The School-Based Allergy, Asthma and Anaphylaxis Management Program®: Comprehensive Asthma Educational Resources

Background

● Childhood asthma is a common, chronic pediatric condition, affecting 6.3 million children.
● Morbidity from childhood asthma adversely affects school performance, with 1 in 2 children reporting school absences due to asthma each year.
● These asthma related absences influence academic achievement, leading to decreased levels of reading proficiency and increased risk of learning disabilities.
● Improving health and school-related outcomes for children with asthma requires the use of school-based partnerships that focus on integrated care coordination amongst families, clinicians, and school nurses

SA³MPRO^TM developed by multiple stakeholders, standardizes recommendations for school based asthma, and provides websites and resources useful for the care of children with asthma in the school setting.

Legislative History

• AAAAI created the SA³MPRO^TM resource in 2016 to assist students with asthma and allergies in managing their conditions at school.
• In April 2019, AAAAI initiated bipartisan legislation, the School-Based Allergies and Asthma Management Program Act (H.R. 2468), to support SA³MPRO^TM.
• H.R. 2468 became law on January 5, 2021, enhancing safety for students with allergies and asthma at school.
• The Act amends the Public Health Service Act to give preference to states that require schools to implement comprehensive allergies and asthma management programs.
• These programs include identifying affected students, maintaining individual action plans, and coordinating support among school staff, families, and healthcare providers.
• The passage of H.R. 2468 reflects ongoing advocacy efforts by AAAAI and patient advocacy organizations.
• AAAAI is working with HHS and CDC to implement the framework of the Act.
• The Act aims to improve health outcomes by focusing on integrated care coordination among families, clinicians, and school nurses.
• AAAAI offered expertise to the Biden Administration to implement the Act, which prioritizes states with trained personnel and individualized support systems for students with allergies and asthma.

The response to these concerns, AAAAI created a central resource in 2016 [termed the SA³MPRO^TM)], in collaboration with others to assist students with asthma and allergies and their families practice consistent management of their conditions at school. In April 2019, with Congressman Phil Roe (R-TN) and Congressman Steny Hoyer (D-MD), the AAAAI and others initiated the School-Based Allergies and Asthma Management Program Act (H.R. 2468) as bipartisan legislation to support the SA³MPRO^TM program. Passed by the U.S. House of Representatives on September 29 and the U.S. Senate on December 17, 2020, it was signed by President Trump on January 5, 2021.

The School-Based Allergies and Asthma Management Program Act (H.R. 2468) amends the Public Health Service Act to revise the conditions under which the Department of Health and Human Services, in making asthma-related grants, gives preference to a state. The measure will give preference to states that require elementary and secondary schools to have at least one individual, such as a school nurse or other school staff, to direct and apply a comprehensive school-based allergies and asthma management program on a voluntary basis. The program will include a method to identify students with allergies and asthma, have on file an action plan for each individual student, and develop a support system for each such student coordinating school staff, family members, and health care providers. The two most important strategies for preparing schools in the event of an asthma incident are implementing individual action plans and preparing school staff to assist children experiencing an attack.

Its passage by the 116th Congress reflects ongoing AAAAI advocacy efforts, and those of its patient advocacy organizations, including the Asthma and Allergy Foundation of America and the Allergy and Asthma Network, along with the American College of Allergy, Asthma and Immunology.

See more about the history of H.R. 2468, similar legislation introduced last session.

January 5, 2021
H.R. 2468, the School-Based Allergies and Asthma Management Program Act became law to enhance the safety of students with allergies and asthma in the school setting. First introduced in support of the AAAAI’s SA³MPRO™ by Majority Leader Steny Hoyer (D-MD) and Representative Phil Roe, MD (R-TN), its passage reflects the efforts of many dedicated physicians and patient advocates who urged its passage.

The measure requires that the Department of Health and Human Services [HHS] award grants first to those states which ensure a school nurse or other trained personnel is available on the premises, and that students diagnosed with allergies and asthma are identified and have an individualized action plan and coordinated support system. The AAAAI will work with HHS and the Centers for Disease Control and Prevention (CDC) to implement this framework.

Improving health and school-related outcomes for children with asthma requires the use of school-based partnerships that focus on integrated care coordination amongst families, clinicians and school nurses.

April 6, 2021
AAAAI wrote to the Biden Administration to offer its expertise in implementing Public Law No. 116-292, the School-Based Allergies and Asthma Management Program Act. The measure amends the Public Health Service Act to provide preference to states which ensure a school nurse or other trained staffer is available on the premises, and that students diagnosed with allergies and asthma are identified and have an individualized action plan and coordinated support system. This legislation was based on the School-based Asthma, Allergy & Anaphylaxis Management Program^TM, or SA³MPRO™.

Development of the Toolkit

The SA³MPRO™ Toolkit was developed by the stakeholders in the SA³MPRO™ Summit Stakeholder Workforce, listed below.

This project was supported by funding from the American Academy of Allergy, Asthma and Immunology (AAAAI) and the National Association of School Nurses (NASN). Additional support was provided by the University of Wisconsin School of Medicine and Public Health’s Health Innovation Program (HIP), the Wisconsin Partnership Program, and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research (UW ICTR), grant 9 U54 TR000021 from the National Center for Advancing Translational Sciences (previously grant 1 UL1 RR025011 from the National Center for Research Resources). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.

Four Components of SA³MPRO™

For asthma care, the School-Based Allergy, Asthma and Anaphylaxis Management Program (SA³MPRO^TM) advocates four components to integrate schools, and specifically school nurses, within the asthma care team. These components are:

1. The creation of a Circle of Support amongst the families, clinicians and schools nurses centered around the child with asthma.

2. The creation and transmission of Asthma Management Plans to schools. This includes an Asthma Emergency Treatment Plan for emergency management of asthma symptoms and an individualized Asthma Action Plan for each child with asthma. A standardized Asthma Action Plan is available.

Asthma Action Plan
Asma - plan de acción

Asthma Action Plan - Fillable PDF AAAAI does not assume responsibility for how these documents are utilized. Consult with your practice’s IT resources for recommendations on document storage, transmission and HIPAA compliance.
Asma - Plan de Acción (Asthma Action Plan) - Formulario PDF Rellenable La AAAAI no asume ninguna responsabilidad sobre cómo se utilizarán estos documentos. Debe consultar los recursos apropiados de tecnología de la información sobre almacenamiento de documentos, transmisión electrónica y cumplimiento de HIPAA.

SA³MPRO^TM picture-based asthma action plan
English
Spanish

School Supplementary Treatment Orders Form (To be Sent with the Asthma Action Plan)
Órdenes de Tratamiento Complementarias para la Escuela (Se enviarán con el plan de acción contra el asma)

3. A comprehensive SA³MPRO^TM Asthma Education Plan for school personnel.

4. A comprehensive SA³MPRO^TM Environmental Asthma Plan to assess and remediate asthma triggers at home and in school.

How to Use SA³MPRO^TM

What does this toolkit contain?
The SA3MPRO™ Toolkit contains several tools to help you implement the key components of SA3MPRO™:
•    Establishing the Circle of Support: Tools for engaging clinicians, school nurses, and families, and how to foster good communication between them.
•    Using and transmitting the Asthma Emergency Treatment Plan and an Asthma Action Plan
•    Tools for the school nurse to provide asthma education to school personnel
•    Additional resources to support effective school-based management of asthma

Who should use it?
This toolkit is intended for school nurses, education administrators, clinicians, or healthcare administrators who are interested in implementing them  at their school or organization.

Stock Inhaler and Epinephrine Toolkits

Andrea A. Pappalardo, MD, FAAAAI, University of Illinois Hospital & Health Sciences System (UIC), discusses the AAAAI stock inhaler and epinephrine toolkits for use by school personnel throughout the United States. These compilations of critical information are essential to establishing and sustaining school-based stock medication programs.

Toolkit Highlights:

• Downloadable Asthma Action Plans in English and Spanish

• Checklists for Clinicians, Families and School Nurses

• Online Asthma Education Videos, Education Links and Much More

• Links to Indoor Quality Management Tools and Education
  
  
  
  
  
  
  Terms to Know
  Comprehensive Asthma Toolkit: A comprehensive set of resources to help better manage Asthma in schools.
  Stock Inhaler Toolkit: An explanation of the process for setting up and initiating a stock inhaler program for your school or district.
  Stock Epinephrine Toolkit: An explanation of the process for setting up and initiating a stock epinephrine program for your school or district.
  Asthma Action Plan (AAP): An individualized plan for individual students with a diagnosis of asthma.
  Picture Based Asthma Action Plan: An individualized plan for individual students with a diagnosis of asthma that includes pictures of the indicated inhalers.
  Asthma Emergency Treatment Plan (AET): A plan that would apply to all students who present with troublesome asthma symptoms but do not have a documented or updated Asthma Action Plan available to school nursing.
  Essential Features of a School related Asthma Action Plan: Included for schools who wish to modify existing forms.
  School Supplementary Treatment Order Form: Adds additional information and context regarding an individual student’s Asthma Action Plan.
  Anaphylaxis Emergency Action Plan: An individualized plan for individual students with a diagnosis of anaphylaxis.
  Provider/Nursing/Family Checklists: Checklists for the provider, nursing and family are included to ensure that all components of SA3MPRO™ are met by each part of the patient’s circle of support.
   

School Attendance, Asthma and COVID-19

With so many important aspects pertaining to a return to in-person learning, issues specific to asthma management inside the school setting are more important than ever. In this episode Robert Lemanske, Jr., MD, FAAAAI, and Liz Clark, MSN, RN, NCSN, FNASN, discuss recommendations for parents, schools, and healthcare professionals to consider this autumn. (September 21, 2020)

Click here to listen to the podcast.

AAP Allergy and Anaphylaxis Emergency Plan in English »

AAP Allergy and Anaphylaxis Emergency Plan in Spanish »

Learn from and network with asthma programs nationwide »

The American Academy of Allergy, Asthma & Immunology and National Association of School Nurses Guidance on School Attendance, Asthma and COVID-19. This document summarizes the overall recommendations for treating students with asthma at school during the ongoing pandemic. »

The American Academy of Allergy, Asthma & Immunology and National Association of School Nurses Food Allergy and Anaphylaxis in School during COVID-19 »

Indoor Air Quality Tools for Schools: Preventive Maintenance Guidance Documents »

Topics in School Environmental Health: Overview of State Laws »

Database of State IAQ Laws: Schools Excerpt »

SA³MPRO^TM: Improving Asthma Management in Schools - A Practice Improvement Module »

EPA Asthma Management in Schools, Indoor Air Quality Webinar Series:
EPA Indoor Air Quality Tools for Schools Action Kit »

IAQ Master Class Professional Training Webinar Series »

How Schools Work & How to Work with Schools »

The 2019 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.

Overview of state legislation related to Stocking Albuterol in Schools
(from the Asthma and Allergy Foundation of America)

6/20/2024