I 

110TH CONGRESS 

1ST SESSION H. R. 2063 

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 

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, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Food Allergy and Ana3 phylaxis Management Act of 2007’’. 

4 SEC. 2. FINDINGS. 

5 Congress finds as follows: 

6 (1) Food allergy is an increasing food safety 

7 and public health concern in the United States, es8 pecially among students. 

9 (2) Peanut allergy doubled among children from 

10 1997 to 2002. 

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

12 nurses, 37 percent reported having at least 10 stu13 dents with severe food allergies and 62 percent re14 ported having at least 5. 

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

16 nurses surveyed reported that the number of stu17 dents in their school with food allergy had increased 

18 over the past 5 years, while only 2 percent reported 

19 a decrease. 

20 (5) In a 2001 study of 32 fatal food-allergy in21 duced anaphylactic reactions (the largest study of its 

22 kind to date), more than half (53 percent) of the in23 dividuals were aged 18 or younger. 

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

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

26 nuts, peanuts, wheat, and soy. 


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1 (7) Currently, there is no cure for food aller2 gies; strict avoidance of the offending food is the 

3 only way to prevent a reaction. 

4 (8) Anaphylaxis is a systemic allergic reaction 

5 that can kill within minutes. 

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

7 of anaphylaxis outside the hospital setting, account8 ing for an estimated 30,000 emergency room visits, 

9 2,000 hospitalizations, and 150 to 200 deaths each 

10 year in the United States. 

11 (10) Fatalities from anaphylaxis are associated 

12 with a delay in the administration of epinephrine 

13 (adrenaline), or when epinephrine was not adminis14 tered at all. In a study of 13 food allergy-induced 

15 anaphylactic reactions in school-age children (6 fatal 

16 and 7 near fatal), only 2 of the children who died 

17 received epinephrine within 1 hour of ingesting the 

18 allergen, and all but 1 of the children who survived 

19 received epinephrine within 30 minutes. 

20 (11) The importance of managing life-threat21 ening food allergies in the school setting has been 

22 recognized by the American Medical Association, the 

23 American Academy of Pediatrics, the American 

24 Academy of Allergy, Asthma and Immunology, the 

25 American College of Allergy, Asthma and ImmuVerDate Aug 31 2005 21:38 Apr 27, 2007 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2063.IH H2063

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1 nology, and the National Association of School 

2 Nurses. 

3 (12) There are no Federal guidelines con4 cerning the management of life-threatening food al5 lergies in the school setting. 

6 (13) Three-quarters of the elementary school 

7 nurses surveyed reported developing their own train8 ing guidelines. 

9 (14) Relatively few schools actually employ a 

10 full-time school nurse. Many are forced to cover 

11 more than 1 school, and are often in charge of hun12 dreds if not thousands of students. 

13 (15) Parents of students with severe food aller14 gies often face entirely different food allergy man15 agement approaches when their students change 

16 schools or school districts. 

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

18 schools and day-care settings, delays in treatment 

19 were attributed to a failure to follow emergency 

20 plans, calling parents instead of administering emer21 gency medications, and an inability to administer ep22 inephrine. 

23 SEC. 3. DEFINITIONS. 

24 In this Act: 


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1 (1) ESEA DEFINITIONS.—The terms ‘‘local 

2 educational agency’’, ‘‘secondary school’’, and ‘‘ele3 mentary school’’ have the meanings given the terms 

4 in section 9101 of the Elementary and Secondary 

5 Education Act of 1965 (20 U.S.C. 7801). 

6 (2) SCHOOL.—The term ‘‘school’’ includes pub7 lic— 

8 (A) kindergartens; 

9 (B) elementary schools; and 

10 (C) secondary schools. 

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

12 the Secretary of Health and Human Services, in 

13 consultation with the Secretary of Education. 

14 SEC. 4. ESTABLISHMENT OF VOLUNTARY FOOD ALLERGY 

15 AND ANAPHYLAXIS MANAGEMENT POLICY. 

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

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

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

19 basis to manage the risk of food allergy and anaphy20 laxis in schools; and 

21 (2) make such policy available to local edu22 cational agencies and other interested individuals 

23 and entities to be implemented on a voluntary basis 

24 only. 


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1 (b) CONTENTS.—The voluntary policy developed by 

2 the Secretary under subsection (a) shall contain guidelines 

3 that address each of the following: 

4 (1) Parental obligation to provide the school, 

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

6 (A) documentation from the student’s phy7 sician or nurse— 

8 (i) supporting a diagnosis of food al9 lergy and the risk of anaphylaxis; 

10 (ii) identifying any food to which the 

11 student is allergic; 

12 (iii) describing, if appropriate, any 

13 prior history of anaphylaxis; 

14 (iv) listing any medication prescribed 

15 for the student for the treatment of ana16 phylaxis; 

17 (v) detailing emergency treatment 

18 procedures in the event of a reaction; 

19 (vi) listing the signs and symptoms of 

20 a reaction; and 

21 (vii) assessing the student’s readiness 

22 for self-administration of prescription 

23 medication; and 


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

2 offered to the student by school food service 

3 personnel. 

4 (2) The creation and maintenance of an indi5 vidual health care plan tailored to the needs of each 

6 student with a documented risk for anaphylaxis, in7 cluding any procedures for the self-administration of 

8 medication by such students in instances where— 

9 (A) the students are capable of self-admin10 istering medication; and 

11 (B) such administration is not prohibited 

12 by State law. 

13 (3) Communication strategies between indi14 vidual schools and local providers of emergency med15 ical services, including appropriate instructions for 

16 emergency medical response. 

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

18 anaphylactic causative agents in classrooms and 

19 common school areas such as cafeterias. 

20 (5) The dissemination of information on life21 threatening food allergies to school staff, parents, 

22 and students, if appropriate by law. 

23 (6) Food allergy management training of school 

24 personnel who regularly come into contact with stu25 dents with life-threatening food allergies. 


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1 (7) The authorization and training of school 

2 personnel to administer epinephrine when the school 

3 nurse is not immediately available. 

4 (8) The timely accessibility of epinephrine by 

5 school personnel when the nurse is not immediately 

6 available. 

7 (9) Extracurricular programs such as non-aca8 demic outings and field trips, before- and after9 school programs, and school-sponsored programs 

10 held on weekends that are addressed in the indi11 vidual health care plan. 

12 (10) The collection and publication of data for 

13 each administration of epinephrine to a student at 

14 risk for anaphylaxis. 

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

16 or the policy developed by the Secretary under subsection 

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

18 State law regarding whether students at risk for anaphy19 laxis may self-administer medication. 

20 SEC. 5. SCHOOL-BASED FOOD ALLERGY MANAGEMENT 

21 GRANTS. 

22 (a) IN GENERAL.—The Secretary may award grants 

23 of not more than $50,000 to local educational agencies 

24 to assist such agencies with implementing voluntary food 

25 allergy management guidelines described in section 4. 


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1 (b) APPLICATION.— 

2 (1) IN GENERAL.—To be eligible to receive a 

3 grant under this section, a local educational agency 

4 shall submit an application to the Secretary at such 

5 time, in such manner, and including such informa6 tion as the Secretary may reasonably require. 

7 (2) CONTENTS.—Each application submitted 

8 under paragraph (1) shall include— 

9 (A) a certification that the food allergy 

10 management guidelines described in section 4 

11 have been adopted by the local educational 

12 agency; 

13 (B) a description of the activities to be 

14 funded by the grant in carrying out the food al15 lergy management guidelines, including— 

16 (i) how the guidelines will be carried 

17 out at individual schools served by the 

18 local educational agency; 

19 (ii) how the local educational agency 

20 will inform parents and students of the 

21 food allergy management guidelines in 

22 place; 

23 (iii) how school nurses, teachers, ad24 ministrators, and other school-based staff 

25 will be made aware of, and given training 


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1 on, when applicable, the food allergy man2 agement guidelines in place; and 

3 (iv) any other activities that the Sec4 retary determines appropriate; 

5 (C) an itemization of how grant funds re6 ceived under this section will be expended; 

7 (D) a description of how adoption of the 

8 guidelines and implementation of grant activi9 ties will be monitored; and 

10 (E) an agreement by the local educational 

11 agency to report information required by the 

12 Secretary to conduct evaluations under this sec13 tion. 

14 (c) USE OF FUNDS.—Each local educational agency 

15 that receives a grant under this section may use the grant 

16 funds for the following: 

17 (1) Creation of systems and databases related 

18 to creation, storage, and maintenance of student 

19 records. 

20 (2) Purchase of equipment or services, or both, 

21 related to the creation, storage, and maintenance of 

22 student records. 

23 (3) In partnership with local health depart24 ments, school nurse, teacher, and personnel training 

25 for food allergy management. 


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1 (4) Purchase and storage of limited medical 

2 supplies, including epinephrine and disposable wet 

3 wipes. 

4 (5) Programs that educate students as to the 

5 presence of, and policies and procedures in place re6 lated to, food allergies and anaphylactic shock. 

7 (6) Outreach to parents. 

8 (7) Any other activities consistent with the 

9 guidelines described in section 4. 

10 (d) DURATION OF AWARDS.—The Secretary may 

11 award grants under this section for a period of not more 

12 than 2 years. In the event the Secretary conducts a pro13 gram evaluation under this section, funding in the second 

14 year of the grant, where applicable, shall be contingent 

15 on a successful program evaluation by the Secretary after 

16 the first year. 

17 (e) MAXIMUM AMOUNT OF ANNUAL AWARDS.—A 

18 grant awarded under this section may not be made in an 

19 amount that is more than $50,000 annually. 

20 (f) PRIORITY.—In awarding grants under this sec21 tion, the Secretary shall give priority to local educational 

22 agencies that receive Federal funding under title I of the 

23 Elementary and Secondary Education Act of 1965 (20 

24 U.S.C. 6301 et seq.). 


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1 (g) ADMINISTRATIVE FUNDS.—A local educational 

2 agency that receives a grant under this section may use 

3 not more than 2 percent of the grant amount for adminis4 trative costs related to carrying out this section. 

5 (h) PROGRESS AND EVALUATIONS.—At the comple6 tion of the grant period referred to in subsection (d), a 

7 local educational agency shall provide the Secretary with 

8 information on the status of implementation of the food 

9 allergy management guidelines described in section 4. 

10 (i) SUPPLEMENT, NOT SUPPLANT.—Grant funds re11 ceived under this section shall be used to supplement, and 

12 not supplant, non-Federal funds and any other Federal 

13 funds available to carry out the activities described in this 

14 section. 

15 (j) AUTHORIZATION OF APPROPRIATIONS.—There 

16 are authorized to be appropriated to carry out this section 

17 $30,000,000 for fiscal year 2008 and such sums as may 

18 be necessary for each of the 4 succeeding fiscal years. 

19 SEC. 6. VOLUNTARY NATURE OF POLICY AND GUIDELINES. 

20 (a) IN GENERAL.—The policy developed by the Sec21 retary under section 4(a) and the food allergy manage22 ment guidelines contained in such policy are voluntary. 

23 Nothing in this Act or the policy developed by the Sec24 retary under section 4(a) shall be construed to require a 


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1 local educational agency or school to implement such pol2 icy or guidelines. 

3 (b) EXCEPTION.—Notwithstanding subsection (a), 

4 the Secretary may enforce an agreement by a local edu5 cational agency to implement food allergy management 

6 guidelines as a condition on the receipt of a grant under 

7 section 5. 

Æ 


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