[Congressional Record Volume 153, Number 68 (Thursday, April 26, 2007)]
[Senate]
[Pages S5209-S5211]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD:
  S. 1232. A bill to direct the Secretary of Health and Human Services, 
in consultation with the Secretary of Education, to develop a voluntary 
policy for managing the risk of food allergy and anaphylaxis in 
schools, to establish school-based food allergy management grants, and 
for other purposes; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. DODD. Mr. President, I rise today to introduce the Food Allergy 
and Anaphylaxis Management Act of 2007. Food allergies are an 
increasing food safety and public health concern in this country, 
especially among young children. I know firsthand just how frightening 
food allergies can be in a young person's life. My own family has been 
personally touched by this troubling condition and we continue to 
struggle with it each and every day. Sadly, there is no cure for food 
allergies.
  In the past 5 years, the number of Americans with food allergies has 
nearly doubled from 6 million to almost 12 million. While food 
allergies were at one time considered relatively infrequent, today they 
rank 3rd among common chronic diseases in children under 18 years of 
age. Peanuts are among several allergenic foods that can produce life 
threatening allergic reactions in susceptible children. Peanut 
allergies have doubled among school age children from 1997-2002.
  Clearly, food allergies are of great concern for school age children 
nationwide, and yet, there are no federal guidelines concerning the 
management of life threatening food allergies in our Nation's schools.
  I have heard from parents, teachers and school administrators that 
students with severe food allergies often face inconsistent food 
allergy management approaches when they change schools. Too often, 
families are not aware of the food allergy policy at their children's 
school, or the policy is vastly different from the one they knew at 
their previous school, and they are left wondering whether their child 
is safe.
  Recently, Connecticut became the first State to enact school-based 
guidelines concerning food allergies and the prevention of life 
threatening incidents in schools. I am very proud of these efforts, and 
I know that the parents of children who suffer from food allergies in 
Connecticut have confidence that their children are safe throughout the 
school day. States such as Massachusetts and Tennessee have enacted 
similar guidelines and Vermont, New Jersey, Arizona, Michigan and New 
York have either passed or have pending legislation to enact statewide 
guidelines. But too many States across the country have food allergy 
management guidelines that are inconsistent from one school district to 
the next. The result is a patchwork of guidelines that not only may 
vary from state to state, but also from school district to school 
district.

  In my view, this lack of consistency underscores the need for 
enactment of uniform Federal policies that school districts can choose 
to adopt and implement. For this reason, I am introducing the Food 
Allergy and Anaphylaxis Management Act of 2007 today to address the 
growing need for uniform and consistent school-based food allergy 
management policy. The bill I am introducing today closely mirrors 
legislation I introduced last Congress with former Senator Frist. I 
thank him for his past leadership and commitment to this important 
legislation.
  The legislation does two things. First, it directs the Secretary of 
Health and Human Services, in consultation with the Secretary of 
Education, to develop and make available voluntary food allergy 
management guidelines for preventing exposure to food allergens and 
assuring a prompt response when a student suffers a potentially fatal 
anaphylactic reaction. The guidelines developed by the Secretary are 
voluntary, not mandatory. Under the legislation, each school district 
across the country can voluntarily choose to implement these 
guidelines. The intent of the legislation is not to mandate individual 
school policy, but rather to provide for consistency of policies 
relating to school-based food allergy management by providing schools 
with consistent guidelines at the Federal level.
  Second, the bill provides for incentive grants to school districts to 
assist them with adoption and implementation of the federal 
government's allergy management guidelines in all K-12 public schools.
  I would like to recognize the leadership of Congresswoman Nita Lowey 
who is introducing companion legislation today in the House of 
Representatives. She has been a longstanding champion for children and 
for awareness of the devastating impact of food allergies. I also wish 
to acknowledge and offer my sincere appreciation to the members of the 
Food Allergy and Anaphylaxis Network for their commitment to this 
legislation and for raising public awareness, providing advocacy, and 
advancing research on behalf of all individuals who suffer from food 
allergies.
  This legislation is supported by the Food Allergy and Anaphylaxis 
Network and the American Academy of Allergy, Asthma, and Immunology. I 
ask unanimous consent that letters of support from these organizations 
be printed in the Record.
  I hope that my colleagues in the Senate and in the House will 
consider and pass this important legislation before the end of the year 
so that the Department of Health and Human Services can begin work on 
developing national guidelines as soon as possible. Schoolchildren 
across the country deserve nothing less than a safe and healthy 
learning environment.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the text of the material was ordered to be 
printed in the Record, as follows:

                                      American Academy of Allergy,


                                          Asthma & Immunology,

                                   Washington, DC, April 26, 2007.
     Hon. Chris Dodd,
     U.S. Senate,
     Washington, DC.
       Dear Senator Dodd: I am writing on behalf of the American 
     Academy of Allergy, Asthma and Immunology (AAAAI) to express 
     our strong support for your legislation, the Food Allergy and 
     Anaphylaxis Management Act of 2007, which would make 
     available to schools appropriate guidelines for the 
     management of students with food allergy who are at risk of 
     anaphylactic shock. The AAAAI is the largest professional 
     medical specialty organization in the United States 
     representing allergists, asthma specialists, clinical 
     immunologists, allied health professionals and others 
     dedicated to improving the treatment of allergic diseases 
     through research and education.
       The number of schoolchildren with food allergies has 
     increased dramatically in recent years. The policy developed 
     under your bill would assist schools in preventing exposure 
     to food allergens and assuring a prompt response when a child 
     suffers a potentially fatal anaphylactic reaction.
       Strict avoidance of the offending food is the only way to 
     prevent an allergic reaction as there is no cure for food 
     allergy. Fatalities from anaphylaxis often result from 
     delayed administration of epinephrine. The importance of 
     managing life-threatening food allergies in the school 
     setting has been recognized by our own organization as well 
     as the American Medical Association, the American Academy of 
     Pediatrics, and the National Association of School Nurses.
       The American Academy of Allergy, Asthma and Immunology 
     applauds your efforts to address the need to assist schools 
     with the policies and information needed to improve the 
     management of children with food allergy and avoid life-
     threatening reactions. We are pleased to endorse your 
     legislation.
           Sincerely,
     Thomas B. Casale, President.
                                  ____

                                                  The Food Allergy


                                        & Anaphylaxis Network,

                                   Washington, DC, April 26, 2007.
     Senator Christopher Dodd,
     Washington, DC.
       Dear Senator Dodd: On behalf of the Food Allergy and 
     Anaphylaxis Network (FAAN), I write to express strong support 
     for the Food Allergy and Anaphylaxis Management Act of 2007. 
     This important piece of legislation directs the Department of 
     Health and Human Services to develop guidelines for schools 
     to

[[Page S5210]]

     prevent exposure to food allergens and assure a prompt 
     response when a child suffers a potentially fatal 
     anaphylactic reaction.
       FAAN was established in 1991 to raise public awareness, 
     provide advocacy and education, and advance research on 
     behalf of the more than 12 million Americans affected by food 
     allergies and anaphylaxis. FAAN has nearly 30,000 members 
     worldwide, including families, dietitians, nurses, 
     physicians, and school staff as well as representatives of 
     government agencies and the food and pharmaceutical 
     industries.
       An estimated 2 million school age children suffer from food 
     allergies, for which there is no cure. Avoiding any and all 
     products with allergy-causing ingredients is the only way to 
     prevent potentially life-threatening reactions for our 
     children. Reactions often occur at school including severe 
     anaphylaxis, which can kill within minutes unless epinephrine 
     (adrenaline) is administered. Deaths from anaphylaxis are 
     usually a result of delayed administration of epinephrine. 
     Nevertheless, there are no current, standardized guidelines 
     to help schools safely manage students with the disease.
       The Food Allergy and Anaphylaxis Network applauds your 
     effort to address the seriousness of food allergies and 
     create a safe learning environment for those children who 
     deal with these issues on a daily basis. We are pleased to 
     endorse your legislation.
           Sincerely,
                                               Anne Munoz Furlong,
     Founder and CEO.
                                  ____


                                S. 1232

       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 2007''.

     SEC. 2. FINDINGS.

       Congress finds as follows:
       (1) Food allergy is an increasing food safety and public 
     health concern in the United States, especially among 
     students.
       (2) Peanut allergy doubled among children from 1997 to 
     2002.
       (3) In a 2004 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.
       (4) 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.
       (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 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 1 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, the American College of Allergy, Asthma and 
     Immunology, and the National Association of School Nurses.
       (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 1 school, 
     and are often in charge of hundreds if not thousands of 
     students.
       (15) Parents of students with severe food allergies often 
     face entirely different food allergy management approaches 
     when their students 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. DEFINITIONS.

       In this Act:
       (1) ESEA definitions.--The terms ``local educational 
     agency'', ``secondary school'', and ``elementary school'' 
     have the meanings given the terms in section 9101 of the 
     Elementary and Secondary Education Act of 1965 (20 U.S.C. 
     7801).
       (2) School.--The term ``school'' includes public--
       (A) kindergartens;
       (B) elementary schools; and
       (C) secondary schools.
       (3) Secretary.--The term ``Secretary'' means the Secretary 
     of Health and Human Services, in consultation with the 
     Secretary of Education.

     SEC. 4. ESTABLISHMENT OF VOLUNTARY FOOD ALLERGY AND 
                   ANAPHYLAXIS MANAGEMENT POLICY.

       (a) Establishment.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary 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 to be 
     implemented on a voluntary basis only.
       (b) Contents.--The voluntary policy developed by the 
     Secretary under subsection (a) shall contain guidelines that 
     address each of the following:
       (1) Parental obligation to provide the school, prior to the 
     start of every school year, with--
       (A) documentation from the student's physician or nurse--
       (i) supporting a diagnosis of food allergy and the risk of 
     anaphylaxis;
       (ii) identifying any food to which the student is allergic;
       (iii) describing, if appropriate, any prior history of 
     anaphylaxis;
       (iv) listing any medication prescribed for the student for 
     the treatment of anaphylaxis;
       (v) detailing emergency treatment procedures in the event 
     of a reaction;
       (vi) listing the signs and symptoms of a reaction; and
       (vii) assessing the student's readiness for self-
     administration of prescription medication; and
       (B) a list of substitute meals that may be offered to the 
     student by school food service personnel.
       (2) 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--
       (A) the students are capable of self-administering 
     medication; and
       (B) such administration is not prohibited by State law.
       (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 cafeterias.
       (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 and training 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 that are addressed 
     in the individual health care plan.
       (10) 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.

     SEC. 5. SCHOOL-BASED FOOD ALLERGY MANAGEMENT GRANTS.

       (a) In General.--The Secretary may award grants of not more 
     than $50,000 to local educational agencies to assist such 
     agencies with implementing voluntary food allergy management 
     guidelines described in section 4.
       (b) Application.--
       (1) In general.--To be eligible to receive a grant under 
     this section, a local educational agency shall submit an 
     application to the Secretary at such time, in such manner, 
     and including such information as the Secretary may 
     reasonably require.
       (2) Contents.--Each application submitted under paragraph 
     (1) shall include--
       (A) a certification that the food allergy management 
     guidelines described in section 4 have been adopted by the 
     local educational agency;
       (B) a description of the activities to be funded by the 
     grant in carrying out the food allergy management guidelines, 
     including--
       (i) how the guidelines will be carried out at individual 
     schools served by the local educational agency;
       (ii) how the local educational agency will inform parents 
     and students of the food allergy management guidelines in 
     place;
       (iii) how school nurses, teachers, administrators, and 
     other school-based staff will be made aware of, and given 
     training on, when

[[Page S5211]]

     applicable, the food allergy management guidelines in place; 
     and
       (iv) any other activities that the Secretary determines 
     appropriate;
       (C) an itemization of how grant funds received under this 
     section will be expended;
       (D) a description of how adoption of the guidelines and 
     implementation of grant activities will be monitored; and
       (E) an agreement by the local educational agency to report 
     information required by the Secretary to conduct evaluations 
     under this section.
       (c) Use of Funds.--Each local educational agency that 
     receives a grant under this section may use the grant funds 
     for the following:
       (1) Creation of systems and databases related to creation, 
     storage, and maintenance of student records.
       (2) Purchase of equipment or services, or both, related to 
     the creation, storage, and maintenance of student records.
       (3) In partnership with local health departments, school 
     nurse, teacher, and personnel training for food allergy 
     management.
       (4) Purchase and storage of limited medical supplies, 
     including epinephrine and disposable wet wipes.
       (5) Programs that educate students as to the presence of, 
     and policies and procedures in place related to, food 
     allergies and anaphylactic shock.
       (6) Outreach to parents.
       (7) Any other activities consistent with the guidelines 
     described in section 4.
       (d) Duration of Awards.--The Secretary may award grants 
     under this section for a period of not more than 2 years. In 
     the event the Secretary conducts a program evaluation under 
     this section, funding in the second year of the grant, where 
     applicable, shall be contingent on a successful program 
     evaluation by the Secretary after the first year.
       (e) Maximum Amount of Annual Awards.--A grant awarded under 
     this section may not be made in an amount that is more than 
     $50,000 annually.
       (f) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to local educational agencies 
     that receive Federal funding under title I of the Elementary 
     and Secondary Education Act of 1965 (20 U.S.C. 6301 et seq.).
       (g) Administrative Funds.--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.
       (h) Progress and Evaluations.--At the completion of the 
     grant period referred to in subsection (d), a local 
     educational agency shall provide the Secretary with 
     information on the status of implementation of the food 
     allergy management guidelines described in section 4.
       (i) Supplement, Not Supplant.--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.
       (j) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $30,000,000 for 
     fiscal year 2008 and such sums as may be necessary for each 
     of the 4 succeeding fiscal years.

     SEC. 6. VOLUNTARY NATURE OF POLICY AND GUIDELINES.

       (a) In General.--The policy developed by the Secretary 
     under section 4(a) and the food allergy management guidelines 
     contained in such policy are voluntary. Nothing in this Act 
     or the policy developed by the Secretary under section 4(a) 
     shall be construed to require a local educational agency or 
     school to implement such policy or guidelines.
       (b) Exception.--Notwithstanding subsection (a), the 
     Secretary may enforce an agreement by a local educational 
     agency to implement food allergy management guidelines as a 
     condition on the receipt of a grant under section 5.
                                 ______