29–006 

113TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 113–182 

SCHOOL ACCESS TO EMERGENCY EPINEPHRINE ACT 

JULY 30, 2013.—Committed to the Committee of the Whole House on the State of 

the Union and ordered to be printed 

Mr. UPTON, from the Committee on Energy and Commerce, 

submitted the following 

R E P O R T 

[To accompany H.R. 2094] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 2094) to amend the Public Health Service Act to increase the preference given, in awarding certain asthma-related 

grants, to certain States (those allowing trained school personnel to 

administer epinephrine and meeting other related requirements), 

having considered the same, report favorably thereon without 

amendment and recommend that the bill do pass. 

CONTENTS 

Page 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation .................................................................... 2 

Hearings ................................................................................................................... 2 

Committee Consideration ........................................................................................ 3 

Committee Votes ...................................................................................................... 3 

Committee Oversight Findings ............................................................................... 3 

Statement of General Performance Goals and Objectives .................................... 3 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 3 

Earmark, Limited Tax Benefits, and Limited Tariff Benefits ............................. 3 

Committee Cost Estimate ....................................................................................... 3 

Congressional Budget Office Estimate ................................................................... 3 

Federal Mandates Statement ................................................................................. 4 

Duplication of Federal Programs ............................................................................ 4 

Disclosure of Directed Rule Makings ..................................................................... 5 

Advisory Committee Statement .............................................................................. 5 

Applicability to Legislative Branch ........................................................................ 5 

Section-by-Section Analysis of the Legislation ...................................................... 5 

Changes in Existing Law Made by the Bill, as Reported ..................................... 5 


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1http://pediatrics.aappublications.org/content/early/2011/06/16/peds.2011–0204.abstract 

2http://www.cdc.gov/healthyyouth/foodallergies/ 

PURPOSE AND SUMMARY

H.R. 2094, the ‘‘School Access to Emergency Epinephrine Act,’’ 

was introduced on May 22, 2013, by Rep. Phil Roe (R-TN) and Rep. 

Steny Hoyer (D-MD) and subsequently referred to the Committee 

on Energy and Commerce. 

The legislation would amend the Public Health Service Act to 

give preference in awarding certain asthma grants to States that 

agree to establish school-based emergency epinephrine programs 

that meet specific requirements. 

BACKGROUND AND NEED FOR LEGISLATION

Nearly 6 million children have food allergies, and many of them 

have had severe reactions. A study in the Journal of Pediatrics suggests these rates are rising.1 Severe allergic reactions can lead to 

anaphylaxis, a systemic reaction that causes swelling that can obstruct airwaves and lead to death. According to the Centers for Disease Control and Prevention (CDC), more than 15% of school-aged 

children with food allergies have had a reaction at school where 

teachers and other school personnel may be unprepared to handle 

the emergency.2

Epinephrine is the most effective treatment for anaphylaxis, and 

it can be administered simply and quickly using an epipen. Children who have had a severe allergic reaction often carry an epipen 

and self-medicate as needed. In 2004, Congress enacted H.R. 2023, 

the ‘‘Asthma Schoolchildren’s Treatment and Health Management 

Act,’’ which created the Children’s Asthma Treatment Grants Program and authorized preferences for States that allow students to 

self-administer medication to treat asthma and anaphylaxis in accordance with specified requirements. The legislation did not address the needs of students who may have severe allergies, but 

have not been diagnosed. 

H.R. 2094, the ‘‘School Access to Emergency Epinephrine Act,’’ 

would amend the Children’s Asthma Treatment Grants Program 

and other asthma programs administered by the Department of 

Health and Human Services (HHS) to aid schools in preparing to 

treat severe allergic reactions. The bill would give preference in 

awarding certain asthma-related grants to States that allow school 

personnel to administer epinephrine to a student in an emergency 

and meet other requirements. To receive the preference, States 

would have to certify that their civil liability laws provide adequate 

civil liability protection to school personnel who administer epinephrine in an emergency. School personnel would be required to 

have appropriate training. Schools would be required to have a 

plan in place for having at least one trained employee on site during school hours and to maintain a supply of epinephrine. 

HEARINGS

The Committee on Energy and Commerce has not held hearings 

on the legislation. 


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COMMITTEE CONSIDERATION

On July 17, 2013, the full Committee met in open markup session and approved H.R. 2094 by unanimous consent. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list the record votes on the motion 

to report legislation and amendments thereto. A motion by Mr. 

Upton to order H.R. 2094, reported to the House, without amendment, was agreed to by unanimous consent. There were no record 

votes taken in connection with ordering H.R. 2094 reported. 

COMMITTEE OVERSIGHT FINDINGS

Pursuant to clause 3(c)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee has not held oversight or legislative hearings on this legislation. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

The goal of the legislation is to give preference in awarding certain asthma grants to States that allow trained school personnel to 

administer epinephrine in an emergency. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

In compliance with clause 3(c)(2) of rule XIII of the Rules of the 

House of Representatives, the Committee finds that H.R. 2094, the 

‘‘School Access to Emergency Epinephrine Act’’, would result in no 

new or increased budget authority, entitlement authority, or tax 

expenditures or revenues. 

EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS

In compliance with clause 9(e), 9(f), and 9(g) of rule XXI of the 

House of Representatives, the Committee finds that H.R. 2094, the 

‘‘School Access to Emergency Epinephrine Act’’ contains no earmarks, limited tax benefits, or limited tariff benefits. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE ESTIMATE

Pursuant to clause 3(c)(3) of rule XIII of the Rules of the House 

of Representatives, the following is the cost estimate provided by 

the Congressional Budget Office pursuant to section 402 of the 

Congressional Budget Act of 1974: 


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JULY 22, 2013. 

Hon. FRED UPTON, 

Chairman, Committee on Energy and Commerce, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 2094, the School Access 

to Emergency Epinephrine Act. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Santiago Vallinas. 

Sincerely, 

DOUGLAS W. ELMENDORF. 

Enclosure. 

H.R. 2094—School Access to Emergency Epinephrine Act 

H.R. 2094 would authorize the Secretary of Health and Human 

Services, in awarding asthma-treatment grants, to give preference 

to states that require schools to: 

• Maintain an emergency supply of epinephrine, 

• Permit trained personnel of the school to administer epinephrine, and 

• Have a plan for ensuring trained personnel are available 

to administer epinephrine during all hours of the school day. 

In addition, to obtain the preference for grants under the bill, 

states would have to certify that their laws provide civil liability 

protection to school personnel that administer epinephrine. 

The bill would not change the purposes for which the Secretary 

makes asthma-related grants or the amount of funding available. 

CBO estimates that implementing H.R. 2094 would not have a significant impact on the federal budget. Enacting H.R. 2094 would 

not affect direct spending or revenues; therefore, pay-as-you-go procedures do not apply. 

H.R. 2094 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would 

impose no costs on state, local, or tribal governments. 

The CBO staff contact for this estimate is Santiago Vallinas. The 

estimate was approved by Holly Harvey, Deputy Assistant Director 

for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates prepared by the Director of the Congressional Budget Office 

pursuant to section 423 of the Unfunded Mandates Reform Act. 

DUPLICATION OF FEDERAL PROGRAMS

No provision of H.R. 2094, the ‘‘School Access to Emergency Epinephrine Act,’’ establishes or reauthorizes a program of the Federal 

Government known to be duplicative of another Federal program, 

a program that was included in any report from the Government 

Accountability Office to Congress pursuant to section 21 of Public 

Law 111–139, or a program related to a program identified in the 

most recent Catalog of Federal Domestic Assistance. 


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DISCLOSURE OF DIRECTED RULE MAKINGS

The Committee estimates that enacting H.R. 2094, the ‘‘School 

Access to Emergency Epinephrine Act,’’ specifically would not direct specific rule making within the meaning of 5 U.S.C. 551. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act were created by this legislation. 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment or access to public services or 

accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

This Act may be cited as the ‘‘School Access to Emergency Epinephrine Act.’’ 

Section 2. Additional preference to pertain States that allow trained 

school personnel to administer epinephrine 

Section 2 would amend the Children’s Asthma Treatment Grants 

Program and other asthma programs administered by HHS to aid 

in preparing schools to treat severe allergic reactions in emergency 

situations. The section would provide a preference in awarding certain asthma-related grants to States that allow school personnel to 

administer epinephrine to a student of the school reasonably believed to be having an anaphylactic reaction. To receive such preference, States would have to certify that their civil liability laws 

provide adequate civil liability protection to school personnel who 

administer epinephrine under such circumstances. School personnel would be required to receive training in the administration 

of epinephrine. Schools would be required to have a plan in place 

for having at least one trained employee on site during school 

hours and to maintain a supply of epinephrine in a secure location 

that is easily accessible. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (new matter is printed in italic 

and existing law in which no change is proposed is shown in 

roman): 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC 

HEALTH SERVICE 

* * * * * * * 


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PART P—ADDITIONAL PROGRAMS 

SEC. 399L. CHILDREN’S ASTHMA TREATMENT GRANTS PROGRAM. 

(a) * * * 

* * * * * * * 

(d) PREFERENCE FOR STATES THAT ALLOW STUDENTS TO SELF-AD- MINISTER 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) * * * 

* * * * * * * 

(F) SCHOOL PERSONNEL ADMINISTRATION OF EPINEPHRINE.—In determining the preference (if any) to be given to 

a State under this subsection, the Secretary shall give additional preference to a State that provides to the Secretary 

the certification described in subparagraph (G) and that requires that each public elementary school and secondary 

school in the State— 

(i) permits trained personnel of the school to administer epinephrine to any student of the school reasonably believed to be having an anaphylactic reaction; 

(ii) maintains a supply of epinephrine in a secure location that is easily accessible to trained personnel of 

the school for the purpose of administration to any student of the school reasonably believed to be having an 

anaphylactic reaction; and 

(iii) has in place a plan for having on the premises 

of the school during all operating hours of the school 

one or more individuals who are trained personnel of 

the school. 

(G) CIVIL LIABILITY PROTECTION LAW.—The certification 

required in subparagraph (F) shall be a certification made 

by the State attorney general that the State has reviewed 

any applicable civil liability protection law to determine the 

application of such law with regard to elementary and secondary school trained personnel who may administer epinephrine to a student reasonably believed to be having an 

anaphylactic reaction and has concluded that such law 

provides adequate civil liability protection applicable to 

such trained personnel. For purposes of the previous sentence, the term ‘‘civil liability protection law’’ means a State 

law offering legal protection to individuals who give aid on 

a voluntary basis in an emergency to an individual who is 

ill, in peril, or otherwise incapacitated. 

* * * * * * * 

(3) DEFINITIONS.—For purposes of this subsection: 

(A) * * * 

* * * * * * * 

(E) The term ‘‘trained personnel’’ means, with respect to 

an elementary or secondary school, an individual— 


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(i) who has been designated by the principal (or 

other appropriate administrative staff) of the school to 

administer epinephrine on a voluntary basis outside 

their scope of employment; 

(ii) who has received training in the administration 

of epinephrine; and 

(iii) whose training in the administration of epinephrine meets appropriate medical standards and has 

been documented by appropriate administrative staff of 

the school. 

* * * * * * * 

Æ 


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