H. Rept. 116-530 - SCHOOL-BASED ALLERGIES AND ASTHMA MANAGEMENT PROGRAM ACT116th Congress (2019-2020)
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116th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 116-530
======================================================================
SCHOOL-BASED ALLERGIES AND ASTHMA MANAGEMENT PROGRAM ACT
_______
September 22, 2020.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Pallone, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 2468]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 2468) to amend the Public Health Service Act to
increase the preference given, in awarding certain allergies
and asthma-related grants, to States that require certain
public schools to have allergies and asthma management
programs, and for other purposes, having considered the same,
reports favorably thereon with an amendment and recommends that
the bill as amended do pass.
CONTENTS
Page
I. Purpose and Summary..............................................2
II. Background and Need for the Legislation..........................3
III. Committee Hearings...............................................4
IV. Committee Consideration..........................................5
V. Committee Votes..................................................5
VI. Oversight Findings...............................................5
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures5
VIII.Federal Mandates Statement.......................................6
IX. Statement of General Performance Goals and Objectives............6
X. Duplication of Federal Programs..................................6
XI. Committee Cost Estimate..........................................6
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits......6
XIII.Advisory Committee Statement.....................................6
XIV. Applicability to Legislative Branch..............................6
XV. Section-by-Section Analysis of the Legislation...................6
XVI. Changes in Existing Law Made by the Bill, as Reported............7
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``School-Based Allergies and Asthma
Management Program Act''.
SEC. 2. ADDITIONAL PREFERENCE TO CERTAIN STATES THAT REQUIRE CERTAIN
PUBLIC SCHOOLS TO HAVE ALLERGIES AND ASTHMA
MANAGEMENT PROGRAMS.
Section 399L(d) of the Public Health Service Act (42 U.S.C. 280g(d))
is amended--
(1) in paragraph (1)(F)--
(A) by redesignating clauses (i), (ii), and (iii) as
subclauses (I), (II), and (III), respectively, and
moving each of such subclauses (as so redesignated) 2
ems to the right;
(B) by striking ``epinephrine.--In determining'' and
inserting ``epinephrine or school comprehensive
allergies and asthma management program.--
``(i) In general.--In determining'';
(C) by striking ``in the State--'' and inserting ``in
the State satisfy the criteria described in clause (ii)
or clause (iii).
``(ii) Criteria for school personnel
administration of epinephrine.--For purposes of
clause (i), the criteria described in this
clause, with respect to each public elementary
school and secondary school in the State, are
that each such school--''; and
(D) by adding at the end the following new clause:
``(iii) Criteria for school comprehensive
allergies and asthma management program.--For
purposes of clause (i), the criteria described
in this clause, with respect to each public
elementary school and secondary school in the
State, are that each such school--
``(I) has in place a plan for having
on the premises of the school during
all operating hours of the school a
school nurse or one or more other
individuals who are designated by the
principal (or other appropriate
administrative staff) of the school to
direct and apply the program described
in subclause (II) on a voluntary basis
outside their scope of employment; and
``(II) has in place, under the
direction of a school nurse or other
individual designated under subclause
(I), a comprehensive school-based
allergies and asthma management program
that includes--
``(aa) a method to identify
all students of such school
with a diagnosis of allergies
and asthma;
``(bb) an individual student
allergies and asthma action
plan for each student of such
school with a diagnosis of
allergies and asthma;
``(cc) allergies and asthma
education for school staff who
are directly responsible for
students who have been
identified as having allergies
or asthma, such as education
regarding basics, management,
trigger management, and
comprehensive emergency
responses with respect to
allergies and asthma;
``(dd) efforts to reduce the
presence of environmental
triggers of allergies and
asthma; and
``(ee) a system to support
students with a diagnosis of
allergies or asthma through
coordination with family
members of such students,
primary care providers of such
students, primary asthma or
allergy care providers of such
students, and others as
necessary.''; and
(2) in paragraph (3)(E)--
(A) in the matter preceding clause (i), by inserting
``, such as the school nurse'' after ``individual'';
and
(B) in clause (i), by inserting ``school nurse or''
before ``principal''.
I. Purpose and Summary
H.R. 2468, the ``School-Based Allergies and Asthma
Management Program Act'', was introduced on May 2, 2019, by
Representatives Steny H. Hoyer (D-MD) and David P. Roe (R-TN).
H.R. 2468 amends the Public Health Service Act to add an
additional preference for grants to those States that have
additional access to certain healthcare professionals and
programs. To be eligible for this preference, States would have
to require: (1) a school nurse or other trained personnel on
school premises during school operating hours; (2) a school-
based allergies and asthma program, including a method to
identify all students in the school with a diagnosis of
allergies and asthma; (3) an individual student allergies and
asthma action plan for each student with a diagnosis of
allergies and asthma; (4) an education program for staff about
allergies and asthma; (5) protocols in place to reduce
environmental triggers of allergies and asthma; and (6) a
coordinated support system for students.
II. Background and Need for Legislation
Established in 1999, the Centers for Disease Control and
Prevention's (CDC) National Asthma Control Program (NACP) was
created to provide aid to the millions of Americans with asthma
or other anaphylaxis-related illnesses, such as allergies.\1\
The program has improved asthma treatment, management, and
control in the U.S. by reducing the number of deaths,
hospitalizations, emergency department visits, school days or
workdays missed, and limitations on activity due to asthma and
allergies.\2\
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\1\Centers for Disease Control and Prevention, CDC's National
Asthma Control Program (www.cdc.gov/asthma/nacp.htm) (accessed Sep. 21,
2020).
\2\See note 1.
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Today, the CDC provides financial assistance to health
departments in 24 States and Puerto Rico to ensure the
availability of and access to guidelines-based medical
management and pharmacotherapy for those with asthma, as well
as offers funding to State programs and national organizations,
promoting asthma quality measures, and informing policymakers
about the burden of asthma.\3\
---------------------------------------------------------------------------
\3\Id.
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More than eight percent of children in the United States
under the age of 18 live with asthma.\4\ For these children and
children with respiratory issues caused by asthma, access to
appropriate treatment and trained personnel can mean the
difference between life and death in emergency situations. In
2004, Congress authorized Children's Asthma Treatment Grants to
expand access to medical care for children who live in areas
with a high prevalence of asthma. Support from these grants
helps to educate parents, children, and health providers on
asthma treatment and symptom prevention, and decreases
preventable trips to the emergency room.\5\ The law included a
preference in awarding grants to States that allow students to
self-administer epinephrine in schools under certain
circumstances. In 2013, Congress amended the law to award an
additional preference to States that allow trained personnel in
schools to administer epinephrine.\6\
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\4\Centers for Disease Control and Prevention, Most Recent National
Asthma Data (2019) (www.cdc.gov/asthma/
most_recent_national_asthma_data.htm).
\5\P.L. 108-377.
\6\P.L. 113-48.
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Asthma and allergies are still, however, a leading cause of
school absenteeism for the more than six million American
children suffering from these illnesses.\7\ As 25 percent of
first-time anaphylactic reactions occur at school, it is
critical that students experiencing an anaphylactic reaction
have immediate access to emergency stock epinephrine at
school.\8\ Further, research suggests that the majority of
fatal food allergy reactions are triggered by food consumed
outside one's home.\9\
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\7\Hatice S. Zahran, MD et al., Vital Signs: Asthma in Children--
United States, 2001-2016, Centers for Disease Control and Prevention
(Feb. 6, 2018) (www.cdc.gov/mmwr/volumes/67/wr/
mm6705e1.htm?s_cid=mm6705e1_w#).
\8\Food Allergy & Anaphylaxis Connection Team, Education: For
School Personnel (www.foodallergyawareness.org/education/for-school-
personnel/for-school-personnel/) (accessed on Sep. 21, 2020).
\9\Food Allergy Research & Education, Food Allergy Facts and
Statistics for the U.S. (2020) (www.foodallergy.org/resources/facts-
and-statistics).
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In response, H.R. 2468 expands upon the current Children's
Asthma Treatment Grant Program to include additional funding
prioritization for States with comprehensive plans in place for
school-based allergies and asthma management programs at all of
the elementary and secondary schools, in addition to plans that
maintain a school nurse or other trained personnel on the
premises of those schools during all operating hours. According
to the American Academy of Allergy, Asthma & Immunology, the
most important strategy for ensuring children living with
asthma and allergies can be safe in school is ensuring schools
are implementing comprehensive management plans, including
preparing school personnel to assist children experiencing an
attack.\10\ H.R. 2468 supports schools in the development of
allergies and asthma management plans. This type of preparation
and management in schools not only will improve child health
but will also ensure students are able to focus on learning.
---------------------------------------------------------------------------
\10\American Academy of Allergy, Asthma & Immunology, School Tools:
Allergy & Asthma Resources For Families, Clinicians And School Nurses
(www.aaaai.org/conditions-and-treatments/school-tools) (accessed Sep.
21, 2020).
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III. Committee Hearings
For the purposes of section 103(i) of H. Res. 6 of the
116th Congress, the following hearing was used to develop or
consider H.R. 2468.
The Subcommittee on Health held a legislative hearing on
January 8, 2020, entitled ``Legislation to Improve Americans'
Health Care Coverage and Outcomes'' to consider H.R. 2468, the
``School-Based Allergies and Asthma Act''. The Subcommittee
received testimony from the following witnesses:
Panel I:
Lee Beers, M.D., President-Elect, American
Academy of Pediatrics
Kenneth Mendez, President and Chief
Executive Officer, Asthma and Allergy Foundation of
America
Stephanie Zarecky, Mother of Scarlett
Pauley, Ambassador Program and Public Relations
Manager, SUDC Foundation
Panel II:
Matthew Cooper, M.D., Director, Kidney and
Pancreas Transplantation, Medical Director, Transplant
QAPI, Medstar Georgetown Transplant Institute,
Professor of Surgery, Georgetown University School of
Medicine
Kevin Koser, Patient Advocate
Fred Riccardi, President Medicare Rights
Center IV.
Committee Consideration
Representatives Hoyer (D-MD) and Roe (R-TN) introduced H.R.
2468, the ``School-Based Allergies and Asthma Management
Program Act'', on May 2, 2019, and the bill was referred to the
Committee on Energy and Commerce. The bill was then referred to
the Subcommittee on Health on May 3, 2019. A legislative
hearing was held on the bill on January 8, 2020.
On March 11, 2020, the Subcommittee on Health met in open
markup session, pursuant to notice, to consider H.R. 2468.
During consideration of the bill, an amendment in the nature of
a substitute offered by Ms. Eshoo of California was agreed to
by a voice vote. The Subcommittee on Health then agreed to a
motion by Ms. Eshoo, Chairwoman of the subcommittee, to forward
favorably H.R. 2468, amended, to the full Committee on Energy
and Commerce by a voice vote.
On July 15, 2020, the full Committee met in virtual open
markup session, pursuant to notice, to consider a committee
print of the bill H.R. 2468, as amended by the Subcommittee on
Health on March 11, 2020. There were no amendments offered to
the committee print of H.R. 2468. Upon conclusion of
consideration of the bill, the full Committee agreed to a
motion on final passage by Mr. Pallone, Chairman of the
committee, to order H.R. 2468 reported favorably to the House,
as amended, by a voice vote, a quorum being present.
V. Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. The
Committee advises that there were no record votes taken on H.R.
2468, including the motion for final passage of the bill.
VI. Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the
oversight findings and recommendations of the Committee are
reflected in the descriptive portion of the report.
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures
Pursuant to 3(c)(2) of rule XIII of the Rules of the House
of Representatives, the Committee adopts as its own the
estimate of new budget authority, entitlement authority, or tax
expenditures or revenues contained in the cost estimate
prepared by the Director of the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
The Committee has requested but not received from the
Director of the Congressional Budget Office a statement as to
whether this bill contains any new budget authority, spending
authority, credit authority, or an increase or decrease in
revenues or tax expenditures.
VIII. Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
IX. Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to improve
outcomes for youth with allergies and asthma by increasing the
preference given, in awarding certain allergies and asthma-
related grants, to States that require certain public schools
to have allergies and asthma management programs and trained
personnel on school grounds during all operating hours.
X. Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 2468 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
XI. Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 2468 contains no earmarks, limited
tax benefits, or limited tariff benefits.
XIII. Advisory Committee Statement
No advisory committee within the meaning of section 5(b) of
the Federal Advisory Committee Act was created by this
legislation.
XIV. Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
XV. Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the short title may be cited as
the ``School-Based Allergies and Asthma Management Program
Act''.
Sec. 2. Additional preference to certain States that require certain
public schools to have allergies and asthma management programs
Section 2 amends section 399(L)(d) of the Public Health
Service Act to direct the Secretary to provide an additional
preference for States that certify each public elementary and
secondary school in the State has a plan for having a school
nurse or other trained personnel on the premises of the school
during operating hours to direct and apply a comprehensive
school-based allergies and asthma management program on a
voluntary basis. The comprehensive school-based allergies and
asthma management program in place under the direction of a
school nurse in each school must include a method to identify
all students in the school with an allergy or asthma diagnosis;
an individualized action plan for each student with such a
diagnosis; allergies and asthma education for certain staff
responsible for students with allergies and asthma; efforts to
reduce the presence of environmental triggers of allergies and
asthma; and a system to support students with these diagnoses
through coordination with families, primary care providers, and
others as necessary.
Section 2 also amends the program to include school nurses
in the definition of ``trained personnel'' within an elementary
or secondary school, as well as including a school nurse as an
authority in designating who may administer epinephrine on a
voluntary basis outside their scope of employment.
XVI. Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italics, and existing law in which no
change is proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
PART P--ADDITIONAL PROGRAMS
SEC. 399L. CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.
(a) Authority To Make Grants.--
(1) In general.--In addition to any other payments
made under this Act or title V of the Social Security
Act, the Secretary shall award grants to eligible
entities to carry out the following purposes:
(A) To provide access to quality medical care
for children who live in areas that have a high
prevalence of asthma and who lack access to
medical care.
(B) To provide on-site education to parents,
children, health care providers, and medical
teams to recognize the signs and symptoms of
asthma, and to train them in the use of
medications to treat asthma and prevent its
exacerbations.
(C) To decrease preventable trips to the
emergency room by making medication available
to individuals who have not previously had
access to treatment or education in the
management of asthma.
(D) To provide other services, such as
smoking cessation programs, home modification,
and other direct and support services that
ameliorate conditions that exacerbate or induce
asthma.
(2) Certain projects.--In making grants under
paragraph (1), the Secretary may make grants designed
to develop and expand the following projects:
(A) Projects to provide comprehensive asthma
services to children in accordance with the
guidelines of the National Asthma Education and
Prevention Program (through the National Heart,
Lung and Blood Institute), including access to
care and treatment for asthma in a community-
based setting.
(B) Projects to fully equip mobile health
care clinics that provide preventive asthma
care including diagnosis, physical
examinations, pharmacological therapy, skin
testing, peak flow meter testing, and other
asthma-related health care services.
(C) Projects to conduct validated asthma
management education programs for patients with
asthma and their families, including patient
education regarding asthma management, family
education on asthma management, and the
distribution of materials, including displays
and videos, to reinforce concepts presented by
medical teams.
(2) Award of grants.--
(A) Application.--
(i) In general.--An eligible entity
shall submit an application to the
Secretary for a grant under this
section in such form and manner as the
Secretary may require.
(ii) Required information.--An
application submitted under this
subparagraph shall include a plan for
the use of funds awarded under the
grant and such other information as the
Secretary may require.
(B) Requirement.--In awarding grants under
this section, the Secretary shall give
preference to eligible entities that
demonstrate that the activities to be carried
out under this section shall be in localities
within areas of known or suspected high
prevalence of childhood asthma or high asthma-
related mortality or high rate of
hospitalization or emergency room visits for
asthma (relative to the average asthma
prevalence rates and associated mortality rates
in the United States). Acceptable data sets to
demonstrate a high prevalence of childhood
asthma or high asthma-related mortality may
include data from Federal, State, or local
vital statistics, claims data under title XIX
or XXI of the Social Security Act, other public
health statistics or surveys, or other data
that the Secretary, in consultation with the
Director of the Centers for Disease Control and
Prevention, deems appropriate.
(3) Definition of eligible entity.--For purposes of
this section, the term ``eligible entity'' means a
public or nonprofit private entity (including a State
or political subdivision of a State), or a consortium
of any of such entities.
(b) Coordination With Other Children's Programs.--An eligible
entity shall identify in the plan submitted as part of an
application for a grant under this section how the entity will
coordinate operations and activities under the grant with--
(1) other programs operated in the State that serve
children with asthma, including any such programs
operated under title V, XIX, or XXI of the Social
Security Act; and
(2) one or more of the following--
(A) the child welfare and foster care and
adoption assistance programs under parts B and
E of title IV of such Act;
(B) the head start program established under
the Head Start Act (42 U.S.C. 9831 et seq.);
(C) the program of assistance under the
special supplemental nutrition program for
women, infants and children (WIC) under section
17 of the Child Nutrition Act of 1966 (42
U.S.C. 1786);
(D) local public and private elementary or
secondary schools; or
(E) public housing agencies, as defined in
section 3 of the United States Housing Act of
1937 (42 U.S.C. 1437a).
(c) Evaluation.--An eligible entity that receives a grant
under this section shall submit to the Secretary an evaluation
of the operations and activities carried out under the grant
that includes--
(1) a description of the health status outcomes of
children assisted under the grant;
(2) an assessment of the utilization of asthma-
related health care services as a result of activities
carried out under the grant;
(3) the collection, analysis, and reporting of asthma
data according to guidelines prescribed by the Director
of the Centers for Disease Control and Prevention; and
(4) such other information as the Secretary may
require.
(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.
(F) School personnel administration of
[epinephrine.--] [In determining] epinephrine
or school comprehensive allergies and asthma
management program._
(i) In general.--In determining the
preference (if any) to be given to a
State under this subsection, the
Secretary shall give additional
preference to a State that provides to
the Secretary the certification
described in subparagraph (G) and that
requires that each public elementary
school and secondary school [in the
State--] in the State satisfy the
criteria described in clause (ii) or
clause (iii).
(ii) Criteria for school personnel
administration of epinephrine.--For
purposes of clause (i), the criteria
described in this clause, with respect
to each public elementary school and
secondary school in the State, are that
each such school--
[(i)] (I) permits trained
personnel of the school to
administer epinephrine to any
student of the school
reasonably believed to be
having an anaphylactic
reaction;
[(ii)] (II) maintains a
supply of epinephrine in a
secure location that is easily
accessible to trained personnel
of the school for the purpose
of administration to any
student of the school
reasonably believed to be
having an anaphylactic
reaction; and
[(iii)] (III) has in place a
plan for having on the premises
of the school during all
operating hours of the school
one or more individuals who are
trained personnel of the
school.
(iii) Criteria for school
comprehensive allergies and asthma
management program.--For purposes of
clause (i), the criteria described in
this clause, with respect to each
public elementary school and secondary
school in the State, are that each such
school--
(I) has in place a plan for
having on the premises of the
school during all operating
hours of the school a school
nurse or one or more other
individuals who are designated
by the principal (or other
appropriate administrative
staff) of the school to direct
and apply the program described
in subclause (II) on a
voluntary basis outside their
scope of employment; and
(II) has in place, under the
direction of a school nurse or
other individual designated
under subclause (I), a
comprehensive school-based
allergies and asthma management
program that includes--
(aa) a method to
identify all students
of such school with a
diagnosis of allergies
and asthma;
(bb) an individual
student allergies and
asthma action plan for
each student of such
school with a diagnosis
of allergies and
asthma;
(cc) allergies and
asthma education for
school staff who are
directly responsible
for students who have
been identified as
having allergies or
asthma, such as
education regarding
basics, management,
trigger management, and
comprehensive emergency
responses with respect
to allergies and
asthma;
(dd) efforts to
reduce the presence of
environmental triggers
of allergies and
asthma; and
(ee) a system to
support students with a
diagnosis of allergies
or asthma through
coordination with
family members of such
students, primary care
providers of such
students, primary
asthma or allergy care
providers of such
students, and others as
necessary.
(G) Civil liability protection law.--The
certification required in subparagraph (F)
shall be a certification made by the State
attorney general that the State has reviewed
any applicable civil liability protection law
to determine the application of such law with
regard to elementary and secondary school
trained personnel who may administer
epinephrine to a student reasonably believed to
be having an anaphylactic reaction and has
concluded that such law provides adequate civil
liability protection applicable to such trained
personnel. For purposes of the previous
sentence, the term ``civil liability protection
law'' means a State law offering legal
protection to individuals who give aid on a
voluntary basis in an emergency to an
individual who is ill, in peril, or otherwise
incapacitated.
(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 8101 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.
(E) The term ``trained personnel'' means,
with respect to an elementary or secondary
school, an individual, such as the school
nurse--
(i) who has been designated by the
school nurse or principal (or other
appropriate administrative staff) of
the school to administer epinephrine on
a voluntary basis outside their scope
of employment;
(ii) who has received training in the
administration of epinephrine; and
(iii) whose training in the
administration of epinephrine meets
appropriate medical standards and has
been documented by appropriate
administrative staff of the school.
(e) Authorization of Appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.
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