[Congressional Record Volume 154, Number 55 (Tuesday, April 8, 2008)]
[House]
[Pages H2036-H2038]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
FOOD ALLERGY AND ANAPHYLAXIS MANAGEMENT ACT OF 2008
Mrs. CAPPS. Madam Speaker, I move to suspend the rules and pass the
bill (H.R. 2063) 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, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 2063
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 2008''.
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,
including licensed child care providers, preschool programs,
and Head Start, 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. VOLUNTARY NATURE OF POLICY AND GUIDELINES.
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
[[Page H2037]]
construed to require a local educational agency or school to
implement such policy or guidelines.
The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from
California (Mrs. Capps) and the gentleman from Georgia (Mr. Deal) each
will control 20 minutes.
The Chair recognizes the gentlewoman from California.
General Leave
Mrs. CAPPS. Madam Speaker, I ask unanimous consent that all Members
may have 5 legislative days to revise and extend their remarks and
include extraneous material on the bill under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentlewoman from California?
There was no objection.
Mrs. CAPPS. Madam Speaker, I yield myself such time as I may consume.
I rise in strong support of H.R. 2063, the Food Allergy and
Anaphylaxis Management Act of 2008.
This legislation would provide schools with uniform guidance on how
to create appropriate management and emergency plans for children with
food allergies.
I was a school nurse, again, for 20 years, and I know so well the
challenges confronting educators when working to ensure that their
students are adequately cared for. And with the current shortage of
school nurses, it is more important than ever that we assist local
educational agencies in being prepared to manage the risk of food
allergy and anaphylaxis in school.
The risk of accidental exposure to foods can be reduced in the school
setting if schools will work with students, parents, nurses, and
physicians to minimize risks and provide a safe educational environment
for food-allergic students.
I want to commend my good friend from New York Nita Lowey for her
tireless work on this important bill. I urge my colleagues on both
sides of the aisle to join me in supporting H.R. 2063.
Madam Speaker, I reserve the balance of my time.
Mr. DEAL of Georgia. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, I do rise in support of H.R. 2063, the Food Allergy
and Anaphylaxis Management Act of 2008.
Many children face life-threatening food allergies which dramatically
impact their lifestyles and make an ordinarily safe place like a school
cafeteria a place filled with potential dangers. However, despite this
threat and the growing prevalence of these food allergies, many schools
struggle to establish effective guidelines to protect the health and
well-being of students with food allergies.
I had the occasion this past year to visit with neighbors and
constituents of mine whose children have these kind of allergies, one
of the children having a very severe food allergy problem. It is truly
remarkable the degree of care that children and parents must take and
the life-changing events that occur as a result of these food
allergies.
This legislation seeks to address this problem by requiring the
Department of Health and Human Services to establish voluntary
guidelines and policies to manage the risks of food allergy in a school
setting. This policy will take into account the important role played
by parents and the individual needs of students with differing
allergies. Hopefully, this legislation will provide important Federal
guidelines, which, when implemented, will provide peace of mind for
parents of children with food allergies when they send their children
to school every day.
Madam Speaker, I reserve the balance of my time.
Mrs. CAPPS. Madam Speaker, I am very pleased to yield 5 minutes to
the author of the bill, our good friend and colleague from New York
(Mrs. Lowey).
Mrs. LOWEY. Madam Speaker, I rise in strong support of H.R. 2063, the
Food Allergy and Anaphylaxis Management Act.
And I want to thank my good friend Congresswoman Lois Capps and
Congressman Deal for your support on this very important legislation.
More than 11 million Americans suffer from food allergies. Each year
several hundred of these individuals die and an estimated 30,000
receive lifesaving treatments in emergency rooms due to food-induced
anaphylaxis. Despite the critical nature of these allergies, the only
way to prevent dangerous reactions is to avoid all foods that contain
allergy-inducing ingredients. And while there have been vast
improvements in food labeling, this is still easier said than done,
particularly for millions of children in school-based settings.
{time} 1545
Unfortunately, we have a patchwork of policies, regulations and State
laws to address this problem. Food allergies and the risk of
anaphylaxis are simply too dangerous to not have a more uniform
approach to safety.
The Food Allergy and Anaphylaxis Management Act, which I first
introduced in 2005, would require the Department of Health and Human
Services to provide schools across the country with uniform guidance on
how to create management and emergency plans for students with food
allergies. These guidelines, which will be developed in consultation
with the country's leading scientists and public health officials, will
help schools tailor management plans to their students' individual
needs, while also giving them confidence that the measures they are
taking have the stamp of approval from the Federal Government. These
guidelines are not only critically important in keeping children safe
throughout the school day, but in ensuring that there is uniformity in
how schools address this growing problem.
With the enactment of this legislation, parents will no longer have
to worry about their children's safety if they move to a different
school district or State. And most importantly, parents will no longer
be charged with creating these policies on their own. This commonsense
legislation will give schools, teachers and parents the information
they need to keep food-allergic children safer and deserves the support
of every one of my colleagues.
I would like to thank Senator Dodd, who is pushing a similar bill in
the Senate, Leader Hoyer and his staff, Ivana Alexander, Chairmen
Dingell, Miller and Pallone and their staffs, particularly William
Garner and Bobby Clark, for their support of this bill, and of course
Jean Doyle, my legislative director, for her tireless efforts on this
issue. I would also like to thank Anne Munoz-Furlong from the Food
Allergy and Anaphylaxis Network, Todd Slotkin from the Food Allergy
Initiative, Dave Bunning from the Food Allergy Project, and Dr. Hugh
Sampson from Mt. Sinai Hospital for their tireless work on behalf of
all individuals with food allergies.
This bill will take an important step in protecting children with
food allergies.
I urge my colleagues to support it.
Mr. DEAL of Georgia. Madam Speaker, I would urge the adoption of this
legislation.
I yield back the balance of my time.
Mrs. CAPPS. Madam Speaker, I am very pleased to yield 1 minute to our
majority leader of the House, the gentleman from Maryland (Mr. Hoyer).
Mr. HOYER. I thank the gentlelady for yielding, and I rise in very
strong support of this legislation, and I thank the gentlelady from New
York for her leadership on this issue. I thank Mr. Deal for his
leadership, as well, on this very, very important issue.
Madam Speaker, today this House is considering seven very important
but largely noncontroversial public health bills. This week, of course,
is National Public Health Week, a time to reflect on the importance of
the quality of public health programs and a time to reiterate our
commitment to addressing the critical problems that afflict America's
health care system, such as exploding costs and the rising number of
uninsured.
Today, however, I want to address one of the seven health bills that
we are considering. The one under consideration right now is H.R. 2063,
the Food Allergy and Anaphylaxis Management Act, introduced by my good
friend, Nita Lowey, of New York, the chairwoman of the Foreign
Operations Subcommittee, with whom I had the great privilege of serving
for many years. She is a longtime member of the Health and Human
Services and Education Subcommittee of the Appropriations Committee. On
that committee, she has focused on health care for Americans, but
health care particularly for children, as she has focused on education
for our children.
In short, Madam Speaker, this legislation will provide schools across
the
[[Page H2038]]
country with uniform guidance on how to create appropriate management
and emergency plans for children with food allergies. It will direct
the Secretary of Health and Human Services to develop a voluntary
policy for schools to implement measures to prevent exposure to food
allergens and to ensure a prompt response if a child suffers a
potentially fatal anaphylactic reaction.
Madam Speaker, deadly food allergies are not some arcane, rare
occurrence. Frankly, even if they were, they would require our
attention. But the reality is that as many as 2 million school-age
children suffer from food allergies. One of those children is my
granddaughter, Alexa.
No cure currently exists. Avoiding any and all products with allergy-
causing ingredients is the only way to prevent potentially life-
threatening reactions, reactions including severe anaphylaxis, which
often occur at school and which can kill within minutes, unless
epinephrine is administered.
Alexa, Madam Speaker, is 5 years of age. When she is at my house, as
she was this past weekend, when she is in a restaurant, she is acutely
aware, extraordinarily aware, for a 5-year-old, of what she can and
cannot eat. And her mother, my daughter, asked the restaurant, what do
you cook your french fries in? What do you use on your foods? It is an
extraordinarily anxious time when my granddaughter eats. Just last
week, for example, members of my family, including Alexa, visited my
office, and we had sandwiches put out for a number of the family
members. We had to make sure that all peanut butter and jelly
sandwiches were removed from our conference room before Alexa entered
to protect her.
To tell you how extraordinarily sensitive she is, she was in Disney
World in Florida. She was walking with her mother and father down the
pathway there from one exhibit to the other, and all of a sudden she
started to wheeze heavily. Anne, who had seen this happen before, could
not understand it because she didn't have anything to eat. They
retraced their steps, and about 100 feet before this started, 100 feet,
they saw some popcorn being popped in peanut oil. And it was simply the
wind wafting that peanut odor. And whatever it was in the air she then
breathed in, and that immediately started to give her a problem.
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 National Association of School
Nurses and the American Academy of Allergy, Asthma and Immunology. One
of the extraordinary nurses of America is our colleague, Lois Capps.
And I want to thank Congresswoman Capps for her leadership on this
issue, as well. As a health professional, she knows firsthand of the
consequences of allowing this to go unchecked and unprepared for.
Unfortunately, no consistent, standardized guidelines currently exist
to help schools safely manage students with potentially deadly food
allergies. As a matter of fact, my daughter, and parents similarly
situated, meet with their child's teacher, Alexa is in kindergarten,
and teaches them how to use the EpiPen, and it is ever present. My
daughter goes nowhere without her EpiPen for use on Alexa should she
have an attack.
That is why it is critical that we pass H.R. 2063 to ensure the
safety of not only Alexa, but the millions of other school-age children
afflicted with food allergies across the country.
I recently went to an event in New York. And after the event, I went
to dinner, and there were eight of us at the table. Three of us were
grandfathers. Eight people, in New York, not anything dealing with this
issue, all three grandfathers were telling one another about the fact
that they have grandchildren with food allergies. That is why it is
critical that we pass this bill to ensure the safety not only of Alexa,
but as I said, of the millions of other school-age children.
Madam Speaker, I urge all Members on both sides of the aisle to
support this important, life-saving legislation.
Mrs. CAPPS. At this point, Madam Speaker, I have no further speakers,
and as has been so eloquently underscored by our majority leader on
behalf of all of the families, millions of children, as has been said
across this country, their families, but also the schools in which they
attend public schools that it is incumbent upon us to pass this
important legislation and get this bill signed into law.
Mr. VAN HOLLEN. Madam Speaker, I rise in strong support of the Food
Allergy and Anaphylaxis Management Act.
Imagine having a child with a food allergy who is at school and can
potentially eat something that will cause a life-threatening or fatal
reaction. This can especially be a very nerve-wracking experience for
any parent when their child is away from home and spends most of their
time in school.
This commonsense legislation was brought to my attention by many
school-age children from my congressional district. They shared their
experiences of what they have to do every day to manage their food
allergies. They have to scrutinize everything they eat in order to make
sure they avoid the allergy-producing ingredients. The least we can do
for these children and their parents is to encourage school districts
across the country to adopt uniform guidelines in managing the risk of
food allergy and anaphylaxis, and develop emergency plans for children
who suffer from this illness. This legislation would accomplish this
goal by creating a new grant program to provide resources for those
school districts who voluntarily implement these measures.
Madam Speaker, by passing this bill, we can help reduce the number of
life-threatening allergic reactions and help children manage their food
allergies. I urge my colleagues to support this legislation.
Mrs. CAPPS. I yield back the balance of my time.
=========================== NOTE ===========================
April 8, 2008--On Page H2038 the following appeared: I yield
back the balance of my time.
The online version should be corrected to read: Mrs. CAPPS. I
yield back the balance of my time.
========================= END NOTE =========================
The SPEAKER pro tempore. The question is on the motion offered by the
gentlewoman from California (Mrs. Capps) that the House suspend the
rules and pass the bill, H.R. 2063, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
The title was amended so as to read: ``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.''.
A motion to reconsider was laid on the table.
____________________