[House Report 113-182]
[From the U.S. Government Publishing Office]
113th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 113-182
======================================================================
SCHOOL ACCESS TO EMERGENCY EPINEPHRINE ACT
_______
July 30, 2013.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Upton, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 2094]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
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), having considered the same, report
favorably thereon without amendment and recommend that the bill
do pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 2
Committee Consideration.......................................... 3
Committee Votes.................................................. 3
Committee Oversight Findings..................................... 3
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 3
Committee Cost Estimate.......................................... 3
Congressional Budget Office Estimate............................. 3
Federal Mandates Statement....................................... 4
Duplication of Federal Programs.................................. 4
Disclosure of Directed Rule Makings.............................. 5
Advisory Committee Statement..................................... 5
Applicability to Legislative Branch.............................. 5
Section-by-Section Analysis of the Legislation................... 5
Changes in Existing Law Made by the Bill, as Reported............ 5
Purpose and Summary
H.R. 2094, the ``School Access to Emergency Epinephrine
Act,'' was introduced on May 22, 2013, by Rep. Phil Roe (R-TN)
and Rep. Steny Hoyer (D-MD) and subsequently referred to the
Committee on Energy and Commerce.
The legislation would amend the Public Health Service Act
to give preference in awarding certain asthma grants to States
that agree to establish school-based emergency epinephrine
programs that meet specific requirements.
Background and Need for Legislation
Nearly 6 million children have food allergies, and many of
them have had severe reactions. A study in the Journal of
Pediatrics suggests these rates are rising.\1\ Severe allergic
reactions can lead to anaphylaxis, a systemic reaction that
causes swelling that can obstruct airwaves and lead to death.
According to the Centers for Disease Control and Prevention
(CDC), more than 15% of school-aged children with food
allergies have had a reaction at school where teachers and
other school personnel may be unprepared to handle the
emergency.\2\
---------------------------------------------------------------------------
\1\http://pediatrics.aappublications.org/content/early/2011/06/16/
peds.2011-0204.abstract
\2\http://www.cdc.gov/healthyyouth/foodallergies/
---------------------------------------------------------------------------
Epinephrine is the most effective treatment for
anaphylaxis, and it can be administered simply and quickly
using an epipen. Children who have had a severe allergic
reaction often carry an epipen and self-medicate as needed. In
2004, Congress enacted H.R. 2023, the ``Asthma Schoolchildren's
Treatment and Health Management Act,'' which created the
Children's Asthma Treatment Grants Program and authorized
preferences for States that allow students to self-administer
medication to treat asthma and anaphylaxis in accordance with
specified requirements. The legislation did not address the
needs of students who may have severe allergies, but have not
been diagnosed.
H.R. 2094, the ``School Access to Emergency Epinephrine
Act,'' would amend the Children's Asthma Treatment Grants
Program and other asthma programs administered by the
Department of Health and Human Services (HHS) to aid schools in
preparing to treat severe allergic reactions. The bill would
give preference in awarding certain asthma-related grants to
States that allow school personnel to administer epinephrine to
a student in an emergency and meet other requirements. To
receive the preference, States would have to certify that their
civil liability laws provide adequate civil liability
protection to school personnel who administer epinephrine in an
emergency. School personnel would be required to have
appropriate training. Schools would be required to have a plan
in place for having at least one trained employee on site
during school hours and to maintain a supply of epinephrine.
Hearings
The Committee on Energy and Commerce has not held hearings
on the legislation.
Committee Consideration
On July 17, 2013, the full Committee met in open markup
session and approved H.R. 2094 by unanimous consent.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto. A
motion by Mr. Upton to order H.R. 2094, reported to the House,
without amendment, was agreed to by unanimous consent. There
were no record votes taken in connection with ordering H.R.
2094 reported.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held oversight
or legislative hearings on this legislation.
Statement of General Performance Goals and Objectives
The goal of the legislation is to give preference in
awarding certain asthma grants to States that allow trained
school personnel to administer epinephrine in an emergency.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
2094, the ``School Access to Emergency Epinephrine Act'', would
result in no new or increased budget authority, entitlement
authority, or tax expenditures or revenues.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
In compliance with clause 9(e), 9(f), and 9(g) of rule XXI
of the House of Representatives, the Committee finds that H.R.
2094, the ``School Access to Emergency Epinephrine Act''
contains no earmarks, limited tax benefits, or limited tariff
benefits.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
July 22, 2013.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 2094, the School
Access to Emergency Epinephrine Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Santiago
Vallinas.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
H.R. 2094--School Access to Emergency Epinephrine Act
H.R. 2094 would authorize the Secretary of Health and Human
Services, in awarding asthma-treatment grants, to give
preference to states that require schools to:
Maintain an emergency supply of epinephrine,
Permit trained personnel of the school to
administer epinephrine, and
Have a plan for ensuring trained personnel
are available to administer epinephrine during all
hours of the school day.
In addition, to obtain the preference for grants under the
bill, states would have to certify that their laws provide
civil liability protection to school personnel that administer
epinephrine.
The bill would not change the purposes for which the
Secretary makes asthma-related grants or the amount of funding
available. CBO estimates that implementing H.R. 2094 would not
have a significant impact on the federal budget. Enacting H.R.
2094 would not affect direct spending or revenues; therefore,
pay-as-you-go procedures do not apply.
H.R. 2094 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act and
would impose no costs on state, local, or tribal governments.
The CBO staff contact for this estimate is Santiago
Vallinas. The estimate was approved by Holly Harvey, Deputy
Assistant Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Duplication of Federal Programs
No provision of H.R. 2094, the ``School Access to Emergency
Epinephrine Act,'' establishes or reauthorizes a program of the
Federal Government known to be duplicative of another Federal
program, a program that was included in any report from the
Government Accountability Office to Congress pursuant to
section 21 of Public Law 111-139, or a program related to a
program identified in the most recent Catalog of Federal
Domestic Assistance.
Disclosure of Directed Rule Makings
The Committee estimates that enacting H.R. 2094, the
``School Access to Emergency Epinephrine Act,'' specifically
would not direct specific rule making within the meaning of 5
U.S.C. 551.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
This Act may be cited as the ``School Access to Emergency
Epinephrine Act.''
Section 2. Additional preference to pertain States that allow trained
school personnel to administer epinephrine
Section 2 would amend the Children's Asthma Treatment
Grants Program and other asthma programs administered by HHS to
aid in preparing schools to treat severe allergic reactions in
emergency situations. The section would provide a preference in
awarding certain asthma-related grants to States that allow
school personnel to administer epinephrine to a student of the
school reasonably believed to be having an anaphylactic
reaction. To receive such preference, States would have to
certify that their civil liability laws provide adequate civil
liability protection to school personnel who administer
epinephrine under such circumstances. School personnel would be
required to receive training in the administration of
epinephrine. Schools would be required to have a plan in place
for having at least one trained employee on site during school
hours and to maintain a supply of epinephrine in a secure
location that is easily accessible.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italic and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
PART P--ADDITIONAL PROGRAMS
SEC. 399L. CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.
(a) * * *
* * * * * * *
(d) Preference for States That Allow Students to Self-
Administer Medication to Treat Asthma and Anaphylaxis.--
(1) Preference.--The Secretary, in making any grant
under this section or any other grant that is asthma-
related (as determined by the Secretary) to a State,
shall give preference to any State that satisfies the
following:
(A) * * *
* * * * * * *
(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.
* * * * * * *
(3) Definitions.--For purposes of this subsection:
(A) * * *
* * * * * * *
(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 standards and has
been documented by appropriate
administrative staff of the school.
* * * * * * *