[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.
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