IB 

Union Calendar No. 353 

110TH CONGRESS 

2D SESSION H. R. 2063 

[Report No. 110–571, Part I] 

To direct the Secretary of Health and Human Services, in consultation 

with the Secretary of Education, to develop a voluntary 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 HOUSE OF REPRESENTATIVES 

APRIL 26, 2007 

Mrs. LOWEY (for herself, Mr. EMANUEL, Mr. MCDERMOTT, and Mr. KENNEDY) introduced the following bill; which was referred to the Committee 

on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

APRIL 8, 2008 

Additional sponsors: Mr. KELLER of Florida, Mrs. MALONEY of New York, 

Mr. KIRK, Mr. GRIJALVA, Mr. DAVIS of Illinois, Mr. ISRAEL, Ms. 

MCCOLLUM of Minnesota, Mr. MCNULTY, Mr. UPTON, Mr. LOBIONDO, 

Mr. VAN HOLLEN, Mr. ANDREWS, Mr. KAGEN, Mr. WALSH of New York, 

Ms. SCHAKOWSKY, Mr. BUCHANAN, Mr. PITTS, Mr. DELAHUNT, Mr. 

WAXMAN, Mr. KUCINICH, Mr. GORDON of Tennessee, Mr. PATRICK J. 

MURPHY of Pennsylvania, Mr. RANGEL, Mr. MARKEY, Mr. SAXTON, Mr. 

MICHAUD, Mr. ALLEN, Mr. HALL of New York, Mr. YARMUTH, Ms. SUTTON, Mr. CARNAHAN, Mrs. CAPPS, Mr. NEAL of Massachusetts, Ms. 

DEGETTE, Mr. MORAN of Virginia, Mr. RUSH, Mr. STUPAK, Mr. TIM

MURPHY of Pennsylvania, Mr. TOWNS, Ms. DELAURO, Mr. HOLT, Ms. 

SOLIS, Ms. CLARKE, Mr. CUMMINGS, Mr. DEFAZIO, Ms. BEAN, Ms. 

ESHOO, Mr. RODRIGUEZ, Mrs. BLACKBURN, Mr. HOYER, Mr. SARBANES, 

Mr. HINCHEY, Mr. SOUDER, Mr. WYNN, Ms. SHEA-PORTER, Mr. HARE, 

Mr. UDALL of Colorado, Mr. GENE GREEN of Texas, Mr. FERGUSON, 

Ms. BALDWIN, Mr. WEINER, Mr. MATHESON, Mr. ALTMIRE, Mr. PRICE

of North Carolina, Mr. RUPPERSBERGER, Mr. PUTNAM, Mr. ROSS, Mr. 


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TIERNEY, Mr. ENGEL, Mr. LAMPSON, Ms. HOOLEY, Mr. FOSSELLA, and 

Mr. PAYNE

APRIL 8, 2008 

Reported from the Committee on Energy and Commerce with amendments 

[Strike out all after the enacting clause and insert the part printed in italic] 

APRIL 8, 2008 

Committee on Education and Labor discharged; committed to the Committee 

of the Whole House on the State of the Union and ordered to be printed 

[For text of introduced bill, see copy of bill as introduced on April 26, 2007] 

A BILL 

To direct the Secretary of Health and Human Services, 

in consultation with the Secretary of Education, to develop a voluntary policy for managing the risk of food 

allergy and anaphylaxis in schools, to establish schoolbased food allergy management grants, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Food Allergy and Ana5 phylaxis Management Act of 2008’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

8 (1) Food allergy is an increasing food safety and 

9 public health concern in the United States, especially 

10 among students. 


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1 (2) Peanut allergy doubled among children from 

2 1997 to 2002. 

3 (3) In a 2004 survey of 400 elementary school 

4 nurses, 37 percent reported having at least 10 stu5 dents with severe food allergies and 62 percent re6 ported having at least 5. 

7 (4) Forty-four percent of the elementary school 

8 nurses surveyed reported that the number of students 

9 in their school with food allergy had increased over 

10 the past 5 years, while only 2 percent reported a de11 crease. 

12 (5) In a 2001 study of 32 fatal food-allergy in13 duced anaphylactic reactions (the largest study of its 

14 kind to date), more than half (53 percent) of the indi15 viduals were aged 18 or younger. 

16 (6) Eight foods account for 90 percent of all 

17 food-allergic reactions: milk, eggs, fish, shellfish, tree 

18 nuts, peanuts, wheat, and soy. 

19 (7) Currently, there is no cure for food allergies; 

20 strict avoidance of the offending food is the only way 

21 to prevent a reaction. 

22 (8) Anaphylaxis is a systemic allergic reaction 

23 that can kill within minutes. 

24 (9) Food-allergic reactions are the leading cause 

25 of anaphylaxis outside the hospital setting, accountVerDate Aug 31 2005 23:06 Apr 08, 2008 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6203 E:\BILLS\H2063.RH H2063

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1 ing for an estimated 30,000 emergency room visits, 

2 2,000 hospitalizations, and 150 to 200 deaths each 

3 year in the United States. 

4 (10) Fatalities from anaphylaxis are associated 

5 with a delay in the administration of epinephrine 

6 (adrenaline), or when epinephrine was not adminis7 tered at all. In a study of 13 food allergy-induced 

8 anaphylactic reactions in school-age children (6 fatal 

9 and 7 near fatal), only 2 of the children who died re10 ceived epinephrine within 1 hour of ingesting the al11 lergen, and all but 1 of the children who survived re12 ceived epinephrine within 30 minutes. 

13 (11) The importance of managing life-threat14 ening food allergies in the school setting has been rec15 ognized by the American Medical Association, the 

16 American Academy of Pediatrics, the American Acad17 emy of Allergy, Asthma and Immunology, the Amer18 ican College of Allergy, Asthma and Immunology, 

19 and the National Association of School Nurses. 

20 (12) There are no Federal guidelines concerning 

21 the management of life-threatening food allergies in 

22 the school setting. 

23 (13) Three-quarters of the elementary school 

24 nurses surveyed reported developing their own train25 ing guidelines. 


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1 (14) Relatively few schools actually employ a 

2 full-time school nurse. Many are forced to cover more 

3 than 1 school, and are often in charge of hundreds if 

4 not thousands of students. 

5 (15) Parents of students with severe food allergies 

6 often face entirely different food allergy management 

7 approaches when their students change schools or 

8 school districts. 

9 (16) In a study of food allergy reactions in 

10 schools and day-care settings, delays in treatment 

11 were attributed to a failure to follow emergency plans, 

12 calling parents instead of administering emergency 

13 medications, and an inability to administer epineph14 rine. 

15 SEC. 3. DEFINITIONS. 

16 In this Act: 

17 (1) ESEA DEFINITIONS.—The terms ‘‘local edu18 cational agency’’, ‘‘secondary school’’, and ‘‘elemen19 tary school’’ have the meanings given the terms in 

20 section 9101 of the Elementary and Secondary Edu21 cation Act of 1965 (20 U.S.C. 7801). 

22 (2) SCHOOL.—The term ‘‘school’’ includes pub23 lic— 

24 (A) kindergartens; 

25 (B) elementary schools; and 


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1 (C) secondary schools. 

2 (3) SECRETARY.—The term ‘‘Secretary’’ means 

3 the Secretary of Health and Human Services, in con4 sultation with the Secretary of Education. 

5 SEC. 4. ESTABLISHMENT OF VOLUNTARY FOOD ALLERGY 

6 AND ANAPHYLAXIS MANAGEMENT POLICY. 

7 (a) ESTABLISHMENT.—Not later than 1 year after the 

8 date of enactment of this Act, the Secretary shall— 

9 (1) develop a policy to be used on a voluntary 

10 basis to manage the risk of food allergy and anaphy11 laxis in schools; and 

12 (2) make such policy available to local edu13 cational agencies and other interested individuals and 

14 entities, including licensed child care providers, pre15 school programs, and Head Start, to be implemented 

16 on a voluntary basis only. 

17 (b) CONTENTS.—The voluntary policy developed by the 

18 Secretary under subsection (a) shall contain guidelines that 

19 address each of the following: 

20 (1) Parental obligation to provide the school, 

21 prior to the start of every school year, with— 

22 (A) documentation from the student’s physi23 cian or nurse— 

24 (i) supporting a diagnosis of food al25 lergy and the risk of anaphylaxis; 


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1 (ii) identifying any food to which the 

2 student is allergic; 

3 (iii) describing, if appropriate, any 

4 prior history of anaphylaxis; 

5 (iv) listing any medication prescribed 

6 for the student for the treatment of anaphy7 laxis; 

8 (v) detailing emergency treatment pro9 cedures in the event of a reaction; 

10 (vi) listing the signs and symptoms of 

11 a reaction; and 

12 (vii) assessing the student’s readiness 

13 for self-administration of prescription medi14 cation; and 

15 (B) a list of substitute meals that may be 

16 offered to the student by school food service per17 sonnel. 

18 (2) The creation and maintenance of an indi19 vidual health care plan tailored to the needs of each 

20 student with a documented risk for anaphylaxis, in21 cluding any procedures for the self-administration of 

22 medication by such students in instances where— 

23 (A) the students are capable of self-admin24 istering medication; and 


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1 (B) such administration is not prohibited 

2 by State law. 

3 (3) Communication strategies between individual 

4 schools and local providers of emergency medical serv5 ices, including appropriate instructions for emergency 

6 medical response. 

7 (4) Strategies to reduce the risk of exposure to 

8 anaphylactic causative agents in classrooms and com9 mon school areas such as cafeterias. 

10 (5) The dissemination of information on life11 threatening food allergies to school staff, parents, and 

12 students, if appropriate by law. 

13 (6) Food allergy management training of school 

14 personnel who regularly come into contact with stu15 dents with life-threatening food allergies. 

16 (7) The authorization and training of school per17 sonnel to administer epinephrine when the school 

18 nurse is not immediately available. 

19 (8) The timely accessibility of epinephrine by 

20 school personnel when the nurse is not immediately 

21 available. 

22 (9) Extracurricular programs such as non-aca23 demic outings and field trips, before- and after-school 

24 programs, and school-sponsored programs held on 


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1 weekends that are addressed in the individual health 

2 care plan. 

3 (10) The collection and publication of data for 

4 each administration of epinephrine to a student at 

5 risk for anaphylaxis. 

6 (c) RELATION TO STATE LAW.—Nothing in this Act 

7 or the policy developed by the Secretary under subsection 

8 (a) shall be construed to preempt State law, including any 

9 State law regarding whether students at risk for anaphy10 laxis may self-administer medication. 

11 SEC. 5. VOLUNTARY NATURE OF POLICY AND GUIDELINES. 

12 The policy developed by the Secretary under section 

13 4(a) and the food allergy management guidelines contained 

14 in such policy are voluntary. Nothing in this Act or the 

15 policy developed by the Secretary under section 4(a) shall 

16 be construed to require a local educational agency or school 

17 to implement such policy or guidelines. 

Amend the title so as to read: ‘‘A bill to direct the 

Secretary of Health and Human Services, in consultation 

with the Secretary of Education, to develop a voluntary 

policy for managing the risk of food allergy and anaphylaxis in schools.’’. 


jlentini on PROD1PC65 with BILLS
Union Calendar No. 353 

110TH CONGRESS 

2D SESSION H. R. 2063 

[Report No. 110

–571, Part I] 

A BILL 

To direct the Secretary of Health and Human 

management grants, and for other purposes. schools, to establish school-based food allergy aging the risk of food allergy and anaphylaxis in Education, to develop a voluntary policy for manServices, in consultation with the Secretary of 

APRIL 8, 2008 

Committee on Education and Labor discharged; comState of the Union and ordered to be printed mitted to the Committee of the Whole House on the 


jlentini on PROD1PC65 with BILLS