I 
109TH CONGRESS 
2D SESSION 
H. R. 6290 
To direct the Secretary of Health and Human Services, in consultation 
with the Secretary of Education, to develop a 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 
SEPTEMBER 29, 2006 
Mrs. LOWEY introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Education and the Workforce, 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 de-
velop a policy for managing the risk of food allergy 
and anaphylaxis in schools, to establish school-based food 
allergy management grants, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Food Allergy and Ana-
phylaxis Management Act of 2006’’. 
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SEC. 2. FINDINGS. 
Congress finds as follows: 
(1) Food allergy is an increasing food safety 
and public health concern in the United States, es-
pecially among students. 
(2) Peanut allergy doubled among students 
from 1997 to 2002. 
(3) In a 2003 survey of 400 elementary school 
nurses, 37 percent reported having at least 10 stu-
dents with severe food allergies and 62 percent re-
ported having at least 5. 
(4) Forty-four percent of the elementary school 
nurses surveyed reported that the number of stu-
dents in their school with food allergy had increased 
over the past 5 years, while only 2 percent reported 
a decrease. 
(5) In a 2001 study of 32 fatal food-allergy in-
duced anaphylactic reactions (the largest study of its 
kind to date), more than half (53 percent) of the in-
dividuals were aged 18 or younger. 
(6) Eight foods account for 90 percent of all 
food-allergic reactions: milk, eggs, fish, shellfish, tree 
nuts, peanuts, wheat, and soy. 
(7) Currently, there is no cure for food aller-
gies; strict avoidance of the offending food is the 
only way to prevent a reaction. 
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(8) Anaphylaxis, or anaphylactic shock, is a 
systemic allergic reaction that can kill within min-
utes. 
(9) Food-allergic reactions are the leading cause 
of anaphylaxis outside the hospital setting, account-
ing for an estimated 30,000 emergency room visits, 
2,000 hospitalizations, and 150 to 200 deaths each 
year in the United States. 
(10) Fatalities from anaphylaxis are associated 
with a delay in the administration of epinephrine 
(adrenaline), or when epinephrine was not adminis-
tered at all. In a study of 13 food allergy-induced 
anaphylactic reactions in school-age children (6 fatal 
and 7 near fatal), only 2 of the children who died 
received epinephrine within 1 hour of ingesting the 
allergen, and all but 1 of the children who survived 
received epinephrine within 30 minutes. 
(11) The importance of managing life-threat-
ening food allergies in the school setting has been 
recognized by the American Medical Association, the 
American Academy of Pediatrics, the American 
Academy of Allergy, Asthma and Immunology, the 
American College of Allergy, Asthma and Immu-
nology, and the National Association of School 
Nurses. 
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(12) There are no Federal guidelines con-
cerning the management of life-threatening food al-
lergies in the school setting. 
(13) Three-quarters of the elementary school 
nurses surveyed reported developing their own train-
ing guidelines. 
(14) Relatively few schools actually employ a 
full-time school nurse. Many are forced to cover 
more than 1 school, and are often in charge of hun-
dreds if not thousands of students. 
(15) Parents of students with severe food aller-
gies often face entirely different food allergy man-
agement approaches when their students change 
schools or school districts. 
(16) In a study of food allergy reactions in 
schools and day-care settings, delays in treatment 
were attributed to a failure to follow emergency 
plans, calling parents instead of administering emer-
gency medications, and an inability to administer ep-
inephrine. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) ESEA DEFINITIONS.—The terms ‘‘local 
educational agency’’, ‘‘secondary school’’, and ‘‘ele-
mentary school’’ have the meanings given the terms 
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in section 9101 of the Elementary and Secondary 
Education Act of 1965 (20 U.S.C. 7801). 
(2) SCHOOL.—The term ‘‘school’’ includes pub-
lic— 
(A) kindergartens; 
(B) elementary schools; and 
(C) secondary schools. 
(3) SECRETARIES.—The term ‘‘Secretaries’’ 
means the Secretary of Health and Human Services, 
in consultation with the Secretary of Education. 
SEC. 4. ESTABLISHMENT OF FOOD ALLERGY AND ANAPHY-
LAXIS MANAGEMENT POLICY. 
(a) ESTABLISHMENT.—Not later than 1 year after 
the date of enactment of this Act, the Secretaries shall— 
(1) develop a policy to be used on a voluntary 
basis to manage the risk of food allergy and anaphy-
laxis in schools; and 
(2) make such policy available to local edu-
cational agencies and other interested individuals 
and entities. 
(b) CONTENTS.—The policy developed by the Secre-
taries under subsection (a) shall contain guidelines that 
address each of the following: 
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(1) Parental obligation to provide the school, 
prior to the start of every school year, with docu-
mentation from the student’s physician or nurse— 
(A) supporting a diagnosis of food allergy 
and anaphylaxis; 
(B) identifying any food to which the stu-
dent is allergic; 
(C) describing, if appropriate, any prior 
history of anaphylaxis; 
(D) listing any medication prescribed for 
the student for the treatment of anaphylaxis; 
(E) detailing emergency treatment proce-
dures in the event of a reaction; 
(F) listing the signs and symptoms of a re-
action; 
(G) assessing the student’s readiness for 
self-administration of prescription medication; 
and 
(H) providing a list of substitute meals 
that may be offered by school food service per-
sonnel. 
(2) The creation and maintenance of an indi-
vidual health care plan tailored to the needs of each 
student with a documented risk for anaphylaxis, in-
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cluding any procedures for the self-administration of 
medication by such students in instances where— 
(A) the students are capable of self-admin-
istering medication; and 
(B) such administration is not prohibited 
by State law. 
(3) Communication strategies between indi-
vidual schools and local providers of emergency med-
ical services, including appropriate instructions for 
emergency medical response. 
(4) Strategies to reduce the risk of exposure to 
anaphylactic causative agents in classrooms and 
common school areas such as cafeterias. 
(5) The dissemination of information on life- 
threatening food allergies to school staff, parents, 
and students, if appropriate by law. 
(6) Food allergy management training of school 
personnel who regularly come into contact with stu-
dents with life-threatening food allergies. 
(7) The authorization and training of school 
personnel to administer epinephrine when the school 
nurse is not immediately available. 
(8) The timely accessibility of epinephrine by 
school personnel when the nurse is not immediately 
available. 
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(9) Extracurricular programs such as non-aca-
demic outings and field trips, before- and after- 
school programs, and school-sponsored programs 
held on weekends that are addressed in the indi-
vidual health care plan. 
(10) The collection and publication of data for 
each administration of epinephrine to a student at 
risk for anaphylaxis. 
(c) RELATION TO STATE LAW.—Nothing in this Act 
or the policy developed by the Secretaries under subsection 
(a) shall be construed to preempt State law, including any 
State law regarding whether students at risk for anaphy-
laxis may self-administer medication. 
SEC. 5. SCHOOL-BASED FOOD ALLERGY MANAGEMENT 
GRANTS. 
(a) IN
GENERAL.—The Secretaries may award 
grants of not more than $50,000 to local educational 
agencies to assist such agencies with implementing food 
allergy management guidelines contained in the policy de-
scribed in section 4. 
(b) APPLICATION.— 
(1) IN GENERAL.—To be eligible to receive a 
grant under this section, a local educational agency 
shall submit an application to the Secretaries at 
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such time, in such manner, and including such infor-
mation as the Secretaries may reasonably require. 
(2) CONTENTS.—Each application submitted 
under paragraph (1) shall include— 
(A) a certification that the food allergy 
management guidelines contained in the policy 
described in section 4 have been adopted by the 
local educational agency; 
(B) a description of the activities to be 
funded by the grant in carrying out the food al-
lergy management guidelines, including— 
(i) how the guidelines will be carried 
out at individual schools served by the 
local educational agency; 
(ii) how the local educational agency 
will inform parents and students of the 
food allergy management guidelines in 
place; 
(iii) how school nurses, teachers, ad-
ministrators, and other school-based staff 
will be made aware of, and given training 
on, when applicable, the food allergy man-
agement guidelines in place; and 
(iv) any other activities that the Sec-
retaries determine appropriate; 
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(C) a budget table that itemizes the 
amounts of grant funds received under this sec-
tion that will be expended on various activities; 
(D) a description of how adoption of the 
guidelines and implementation of grant activi-
ties will be monitored; and 
(E) an assurance that the local educational 
agency will provide such information and co-
operate in any evaluation that the Secretaries 
may conduct under this section. 
(c) USE OF FUNDS.—Each local educational agency 
that receives a grant under this section may use the grant 
funds for the following: 
(1) Creation of systems and databases related 
to creation, storage, and maintenance of student 
records. 
(2) Purchase of equipment or services, or both, 
related to the creation, storage, and maintenance of 
student records. 
(3) In partnership with local health depart-
ments, school nurse, teacher, and personnel training 
for food allergy management. 
(4) Purchase and storage of limited medical 
supplies, including epinephrine and disposable wet 
wipes. 
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