[Congressional Record (Bound Edition), Volume 154 (2008), Part 4]
[House]
[Pages 5388-5390]
[From the U.S. 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 
     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?

[[Page 5389]]

  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 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.

[[Page 5390]]

  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.
  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.

                          ____________________