[Congressional Record Volume 159, Number 111 (Tuesday, July 30, 2013)]
[House]
[Pages H5145-H5147]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




               SCHOOL ACCESS TO EMERGENCY EPINEPHRINE ACT

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 2094) to amend the Public Health Service Act to increase the 
preference given, in awarding certain asthma-related grants, to certain 
States (those allowing trained school personnel to administer 
epinephrine and meeting other related requirements).
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2094

       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 ``School Access to Emergency 
     Epinephrine Act''.

     SEC. 2. ADDITIONAL PREFERENCE TO CERTAIN STATES THAT ALLOW 
                   TRAINED SCHOOL PERSONNEL TO ADMINISTER 
                   EPINEPHRINE.

       Section 399L(d) of part P of title III of the Public Health 
     Service Act (42 U.S.C. 280g(d)) is amended--
       (1) in paragraph (1), by adding at the end the following:
       ``(F) School personnel administration of epinephrine.--In 
     determining the preference (if any) to be given to a State 
     under this subsection, the Secretary shall give additional 
     preference to a State that provides to the Secretary the 
     certification described in subparagraph (G) and that requires 
     that each public elementary school and secondary school in 
     the State--
       ``(i) permits trained personnel of the school to administer 
     epinephrine to any student of the school reasonably believed 
     to be having an anaphylactic reaction;
       ``(ii) maintains a supply of epinephrine in a secure 
     location that is easily accessible to trained personnel of 
     the school for the purpose of administration to any student 
     of the school reasonably believed to be having an 
     anaphylactic reaction; and
       ``(iii) has in place a plan for having on the premises of 
     the school during all operating hours of the school one or 
     more individuals who are trained personnel of the school.
       ``(G) Civil liability protection law.--The certification 
     required in subparagraph (F) shall be a certification made by 
     the State attorney general that the State has reviewed any 
     applicable civil liability protection law to determine the 
     application of such law with regard to elementary and 
     secondary school trained personnel who may administer 
     epinephrine to a student reasonably believed to be having an 
     anaphylactic reaction and has concluded that such law 
     provides adequate civil liability protection applicable to 
     such trained personnel. For purposes of the previous 
     sentence, the term `civil liability protection law' means a 
     State law offering legal protection to individuals who give 
     aid on a voluntary basis in an emergency to an individual who 
     is ill, in peril, or otherwise incapacitated.''; and
       (2) in paragraph (3), by adding at the end the following:
       ``(E) The term `trained personnel' means, with respect to 
     an elementary or secondary school, an individual--
       ``(i) who has been designated by the principal (or other 
     appropriate administrative staff) of the school to administer 
     epinephrine on a voluntary basis outside their scope of 
     employment;
       ``(ii) who has received training in the administration of 
     epinephrine; and
       ``(iii) whose training in the administration of epinephrine 
     meets appropriate medical

[[Page H5146]]

     standards and has been documented by appropriate 
     administrative staff of the school.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Burgess) and the gentleman from North Carolina (Mr. 
Butterfield) each will control 20 minutes.
  The Chair recognizes the gentleman from Texas.


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous materials into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  I rise in support and urge my colleagues to vote for H.R. 2094, the 
School Access to Emergency Epinephrine Act.
  Mr. Speaker, according to the CDC, one out of every 13 children has a 
food allergy and that rate is rising. Some of these children can 
experience a severe allergic reaction known as anaphylaxis that can be 
deadly unless a medication called ``epinephrine'' is promptly 
administered. Studies also show that 16 percent to 18 percent of 
children with food allergies have had allergic reactions while in 
school. If those reactions are severe, school personnel should be ready 
to effectively manage students with known allergies and to be prepared 
for emergencies.
  In 2004, Congress passed legislation to encourage States to allow 
children with known food allergies to bring their medication to school; 
however, there are many children who do not know that they have a 
serious food allergy, and they continue to be at risk.
  Currently, less than half of the States have legislation concerning 
the stocking of epinephrine in schools. Even in these States with 
legislation, there is a broad range of different provisions about who 
can administer the epinephrine. Keeping a stock of nonstudent-specific 
epinephrine in schools is a lifesaving measure and should be 
implemented nationwide. H.R. 2094, the School Access to Emergency 
Epinephrine Act, is an important step to protect children who do not 
know that they are at risk for anaphylaxis. The bill would amend the 
Public Health Service Act to allow a preference in awarding asthma 
grants to States that prevent school personnel to administer 
epinephrine to a student in an emergency.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  2000

  Mr. BUTTERFIELD. Mr. Speaker, I yield myself such time as I may 
consume.
  (Mr. BUTTERFIELD asked and was given permission to revise and extend 
his remarks.)
  Mr. BUTTERFIELD. Mr. Speaker, I rise tonight in support of H.R. 2094, 
the School Access to Emergency Epinephrine Act. I am a cosponsor of 
this bill and urge its passage in the House.
  Mr. Speaker, this bill provides incentives for schools to stock the 
lifesaving medicine that is critical for students and school staff who 
experience an anaphylactic emergency. Anaphylaxis is serious and life 
threatening. It is often caused by bee stinks, bug bites, latex, and 
some medications, and can take just a few minutes to cause serious harm 
and even death.
  Epinephrine is used to treat the symptoms of anaphylaxis and comes in 
the form of an EpiPen that is injected into the body and provides 
almost instant relief. Nearly 30 States across the country are working 
on legislation that would permit schools to keep a stock of EpiPens 
that aren't designated for particular individuals but, rather, 
available to students and staff who experience an allergic reaction 
that can be treated with epinephrine. H.R. 2094 that we are considering 
tonight would encourage the remaining States to work on enacting 
similar legislation.
  This bill creates a preference in the existing Children's Asthma 
Treatment Grants Program, administered by the Department of Health and 
Human Services, for States that meet certain requirements that are 
enumerated in the bill.
  Food allergies affect 5.9 million children. That's one in 13. This 
legislation is especially important because about 25 percent of 
individuals who are injected with an EpiPen for the first time don't 
know they have allergies that warrant the use of epinephrine. No 
student experiencing a severe allergic reaction at school should lose 
their life because there was no medicine prescribed to them.
  Mr. Speaker, simply put, the passage and enactment of this bill will 
save the lives of countless students across our country who live with 
severe allergies. So I want to take a moment to commend the bill's 
author, the gentleman from Maryland (Mr. Hoyer), who has worked on this 
legislation for at least 3 years, and also Congressman Phil Roe, for 
their bipartisan work on behalf of all Americans with allergies.
  At this time, I yield such time as he may consume to the Democratic 
whip, the gentleman from Maryland (Mr. Hoyer).
  (Mr. HOYER asked and was given permission to revise and extend his 
remarks.)
  Mr. HOYER. Mr. Speaker, I want to thank Dr. Burgess and Mr. 
Butterfield for their leadership on this bill, but I certainly want to 
thank my friend, Dr. Phil Roe, who has been a delight to work with. It 
has taken us a little bit of time, but we stayed after it. We stayed 
after it because, as Dr. Burgess and Judge Butterfield have observed, 
this will save lives. This will save the lives of children. This will 
save the lives of children who do not know that they have an allergy 
which is life threatening.
  I'm the grandfather of an 11-year-old little girl. I've been with her 
twice in the emergency room when she was but an infant and when she was 
slightly older than an infant. I want to tell my colleagues a story 
about my daughter who took Alexa to Disney World.
  They were walking down the pathway, one of the walkways at Disney 
World, and all of a sudden my granddaughter started wheezing heavily 
and stated having an allergic reaction. She is extraordinarily allergic 
to peanut butter and peanuts. But she'd had no peanut butter and she'd 
had no peanuts. As a matter of fact, this little girl is 
extraordinarily careful about what she eats. She comes to my house, she 
makes sure that I read the labels and she reads the labels. She brings 
with her her EpiPen in the little case that is always with her.
  But as they were walking down that pathway, she started to wheeze 
heavily, and they had no idea why. My daughter turned around and 
retraced a few of their steps, and they saw popcorn being made--popcorn 
being made with peanut oil. And the mere breathing in of that peanut 
oil air caused her to start wheezing heavily. Now, she didn't have 
anaphylactic shock at that point in time, and she did not need to go to 
an emergency room at that time, but it shows how extraordinarily 
vulnerable people can be to these food allergies.
  So I'm very pleased to stand here in support of this bill. I'm very 
pleased to stand here as a cosponsor of this legislation with my 
friend, Dr. Roe from Tennessee, and I want to thank him. I want to 
thank him for his work. I want to thank him as a doctor and as a Member 
of Congress and as a parent. He shared my concern and we worked 
together.
  There were some difficulties to overcome, but he and I together, 
working together with Fred Upton--and I want to thank Fred Upton and 
Henry Waxman, the chair and ranking member of the committee, as well as 
Dr. Burgess and Mr. Butterfield for their help. They have both said, 
and I'm sure Dr. Roe will say, this will save lives. It is not a 
mandate, but it is a suggestion. It is an urging to make sure that, 
given the fact that we have this lifesaving capability, that that 
capability be deployed and be present so that no child will have to die 
because of a reaction to one of these allergies.
  So I thank them again and thank my friend for yielding.
  Mr. BUTTERFIELD. I thank the gentleman for those words, and I reserve 
the balance of my time.
  Mr. BURGESS. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Tennessee, Dr. Phil Roe.
  Mr. ROE of Tennessee. I thank Dr. Burgess, and, Mr. Speaker, I rise 
to urge my colleagues to support the School Access to Emergency 
Epinephrine Act.

[[Page H5147]]

  This bill will encourage States and schools to take small but 
meaningful steps to protect schoolchildren from anaphylaxis, a severe 
and potentially fatal allergic reaction that can be triggered by a food 
allergy, or even an insect sting. According to Food Allergy Research 
and Education, one in 13 children has a food allergy--roughly two in 
every classroom.
  The bipartisan bill I introduced with Congressman Hoyer--and I want 
to thank Congressman Hoyer profusely today. His staff and my staff 
worked diligently on this bill to bring it to the floor. This bill 
provides a preference for asthma-related grants to States that adopt 
laws to permit properly trained school personnel to administer 
epinephrine to a student reasonably believed to have an anaphylactic 
reaction. To obtain preference, schools would have to maintain a supply 
of epinephrine and ensure trained personnel are present to administer.
  This legislation has been scored by the Congressional Budget Office 
at no cost to the taxpayer. Our bill simply builds on an existing 
preference system signed into law in 2004 that helped make student 
self-administration of epinephrine a reality in 49 States.
  Anaphylaxis, however, is not always predictable. An individual--adult 
or child--could have a severe allergic reaction even with no prior 
history of a food allergy, and I've seen this many times in my 
practice. Because anaphylaxis can cause deaths in just minutes, it is 
essential that epinephrine, the best treatment for anaphylaxis, be 
readily available for treatment. In most States, however, schools are 
not required to keep epinephrine stocked in case of emergencies. The 
result is needless tragedies, like that of Amarria Johnson.

  Amarria was a 7-year-old girl--the same age of my granddaughter--who 
lived in Chesterfield County, Virginia. On January 2, 2012, she died 
from cardiac arrest and anaphylaxis as a result of eating a peanut. I 
had an opportunity to meet Amarria's mother, Laura Pendleton, at a 
briefing that Mr. Hoyer and I hosted on our bill. Her story is 
absolutely heartbreaking.
  As a father and a grandfather, I can't begin to imagine what she had 
to go through. In response to her death, the Virginia Legislature 
passed what has become known as ``Amarria's law,'' which required 
public schools in the State to keep epinephrine on hand. But while 28 
States have laws allowing schools to stock epinephrine, the States 
requiring the same remain in the minority.
  A set of two epinephrine autoinjectors costs about $150 and are good 
for a year. With new competition in the marketplace to produce what are 
commonly known as EpiPens, I'm confident the price will come down even 
further. The training required to use an EpiPen is minimal. School 
personnel could be trained by an EMT or a school nurse in a brief 
session. The autoinjectors themselves are safe and very easy to use. 
The needle is covered by a protective sheath and only comes out when 
the EpiPen is pressed against the leg.
  To make sure that teachers and other adults working at the school 
don't have to worry about a lawsuit for doing the right thing, our bill 
requires, as a condition of receiving preference for asthma-related 
grants, that the State attorney general reviews existing civil 
liability protection laws and certifies that they provide adequate 
protection to the trained school personnel.
  I thank the minority whip, Mr. Hoyer, who worked tirelessly on this, 
for being an outstanding partner in this process. His story with his 
granddaughter is a compelling one. This has become a bipartisan process 
every step of the way.
  I would also like to thank Chairman Upton and Mr. Waxman and his 
staff for helping advance this proposal. My hope is that this bill 
gives the States a little encouragement to ensure that what happened to 
Amarria doesn't ever happen to another child.
  I thank Mr. Butterfield, and I thank Dr. Burgess for allowing me to 
be here this evening, and I encourage my colleagues to support this 
bill.
  Mr. BUTTERFIELD. Mr. Speaker, I don't have any other speakers, and 
with that I yield back the balance of my time.
  Mr. BURGESS. Mr. Speaker, as a physician, a parent and grandparent, I 
share the same fears that we have heard discussed this evening. I am 
worried that schools may not be prepared to act quickly in an 
emergency. I am pleased to support this legislation. I urge everyone on 
the floor to vote in favor of H.R. 2094.
  I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Texas (Mr. Burgess) that the House suspend the rules and 
pass the bill, H.R. 2094.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

                          ____________________