[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4063 Introduced in House (IH)]







109th CONGRESS
  1st Session
                                H. R. 4063

   To direct the Secretary of Health and Human Services to develop a 
    policy for managing the risk of food allergy and anaphylaxis in 
                                schools.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 17, 2005

Mrs. Lowey (for herself, Mrs. Maloney, Mr. Emanuel, Mr. Owens, Mr. Meek 
   of Florida, Ms. Jackson-Lee of Texas, Ms. Millender-McDonald, Mr. 
    Sherman, Mr. Sanders, Mr. Levin, and Mr. Wexler) introduced the 
   following bill; which was referred to the Committee on Energy and 
    Commerce, and in addition to the Committee on Education and the 
 Workforce, for a period to be subsequently determined by the Speaker, 
 in each case for consideration of such provisions as fall within the 
                jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
   To direct the Secretary of Health and Human Services to develop a 
    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 2005''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Food allergy is an increasing food safety and public 
        health concern in the United States, especially among children.
            (2) Peanut allergy doubled among children from 1997 to 
        2002.
            (3) In a 2003 survey of 400 elementary school nurses, 37 
        percent reported having at least 10 students with severe food 
        allergies; 62 percent reported having at least 5.
            (4) Forty-four percent of the elementary school nurses 
        surveyed reported that the number of children in their school 
        with food allergy had increased over the past 5 years; 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, or anaphylactic shock, 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 one 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, and the American College of Allergy, Asthma and 
        Immunology.
            (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 one school, 
        and are often in charge of hundreds if not thousands of 
        children.
            (15) Parents of children with severe food allergies often 
        face entirely different food allergy management approaches when 
        their children 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. ESTABLISHMENT OF FOOD ALLERGY AND ANAPHYLAXIS MANAGEMENT 
              POLICY.

    (a) Establishment.--Not later than 1 year after the date of the 
enactment of this Act, the Secretary of Health and Human Services 
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.
    (b) Contents.--The policy developed by the Secretary under 
subsection (a) shall address each of the following:
            (1) Parental obligation to provide the school, prior to the 
        start of every school year, with documentation from the 
        student's physician or nurse--
                    (A) supporting a diagnosis of food allergy and 
                anaphylaxis;
                    (B) identifying any food to which the student is 
                allergic;
                    (C) describing, if appropriate, any prior history 
                of anaphylaxis;
                    (D) listing any medication prescribed for the child 
                for the treatment of anaphylaxis;
                    (E) detailing emergency treatment procedures in the 
                event of a reaction;
                    (F) listing the signs and symptoms of a reaction;
                    (G) assessing the student's readiness for self-
                administration of prescription medication; and
                    (H) providing a list of substitute meals that may 
                be offered by school food service personnel.
            (2) The maintenance of a file by the school nurse or 
        principal for each student at risk for anaphylaxis.
            (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 the cafeteria.
            (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 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.
            (10) The creation of an individual health care plan 
        tailored to the needs of each individual child at risk for 
        anaphylaxis, including any procedures for the self-
        administration of medication by such children in instances 
        where--
                    (A) the children are capable of self-administering 
                medication; and
                    (B) such administration is not prohibited by State 
                law.
            (11) 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.
    (d) Definitions.--In this Act:
            (1) The term ``school'' includes kindergartens, elementary 
        schools, and secondary schools.
            (2) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
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