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[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2023 Received in Senate (RDS)]

  2d Session
                                H. R. 2023

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                            October 6, 2004

                                Received

_______________________________________________________________________

                                 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.

    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 ``Asthmatic Schoolchildren's Treatment 
and Health Management Act of 2004''.

SEC. 2. FINDINGS.

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

            Passed the House of Representatives October 5, 2004.

            Attest:

                                                 JEFF TRANDAHL,

                                                                 Clerk.
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