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(8) According to the Centers for Disease Con-
trol and Prevention, asthma is a common cause of 
missed school days, accounting for approximately 
14,000,000 missed school days annually. 
(9) According to the New England Journal of 
Medicine, working parents of children with asthma 
lose an estimated $1,000,000,000 a year in produc-
tivity. 
(10) At least 30 States have legislation pro-
tecting the rights of children to carry and self-ad-
minister asthma metered-dose inhalers, and at least 
18 States expand this protection to epinephrine 
auto-injectors. 
(11) Tragic refusals of schools to permit stu-
dents to carry their inhalers and auto-injectable epi-
nephrine have occurred, some resulting in death and 
spawning litigation. 
(12) School district medication policies must be 
developed with the safety of all students in mind. 
The immediate and correct use of asthma inhalers 
and auto-injectable epinephrine are necessary to 
avoid serious respiratory complications and improve 
health care outcomes. 
(13) No school should interfere with the pa-
tient-physician relationship.
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(14) Anaphylaxis, or anaphylactic shock, is a 
systemic allergic reaction that can kill within min-
utes. Anaphylaxis occurs in some asthma patients. 
According to the American Academy of Allergy, 
Asthma, and Immunology, people who have experi-
enced symptoms of anaphylaxis previously are at 
risk for subsequent reactions and should carry an 
epinephrine auto-injector with them at all times, if 
prescribed. 
(15) An increasing number of students and 
school staff have life-threatening allergies. Exposure 
to the affecting allergen can trigger anaphylaxis. An-
aphylaxis requires prompt medical intervention with 
an injection of epinephrine. 
SEC. 3. PREFERENCE FOR STATES THAT ALLOW STUDENTS 
TO 
SELF-ADMINISTER 
MEDICATION 
TO 
TREAT ASTHMA AND ANAPHYLAXIS. 
(a) AMENDMENTS.—Section 399L of the Public 
Health Service Act (42 U.S.C. 280g) is amended— 
(1) by redesignating subsection (d) as sub-
section (e); and 
(2) by inserting after subsection (c) the fol-
lowing:
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‘‘(d) PREFERENCE FOR STATES THAT ALLOW STU-
DENTS
TO SELF-ADMINISTER 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) IN GENERAL.—The State must re-
quire that each public elementary school and 
secondary school in that State will grant to any 
student in the school an authorization for the 
self-administration of medication to treat that 
student’s asthma or anaphylaxis, if— 
‘‘(i) a health care practitioner pre-
scribed the medication for use by the stu-
dent during school hours and instructed 
the student in the correct and responsible 
use of the medication; 
‘‘(ii) the student has demonstrated to 
the health care practitioner (or such prac-
titioner’s designee) and the school nurse (if 
available) the skill level necessary to use 
the medication and any device that is nec-
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essary to administer such medication as 
prescribed; 
‘‘(iii) the health care practitioner for-
mulates a written treatment plan for man-
aging asthma or anaphylaxis episodes of 
the student and for medication use by the 
student during school hours; and 
‘‘(iv) the student’s parent or guardian 
has completed and submitted to the school 
any written documentation required by the 
school, including the treatment plan for-
mulated under clause (iii) and other docu-
ments related to liability. 
‘‘(B) SCOPE.—An authorization granted 
under subparagraph (A) must allow the student 
involved to possess and use his or her medica-
tion— 
‘‘(i) while in school; 
‘‘(ii) while at a school-sponsored activ-
ity, such as a sporting event; and 
‘‘(iii) in transit to or from school or 
school-sponsored activities. 
‘‘(C) DURATION OF AUTHORIZATION.—An 
authorization 
granted 
under 
subparagraph 
(A)—
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‘‘(i) must be effective only for the 
same school and school year for which it is 
granted; and 
‘‘(ii) must be renewed by the parent 
or guardian each subsequent school year in 
accordance with this subsection. 
‘‘(D) BACKUP
MEDICATION.—The State 
must require that backup medication, if pro-
vided by a student’s parent or guardian, be 
kept at a student’s school in a location to which 
the student has immediate access in the event 
of an asthma or anaphylaxis emergency. 
‘‘(E) MAINTENANCE OF INFORMATION.— 
The State must require that information de-
scribed in subparagraphs (A)(iii) and (A)(iv) be 
kept on file at the student’s school in a location 
easily accessible in the event of an asthma or 
anaphylaxis emergency. 
‘‘(2) RULE
OF
CONSTRUCTION.—Nothing in 
this subsection creates a cause of action or in any 
other way increases or diminishes the liability of any 
person under any other law. 
‘‘(3) DEFINITIONS.—For purposes of this sub-
section:
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‘‘(A) The terms ‘elementary school’ and 
‘secondary school’ have the meaning given to 
those terms in section 9101 of the Elementary 
and Secondary Education Act of 1965. 
‘‘(B) The term ‘health care practitioner’ 
means a person authorized under law to pre-
scribe drugs subject to section 503(b) of the 
Federal Food, Drug, and Cosmetic Act. 
‘‘(C) The term ‘medication’ means a drug 
as that term is defined in section 201 of the 
Federal Food, Drug, and Cosmetic Act and in-
cludes 
inhaled 
bronchodilators 
and 
auto- 
injectable epinephrine. 
‘‘(D) The term ‘self-administration’ means 
a student’s discretionary use of his or her pre-
scribed asthma or anaphylaxis medication, pur-
suant to a prescription or written direction 
from a health care practitioner.’’. 
(b) APPLICABILITY.—The amendments made by this 
section shall apply only with respect to grants made on 
or after the date that is 9 months after the date of the 
enactment of this Act.