II 

110TH CONGRESS 

1ST SESSION S. 1232 

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 SENATE OF THE UNITED STATES 

APRIL 26, 2007 

Mr. DODD introduced the following bill; which was read twice and referred to 

the Committee on Health, Education, Labor, and Pensions 

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 2007’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds as follows: 

3 (1) Food allergy is an increasing food safety 

4 and public health concern in the United States, es5 pecially among students. 

6 (2) Peanut allergy doubled among children from 

7 1997 to 2002. 

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

9 nurses, 37 percent reported having at least 10 stu10 dents with severe food allergies and 62 percent re11 ported having at least 5. 

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

13 nurses surveyed reported that the number of stu14 dents in their school with food allergy had increased 

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

16 a decrease. 

17 (5) In a 2001 study of 32 fatal food-allergy in18 duced anaphylactic reactions (the largest study of its 

19 kind to date), more than half (53 percent) of the in20 dividuals were aged 18 or younger. 

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

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

23 nuts, peanuts, wheat, and soy. 

24 (7) Currently, there is no cure for food aller25 gies; strict avoidance of the offending food is the 

26 only way to prevent a reaction. 


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1 (8) Anaphylaxis is a systemic allergic reaction 

2 that can kill within minutes. 

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

4 of anaphylaxis outside the hospital setting, account5 ing for an estimated 30,000 emergency room visits, 

6 2,000 hospitalizations, and 150 to 200 deaths each 

7 year in the United States. 

8 (10) Fatalities from anaphylaxis are associated 

9 with a delay in the administration of epinephrine 

10 (adrenaline), or when epinephrine was not adminis11 tered at all. In a study of 13 food allergy-induced 

12 anaphylactic reactions in school-age children (6 fatal 

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

14 received epinephrine within 1 hour of ingesting the 

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

16 received epinephrine within 30 minutes. 

17 (11) The importance of managing life-threat18 ening food allergies in the school setting has been 

19 recognized by the American Medical Association, the 

20 American Academy of Pediatrics, the American 

21 Academy of Allergy, Asthma and Immunology, the 

22 American College of Allergy, Asthma and Immu23 nology, and the National Association of School 

24 Nurses. 


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1 (12) There are no Federal guidelines con2 cerning the management of life-threatening food al3 lergies in the school setting. 

4 (13) Three-quarters of the elementary school 

5 nurses surveyed reported developing their own train6 ing guidelines. 

7 (14) Relatively few schools actually employ a 

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

9 more than 1 school, and are often in charge of hun10 dreds if not thousands of students. 

11 (15) Parents of students with severe food aller12 gies often face entirely different food allergy man13 agement approaches when their students change 

14 schools or school districts. 

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

16 schools and day-care settings, delays in treatment 

17 were attributed to a failure to follow emergency 

18 plans, calling parents instead of administering emer19 gency medications, and an inability to administer ep20 inephrine. 

21 SEC. 3. DEFINITIONS. 

22 In this Act: 

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

24 educational agency’’, ‘‘secondary school’’, and ‘‘ele25 mentary school’’ have the meanings given the terms 


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1 in section 9101 of the Elementary and Secondary 

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

3 (2) SCHOOL.—The term ‘‘school’’ includes pub4 lic— 

5 (A) kindergartens; 

6 (B) elementary schools; and 

7 (C) secondary schools. 

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

9 the Secretary of Health and Human Services, in 

10 consultation with the Secretary of Education. 

11 SEC. 4. ESTABLISHMENT OF VOLUNTARY FOOD ALLERGY 

12 AND ANAPHYLAXIS MANAGEMENT POLICY. 

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

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

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

16 basis to manage the risk of food allergy and anaphy17 laxis in schools; and 

18 (2) make such policy available to local edu19 cational agencies and other interested individuals 

20 and entities to be implemented on a voluntary basis 

21 only. 

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

23 the Secretary under subsection (a) shall contain guidelines 

24 that address each of the following: 


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1 (1) Parental obligation to provide the school, 

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

3 (A) documentation from the student’s phy4 sician or nurse— 

5 (i) supporting a diagnosis of food al6 lergy and the risk of anaphylaxis; 

7 (ii) identifying any food to which the 

8 student is allergic; 

9 (iii) describing, if appropriate, any 

10 prior history of anaphylaxis; 

11 (iv) listing any medication prescribed 

12 for the student for the treatment of ana13 phylaxis; 

14 (v) detailing emergency treatment 

15 procedures in the event of a reaction; 

16 (vi) listing the signs and symptoms of 

17 a reaction; and 

18 (vii) assessing the student’s readiness 

19 for self-administration of prescription 

20 medication; and 

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

22 offered to the student by school food service 

23 personnel. 

24 (2) The creation and maintenance of an indi25 vidual health care plan tailored to the needs of each 


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1 student with a documented risk for anaphylaxis, in2 cluding any procedures for the self-administration of 

3 medication by such students in instances where— 

4 (A) the students are capable of self-admin5 istering medication; and 

6 (B) such administration is not prohibited 

7 by State law. 

8 (3) Communication strategies between indi9 vidual schools and local providers of emergency med10 ical services, including appropriate instructions for 

11 emergency medical response. 

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

13 anaphylactic causative agents in classrooms and 

14 common school areas such as cafeterias. 

15 (5) The dissemination of information on life16 threatening food allergies to school staff, parents, 

17 and students, if appropriate by law. 

18 (6) Food allergy management training of school 

19 personnel who regularly come into contact with stu20 dents with life-threatening food allergies. 

21 (7) The authorization and training of school 

22 personnel to administer epinephrine when the school 

23 nurse is not immediately available. 


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1 (8) The timely accessibility of epinephrine by 

2 school personnel when the nurse is not immediately 

3 available. 

4 (9) Extracurricular programs such as non-aca5 demic outings and field trips, before- and after6 school programs, and school-sponsored programs 

7 held on weekends that are addressed in the indi8 vidual health care plan. 

9 (10) The collection and publication of data for 

10 each administration of epinephrine to a student at 

11 risk for anaphylaxis. 

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

13 or the policy developed by the Secretary under subsection 

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

15 State law regarding whether students at risk for anaphy16 laxis may self-administer medication. 

17 SEC. 5. SCHOOL-BASED FOOD ALLERGY MANAGEMENT 

18 GRANTS. 

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

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

21 to assist such agencies with implementing voluntary food 

22 allergy management guidelines described in section 4. 

23 (b) APPLICATION.— 

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

25 grant under this section, a local educational agency 


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1 shall submit an application to the Secretary at such 

2 time, in such manner, and including such informa3 tion as the Secretary may reasonably require. 

4 (2) CONTENTS.—Each application submitted 

5 under paragraph (1) shall include— 

6 (A) a certification that the food allergy 

7 management guidelines described in section 4 

8 have been adopted by the local educational 

9 agency; 

10 (B) a description of the activities to be 

11 funded by the grant in carrying out the food al12 lergy management guidelines, including— 

13 (i) how the guidelines will be carried 

14 out at individual schools served by the 

15 local educational agency; 

16 (ii) how the local educational agency 

17 will inform parents and students of the 

18 food allergy management guidelines in 

19 place; 

20 (iii) how school nurses, teachers, ad21 ministrators, and other school-based staff 

22 will be made aware of, and given training 

23 on, when applicable, the food allergy man24 agement guidelines in place; and 


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1 (iv) any other activities that the Sec2 retary determines appropriate; 

3 (C) an itemization of how grant funds re4 ceived under this section will be expended; 

5 (D) a description of how adoption of the 

6 guidelines and implementation of grant activi7 ties will be monitored; and 

8 (E) an agreement by the local educational 

9 agency to report information required by the 

10 Secretary to conduct evaluations under this sec11 tion. 

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

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

14 funds for the following: 

15 (1) Creation of systems and databases related 

16 to creation, storage, and maintenance of student 

17 records. 

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

19 related to the creation, storage, and maintenance of 

20 student records. 

21 (3) In partnership with local health depart22 ments, school nurse, teacher, and personnel training 

23 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 is 

16 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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