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NEW HAMPSHIRE

Overall, New Hampshire meets 17 of 23 core policy standards and four of 13 extra credit indicators.

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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 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 one of two 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 zero of two 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 six 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:

Nurse to Student Ratio, Epinephrine Stocking in Schools

Noteworthy:

Asthma Medication and Epinephrine in Schools: New Hampshire requires local boards to develop policies regarding the administration of medications during the school day.  The rule specifies that asthma inhalers and epinephrine auto injectors may be possessed and self-administered by students, according to certain provisions such as parental authorization and health care provider instructions. The state protects school districts and employees from liability for damages resulting in a pupil’s use of an epinephrine auto-injector or inhaler unless the damages were caused by willful or wanton conduct or disregard for the established criteria.  State law requires the school nurse or principal to maintain at least one epinephrine auto-injector for the student's use in an accessible location if provided by the student.  State law also gives the school nurse the responsibility of developing and communicating a system of documenting observations related to the prescriptions. All levels of emergency medical technicians are allowed to carry and trained to use epinephrine auto-injectors. Technical Advisory: Medication During School Day, 311.02

Sources:

State Education Agency Website

State Legislature Website

Frequently Asked Questions about Delegation of Nursing Care in Schools – asks about delegating administration of epinephrine to non-nursing professionals when student does and does not have a prescription.

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