Testimony Before the DC Council Committee on Health at the Hearing on B25-226, the “Access to Emergency Albuterol & Glucagon Amendment Act of 2023”
By Rachel Johnston, Senior Director of Operations and School Support, DC Charter School Alliance
July 13, 2023
Good morning Chairperson Henderson and members of the Committee. My name is Rachel Johnston, and I’m a Ward 5 resident and the Senior Director of Operations and School Support at the DC Charter School Alliance, the local non-profit that advocates on behalf of public charter schools to ensure that every student can choose high-quality public schools that prepare them for lifelong success.
I want to start by thanking you for your leadership along with DC Health, OSSE, DBH, and Children’s School Services (CSS) for working hard to make sure students have equitable access to public health resources. This includes actively engaging to make improvements to streamline Administration of Medication (AOM) training for schools, as well as increasing access to lifesaving drugs like EpiPens and Narcan. Ensuring students’ health needs are met is a crucial step to being able to actively participate in learning.
I’m here today to share our support for the Access to Emergency Albuterol & Glucagon Amendment Act of 2023. All students, preK through adult, should have access to these important medications while at school. We appreciate that this legislation requires the city to supply these medications to schools and aligns with nationally recommended best practices that many other states have passed or are considering to strengthen public health access for students. My testimony today will offer a few recommendations for the implementation of this program that we believe will make this bill stronger.
Recommendations
First, we recommend consolidating all medication administration, training, guidance, and management in a single agency. With multiple agencies overseeing each process, it’s confusing for schools to remember which is responsible for each when they have questions. It also increases the possibility of duplicative components of training. Lastly, reporting processes and compliance requirements aren’t always the same across agencies. School staff aren’t health care experts – they need this streamlined to ensure they can support students.
Second, we appreciate and support the need for closely monitoring medication supplies. But we believe there’s an opportunity to streamline the reporting for the stock supply of all four life-saving medications: Narcan, albuterol, glucagon and EpiPens to ensure the process is simple, clear and efficient for schools.
Third, our schools believe it’s important to ensure their families have the assistance they need to secure prescriptions if necessary. We think this legislation could be strengthened by including a requirement that school nurses reach out to families after administration of stock albuterol or glucagon to ensure they have up-to-date prescriptions or access to these medications, and to create a medication plan with the family if they don’t already have one. For schools that do not have an assigned school nurse, we request that OSSE, in consultation with CSS, designate staff responsible for prompt family outreach.
Fourth, we recommend that the legislation be strengthened by requiring the agency overseeing medication administration to purchase inhalers with valved holding chambers/spacers for administration, as recommended by the NIH (1). This allows the inhaler to be used for multiple individuals with less cleaning and easier storage and portability.
Fifth, because glucagon has some serious side effects, we recommend ensuring appropriate safeguards are in place to mitigate this risk, especially when school nurses are not present for administration. For example, many states with similar legislation have limited administering glucagon only to cases where a medication plan is in place for a student.
Finally, while this bill already includes many of the recommendations from the NIH (2) for improving medication access in schools, we think it can be strengthened by aligning on all aspects including providing explicit immunity from civil liability for staff and prescribers.
Moving Forward
As always, charter schools value the health and well-being of their students first and foremost. The DC Charter School Alliance is grateful for our partnership with the city, and we welcome the opportunity to continue collaborating to make sure every student has their health needs met so that they can actively and safely engage in learning.
Thank you for your time and attention, and I welcome your questions.
Citations:
Ensuring Access to Albuterol in Schools: From Policy to Implementation. An Official ATS/AANMA/ALA/NASN Policy Statement. Am J Respir Crit Care Med. March 30, 2021
Ensuring Access to Albuterol in Schools: From Policy to Implementation. An Official ATS/AANMA/ALA/NASN Policy Statement. Am J Respir Crit Care Med. March 30, 2021
