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<bill bill-stage="Introduced-in-House" bill-type="olc" dms-id="H7394377DA8D24ECB8DFB95DAC96729A0" public-private="public">
<metadata xmlns:dc="http://purl.org/dc/elements/1.1/">
<dublinCore>
<dc:title>109 HR 6290 IH: Food Allergy and Anaphylaxis
</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2006-09-29</dc:date>
<dc:format>text/xml</dc:format>
<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
</dublinCore>
</metadata>
	<form>
		<distribution-code display="yes">I</distribution-code>
		<congress>109th CONGRESS</congress>
		<session>2d Session</session>
		<legis-num>H. R. 6290</legis-num>
		<current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber>
		<action>
			<action-date date="20060929">September 29, 2006</action-date>
			<action-desc><sponsor name-id="L000480">Mrs. Lowey</sponsor> introduced
			 the following bill; which was referred to the
			 <committee-name committee-id="HIF00">Committee on Energy and
			 Commerce</committee-name>, and in addition to the Committee on
			 <committee-name committee-id="HED00">Education and the
			 Workforce</committee-name>, 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</action-desc>
		</action>
		<legis-type>A BILL</legis-type>
		<official-title>To direct the Secretary of Health and Human Services, in
		  consultation with the Secretary of Education, to develop a policy for managing
		  the risk of food allergy and anaphylaxis in schools, to establish school-based
		  food allergy management grants, and for other purposes.</official-title>
	</form>
	<legis-body id="H292B44A741BC4AD78F07A52EBC2BE0" style="OLC">
		<section display-inline="no-display-inline" id="HF1337CB8AD88469AAE48144B45671D54" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the
			 <quote><short-title>Food Allergy and Anaphylaxis
			 Management Act of 2006</short-title></quote>.</text>
		</section><section id="H43E69E4F8635462696C614FE08ADCBB4"><enum>2.</enum><header>Findings</header><text display-inline="no-display-inline">Congress finds as follows:</text>
			<paragraph id="HDC30C05FE76E4431A3CE509170C6AF75"><enum>(1)</enum><text>Food allergy is an
			 increasing food safety and public health concern in the United States,
			 especially among students.</text>
			</paragraph><paragraph id="H8598D8B7466E4C1087BAD1F3B30836C0"><enum>(2)</enum><text>Peanut allergy
			 doubled among students from 1997 to 2002.</text>
			</paragraph><paragraph id="H5D6E4707F5E7483682F595619808551D"><enum>(3)</enum><text>In a 2003 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.</text>
			</paragraph><paragraph id="H0354AE82C59A47CD807952810198EB3F"><enum>(4)</enum><text>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.</text>
			</paragraph><paragraph id="H7D16CD9F59584AD1AF97A17041FE931E"><enum>(5)</enum><text>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.</text>
			</paragraph><paragraph id="HCD76ACE4184D4AF70035A2E5E384DDBC"><enum>(6)</enum><text>Eight foods
			 account for 90 percent of all food-allergic reactions: milk, eggs, fish,
			 shellfish, tree nuts, peanuts, wheat, and soy.</text>
			</paragraph><paragraph id="HE0A5C6821F0D4458B9D991F348594803"><enum>(7)</enum><text>Currently, there
			 is no cure for food allergies; strict avoidance of the offending food is the
			 only way to prevent a reaction.</text>
			</paragraph><paragraph id="H53DAFAE2587E43858D02CF93767137BB"><enum>(8)</enum><text>Anaphylaxis, or
			 anaphylactic shock, is a systemic allergic reaction that can kill within
			 minutes.</text>
			</paragraph><paragraph id="H03687BCD2C274AA989BAD8DF428C2DE9"><enum>(9)</enum><text>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.</text>
			</paragraph><paragraph id="H7745F58D38F64709A7A72293BF0003C8"><enum>(10)</enum><text>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.</text>
			</paragraph><paragraph id="H74906EC8BD5C4692BE502E5CE6F362DB"><enum>(11)</enum><text>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.</text>
			</paragraph><paragraph id="H900AB79CB4ED4F0D86AD92398E337B84"><enum>(12)</enum><text>There are no
			 Federal guidelines concerning the management of life-threatening food allergies
			 in the school setting.</text>
			</paragraph><paragraph id="H928D29F5BB69435CA5AB486474A37CDE"><enum>(13)</enum><text>Three-quarters of
			 the elementary school nurses surveyed reported developing their own training
			 guidelines.</text>
			</paragraph><paragraph id="HE7F97F7F4AB044BEA14D7CBF48A67FD"><enum>(14)</enum><text>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.</text>
			</paragraph><paragraph id="H0421D166ADF34476B82C019D4F3D7300"><enum>(15)</enum><text>Parents of
			 students with severe food allergies often face entirely different food allergy
			 management approaches when their students change schools or school
			 districts.</text>
			</paragraph><paragraph id="H4A84F2C7B34344A3A8E4C7F35FCFEE3"><enum>(16)</enum><text>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.</text>
			</paragraph></section><section id="H3390A63334B84B16B7738430DF46F24E"><enum>3.</enum><header>Definitions</header><text display-inline="no-display-inline">In this Act:</text>
			<paragraph id="HFCD490ED889A4A27B1D217B72B8CD627"><enum>(1)</enum><header>ESEA
			 definitions</header><text>The terms <term>local educational agency</term>,
			 <term>secondary school</term>, and <term>elementary school</term> have the
			 meanings given the terms in section 9101 of the Elementary and Secondary
			 Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7801">20 U.S.C. 7801</external-xref>).</text>
			</paragraph><paragraph id="H3E9258C3C988486F87C9B77F314BE8C9"><enum>(2)</enum><header>School</header><text>The
			 term <term>school</term> includes public—</text>
				<subparagraph id="H845402B88E914A57BD83992EFDC7B237"><enum>(A)</enum><text>kindergartens;</text>
				</subparagraph><subparagraph id="HB692DDA80FD44E3A83AF209976ED7FCC"><enum>(B)</enum><text>elementary
			 schools; and</text>
				</subparagraph><subparagraph id="H8448B4C1D09140C09E2541E06FEEF33D"><enum>(C)</enum><text>secondary
			 schools.</text>
				</subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="H2BD8A6AACF40429C95B7FD9492B5ECD"><enum>(3)</enum><header>Secretaries</header><text>The
			 term <term>Secretaries</term> means the Secretary of Health and Human Services,
			 in consultation with the Secretary of Education.</text>
			</paragraph></section><section id="HFC5E860F7DAA44C488898DE979A9EC8B"><enum>4.</enum><header>Establishment of
			 food allergy and anaphylaxis management policy</header>
			<subsection id="HD54BA63AD0F9462F8B1BAE203C578518"><enum>(a)</enum><header>Establishment</header><text>Not
			 later than 1 year after the date of enactment of this Act, the Secretaries
			 shall—</text>
				<paragraph id="H2E2190EF89B94E9CAD2DAF6FC8EFB713"><enum>(1)</enum><text>develop a policy
			 to be used on a voluntary basis to manage the risk of food allergy and
			 anaphylaxis in schools; and</text>
				</paragraph><paragraph commented="no" display-inline="no-display-inline" id="H8693614732224A909629B853E8DB78F0"><enum>(2)</enum><text>make such policy
			 available to local educational agencies and other interested individuals and
			 entities.</text>
				</paragraph></subsection><subsection id="H0D2325CCF6284B4DA9A454653D5FD4E3"><enum>(b)</enum><header>Contents</header><text>The
			 policy developed by the Secretaries under subsection (a) shall contain
			 guidelines that address each of the following:</text>
				<paragraph id="H1B93C54D79284C53ACB673D1F6FCB59"><enum>(1)</enum><text>Parental obligation
			 to provide the school, prior to the start of every school year, with
			 documentation from the student’s physician or nurse—</text>
					<subparagraph id="HFC572508D2DD4400B942B6572B64FF82"><enum>(A)</enum><text>supporting a
			 diagnosis of food allergy and anaphylaxis;</text>
					</subparagraph><subparagraph id="H9DD60A506695497B898434022011A4CD"><enum>(B)</enum><text>identifying any
			 food to which the student is allergic;</text>
					</subparagraph><subparagraph id="H960DDBAAF43840E2952189491C107BDE"><enum>(C)</enum><text>describing, if
			 appropriate, any prior history of anaphylaxis;</text>
					</subparagraph><subparagraph id="H5A8442E7B7DE417CA356063682BC66B3"><enum>(D)</enum><text>listing any
			 medication prescribed for the student for the treatment of anaphylaxis;</text>
					</subparagraph><subparagraph id="H40FEB390864B42279846611649B1EEA3"><enum>(E)</enum><text>detailing
			 emergency treatment procedures in the event of a reaction;</text>
					</subparagraph><subparagraph id="H3CADBAEEDCB24187BC65F2BC40F3E25"><enum>(F)</enum><text>listing the signs
			 and symptoms of a reaction;</text>
					</subparagraph><subparagraph id="H4184B3998ABF4E628F295D0700D800A1"><enum>(G)</enum><text>assessing the
			 student’s readiness for self-administration of prescription medication;
			 and</text>
					</subparagraph><subparagraph id="H2E11E46756B64CF496779F258B676400"><enum>(H)</enum><text>providing a list
			 of substitute meals that may be offered by school food service
			 personnel.</text>
					</subparagraph></paragraph><paragraph id="H2616B264AFB449EF88AE83CDDE8CA176"><enum>(2)</enum><text>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—</text>
					<subparagraph id="H898300DE7EF942EAB7CF30936001E01"><enum>(A)</enum><text>the students are
			 capable of self-administering medication; and</text>
					</subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="HDF0475FB8C7242B200CFCC3423005B1E"><enum>(B)</enum><text>such
			 administration is not prohibited by State law.</text>
					</subparagraph></paragraph><paragraph id="HC3ECB62DA5164842B190E1A9C2716400"><enum>(3)</enum><text>Communication
			 strategies between individual schools and local providers of emergency medical
			 services, including appropriate instructions for emergency medical
			 response.</text>
				</paragraph><paragraph id="HE459EB53CC134F49BEF919F9ACD721CC"><enum>(4)</enum><text>Strategies to
			 reduce the risk of exposure to anaphylactic causative agents in classrooms and
			 common school areas such as cafeterias.</text>
				</paragraph><paragraph id="H86539ABD6DEB43358E19FFD27B15A8E1"><enum>(5)</enum><text>The dissemination
			 of information on life-threatening food allergies to school staff, parents, and
			 students, if appropriate by law.</text>
				</paragraph><paragraph id="H878F2F70367C459CAA6FF8266D005D31"><enum>(6)</enum><text>Food allergy
			 management training of school personnel who regularly come into contact with
			 students with life-threatening food allergies.</text>
				</paragraph><paragraph id="H769005CF3D084829B8C232B72726FB01"><enum>(7)</enum><text>The authorization
			 and training of school personnel to administer epinephrine when the school
			 nurse is not immediately available.</text>
				</paragraph><paragraph id="H5EB337586C8D45309255353CA578E36B"><enum>(8)</enum><text>The timely
			 accessibility of epinephrine by school personnel when the nurse is not
			 immediately available.</text>
				</paragraph><paragraph id="HA6732021A3004DFD91CB7E413BA0EC4"><enum>(9)</enum><text>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.</text>
				</paragraph><paragraph id="H36ADCE3F63F242A2831CED5EA607103E"><enum>(10)</enum><text>The collection
			 and publication of data for each administration of epinephrine to a student at
			 risk for anaphylaxis.</text>
				</paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="HF18400C06B9A4502AD2711FAA442691"><enum>(c)</enum><header>Relation to State
			 law</header><text display-inline="yes-display-inline">Nothing in this Act or
			 the policy developed by the Secretaries 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.</text>
			</subsection></section><section commented="no" display-inline="no-display-inline" id="H7DC2A5A70F3B46D1BBE181B6674BC3A7"><enum>5.</enum><header>School-based food
			 allergy management grants</header>
			<subsection commented="no" display-inline="no-display-inline" id="HE650FCBEBF5C47EB9930B74F12A00937"><enum>(a)</enum><header>In
			 general</header><text>The Secretaries may award grants of not more than $50,000
			 to local educational agencies to assist such agencies with implementing food
			 allergy management guidelines contained in the policy described in section
			 4.</text>
			</subsection><subsection id="HE0E6AA1194E249499B68E8F4CCA17889"><enum>(b)</enum><header>Application</header>
				<paragraph id="H1CCD082565D84902933B4FD1618CAD54"><enum>(1)</enum><header>In
			 general</header><text>To be eligible to receive a grant under this section, a
			 local educational agency shall submit an application to the Secretaries at such
			 time, in such manner, and including such information as the Secretaries may
			 reasonably require.</text>
				</paragraph><paragraph id="H24556A61ACB74A91003DDBED6940026"><enum>(2)</enum><header>Contents</header><text>Each
			 application submitted under paragraph (1) shall include—</text>
					<subparagraph id="HCAF34D3FD0E3438E86789ED056DCF22E"><enum>(A)</enum><text>a certification
			 that the food allergy management guidelines contained in the policy described
			 in section 4 have been adopted by the local educational agency;</text>
					</subparagraph><subparagraph id="H2124A66EEEF248ADB405976D61D452B0"><enum>(B)</enum><text>a description of
			 the activities to be funded by the grant in carrying out the food allergy
			 management guidelines, including—</text>
						<clause id="H5EAE30A5B2DF4A0A9B9400146F4EF52B"><enum>(i)</enum><text>how
			 the guidelines will be carried out at individual schools served by the local
			 educational agency;</text>
						</clause><clause id="HE48B830246004DE7B9F85E834C1C3C83"><enum>(ii)</enum><text>how
			 the local educational agency will inform parents and students of the food
			 allergy management guidelines in place;</text>
						</clause><clause id="H19B41049C5DE449C83FB1958F0B9D397"><enum>(iii)</enum><text>how school
			 nurses, teachers, administrators, and other school-based staff will be made
			 aware of, and given training on, when applicable, the food allergy management
			 guidelines in place; and</text>
						</clause><clause id="H0E372C5F43A3412999C7F35B6CF255B5"><enum>(iv)</enum><text>any
			 other activities that the Secretaries determine appropriate;</text>
						</clause></subparagraph><subparagraph id="HB62B418DC5414222B056AB09BFDF3159"><enum>(C)</enum><text>a budget table
			 that itemizes the amounts of grant funds received under this section that will
			 be expended on various activities;</text>
					</subparagraph><subparagraph id="HF370A41A223A48CCB7FE8D8B70D88F2D"><enum>(D)</enum><text>a description of
			 how adoption of the guidelines and implementation of grant activities will be
			 monitored; and</text>
					</subparagraph><subparagraph id="HE9EF1B3EA1A74302AF89ACE2398635CD"><enum>(E)</enum><text>an assurance that
			 the local educational agency will provide such information and cooperate in any
			 evaluation that the Secretaries may conduct under this section.</text>
					</subparagraph></paragraph></subsection><subsection id="H03EB28F3F87144C7B1779B5474CA1223"><enum>(c)</enum><header>Use of
			 funds</header><text>Each local educational agency that receives a grant under
			 this section may use the grant funds for the following:</text>
				<paragraph id="HE9D21F1983A04994B2E8A844DF2FC4B"><enum>(1)</enum><text>Creation of systems
			 and databases related to creation, storage, and maintenance of student
			 records.</text>
				</paragraph><paragraph id="HD33BEB5A18D04683ACB351F23BF3D6EE"><enum>(2)</enum><text>Purchase of
			 equipment or services, or both, related to the creation, storage, and
			 maintenance of student records.</text>
				</paragraph><paragraph id="H81A7A224181544569C9C23C7F0B2E74"><enum>(3)</enum><text>In
			 partnership with local health departments, school nurse, teacher, and personnel
			 training for food allergy management.</text>
				</paragraph><paragraph id="HD1B43F9D49434517ADC257B16838DBF"><enum>(4)</enum><text>Purchase and
			 storage of limited medical supplies, including epinephrine and disposable wet
			 wipes.</text>
				</paragraph><paragraph id="H5B51C0FF5313478A8CA8E6B0B1F1727"><enum>(5)</enum><text>Programs that
			 educate students as to the presence of, and policies and procedures in place
			 related to, food allergies and anaphylactic shock.</text>
				</paragraph><paragraph id="H6AFC3FF8E36846038CD1E4DFA494B60"><enum>(6)</enum><text>Outreach to
			 parents.</text>
				</paragraph><paragraph id="H62EA353C9DFE4D02A4ABF28DADDE7698"><enum>(7)</enum><text>Any other
			 activities consistent with the guidelines contained in the policy described in
			 section 4.</text>
				</paragraph></subsection><subsection id="H260C57DA505A4C689CEFA33B59B53DA"><enum>(d)</enum><header>Duration of
			 awards</header><text>The Secretaries may award grants under this section for a
			 period of not more than 2 years. Funding for the second year of the grant,
			 where applicable, shall be contingent on successful review of the program by
			 the Secretaries after the first year.</text>
			</subsection><subsection id="HEECE138810FF4CC192C13514C7E86D74"><enum>(e)</enum><header>Maximum amount
			 of awards</header><text>A grant awarded under this section may not be made in
			 an amount that is more than $50,000.</text>
			</subsection><subsection id="H736957A2E54A44978752E7C33BF14DCC"><enum>(f)</enum><header>Priority</header><text>In
			 awarding grants under this section, the Secretaries shall give priority to
			 local educational agencies that receive Federal funding under title I of the
			 Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/6301">20 U.S.C. 6301 et seq.</external-xref>).</text>
			</subsection><subsection id="H060A28C3EEEA4A8FA8B815BA161B3DDE"><enum>(g)</enum><header>Administrative
			 funds</header><text>A local educational agency that receives a grant under this
			 section may use not more than 2 percent of the grant amount for administrative
			 costs related to carrying out this section.</text>
			</subsection><subsection id="H178A01AFB6144CEA871E60C402AF1CFB"><enum>(h)</enum><header>Progress and
			 evaluations</header>
				<paragraph id="H770AD683E25C4CD5A842E20035DF9300"><enum>(1)</enum><header>Less than a 1
			 year grant</header><text>A local educational agency that receives a grant under
			 this section for a period of not more than 1 year shall provide the
			 Secretaries, at the completion of the grant period, with information on whether
			 the agency successfully implemented the food allergy management guidelines
			 contained in the policy described in section 4.</text>
				</paragraph><paragraph id="HC66F8668A1A243E3A24D28F9D0ABFA60"><enum>(2)</enum><header>Grants for a 1
			 to 2 year period</header><text>A local educational agency that receives a grant
			 under this section for a period of 1 to 2 years shall provide the
			 Secretaries—</text>
					<subparagraph id="H26A5E4D9F8AC40C89D1236F4A66500CB"><enum>(A)</enum><text>not later than 1
			 year after the agency receives such grant, with information on the progress
			 made in implementing the food allergy management guidelines contained in the
			 policy described in section 4; and</text>
					</subparagraph><subparagraph id="H6FFD4A1EA8C44268BC57266D6238EA89"><enum>(B)</enum><text>at the completion
			 of the grant period, with information on whether the agency successfully
			 implemented the food allergy management guidelines contained in the policy
			 described in section 4.</text>
					</subparagraph></paragraph></subsection><subsection id="HE661777C55774EAA8874A8E956C3982"><enum>(i)</enum><header>Rule of
			 construction</header><text>The food allergy management guidelines contained in
			 the policy described in section 4 are voluntary but a condition of receiving
			 grant funds under this section.</text>
			</subsection><subsection id="HC890709FE879406F91FA00BFA1BC02E4"><enum>(j)</enum><header>Supplement, not
			 supplant</header><text>Grant funds received under this section shall be used to
			 supplement, and not supplant, non-Federal funds and any other Federal funds
			 available to carry out the activities described in this section.</text>
			</subsection><subsection id="HCFD95EE806A84570A21C1913D5BEF705"><enum>(k)</enum><header>Authorization of
			 appropriations</header><text>There is authorized to be appropriated to carry
			 out this section $30,000,000 for fiscal year 2007 and such sums as may be
			 necessary for each of the 4 succeeding fiscal years.</text>
			</subsection></section></legis-body>
</bill>


