[108th Congress Public Law 377]
[From the U.S. Government Printing Office]


[DOCID: f:publ377.108]

[[Page 2201]]

 ASTHMATIC SCHOOLCHILDREN'S TREATMENT AND HEALTH MANAGEMENT ACT OF 2004

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Public Law 108-377
108th Congress

                                 An Act


 
  To give a preference regarding States that require schools to allow 
students to self-administer medication to treat that student's asthma or 
  anaphylaxis, and for other purposes. <<NOTE: Oct. 30, 2004 -  [H.R. 
                                2023]>> 


    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Asthmatic 
Schoolchildren's Treatment and Health Management Act of 2004.>> 

SECTION 1. SHORT TITLE. <<NOTE: 42 USC 201 note.>> 

    This Act may be cited as the ``Asthmatic Schoolchildren's Treatment 
and Health Management Act of 2004''.

SEC. 2. FINDINGS. <<NOTE: 42 USC 280g note.>> 

    The Congress finds the following:
            (1) Asthma is a chronic condition requiring lifetime, 
        ongoing medical intervention.
            (2) In 1980, 6,700,000 Americans had asthma.
            (3) In 2001, 20,300,000 Americans had asthma; 6,300,000 
        children under age 18 had asthma.
            (4) The prevalence of asthma among African-American children 
        was 40 percent greater than among Caucasian children, and more 
        than 26 percent of all asthma deaths are in the African-American 
        population.
            (5) In 2000, there were 1,800,000 asthma-related visits to 
        emergency departments (more than 728,000 of these involved 
        children under 18 years of age).
            (6) In 2000, there were 465,000 asthma-related 
        hospitalizations (214,000 of these involved children under 18 
        years of age).
            (7) In 2000, 4,487 people died from asthma, and of these 223 
        were children.
            (8) According to the Centers for Disease Control and 
        Prevention, asthma is a common cause of missed school days, 
        accounting for approximately 14,000,000 missed school days 
        annually.
            (9) According to the New England Journal of Medicine, 
        working parents of children with asthma lose an estimated 
        $1,000,000,000 a year in productivity.
            (10) At least 30 States have legislation protecting the 
        rights of children to carry and self-administer asthma metered-
        dose inhalers, and at least 18 States expand this protection to 
        epinephrine auto-injectors.
            (11) Tragic refusals of schools to permit students to carry 
        their inhalers and auto-injectable epinephrine have occurred, 
        some resulting in death and spawning litigation.

[[Page 118 STAT. 2203]]

            (12) School district medication policies must be developed 
        with the safety of all students in mind. The immediate and 
        correct use of asthma inhalers and auto-injectable epinephrine 
        are necessary to avoid serious respiratory complications and 
        improve health care outcomes.
            (13) No school should interfere with the patient-physician 
        relationship.
            (14) Anaphylaxis, or anaphylactic shock, is a systemic 
        allergic reaction that can kill within minutes. Anaphylaxis 
        occurs in some asthma patients. According to the American 
        Academy of Allergy, Asthma, and Immunology, people who have 
        experienced symptoms of anaphylaxis previously are at risk for 
        subsequent reactions and should carry an epinephrine auto-
        injector with them at all times, if prescribed.
            (15) An increasing number of students and school staff have 
        life-threatening allergies. Exposure to the affecting allergen 
        can trigger anaphylaxis. Anaphylaxis requires prompt medical 
        intervention with an injection of epinephrine.

SEC. 3. PREFERENCE FOR STATES THAT ALLOW STUDENTS TO SELF-ADMINISTER 
            MEDICATION TO TREAT ASTHMA AND ANAPHYLAXIS.

    (a) Amendments.--Section 399L of the Public Health Service Act (42 
U.S.C. 280g) is amended--
            (1) by redesignating subsection (d) as subsection (e); and
            (2) by inserting after subsection (c) the following:

    ``(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) In general.--The State must require that each 
                public elementary school and secondary school in that 
                State will grant to any student in the school an 
                authorization for the self-administration of medication 
                to treat that student's asthma or anaphylaxis, if--
                          ``(i) a health care practitioner prescribed 
                      the medication for use by the student during 
                      school hours and instructed the student in the 
                      correct and responsible use of the medication;
                          ``(ii) the student has demonstrated to the 
                      health care practitioner (or such practitioner's 
                      designee) and the school nurse (if available) the 
                      skill level necessary to use the medication and 
                      any device that is necessary to administer such 
                      medication as prescribed;
                          ``(iii) the health care practitioner 
                      formulates a written treatment plan for managing 
                      asthma or anaphylaxis episodes of the student and 
                      for medication use by the student during school 
                      hours; and
                          ``(iv) the student's parent or guardian has 
                      completed and submitted to the school any written 
                      documentation required by the school, including 
                      the treatment plan formulated under clause (iii) 
                      and other documents related to liability.

[[Page 118 STAT. 2204]]

                    ``(B) Scope.--An authorization granted under 
                subparagraph (A) must allow the student involved to 
                possess and use his or her medication--
                          ``(i) while in school;
                          ``(ii) while at a school-sponsored activity, 
                      such as a sporting event; and
                          ``(iii) in transit to or from school or 
                      school-sponsored activities.
                    ``(C) Duration of authorization.--An authorization 
                granted under subparagraph (A)--
                          ``(i) must be effective only for the same 
                      school and school year for which it is granted; 
                      and
                          ``(ii) must be renewed by the parent or 
                      guardian each subsequent school year in accordance 
                      with this subsection.
                    ``(D) Backup medication.--The State must require 
                that backup medication, if provided by a student's 
                parent or guardian, be kept at a student's school in a 
                location to which the student has immediate access in 
                the event of an asthma or anaphylaxis emergency.
                    ``(E) Maintenance of information.--The State must 
                require that information described in subparagraphs 
                (A)(iii) and (A)(iv) be kept on file at the student's 
                school in a location easily accessible in the event of 
                an asthma or anaphylaxis emergency.
            ``(2) Rule of construction.--Nothing in this subsection 
        creates a cause of action or in any other way increases or 
        diminishes the liability of any person under any other law.
            ``(3) Definitions.--For purposes of this subsection:
                    ``(A) The terms `elementary school' and `secondary 
                school' have the meaning given to those terms in section 
                9101 of the Elementary and Secondary Education Act of 
                1965.
                    ``(B) The term `health care practitioner' means a 
                person authorized under law to prescribe drugs subject 
                to section 503(b) of the Federal Food, Drug, and 
                Cosmetic Act.
                    ``(C) The term `medication' means a drug as that 
                term is defined in section 201 of the Federal Food, 
                Drug, and Cosmetic Act and includes inhaled 
                bronchodilators and auto-injectable epinephrine.
                    ``(D) The term `self-administration' means a 
                student's discretionary use of his or her prescribed 
                asthma or anaphylaxis medication, pursuant to a 
                prescription or written direction from a health care 
                practitioner.''.

    (b) <<NOTE: 42 USC 280g note.>> Applicability.--The amendments made 
by this section shall apply only with respect to grants made on or after 
the date that is 9 months after the date of the enactment of this Act.

SEC. 4. SENSE OF CONGRESS COMMENDING CDC FOR ITS STRATEGIES FOR 
            ADDRESSING ASTHMA WITHIN A COORDINATED SCHOOL HEALTH 
            PROGRAM.

    The Congress--
            (1) commends the Centers for Disease Control and Prevention 
        for identifying and creating ``Strategies for Addressing Asthma 
        Within a Coordinated School Program'' for schools to address 
        asthma; and

[[Page 118 STAT. 2205]]

            (2) encourages all schools to review these strategies and 
        adopt policies that will best meet the needs of their student 
        population.

    Approved October 30, 2004.

LEGISLATIVE HISTORY--H.R. 2023 (S. 2815):
---------------------------------------------------------------------------

HOUSE REPORTS: No. 108-606, Pt. 1 (Comm. on Energy and Commerce).
SENATE REPORTS: No. 108-395 accompanying S. 2815 (Comm. on Health, 
Education, Labor, and Pensions)
CONGRESSIONAL RECORD, Vol. 150 (2004):
            Oct. 5, considered and passed House.
            Oct. 11, considered and passed Senate.

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