[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2023 Enrolled Bill (ENR)]
H.R.2023
One Hundred Eighth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Tuesday,
the twentieth day of January, two thousand and four
An Act
To give a preference regarding States that require schools to allow
students to self-administer medication to treat that student's asthma or
anaphylaxis, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Asthmatic Schoolchildren's Treatment
and Health Management Act of 2004''.
SEC. 2. FINDINGS.
The Congress finds the following:
(1) Asthma is a chronic condition requiring lifetime, ongoing
medical intervention.
(2) In 1980, 6,700,000 Americans had asthma.
(3) In 2001, 20,300,000 Americans had asthma; 6,300,000
children under age 18 had asthma.
(4) The prevalence of asthma among African-American children
was 40 percent greater than among Caucasian children, and more than
26 percent of all asthma deaths are in the African-American
population.
(5) In 2000, there were 1,800,000 asthma-related visits to
emergency departments (more than 728,000 of these involved children
under 18 years of age).
(6) In 2000, there were 465,000 asthma-related hospitalizations
(214,000 of these involved children under 18 years of age).
(7) In 2000, 4,487 people died from asthma, and of these 223
were children.
(8) According to the Centers for Disease Control and
Prevention, asthma is a common cause of missed school days,
accounting for approximately 14,000,000 missed school days
annually.
(9) According to the New England Journal of Medicine, working
parents of children with asthma lose an estimated $1,000,000,000 a
year in productivity.
(10) At least 30 States have legislation protecting the rights
of children to carry and self-administer asthma metered-dose
inhalers, and at least 18 States expand this protection to
epinephrine auto-injectors.
(11) Tragic refusals of schools to permit students to carry
their inhalers and auto-injectable epinephrine have occurred, some
resulting in death and spawning litigation.
(12) School district medication policies must be developed with
the safety of all students in mind. The immediate and correct use
of asthma inhalers and auto-injectable epinephrine are necessary to
avoid serious respiratory complications and improve health care
outcomes.
(13) No school should interfere with the patient-physician
relationship.
(14) Anaphylaxis, or anaphylactic shock, is a systemic allergic
reaction that can kill within minutes. Anaphylaxis occurs in some
asthma patients. According to the American Academy of Allergy,
Asthma, and Immunology, people who have experienced symptoms of
anaphylaxis previously are at risk for subsequent reactions and
should carry an epinephrine auto-injector with them at all times,
if prescribed.
(15) An increasing number of students and school staff have
life-threatening allergies. Exposure to the affecting allergen can
trigger anaphylaxis. Anaphylaxis requires prompt medical
intervention with an injection of epinephrine.
SEC. 3. PREFERENCE FOR STATES THAT ALLOW STUDENTS TO SELF-ADMINISTER
MEDICATION TO TREAT ASTHMA AND ANAPHYLAXIS.
(a) Amendments.--Section 399L of the Public Health Service Act (42
U.S.C. 280g) is amended--
(1) by redesignating subsection (d) as subsection (e); and
(2) by inserting after subsection (c) the following:
``(d) Preference for States That Allow Students to Self-Administer
Medication to Treat Asthma and Anaphylaxis.--
``(1) Preference.--The Secretary, in making any grant under
this section or any other grant that is asthma-related (as
determined by the Secretary) to a State, shall give preference to
any State that satisfies the following:
``(A) In general.--The State must require that each public
elementary school and secondary school in that State will grant
to any student in the school an authorization for the self-
administration of medication to treat that student's asthma or
anaphylaxis, if--
``(i) a health care practitioner prescribed the
medication for use by the student during school hours and
instructed the student in the correct and responsible use
of the medication;
``(ii) the student has demonstrated to the health care
practitioner (or such practitioner's designee) and the
school nurse (if available) the skill level necessary to
use the medication and any device that is necessary to
administer such medication as prescribed;
``(iii) the health care practitioner formulates a
written treatment plan for managing asthma or anaphylaxis
episodes of the student and for medication use by the
student during school hours; and
``(iv) the student's parent or guardian has completed
and submitted to the school any written documentation
required by the school, including the treatment plan
formulated under clause (iii) and other documents related
to liability.
``(B) Scope.--An authorization granted under subparagraph
(A) must allow the student involved to possess and use his or
her medication--
``(i) while in school;
``(ii) while at a school-sponsored activity, such as a
sporting event; and
``(iii) in transit to or from school or school-
sponsored activities.
``(C) Duration of authorization.--An authorization granted
under subparagraph (A)--
``(i) must be effective only for the same school and
school year for which it is granted; and
``(ii) must be renewed by the parent or guardian each
subsequent school year in accordance with this subsection.
``(D) Backup medication.--The State must require that
backup medication, if provided by a student's parent or
guardian, be kept at a student's school in a location to which
the student has immediate access in the event of an asthma or
anaphylaxis emergency.
``(E) Maintenance of information.--The State must require
that information described in subparagraphs (A)(iii) and
(A)(iv) be kept on file at the student's school in a location
easily accessible in the event of an asthma or anaphylaxis
emergency.
``(2) Rule of construction.--Nothing in this subsection creates
a cause of action or in any other way increases or diminishes the
liability of any person under any other law.
``(3) Definitions.--For purposes of this subsection:
``(A) The terms `elementary school' and `secondary school'
have the meaning given to those terms in section 9101 of the
Elementary and Secondary Education Act of 1965.
``(B) The term `health care practitioner' means a person
authorized under law to prescribe drugs subject to section
503(b) of the Federal Food, Drug, and Cosmetic Act.
``(C) The term `medication' means a drug as that term is
defined in section 201 of the Federal Food, Drug, and Cosmetic
Act and includes inhaled bronchodilators and auto-injectable
epinephrine.
``(D) The term `self-administration' means a student's
discretionary use of his or her prescribed asthma or
anaphylaxis medication, pursuant to a prescription or written
direction from a health care practitioner.''.
(b) Applicability.--The amendments made by this section shall apply
only with respect to grants made on or after the date that is 9 months
after the date of the enactment of this Act.
SEC. 4. SENSE OF CONGRESS COMMENDING CDC FOR ITS STRATEGIES FOR
ADDRESSING ASTHMA WITHIN A COORDINATED SCHOOL HEALTH
PROGRAM.
The Congress--
(1) commends the Centers for Disease Control and Prevention for
identifying and creating ``Strategies for Addressing Asthma Within
a Coordinated School Program'' for schools to address asthma; and
(2) encourages all schools to review these strategies and adopt
policies that will best meet the needs of their student population.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.