In California a student with an asthma inhaler stored on campus can only gain access to the prescription if an authorized school district staff member is available to open the school’s medicine cabinet. While access issues may emerge during the school day, accessing the emergency medication can be dangerously difficult during the hours that state and federally funded after school programs operate.

Typically, after school programs are established for elementary and middle school students through partnerships between schools and community-based organizations such as the YMCA, Campfire USA, Boys and Girls Clubs, as well as smaller local agencies.    More than 400,000 California students participate each day. 

The organizations that offer the after school programs use school campuses; however, their staff are not school district personnel and therefore are not permitted to retrieve and provide students the stored medication.  The biggest challenge to gaining access to the prescriptions occurs after 4:30 pm when regular day staff often leaves campus.

According to California law, students are permitted to carry and self-administer their asthma medication during and after school if the district receives written permission from the physician and parent/guardian.  Even if the students have the capacity to responsibly carry and manage their medication, some parents, especially those without good health insurance coverage, may find obstacles to getting the proper form completed by a physician.  In addition, many campuses discourage students from carrying and self-administering because of concerns, including the student being too young to know when to use the medication appropriately, or even worry over the possibility of theft by other students.  

Of course, parents are likely to assume that since their children are remaining on campus the medication that is stored for them is available during the after school program.   Parents and providers can discuss having duplicate medication on hand and managed by the after school program, but the cost of duplicate medication may not be covered under medical insurance, making it expensive for lower income families to have three sets of inhalers for their child (one for home, one for school and one for after-school). Of course, this would be dwarfed by the cost of an emergency department visit due to a child’s inability to access an inhaler that is stored on campus but unavailable during after school hours. 

Breathe LA is undertaking a research and policy project with the Long Beach Unified School District to identify the challenges to securing access to prescribed asthma medication in after-school programs. Together, we will develop solutions that can be standardized across the district, and, if successful, be shared with representatives of the State Department of Education and others.  Often parents choose after school programs for their children to ensure their safety. Safety must entail access to asthma and other medication that can save children’s lives.