109th CONGRESS
2d Session
S. 3980
To direct the Secretary of Health and Human Services, in consultation
with the Secretary of Education, to develop a policy for managing the risk
of food allergy and anaphylaxis in schools, to establish school-based food
allergy management grants, and for other purposes.
IN THE SENATE OF THE UNITED STATES
September 28, 2006
Mr. DODD (for himself, Mr. FRIST, Mr. HARKIN, Mrs. CLINTON, Mr. REED, and
Mr. DURBIN) introduced the following bill; which was read twice and referred
to the Committee on Health, Education, Labor, and Pensions
A BILL
To direct the Secretary of Health and Human Services, in consultation
with the Secretary of Education, to develop a policy for managing the risk
of food allergy and anaphylaxis in schools, to establish school-based food
allergy management grants, and for other purposes.
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 2006'.
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 students from 1997 to 2002.
(3) In a 2003 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) 44 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) 8 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, or anaphylactic shock, 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.
(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--
(B) elementary schools; and
(3) SECRETARIES- The term `Secretaries' means the Secretary of Health
and Human Services, in consultation with the Secretary of Education.
SEC. 4. ESTABLISHMENT OF FOOD ALLERGY AND ANAPHYLAXIS MANAGEMENT POLICY.
(a) Establishment- Not later than 1 year after the date of enactment of
this Act, the Secretaries 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.
(b) Contents- The policy developed by the Secretaries 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 documentation from the student's physician or nurse--
(A) supporting a diagnosis of food allergy and anaphylaxis;
(B) identifying any food to which the student is allergic;
(C) describing, if appropriate, any prior history of anaphylaxis;
(D) listing any medication prescribed for the student for the treatment
of anaphylaxis;
(E) detailing emergency treatment procedures in the event of a reaction;
(F) listing the signs and symptoms of a reaction;
(G) assessing the student's readiness for self-administration of prescription
medication; and
(H) providing a list of substitute meals that may be offered 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 Secretaries 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. SCHOOL-BASED FOOD ALLERGY MANAGEMENT GRANTS.
(a) In General- The Secretaries may award grants of not more than $50,000
to local educational agencies to assist such agencies with implementing
food allergy management guidelines contained in the policy described in
section 4.
(1) IN GENERAL- To be eligible to receive a grant under this section,
a local educational agency shall submit an application to the Secretaries
at such time, in such manner, and including such information as the Secretaries
may reasonably require.
(2) CONTENTS- Each application submitted under paragraph (1) shall include--
(A) a certification that the food allergy management guidelines contained
in the policy described in section 4 have been adopted by the local
educational agency;
(B) a description of the activities to be funded by the grant in carrying
out the food allergy management guidelines, including--
(i) how the guidelines will be carried out at individual schools served
by the local educational agency;
(ii) how the local educational agency will inform parents and students
of the food allergy management guidelines in place;
(iii) how school nurses, teachers, administrators, and other school-based
staff will be made aware of, and given training on, when applicable,
the food allergy management guidelines in place; and
(iv) any other activities that the Secretaries determine appropriate;
(C) a budget table that itemizes the amounts of grant funds received
under this section that will be expended on various activities;
(D) a description of how adoption of the guidelines and implementation
of grant activities will be monitored; and
(E) an assurance that the local educational agency will provide such
information and cooperate in any evaluation that the Secretaries may
conduct under this section.
(c) Use of Funds- Each local educational agency that receives a grant under
this section may use the grant funds for the following:
(1) Creation of systems and databases related to creation, storage, and
maintenance of student records.
(2) Purchase of equipment or services, or both, related to the creation,
storage, and maintenance of student records.
(3) In partnership with local health departments, training school nurse,
teacher, and personnel for food allergy management.
(4) Purchase and storage of limited medical supplies, including epinephrine
and disposable wet wipes.
(5) Programs that educate students as to the presence of, and policies
and procedures in place related to, food allergies and anaphylactic shock.
(7) Any other activities consistent with the guidelines contained in the
policy described in section 4.
(d) Duration of Awards- The Secretaries may award grants under this section
for a period of not more than 2 years. Funding for the second year of the
grant, where applicable, shall be contingent on successful review of the
program by the Secretaries after the first year.
(e) Maximum Amount of Awards- A grant awarded under this section may not
be made in an amount that is more than $50,000.
(f) Priority- In awarding grants under this section, the Secretaries shall
give priority to local educational agencies that receive Federal funding
under title I of the Elementary and Secondary Education Act of 1965 (20
U.S.C. 6301 et seq.).
(g) Administrative Funds- A local educational agency that receives a grant
under this section may use not more than 2 percent of the grant amount for
administrative costs related to carrying out this section.
(h) Progress and Evaluations-
(1) LESS THAN A 1 YEAR GRANT- A local educational agency that receives
a grant under this section for a period of not more than 1 year shall
provide the Secretaries, at the completion of the grant period, with information
on whether the agency successfully implemented the food allergy management
guidelines contained in the policy described in section 4.
(2) GRANTS FOR A 1 TO 2 YEAR PERIOD- A local educational agency that receives
a grant under this section for a period of 1 to 2 years shall provide
the Secretaries--
(A) not later than 1 year after the agency receives such grant, with
information on the progress made in implementing the food allergy management
guidelines contained in the policy described in section 4; and
(B) at the completion of the grant period, with information on whether
the agency successfully implemented the food allergy management guidelines
contained in the policy described in section 4.
(i) Rule of Construction- The food allergy management guidelines contained
in the policy described in section 4 are voluntary but a condition of receiving
grant funds under this section.
(j) Supplement, Not Supplant- Grant funds received under this section shall
be used to supplement, and not supplant, non-Federal funds and any other
Federal funds available to carry out the activities described in this section.
(k) Authorization of Appropriations- There is authorized to be appropriated
to carry out this section $30,000,000 for fiscal year 2007 and such sums
as may be necessary for each of the 4 succeeding fiscal years.
END
