[108th Congress Public Law 377]
[From the U.S. Government Printing Office]
[DOCID: f:publ377.108]
[[Page 2201]]
ASTHMATIC SCHOOLCHILDREN'S TREATMENT AND HEALTH MANAGEMENT ACT OF 2004
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Public Law 108-377
108th Congress
An Act
To give a preference regarding States that require schools to allow
students to self-administer medication to treat that student's asthma or
anaphylaxis, and for other purposes. <<NOTE: Oct. 30, 2004 - [H.R.
2023]>>
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled, <<NOTE: Asthmatic
Schoolchildren's Treatment and Health Management Act of 2004.>>
SECTION 1. SHORT TITLE. <<NOTE: 42 USC 201 note.>>
This Act may be cited as the ``Asthmatic Schoolchildren's Treatment
and Health Management Act of 2004''.
SEC. 2. FINDINGS. <<NOTE: 42 USC 280g note.>>
The Congress finds the following:
(1) Asthma is a chronic condition requiring lifetime,
ongoing medical intervention.
(2) In 1980, 6,700,000 Americans had asthma.
(3) In 2001, 20,300,000 Americans had asthma; 6,300,000
children under age 18 had asthma.
(4) The prevalence of asthma among African-American children
was 40 percent greater than among Caucasian children, and more
than 26 percent of all asthma deaths are in the African-American
population.
(5) In 2000, there were 1,800,000 asthma-related visits to
emergency departments (more than 728,000 of these involved
children under 18 years of age).
(6) In 2000, there were 465,000 asthma-related
hospitalizations (214,000 of these involved children under 18
years of age).
(7) In 2000, 4,487 people died from asthma, and of these 223
were children.
(8) According to the Centers for Disease Control 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 productivity.
(10) At least 30 States have legislation protecting the
rights of children to carry and self-administer asthma metered-
dose inhalers, and at least 18 States expand this protection to
epinephrine auto-injectors.
(11) Tragic refusals of schools to permit students to carry
their inhalers and auto-injectable epinephrine have occurred,
some resulting in death and spawning litigation.
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(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 patient-physician
relationship.
(14) Anaphylaxis, or anaphylactic shock, is a systemic
allergic reaction that can kill within minutes. Anaphylaxis
occurs in some asthma patients. According to the American
Academy of Allergy, Asthma, and Immunology, people who have
experienced 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. Anaphylaxis 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 subsection (e); and
(2) by inserting after subsection (c) the following:
``(d) Preference for States That Allow Students 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 require 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 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 demonstrated to the
health care practitioner (or such practitioner's
designee) and the school nurse (if available) the
skill level necessary to use the medication and
any device that is necessary to administer such
medication as prescribed;
``(iii) the health care practitioner
formulates a written treatment plan for managing
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 formulated under clause (iii)
and other documents related to liability.
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``(B) Scope.--An authorization granted under
subparagraph (A) must allow the student involved to
possess and use his or her medication--
``(i) while in school;
``(ii) while at a school-sponsored activity,
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)--
``(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 provided 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 described 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 subsection:
``(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 prescribe 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 includes inhaled
bronchodilators and auto-injectable epinephrine.
``(D) The term `self-administration' means a
student's discretionary use of his or her prescribed
asthma or anaphylaxis medication, pursuant to a
prescription or written direction from a health care
practitioner.''.
(b) <<NOTE: 42 USC 280g note.>> 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.
SEC. 4. SENSE OF CONGRESS COMMENDING CDC FOR ITS STRATEGIES FOR
ADDRESSING ASTHMA WITHIN A COORDINATED SCHOOL HEALTH
PROGRAM.
The Congress--
(1) commends the Centers for Disease Control and Prevention
for identifying and creating ``Strategies for Addressing Asthma
Within a Coordinated School Program'' for schools to address
asthma; and
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(2) encourages all schools to review these strategies and
adopt policies that will best meet the needs of their student
population.
Approved October 30, 2004.
LEGISLATIVE HISTORY--H.R. 2023 (S. 2815):
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HOUSE REPORTS: No. 108-606, Pt. 1 (Comm. on Energy and Commerce).
SENATE REPORTS: No. 108-395 accompanying S. 2815 (Comm. on Health,
Education, Labor, and Pensions)
CONGRESSIONAL RECORD, Vol. 150 (2004):
Oct. 5, considered and passed House.
Oct. 11, considered and passed Senate.
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