[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.