University and Children’s Memorial Hospital, nearly 
6,000,000 children in the United States have food 
allergies. 
(2) Anaphylaxis, or anaphylactic shock, is a 
systemic allergic reaction that can kill within min-
utes. 
(3) More than 15 percent of school-aged chil-
dren with food allergies have had an allergic reaction 
in school. 
(4) Teenagers and young adults with food aller-
gies are at the highest risk of fatal food-induced an-
aphylaxis. 
(5) Individuals with food allergies who also have 
asthma may be at increased risk for severe or fatal 
food allergy reactions. 
(6) Studies have shown that 25 percent of epi-
nephrine administrations in schools involve individ-
uals with a previously unknown allergy. 
(7) The National Institute of Allergy and Infec-
tious Diseases (‘‘NIAID’’) has reported that delays 
in the administration of epinephrine to patients in 
anaphylaxis can result in rapid decline and death. 
NIAID recommends that epinephrine be given 
promptly to treat anaphylaxis. 
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(8) Physicians can provide standing orders to 
furnish a school with epinephrine for injection, and 
several States have passed laws to authorize this 
practice. 
(9) The American Academy of Allergy, Asthma, 
and Immunology recommends that epinephrine 
injectors should be included in all emergency medical 
treatment kits in schools. 
(10) The American Academy of Pediatrics rec-
ommends that an anaphylaxis kit should be kept 
with medications in each school and made available 
to trained staff for administration in an emergency. 
(11) According to the Food Allergy and Ana-
phylaxis Network, there are no contraindications to 
the use of epinephrine for a life-threatening reaction. 
SEC. 3. PREFERENCE FOR STATES REGARDING ADMINIS-
TRATION OF EPINEPHRINE BY SCHOOL PER-
SONNEL. 
Section 399L of the Public Health Service Act (42 
U.S.C. 280g(d)) is amended— 
(1) in subsection (a), by redesignating the sec-
ond paragraph (2) and paragraph (3) as paragraphs 
(3) and (4), respectively; and 
(2) by striking subsection (d) and inserting the 
following: 
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‘‘(d) PREFERENCE FOR STATES REGARDING MEDI-
CATION 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 each of the following requirements: 
‘‘(A) SELF-ADMINISTRATION
OF
MEDICA-
TION.— 
‘‘(i) IN
GENERAL.—The State shall 
require that each public elementary school 
and secondary school in that State will 
grant to any student in the school an au-
thorization for the self-administration of 
medication to treat that student’s asthma 
or anaphylaxis, if— 
‘‘(I) a health care practitioner 
prescribed the medication for use by 
the student during school hours and 
instructed the student in the correct 
and responsible use of the medication; 
‘‘(II) 
the 
student 
has 
dem-
onstrated to the health care practi-
tioner (or such practitioner’s des-
ignee) and the school nurse (if avail-
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able) the skill level necessary to use 
the medication and any device that is 
necessary to administer such medica-
tion as prescribed; 
‘‘(III) the health care practi-
tioner formulates a written treatment 
plan for managing asthma or anaphy-
laxis 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 sub-
mitted to the school any written docu-
mentation required by the school, in-
cluding the treatment plan formulated 
under subclause (III) and other docu-
ments related to liability. 
‘‘(ii) SCOPE.—An authorization grant-
ed under clause (i) shall allow the student 
involved to possess and use the student’s 
medication— 
‘‘(I) while in school; 
‘‘(II) while at a school-sponsored 
activity, such as a sporting event; and 
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‘‘(III) in transit to or from school 
or school-sponsored activities. 
‘‘(iii) 
DURATION
OF
AUTHORIZA-
TION.—An authorization granted under 
clause (i)— 
‘‘(I) shall 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. 
‘‘(iv) 
BACKUP
MEDICATION.—The 
State shall require that backup medication, 
if provided by a student’s parent or guard-
ian, be kept at a student’s school in a loca-
tion to which the student has prompt ac-
cess in the event of an asthma or anaphy-
laxis emergency. 
‘‘(v) MAINTENANCE
OF
INFORMA-
TION.—The State shall require that infor-
mation described in clauses (i)(III) and 
(i)(IV) be kept on file at the student’s 
school in a location easily accessible in the 
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event of an asthma or anaphylaxis emer-
gency. 
‘‘(vi) RULE
OF
CONSTRUCTION.— 
Nothing in this subparagraph creates a 
cause of action or in any other way in-
creases or diminishes the liability of any 
person under any other law. 
‘‘(B) SCHOOL
PERSONNEL
ADMINISTRA-
TION OF EPINEPHRINE.— 
‘‘(i) IN
GENERAL.—The State shall 
require that each public elementary school 
and secondary school in the State— 
‘‘(I) permit authorized personnel 
to administer epinephrine to any stu-
dent believed in good faith to be hav-
ing an anaphylactic reaction; and 
‘‘(II) maintain in a secure and 
easily accessible location a supply of 
epinephrine that— 
‘‘(aa) is prescribed under a 
standing protocol from a licensed 
physician; and 
‘‘(bb) is accessible to author-
ized personnel for administration 
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