IIB 
110TH CONGRESS 
2D SESSION 
H. R. 2063 
IN THE SENATE OF THE UNITED STATES 
APRIL 9, 2008 
Received; read twice and referred to the Committee on Health, Education, 
Labor, and Pensions 
AN ACT 
To direct the Secretary of Health and Human Services, 
in consultation with the Secretary of Education, to de-
velop a voluntary policy for managing the risk of food 
allergy and anaphylaxis in schools. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Food Allergy and Ana-
phylaxis Management Act of 2008’’. 
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 children from 
1997 to 2002. 
(3) In a 2004 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. 
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(7) Currently, there is no cure for food aller-
gies; strict avoidance of the offending food is the 
only way to prevent a reaction. 
(8) Anaphylaxis is a systemic allergic reaction 
that can kill within minutes. 
(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-
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nology, and the National Association of School 
Nurses. 
(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: 
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(1) ESEA DEFINITIONS.—The terms ‘‘local 
educational agency’’, ‘‘secondary school’’, and ‘‘ele-
mentary school’’ have the meanings given the terms 
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) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services, in 
consultation with the Secretary of Education. 
SEC. 4. ESTABLISHMENT OF VOLUNTARY FOOD ALLERGY 
AND ANAPHYLAXIS MANAGEMENT POLICY. 
(a) ESTABLISHMENT.—Not later than 1 year after 
the date of enactment of this Act, the Secretary 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, including licensed child care providers, 
preschool programs, and Head Start, to be imple-
mented on a voluntary basis only. 
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(b) CONTENTS.—The voluntary policy developed by 
the Secretary under subsection (a) shall contain guidelines 
that address each of the following: 
(1) Parental obligation to provide the school, 
prior to the start of every school year, with— 
(A) documentation from the student’s phy-
sician or nurse— 
(i) supporting a diagnosis of food al-
lergy and the risk of anaphylaxis; 
(ii) identifying any food to which the 
student is allergic; 
(iii) describing, if appropriate, any 
prior history of anaphylaxis; 
(iv) listing any medication prescribed 
for the student for the treatment of ana-
phylaxis; 
(v) detailing emergency treatment 
procedures in the event of a reaction; 
(vi) listing the signs and symptoms of 
a reaction; and 
(vii) assessing the student’s readiness 
for 
self-administration 
of 
prescription 
medication; and 
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(B) a list of substitute meals that may be 
offered to the student by school food service 
personnel. 
(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-
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. 
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(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. 
(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 Secretary 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. VOLUNTARY NATURE OF POLICY AND GUIDELINES. 
The policy developed by the Secretary under section 
4(a) and the food allergy management guidelines con-
tained in such policy are voluntary. Nothing in this Act 
or the policy developed by the Secretary under section 4(a) 
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shall be construed to require a local educational agency 
or school to implement such policy or guidelines. 
Passed the House of Representatives April 8, 2008. 
Attest: 
LORRAINE C. MILLER, 
Clerk. 
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