Text: H.R.2063 — 110th Congress (2007-2008)All Information (Except Text)

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Referred in Senate (04/09/2008)

[Congressional Bills 110th Congress]
[From the U.S. Government Printing Office]
[H.R. 2063 Referred in Senate (RFS)]

  2d Session
                                H. R. 2063



                             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,


    This Act may be cited as the ``Food Allergy and Anaphylaxis 
Management Act of 2008''.


    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 
            (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 
            (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 
            (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 
            (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.


    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.

              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 
            (1) Parental obligation to provide the school, prior to the 
        start of every school year, with--
                    (A) documentation from the student's physician or 
                            (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; 
                    (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 
            (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 
            (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 
    (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.


    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.


                                            LORRAINE C. MILLER,