II 

112TH CONGRESS 

1ST SESSION S. 1884 

To provide States with incentives to require elementary schools and secondary 

schools to maintain, and permit school personnel to administer, epinephrine at schools. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 17, 2011 

Mr. DURBIN (for himself and Mr. KIRK) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To provide States with incentives to require elementary 

schools and secondary schools to maintain, and permit 

school personnel to administer, epinephrine at schools. 

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 ‘‘School Access to Emer5 gency Epinephrine Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) According to research funded by the Food 

9 Allergy Initiative and conducted by Northwestern 


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1 University and Children’s Memorial Hospital, nearly 

2 6,000,000 children in the United States have food 

3 allergies. 

4 (2) Anaphylaxis, or anaphylactic shock, is a 

5 systemic allergic reaction that can kill within min6 utes. 

7 (3) More than 15 percent of school-aged chil8 dren with food allergies have had an allergic reaction 

9 in school. 

10 (4) Teenagers and young adults with food aller11 gies are at the highest risk of fatal food-induced an12 aphylaxis. 

13 (5) Individuals with food allergies who also have 

14 asthma may be at increased risk for severe or fatal 

15 food allergy reactions. 

16 (6) Studies have shown that 25 percent of epi17 nephrine administrations in schools involve individ18 uals with a previously unknown allergy. 

19 (7) The National Institute of Allergy and Infec20 tious Diseases (‘‘NIAID’’) has reported that delays 

21 in the administration of epinephrine to patients in 

22 anaphylaxis can result in rapid decline and death. 

23 NIAID recommends that epinephrine be given 

24 promptly to treat anaphylaxis. 


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1 (8) Physicians can provide standing orders to 

2 furnish a school with epinephrine for injection, and 

3 several States have passed laws to authorize this 

4 practice. 

5 (9) The American Academy of Allergy, Asthma, 

6 and Immunology recommends that epinephrine 

7 injectors should be included in all emergency medical 

8 treatment kits in schools. 

9 (10) The American Academy of Pediatrics rec10 ommends that an anaphylaxis kit should be kept 

11 with medications in each school and made available 

12 to trained staff for administration in an emergency. 

13 (11) According to the Food Allergy and Ana14 phylaxis Network, there are no contraindications to 

15 the use of epinephrine for a life-threatening reaction. 

16 SEC. 3. PREFERENCE FOR STATES REGARDING ADMINIS17 TRATION OF EPINEPHRINE BY SCHOOL PER18 SONNEL. 

19 Section 399L of the Public Health Service Act (42 

20 U.S.C. 280g(d)) is amended— 

21 (1) in subsection (a), by redesignating the sec22 ond paragraph (2) and paragraph (3) as paragraphs 

23 (3) and (4), respectively; and 

24 (2) by striking subsection (d) and inserting the 

25 following: 


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1 ‘‘(d) PREFERENCE FOR STATES REGARDING MEDI2 CATION TO TREAT ASTHMA AND ANAPHYLAXIS.— 

3 ‘‘(1) PREFERENCE.—The Secretary, in making 

4 any grant under this section or any other grant that 

5 is asthma-related (as determined by the Secretary) 

6 to a State, shall give preference to any State that 

7 satisfies each of the following requirements: 

8 ‘‘(A) SELF-ADMINISTRATION OF MEDICA9 TION.— 

10 ‘‘(i) IN GENERAL.—The State shall 

11 require that each public elementary school 

12 and secondary school in that State will 

13 grant to any student in the school an au14 thorization for the self-administration of 

15 medication to treat that student’s asthma 

16 or anaphylaxis, if— 

17 ‘‘(I) a health care practitioner 

18 prescribed the medication for use by 

19 the student during school hours and 

20 instructed the student in the correct 

21 and responsible use of the medication; 

22 ‘‘(II) the student has dem23 onstrated to the health care practi24 tioner (or such practitioner’s des25 ignee) and the school nurse (if availVerDate Mar 15 2010 00:56 Nov 19, 2011 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1884.IS S1884

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1 able) the skill level necessary to use 

2 the medication and any device that is 

3 necessary to administer such medica4 tion as prescribed; 

5 ‘‘(III) the health care practi6 tioner formulates a written treatment 

7 plan for managing asthma or anaphy8 laxis episodes of the student and for 

9 medication use by the student during 

10 school hours; and 

11 ‘‘(IV) the student’s parent or 

12 guardian has completed and sub13 mitted to the school any written docu14 mentation required by the school, in15 cluding the treatment plan formulated 

16 under subclause (III) and other docu17 ments related to liability. 

18 ‘‘(ii) SCOPE.—An authorization grant19 ed under clause (i) shall allow the student 

20 involved to possess and use the student’s 

21 medication— 

22 ‘‘(I) while in school; 

23 ‘‘(II) while at a school-sponsored 

24 activity, such as a sporting event; and 


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1 ‘‘(III) in transit to or from school 

2 or school-sponsored activities. 

3 ‘‘(iii) DURATION OF AUTHORIZA4 TION.—An authorization granted under 

5 clause (i)— 

6 ‘‘(I) shall be effective only for the 

7 same school and school year for which 

8 it is granted; and 

9 ‘‘(II) must be renewed by the 

10 parent or guardian each subsequent 

11 school year in accordance with this 

12 subsection. 

13 ‘‘(iv) BACKUP MEDICATION.—The 

14 State shall require that backup medication, 

15 if provided by a student’s parent or guard16 ian, be kept at a student’s school in a loca17 tion to which the student has prompt ac18 cess in the event of an asthma or anaphy19 laxis emergency. 

20 ‘‘(v) MAINTENANCE OF INFORMA21 TION.—The State shall require that infor22 mation described in clauses (i)(III) and 

23 (i)(IV) be kept on file at the student’s 

24 school in a location easily accessible in the 


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1 event of an asthma or anaphylaxis emer2 gency. 

3 ‘‘(vi) RULE OF CONSTRUCTION.— 

4 Nothing in this subparagraph creates a 

5 cause of action or in any other way in6 creases or diminishes the liability of any 

7 person under any other law. 

8 ‘‘(B) SCHOOL PERSONNEL ADMINISTRA9 TION OF EPINEPHRINE.— 

10 ‘‘(i) IN GENERAL.—The State shall 

11 require that each public elementary school 

12 and secondary school in the State— 

13 ‘‘(I) permit authorized personnel 

14 to administer epinephrine to any stu15 dent believed in good faith to be hav16 ing an anaphylactic reaction; and 

17 ‘‘(II) maintain in a secure and 

18 easily accessible location a supply of 

19 epinephrine that— 

20 ‘‘(aa) are prescribed under a 

21 standing protocol from a licensed 

22 physician; and 

23 ‘‘(bb) are accessible to au24 thorized personnel for adminisVerDate Mar 15 2010 00:56 Nov 19, 2011 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1884.IS S1884

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1 tration to a student having an 

2 anaphylactic reaction. 

3 ‘‘(ii) LIABILITY AND STATE LAW.— 

4 ‘‘(I) GOOD SAMARITAN LAW.— 

5 The State shall have a State law en6 suring that elementary school and sec7 ondary school employees and agents, 

8 including a physician providing a pre9 scription for school epinephrine, will 

10 incur no liability related to the admin11 istration of epinephrine to any student 

12 believed in good faith to be having an 

13 anaphylactic reaction, except in the 

14 case of willful or wanton conduct. 

15 ‘‘(II) STATE LAW.—Nothing in 

16 this subparagraph shall be construed 

17 to preempt State law, including any 

18 State law regarding whether students 

19 with allergy or asthma may possess 

20 and self-administer medication. 

21 ‘‘(2) DEFINITIONS.—For purposes of this sub22 section: 

23 ‘‘(A) The terms ‘elementary school’ and 

24 ‘secondary school’ have the meaning given to 


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1 those terms in section 9101 of the Elementary 

2 and Secondary Education Act of 1965. 

3 ‘‘(B) The term ‘health care practitioner’ 

4 means a person authorized under law to pre5 scribe drugs subject to section 503(b) of the 

6 Federal Food, Drug, and Cosmetic Act. 

7 ‘‘(C) The term ‘medication’ means a drug 

8 as that term is defined in section 201 of the 

9 Federal Food, Drug, and Cosmetic Act and in10 cludes inhaled bronchodilators and epinephrine. 

11 ‘‘(D) The term ‘self-administration’ means 

12 a student’s discretionary use of his or her pre13 scribed asthma or anaphylaxis medication, pur14 suant to a prescription or written direction 

15 from a health care practitioner. 

16 ‘‘(E) The term ‘authorized personnel’ 

17 means the school nurse or, if the school nurse 

18 is absent, an individual who has been des19 ignated by the school nurse and has received 

20 training in the administration of epinephrine.’’. 

Æ 


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