[Congressional Record Volume 166, Number 169 (Tuesday, September 29, 2020)]
[House]
[Pages H5004-H5006]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




        SCHOOL-BASED ALLERGIES AND ASTHMA MANAGEMENT PROGRAM ACT

  Mr. PALLONE. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 2468) to amend the Public Health Service Act to increase the 
preference given, in awarding certain allergies and asthma-related 
grants, to States that require certain public schools to have allergies 
and asthma management programs, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2468

       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-Based Allergies and 
     Asthma Management Program Act''.

     SEC. 2. ADDITIONAL PREFERENCE TO CERTAIN STATES THAT REQUIRE 
                   CERTAIN PUBLIC SCHOOLS TO HAVE ALLERGIES AND 
                   ASTHMA MANAGEMENT PROGRAMS.

       Section 399L(d) of the Public Health Service Act (42 U.S.C. 
     280g(d)) is amended--
       (1) in paragraph (1)(F)--
       (A) by redesignating clauses (i), (ii), and (iii) as 
     subclauses (I), (II), and (III), respectively, and moving 
     each of such subclauses (as so redesignated) 2 ems to the 
     right;
       (B) by striking ``epinephrine.--In determining'' and 
     inserting ``epinephrine or school comprehensive allergies and 
     asthma management program.--
       ``(i) In general.--In determining'';
       (C) by striking ``in the State--'' and inserting ``in the 
     State satisfy the criteria described in clause (ii) or clause 
     (iii).
       ``(ii) Criteria for school personnel administration of 
     epinephrine.--For purposes of clause (i), the criteria 
     described in this clause, with respect to each public 
     elementary school and secondary school in the State, are that 
     each such school--''; and
       (D) by adding at the end the following new clause:
       ``(iii) Criteria for school comprehensive allergies and 
     asthma management program.--For purposes of clause (i), the 
     criteria described in this clause, with respect to each 
     public elementary school and secondary school in the State, 
     are that each such school--

       ``(I) has in place a plan for having on the premises of the 
     school during all operating hours of the school a school 
     nurse or one or more other individuals who are designated by 
     the principal (or other appropriate administrative staff) of 
     the school to direct and apply the program described in 
     subclause (II) on a voluntary basis outside their scope of 
     employment; and
       ``(II) has in place, under the direction of a school nurse 
     or other individual designated under subclause (I), a 
     comprehensive school-based allergies and asthma management 
     program that includes--

       ``(aa) a method to identify all students of such school 
     with a diagnosis of allergies and asthma;
       ``(bb) an individual student allergies and asthma action 
     plan for each student of such school with a diagnosis of 
     allergies and asthma;
       ``(cc) allergies and asthma education for school staff who 
     are directly responsible for students who have been 
     identified as having allergies or asthma, such as education 
     regarding basics, management, trigger management, and 
     comprehensive emergency responses with respect to allergies 
     and asthma;
       ``(dd) efforts to reduce the presence of environmental 
     triggers of allergies and asthma; and
       ``(ee) a system to support students with a diagnosis of 
     allergies or asthma through coordination with family members 
     of such students, primary care providers of such students, 
     primary asthma or allergy care providers of such students, 
     and others as necessary.''; and
       (2) in paragraph (3)(E)--
       (A) in the matter preceding clause (i), by inserting ``, 
     such as the school nurse'' after ``individual''; and
       (B) in clause (i), by inserting ``school nurse or'' before 
     ``principal''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Oregon (Mr. Walden) each 
will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in

[[Page H5005]]

which to revise and extend their remarks and include extraneous 
material on H.R. 2468.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, more than 8 percent of children in the U.S. under the 
age of 18 live with asthma. For these children and children with 
respiratory issues caused by asthma, access to appropriate treatment 
and trained personnel can mean the difference between life and death in 
emergency situations.
  In 2004, Congress authorized children's asthma treatment grants to 
expand access to medical care for children who live in areas with a 
prevalence of asthma. Today, CDC provides financial assistance to 
health departments in 24 States and Puerto Rico to ensure that 
guidelines-based medical management and pharmacotherapy for those with 
asthma are both available and accessible. The CDC also offers funding 
to State programs and national organizations promoting asthma quality 
measures and informing policymakers about the burden of asthma.
  H.R. 2468, the School-Based Allergies and Management Program Act, 
takes the most recent data and builds on this program to make it work 
best for kids and schools today. To achieve this, preference will be 
given for certain grants to States that require schools to have a 
school-based allergies and asthma program, as well as the presence of a 
school nurse or other trained personnel who can support students and 
staff treat those with allergies and asthma.
  Helping States and schools to better support students and families 
treat asthma and allergies is critical to the health and well-being of 
our students, and this bill will go a long way towards achieving this 
goal.
  Madam Speaker, I want to thank Majority Leader Hoyer for his 
leadership on this bill as well as our colleague, Representative Roe. I 
urge my colleagues to support the bill, and I reserve the balance of my 
time.
  Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I rise today in support of H.R. 2468, the School-Based 
Allergies and Asthma Management Program Act, introduced by 
Representatives Roe and Hoyer.
  This important legislation would direct the Secretary of Health and 
Human Services, in making asthma-related grants, to give preference to 
States that require schools to implement policies that improve the care 
of children with allergies and asthma. These policies include having 
plans in place for managing students with allergies and asthma and 
having at least one person trained to administer rescue medication on 
the premises during operating hours.
  By incentivizing States to have comprehensive school-based asthma and 
allergy management programs in place, this bill will help ensure that 
school nurses, staff, and administrators are prepared to help students 
with allergies and asthma excel at school in a safe environment.
  I want to thank Dr. Roe and Leader Hoyer, who have championed the 
cause of ensuring children at school have access to needed medicines 
for many, many years.
  I also want to thank Dr. Roe for his years of service to this 
institution. Like some of the rest of us, he, too, will be retiring at 
the end of this year. As a veteran, as a doctor, and as a leader--and, 
by the way, as a great musician, not that he will be able to perform 
that here on the House floor--he has done so much for veterans, for 
improving healthcare, and for the people of the district he represents. 
He has left his mark, and he doesn't have to worry about whether he 
made a difference, because he has.
  So, Madam Speaker, I urge my colleagues to support this legislation, 
and I reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield such time as he may consume to 
the gentleman from Maryland (Mr. Hoyer), who is our majority leader.
  Mr. HOYER. Madam Speaker, I thank my friend, the chairman of the 
Energy and Commerce Committee, and Mr. Walden, the ranking member of 
the Energy and Commerce Committee, for bringing this bill to the floor.
  But, most of all, I want to thank my friend, Dr. Phil Roe from 
Tennessee. He is a medical doctor. He and I, as Mr. Walden pointed out, 
for many, many years have been focused on making sure that those 
children with asthma are safer in the school than they otherwise would 
be if the schools were not prepared to deal with an asthmatic or 
allergic attack. I want to thank Dr. Roe, who has been such a steadfast 
ally and partner in this effort.
  I am hopeful that this bill will go to the Senate, and when we come 
back in the lameduck, hopefully, we will pass this and we will have 
another bipartisan bill that will help children and the school systems 
of America.
  I am proud to be joined by Dr. Roe. It is emblematic of when you have 
a problem that is needed to be solved, Madam Speaker; it is not a 
partisan problem. These are not partisan issues. These are issues that 
kids have, families have, and schools have.
  We stood together on this floor 7 years ago when the House passed our 
School Access to Emergency Epinephrine Act. President Obama signed that 
bipartisan bill into law in November 2013. It encouraged States to 
adopt policies that require schools to stock emergency epinephrine and 
train staff how to use it in case a student experiences a severe 
allergy or asthma attack. Those attacks can result in death.
  This is not just an inconvenience; this is just not an illness; it is 
a mortal challenge, and I am proud that we got that bill done together 
and we do again, today, the same.
  This new bipartisan legislation would build on that earlier success, 
as the ranking member and chairman of have all explained, by providing 
additional incentives for States to ensure that American schools create 
asthma management plans for students who need them.
  This is not a difficult task, I might say, and it is not an expensive 
task, but it has a lifesaving result.
  I know all too well how terrifying severe childhood asthma can be. I 
was diagnosed with asthma at age 4 when I went to the hospital in 
Mexia, Texas. My father was stationed at a POW camp in Mexia, Texas, 
not too far from Galveston. So I know the consequences of asthma.
  In addition to that, my granddaughter has experienced severe food 
allergies, a peanut allergy which is so much more evident today than it 
was, for whatever reason, and is life threatening. I have been with my 
granddaughter twice in the emergency room. Luckily, she got there in 
time so that her life was not in danger, but had she not gotten there 
in a timely fashion, it would have been.
  Like many families, we constantly have to be vigilant and always keep 
asthma inhalers present. My granddaughter always keeps an EpiPen with 
her. She is 18 years of age, and she does not go anywhere without an 
EpiPen.
  Very frankly, my daughter, her mother, every school that she went to, 
counseled with the principal, with the teacher, and with the school 
personnel to let them know, A, that Alexa had that challenge and, B, 
how to help her deal with it.

                              {time}  1500

  Having a plan to manage asthma and peanut allergies makes a critical 
difference. This legislation will help reduce school absenteeism, for 
which asthma is one of the leading causes. I know that because as an 
elementary school and junior high school student, I lost significant 
time because of asthma.
  Madam Speaker, again, I thank Dr. Roe for his leadership on this 
issue and for working with me on these bills over the years. He is 
retiring at the end of this Congress, and I will certainly miss working 
with him. We will miss his expertise here in the Congress of the United 
States, and I know the Committee on Energy and Commerce will miss his 
advice and counsel as well. I believe that legislation like this and 
the law we enacted in 2013 will be a fitting part of his legacy of 
public service.
  Madam Speaker, I hope that all of our colleagues will join us in 
supporting this legislation and in thanking Dr. Roe for his efforts to 
ensure that protecting our Nation's children against asthma 
consequences remains a truly bipartisan effort.
  Mr. WALDEN. Madam Speaker, I thank the majority leader for his 
comments in support and authorship of this

[[Page H5006]]

legislation. Our son battled childhood asthma. It is a really scary 
thing as a parent to watch a child deal with an asthma attack.
  Madam Speaker, I yield such time as he may consume to the gentleman 
from Tennessee (Mr. David P. Roe), the champion of this legislation, 
the great champion for a positive public health outcome for all of us, 
especially for our veterans.
  Mr. DAVID P. ROE of Tennessee. Madam Speaker, today, I rise in 
support of H.R. 2468, the School-Based Allergies and Asthma Management 
Program Act, a bill I have been proud to work on with my friend, Leader 
Hoyer, that will help students with asthma excel in an asthma-friendly 
learning environment.
  Madam Speaker, I will say that I had the privilege of visiting Mr. 
Walden's district a few years ago when we were working on the VA 
MISSION Act, and he explained to me that his congressional district had 
more square miles than the State of Tennessee. I didn't believe that, 
but it happens to be true. It has more square miles. And that one 
statement really helped me in composing that bill.
  I also thank Leader Hoyer--when he mentioned that in 2013, we didn't 
know each other very well then, but we got to know each other. And that 
bill, the EpiPen bill it is called, passed. And in my own community, 
just a community about 20 miles north of me, not 2, 3 years ago, a 
middle school student, who didn't know she had allergies, had 
anaphylaxis, and because the EpiPen was available, because of Mr. 
Hoyer's work and others, that child survived.
  I also thank Mr. Pallone and Mr. Walden. Remember the incredible 
arguments we had about the cost of the EpiPen? I travel with one all 
the time because I am more concerned about an allergy of some kind when 
I travel. They always ask on airplanes: ``Is there a doctor here?'' I 
am always with one. And you all helped push the price of that down--
your work on that did--from $600, which was absurd for an EpiPen.
  And you know, Mr. Hoyer, with your daughter, I don't care how much 
money you have, that is a lot of money to pay. And you have to have two 
of them, not one. So that price has dropped dramatically because I 
think a lot of the work this Congress has done.
  Last week marked the beginning of fall, as we all know. And for many 
of us, the cooler weather means the return to football and a new school 
year--different school year, but back. For millions of other Americans 
living with asthma, seasonal allergies, and other respiratory diseases, 
these changes of temperature mean difficulty breathing.
  There are roughly 6 million school-aged children in the U.S. 
currently living with asthma. This is one of the leading causes of 
absenteeism. In fact, according to the National Asthma Education and 
Prevention Program, parents have reported that students collectively 
miss 14 million days of school every year due to asthma alone. While 
asthma poses serious health risks, it can be effectively managed with 
proper education, planning, and treatment, and does not have to 
negatively impact a child's access to education.
  The Department of Education and the Department of Health and Human 
Services both recommend that schools have comprehensive management 
programs in place to support children with lower airway disorders like 
asthma and keep these disorders under control while they are at school. 
Unfortunately, most schools do not have such programs in place. And 
that is why our bill, the School-Based Allergies and Asthma Management 
Program uses a proven model to encourage States to ensure schools are 
prepared to help children suffering from asthma.
  The two most important strategies for preparing schools are 
implementing management plans and ensuring that school staff members 
are prepared to assist children experiencing an attack. Our bill 
encourages States to do just that. This type of preparation and 
management in schools will not only improve a child's health but also 
ensure that students are able to focus on learning. No student should 
be at risk in a school because of a failure for them to manage a 
respiratory disorder. The good news is that together, we can fix this.
  The start of the new school year serves as a valuable reminder of the 
work that still needs to be done, and I look forward to passing this 
bipartisan legislation today and getting it one step closer to the 
President's desk so that students with asthma and allergies can focus 
on their education.
  Madam Speaker, I thank my colleagues on both sides of the aisle for 
their very, very kind comments, and I encourage support of this bill.
  Mr. PALLONE. Madam Speaker, I have no additional speakers, and I 
reserve the balance of my time.
  Mr. WALDEN. Madam Speaker, I yield myself such time as I may consume.
  Mr. PALLONE. Madam Speaker, I urge support of this legislation, and I 
yield back the balance of my time.
  Ms. JACKSON LEE. Madam Speaker, I rise in support of H.R. 2468, the 
``School-Based Allergies and Asthma Management Program Act,'' which 
would provide important guidance to schools on how to support students 
who have asthma.
  Across the United States nearly 25 million people have been diagnosed 
with asthma, including almost 7 million children.
  Childhood asthma is a common, chronic pediatric condition, affecting 
6.3 million children.
  Morbidity from childhood asthma adversely affects school performance, 
with 1 in 2 children reporting school absences due to asthma each year.
  These asthma related absences influence academic achievement, leading 
to decreased levels of reading proficiency and increased risk of 
learning disabilities.
  Improving health and school-related outcomes for children with asthma 
requires the use of school-based partnerships that focus on integrated 
care coordination amongst families, clinicians, and school nurses.
  The best defense to asthma attacks is immediate treatment as soon as 
symptoms present themselves.
  Instead of contributing to the nearly 2 million asthma-related 
emergency room visits each year, this bill would provide schools with 
the necessary guidance on how to treat asthma attacks and support lung 
health of student while in school and at home.
  Improving health and school-related outcomes for children with asthma 
requires the use of school-based partnerships that focus on integrated 
care coordination amongst families, clinicians and school nurses.
  Every day in America 30,000 Americans have an asthma attack, and 11 
are killed by them.
  The School-based Asthma Management Program as outlined by H.R. 2468, 
is supported by the American Academy of Allergy, Asthma & Immunology.
  For asthma care, the School-based Asthma Management Program has four 
components to integrate schools, and specifically school nurses, within 
the asthma care team.
  First, the creation of a Circle of Support amongst the families, 
clinicians and schools' nurses are centered around the child with 
asthma.
  Second, the creation and transmission of Asthma Management Plans to 
schools, which includes an Asthma Emergency Treatment Plan for 
emergency management of asthma symptoms and an individualized Asthma 
Action Plan for each child with asthma.
  Third, the development of a comprehensive Asthma Education Plan for 
school personnel.
  Finally, a comprehensive Environmental Asthma Plan to assess and 
remediate asthma triggers at home and in school.
  This bill is supported by the American Academy of Allergy, Asthma and 
Immunology (AAAAI) and the National Association of School Nurses 
(NASN).
  I ask my colleagues to join me in supporting this bill.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 2468, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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