State Honor Roll 2016 logo&


Overall, Vermont meets 21 of 23 core policy standards and eight of 13 extra credit indicators.

Vermont state icon

The 2016 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.
Back to main State Honor Roll page

Medication and Treatment Policies:

Meets 11 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. 12. Nurse-to-student ratio is 1:750 or better.

Meets three of six extra credit indicators in this category:

A. State requires anaphylaxis epinephrine stocking and authority to administer in schools.
B. State requires or allows albuterol asthma medication 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.

Awareness Policies:

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 eight 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 ofheating, ventilation and air conditioning (HVAC) system & other items important in asthma/allergymanagement.
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 three 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.

Policy Gaps:



Vermont has been selected for the State Honor Roll since 2008.

Epinephrine in Schools: In 2013, Vermont passed a law allowing schools to stock epinephrine auto-injectors, The law allows a health care professional to prescribe epinephrine auto-injectors to a school, requires the health care professional to issue protocols for assessing a potential life-threatening emergency, and allows administering the medication and caring for the individual after administration of the medication. The bill also allows pharmacists to dispense the medication to a school and includes a provision immunizing school personnel from liability related to administration and student self-administration. The law does not address liability related to asthma inhalers. No. 68

Indoor Air Quality: A 2012 Vermont law states a commitment to improving air quality of schools and environmental health of students. Further, it directs cleaning service contractors with school districts to use only environmentally preferable cleaning products and to provide green training to each school district it provides with such products. S.92 (Act 68 of 2012) The state's "Envision Program”, adopted in 1999, mandates that cleaning services contractors use cleaning products that are certified as environmentally preferable by an independent third party and that the distributors and manufacturers of these products provide training to contracting school districts at no costs to the districts. “The Envision—Promoting Healthy School Environments program”.


State Education Agency Website

State Legislature Website

Managing Life-Threatening Allergic Conditions in Schools

State Honor Roll report 2016
View this year’s full report Download PDF

Asthma Capitals: Poor Air Quality and Asthma Outcomes | AAFA | Poor Air Quality


Asthma Capitals 2018: Poor Air Quality

In the Asthma Capitals 2018 ReportDownload PDF, AAFA looked at eight risk factors that can affect asthma rates: povertylack of health insurance, poor air quality, pollen counts, long-term control medicine use, quick-relief medicine usesmoking laws and access to specialists.

Air pollution is a mix of natural and man-made substances in the air. There is outdoor and indoor pollution. Air pollution includes:

  • Gases (like ozone)
  • Smoke from fires
  • Volcanic ash
  • Dust particles

Research shows that air pollution can worsen asthma symptoms. Air pollution is also connected to the development of asthma.1 Asthma rates are higher in polluted areas. Young children are very vulnerable to living in areas with bad air quality.2

Many sources, including local TV weather forecasts, report the expected air quality for the next day or two. This information can help you know when the air quality may trigger an asthma episode and allow you to plan accordingly.

The Environmental Protection Agency (EPA) tracks and reports on daily air quality around the country using the Air Quality Index (AQI). The AQI is a measure of air pollution to indicate the safety of the air and possible health effects. Those with asthma can watch air quality on to help them manage their symptoms.

AQI values are color coded by level of health concern. Green (AQI value of 0-50) means air quality is good. When the air quality reaches yellow (AQI value of 51-100) or higher, those who are sensitive to air pollution need to take caution, especially when outside.

poor air quality index

This proves that we need to protect the Clean Air Act. We need to enact policies that fight climate change. As temperatures rise, the risk of wildfires goes up. And high-pressure weather systems trap ozone and other pollutants closer to the ground.

“Last fall we had wildfires in our area, and the smoke got trapped in our valley, and the air quality plummeted,” said Kathy Przywara, AAFA’s Community Director who lives near San Jose, California (overall #97 on Asthma Capitals). “I couldn’t go outside and do any activities that I would normally enjoy because my asthma made it very difficult to breathe the polluted air. I had to keep my windows closed – even though the weather was hot and we have no air conditioning.”

Air quality can limit outdoor activities for those with asthma because asthmatic lungs are more sensitive to poor air quality. April Behounek lives on the northwest side of Milwaukee, Wisconsin (overall #14 on Asthma Capitals), on the bank of Lake Michigan. She loves riding the miles of bike trails around the lake and throughout the city. But outdoor fitness activities are a challenge because of her asthma. 

“When I started to do more fitness activities, like riding bikes, I felt like my asthma was being impacted differently here in the city than when I’d go on a bike ride in my hometown,” shared April. “I’m assuming the pollution in the city contributes to having to use my rescue inhaler when I’m exercising outside.” 

Weather permitting, you can find April on the bike trails almost every day. She rides 8-9 miles a day. Despite her asthma, she loves to be outdoors and loves to ride her bike.

“The biggest impact living in Milwaukee has on my asthma is the air quality,” says April. “I enjoy outdoor activities, and I know that the poor air quality negatively impacts my asthma as I feel better when I visit other communities and engage in the same activities.”




1. Gehring, U., Wijga, A. H., Hoek, G., Bellander, T., Berdel, D., Brüske, I., . . . Brunekreef, B. (2015). Exposure to air pollution and development of asthma and rhinoconjunctivitis throughout childhood and adolescence: A population-based birth cohort study. The Lancet Respiratory Medicine,3(12), 933-942. doi:10.1016/s2213-2600(15)00426-9
2. The Effect of Air Pollution on Lung Development from 10 to 18 Years of Age. (2005). New England Journal of Medicine,352(12), 1276-1276. doi:10.1056/nejm200503243521230