H. R. 3627
IN THE HOUSE OF REPRESENTATIVES
December 8, 2011
Mr. Roe of Tennessee (for himself and Mr. Hoyer) introduced the following bill; which was referred to the Committee on Energy and Commerce
To provide States with incentives to require elementary schools and secondary schools to maintain, and permit school personnel to administer, epinephrine at schools.
This Act may be cited as the
School Access to Emergency Epinephrine
Congress finds the following:
According to research funded by the Food Allergy Initiative and conducted by Northwestern University and Children's Memorial Hospital, nearly 6,000,000 children in the United States have food allergies.
Anaphylaxis, or anaphylactic shock, is a systemic allergic reaction that can kill within minutes.
More than 15 percent of school-aged children with food allergies have had an allergic reaction in school.
Teenagers and young adults with food allergies are at the highest risk of fatal food-induced anaphylaxis.
Individuals with food allergies who also have asthma may be at increased risk for severe or fatal food allergy reactions.
Studies have shown that 25 percent of epinephrine administrations in schools involve individuals with a previously unknown allergy.
The National Institute of Allergy and Infectious Diseases (NIAID) has reported that delays in the administration of epinephrine to patients in anaphylaxis can result in rapid decline and death. NIAID recommends that epinephrine be given promptly to treat anaphylaxis.
Physicians can provide standing orders to furnish a school with epinephrine for injection, and several States have passed laws to authorize this practice.
The American Academy of Allergy, Asthma, and Immunology recommends that epinephrine injectors should be included in all emergency medical treatment kits in schools.
The American Academy of Pediatrics recommends that an anaphylaxis kit should be kept with medications in each school and made available to trained staff for administration in an emergency.
According to the Food Allergy and Anaphylaxis Network, there are no contraindications to the use of epinephrine for a life-threatening reaction.
Preference for States regarding administration of epinephrine by school personnel
Section 399L of the Public Health Service Act (42 U.S.C. 280g(d)) is amended—
in subsection (a), by redesignating the second paragraph (2) and paragraph (3) as paragraphs (3) and (4), respectively; and
by striking subsection (d) and inserting the following:
Preference for States Regarding Medication To Treat Asthma and Anaphylaxis
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 each of the following requirements:
Self-Administration of Medication
The State shall 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—
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;
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;
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
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 subclause (III) and other documents related to liability.
An authorization granted under clause (i) shall allow the student involved to possess and use the student's medication—
while in school;
while at a school-sponsored activity, such as a sporting event; and
in transit to or from school or school-sponsored activities.
Duration of Authorization
An authorization granted under clause (i)—
shall be effective only for the same school and school year for which it is granted; and
must be renewed by the parent or guardian each subsequent school year in accordance with this subsection.
The State shall 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 prompt access in the event of an asthma or anaphylaxis emergency.
Maintenance of Information
The State shall require that information described in clauses (i)(III) and (i)(IV) be kept on file at the student's school in a location easily accessible in the event of an asthma or anaphylaxis emergency.
Rule of construction
Nothing in this subparagraph creates a cause of action or in any other way increases or diminishes the liability of any person under any other law.
School personnel administration of epinephrine
The State shall require that each public elementary school and secondary school in the State—
permit authorized personnel to administer epinephrine to any student believed in good faith to be having an anaphylactic reaction; and
maintain in a secure and easily accessible location a supply of epinephrine that—
is prescribed under a standing protocol from a licensed physician; and
is accessible to authorized personnel for administration to a student having an anaphylactic reaction.
Liability and State Law
Good Samaritan Law
The State shall have a State law ensuring that elementary school and secondary school employees and agents, including a physician providing a prescription for school epinephrine, will incur no liability related to the administration of epinephrine to any student believed in good faith to be having an anaphylactic reaction, except in the case of willful or wanton conduct.
Nothing in this subparagraph shall be construed to preempt State law, including any State law regarding whether students with allergy or asthma may possess and self-administer medication.
For purposes of this subsection:
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.
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.
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 epinephrine.
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.
The term authorized personnel means the school nurse or, if the school nurse is absent, an individual who has been designated by the school nurse and has received training in the administration of epinephrine.