[Congressional Record Volume 150, Number 113 (Monday, September 20, 2004)]
[Senate]
[Pages S9387-S9389]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DeWINE (for himself and Mr. Kennedy):
  S. 2815. A bill to give a preference regarding States that require 
schools to allow students to self-administer medication to treat that 
student's asthma

[[Page S9388]]

or anaphylaxis, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. DeWINE. Mr. President, I come to the floor today to introduce the 
Asthmatic Schoolchildren's Treatment and Health Management Act of 2004. 
I would like to thank my colleague, Senator Kennedy, for cosponsoring 
this important piece of legislation.
  I have come to the floor now many times to talk about asthma, a 
condition that affects more than 20 million people, including 6.3 
million children. As a parent of eight and a grandparent of eight, I am 
particularly concerned with the disproportionately high number of 
children who suffer from pediatric asthma--the worst chronic health 
problem among our Nation's youth.
  I suffer from asthma, as have some of my children, so I know how 
frightening and dangerous this disease can be. The statistics on 
pediatric asthma, especially, highlight the need to do more to combat 
this disease. An average of one out of every 13 school-age children has 
asthma and the disease is the leading cause of missed school days due 
to chronic illness. In 2002, the Centers for Disease Control reported 
that 14 million school days were missed annually because of asthma.
  More than missed school days, however, are the tragic consequences of 
the condition. The number of deaths related to pediatric asthma nearly 
tripled between 1979 and 1996. In 2000, asthma attacks were the cause 
of 728,000 visits to the emergency room, 214,000 hospitalizations, and 
223 deaths.
  We know that the severity of asthma attacks can be decreased 
primarily through the control of the disease. Physicians instruct 
patients to carry their inhalers with them at all times, as they know 
asthma can strike a child anytime, anywhere--in the classroom, on the 
playground, or in the lunchroom. Therefore, it is imperative that 
students have immediate access to their inhalers. However, many schools 
do not allow students to carry their prescribed lifesaving asthma 
medication. To date, only 30 States, including my home State of Ohio, 
have laws or developed policies protecting children's right to carry an 
inhaler at school.
  The bill I am introducing today would encourage more States to allow 
their children to carry their needed asthma medication while they are 
at school, on the school bus, on the playground, at school sporting 
events, or on school field trips. It would do so by giving States 
preference when applying for asthma-related grants.
  This bill would help protect our Nation's children from the dangers 
of a sudden asthma attack--an attack that could result in 
hospitalization or even death. It also would help prevent the 
consequences of more severe allergic reactions. Many children suffer 
from asthma attacks and allergy reactions so severe that they need to 
carry an epinephrine injector with them at all times in the event of 
sudden, life-threatening attacks. Severe attacks can cause anaphylactic 
shock which can kill within minutes. This bill would encourage States 
to adopt laws and policies allowing children to carry their anaphylaxis 
medication, including epinephrine injectors, while they are at school.
  Currently, 18 States have developed legislation protecting the rights 
of children to carry and self-administer epinephrine-injectors. We 
applaud these States and hope that this bill will encourage more States 
to follow suit.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 2815

       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.

       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 and 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 awarding 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 clauses (iii) and (iv) of 
     subparagraph (A) be kept on file at the student's school in a 
     location easily accessible in the

[[Page S9389]]

     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) Elementary school and secondary school.--The terms 
     `elementary school' and `secondary school' have the meanings 
     given to those terms in section 9101 of the Elementary and 
     Secondary Education Act of 1965.
       ``(B) Health care practitioner.--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) Medication.--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) Self-administration.--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.

       It is the sense of Congress--
       (1) to commend 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) to encourage all schools to review these strategies and 
     adopt policies that will best meet the needs of their student 
     population.

  Mr. KENNEDY. Mr. President, it is a privilege to join Senator DeWine 
in introducing the Asthmatic School-Children's Treatment and Health 
Management Act. This legislation will save lives by enabling children 
to carry their medications with them and quickly treat their asthma 
attacks or allergic reactions.
  Asthma continues to be a major, and often preventable cause of 
needless suffering and death among children in the United States. Over 
6 million children under 18 have asthma, and it is significantly more 
prevalent in minority groups. Tragically, over 200 children die from 
this disease every year. Asthma affects more than health. It accounts 
for 14 million missed school days annually, and affects grades and 
personality. The estimated cost of asthma-related health care in our 
society is over $14 billion a year.
  The key to preventing deaths and severe health effects caused by 
asthma and allergic reactions is prompt treatment. Inhalers work within 
minutes to end acute asthma attacks in children. Children experiencing 
severe allergic reactions must receive life-saving injections of 
epinephrine immediately, in order to avoid serious complications or 
even death.
  Children need quick access to these medications when they are at 
school. Yet, in many States, these medications are locked up. Twenty 
States do not have legislation allowing students to carry and use their 
asthma inhalers, and 32 states have not yet passed legislation 
permitting students to carry and use epinephrine.
  Some say that school nurses should control access to these lifesaving 
medications. But in America today, we have only 56,000 school nurses 
serving 47 million students in public schools. The ratio is only one 
school nurse for every 840 students. If access to these needed 
medications is controlled by nurses, the safety of asthma and allergy 
sufferers may often be compromised, and needless deaths may occur. 
Students without immediate access to needed medications could be at 
increased risk of harm while in a classroom far away from a nurse's 
office or other school facility. Allowing children to take their own 
medicine during asthma attacks and severe allergic reactions can 
prevent many life-threatening situations.
  Our bill will help to see that children with asthma or allergic 
reactions will get their medications when they need it. Under this Act, 
States that allow students to carry and self-administer asthma or 
allergy medications will receive preferences for asthma-related grants. 
It requires that a health care practitioner must prescribe the 
medication and instruct students on its proper use. The student must 
demonstrate to the practitioner that they have the skills to administer 
the medication correctly. This bill also requires the student's parent 
or guardian to provide written consent for the student to take their 
medication according to the treatment plan.
  When they face a life-threatening asthma attack or allergic reaction, 
children deserve an effective way to avoid severe health consequences. 
Schools should give our children the right to carry their medications 
with them in order to minimize the time lost between the onset of 
symptoms and the needed treatment. The ``Asthmatic School-Children's 
Treatment and Health Management Act'' will save children's lives and 
minimize suffering during these attacks. I commend Senator DeWine for 
his leadership on this important health issue, and I encourage Congress 
to act quickly to improve every child's access in school of life-saving 
medications.

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