications and have trained personnel available to administer the medication is essential. Seventeen states have laws or state administrative guidelines allowing schools to stock quick-relief medications for students with asthma. Schools implementing stock asthma medication often run into barriers when implementing a program. Some of the most common barriers include obtaining standing orders for medications and devices. 

In September, the American Lung Association brought together school health professionals such as nurses for a  to share some of the successful strategies and tactics that worked to overcome these barriers. Below, find some of the tactics that school nurses shared. Listen to the recorded webinar for even more tips. 

How can schools and districts get started on obtaining standing orders, inhalers and devices?

• Find a champion in the school, district or community. Note: Check state law for indemnification of liability.
• If available, a Medical Director or Nurse Practitioner can establish the standing order. 
• Partner with local or county health departments.
• Partner with hospitals, local community health centers or healthcare providers.
• Engage Parent, Teacher Organizations (PTO), to help increase awareness and support funding. 
• Use standing order templates available in the AAAAI Stock Inhaler Toolkit for Schools and through the American Lung Association Stock Asthma Medication course. 
• Tip: Some providers won't write a standing order when you first approach them, but they may be more willing if you say, “I have a standing order from a reputable source (e.g., American Lung Association, American Association of Allergy Asthma & Immunology, National Association of School Nurses).”

How much does it cost?

• Some schools report about $85 per school to cover 1 inhaler and disposable spacers.
• Costs vary based on a few factors:
  • Is there a fee associated with obtaining the standing order? (This would apply if obtaining the standing order from a local physician). 
  • Valved holding chambers are considered durable medical equipment and will also require a prescription. A disposable cardboard model or plastic model can be used 
  • Quick-relief medication (i.e. albuterol). Medication costs vary by pharmacy. Consider the dosage amount needed for the school year and student population served. 

How can you secure funding for medications and devices?

• Approach your district administrators with an approximate cost. Be sure to include data regarding the number of students in your school with asthma, and the number of those students that have asthma action plans and inhalers at school. Often, there is a discrepancy and a good justification for why administrators should support stock medications.
• Partner with Health Departments and patient advocacy organizations to help support your Stock Asthma Medication program. 
• Look for statewide funding or grants to support the program (if allowable by state legislation).

To learn more about starting a stock asthma medication program in your school, be sure to participate in the free online course, Stock Asthma Medication: Implementation Guidance for Schools. And visit Asthma Medication in Schools page on Lung.org for more information on improving access to asthma medication in schools.