[Congressional Bills 110th Congress]
[From the U.S. Government Printing Office]
[H.R. 2063 Referred in Senate (RFS)]
2d Session
H. R. 2063
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
April 9, 2008
Received; read twice and referred to the Committee on Health,
Education, Labor, and Pensions
_______________________________________________________________________
AN ACT
To direct the Secretary of Health and Human Services, in consultation
with the Secretary of Education, to develop a voluntary policy for
managing the risk of food allergy and anaphylaxis in schools.
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 ``Food Allergy and Anaphylaxis
Management Act of 2008''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) Food allergy is an increasing food safety and public
health concern in the United States, especially among students.
(2) Peanut allergy doubled among children from 1997 to
2002.
(3) In a 2004 survey of 400 elementary school nurses, 37
percent reported having at least 10 students with severe food
allergies and 62 percent reported having at least 5.
(4) Forty-four percent of the elementary school nurses
surveyed reported that the number of students in their school
with food allergy had increased over the past 5 years, while
only 2 percent reported a decrease.
(5) In a 2001 study of 32 fatal food-allergy induced
anaphylactic reactions (the largest study of its kind to date),
more than half (53 percent) of the individuals were aged 18 or
younger.
(6) Eight foods account for 90 percent of all food-allergic
reactions: milk, eggs, fish, shellfish, tree nuts, peanuts,
wheat, and soy.
(7) Currently, there is no cure for food allergies; strict
avoidance of the offending food is the only way to prevent a
reaction.
(8) Anaphylaxis is a systemic allergic reaction that can
kill within minutes.
(9) Food-allergic reactions are the leading cause of
anaphylaxis outside the hospital setting, accounting for an
estimated 30,000 emergency room visits, 2,000 hospitalizations,
and 150 to 200 deaths each year in the United States.
(10) Fatalities from anaphylaxis are associated with a
delay in the administration of epinephrine (adrenaline), or
when epinephrine was not administered at all. In a study of 13
food allergy-induced anaphylactic reactions in school-age
children (6 fatal and 7 near fatal), only 2 of the children who
died received epinephrine within 1 hour of ingesting the
allergen, and all but 1 of the children who survived received
epinephrine within 30 minutes.
(11) The importance of managing life-threatening food
allergies in the school setting has been recognized by the
American Medical Association, the American Academy of
Pediatrics, the American Academy of Allergy, Asthma and
Immunology, the American College of Allergy, Asthma and
Immunology, and the National Association of School Nurses.
(12) There are no Federal guidelines concerning the
management of life-threatening food allergies in the school
setting.
(13) Three-quarters of the elementary school nurses
surveyed reported developing their own training guidelines.
(14) Relatively few schools actually employ a full-time
school nurse. Many are forced to cover more than 1 school, and
are often in charge of hundreds if not thousands of students.
(15) Parents of students with severe food allergies often
face entirely different food allergy management approaches when
their students change schools or school districts.
(16) In a study of food allergy reactions in schools and
day-care settings, delays in treatment were attributed to a
failure to follow emergency plans, calling parents instead of
administering emergency medications, and an inability to
administer epinephrine.
SEC. 3. DEFINITIONS.
In this Act:
(1) ESEA definitions.--The terms ``local educational
agency'', ``secondary school'', and ``elementary school'' have
the meanings given the terms in section 9101 of the Elementary
and Secondary Education Act of 1965 (20 U.S.C. 7801).
(2) School.--The term ``school'' includes public--
(A) kindergartens;
(B) elementary schools; and
(C) secondary schools.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services, in consultation with the
Secretary of Education.
SEC. 4. ESTABLISHMENT OF VOLUNTARY FOOD ALLERGY AND ANAPHYLAXIS
MANAGEMENT POLICY.
(a) Establishment.--Not later than 1 year after the date of
enactment of this Act, the Secretary shall--
(1) develop a policy to be used on a voluntary basis to
manage the risk of food allergy and anaphylaxis in schools; and
(2) make such policy available to local educational
agencies and other interested individuals and entities,
including licensed child care providers, preschool programs,
and Head Start, to be implemented on a voluntary basis only.
(b) Contents.--The voluntary policy developed by the Secretary
under subsection (a) shall contain guidelines that address each of the
following:
(1) Parental obligation to provide the school, prior to the
start of every school year, with--
(A) documentation from the student's physician or
nurse--
(i) supporting a diagnosis of food allergy
and the risk of anaphylaxis;
(ii) identifying any food to which the
student is allergic;
(iii) describing, if appropriate, any prior
history of anaphylaxis;
(iv) listing any medication prescribed for
the student for the treatment of anaphylaxis;
(v) detailing emergency treatment
procedures in the event of a reaction;
(vi) listing the signs and symptoms of a
reaction; and
(vii) assessing the student's readiness for
self-administration of prescription medication;
and
(B) a list of substitute meals that may be offered
to the student by school food service personnel.
(2) The creation and maintenance of an individual health
care plan tailored to the needs of each student with a
documented risk for anaphylaxis, including any procedures for
the self-administration of medication by such students in
instances where--
(A) the students are capable of self-administering
medication; and
(B) such administration is not prohibited by State
law.
(3) Communication strategies between individual schools and
local providers of emergency medical services, including
appropriate instructions for emergency medical response.
(4) Strategies to reduce the risk of exposure to
anaphylactic causative agents in classrooms and common school
areas such as cafeterias.
(5) The dissemination of information on life-threatening
food allergies to school staff, parents, and students, if
appropriate by law.
(6) Food allergy management training of school personnel
who regularly come into contact with students with life-
threatening food allergies.
(7) The authorization and training of school personnel to
administer epinephrine when the school nurse is not immediately
available.
(8) The timely accessibility of epinephrine by school
personnel when the nurse is not immediately available.
(9) Extracurricular programs such as non-academic outings
and field trips, before- and after-school programs, and school-
sponsored programs held on weekends that are addressed in the
individual health care plan.
(10) The collection and publication of data for each
administration of epinephrine to a student at risk for
anaphylaxis.
(c) Relation to State Law.--Nothing in this Act or the policy
developed by the Secretary under subsection (a) shall be construed to
preempt State law, including any State law regarding whether students
at risk for anaphylaxis may self-administer medication.
SEC. 5. VOLUNTARY NATURE OF POLICY AND GUIDELINES.
The policy developed by the Secretary under section 4(a) and the
food allergy management guidelines contained in such policy are
voluntary. Nothing in this Act or the policy developed by the Secretary
under section 4(a) shall be construed to require a local educational
agency or school to implement such policy or guidelines.
Passed the House of Representatives April 8, 2008.
Attest:
LORRAINE C. MILLER,
Clerk.