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Lynda Mitchell, MA
To Increase Your Understanding of
Existing and Pending Laws
regarding:
• Epinephrine in Schools
• School Food Allergy Management
Guidelines
• Other State Laws

What You Can Do as an Advocate

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

2
State Epinephrine Self Carry Laws
State Stock Epinephrine Laws
Federal Bill for Stocking Epinephrine

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

3







Allows for students to self-carry their
prescribed epinephrine auto-injectors
Requires written order by licensed
practitioner
Every state except New York
Many state laws use language “self-carry to
self-inject”

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

4
11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

5








Allows schools to get epinephrine by order of
designated clinicians
Allow designated clinicians to order for a
school or school district
Allows state school board to set up processes
and specific rules
“Good Samaritan” provisions

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

6










Authorizes staff to use a stock epinephrine
auto-injector if someone suffers anaphylaxis
in the school setting.
~ 25% of episodes of anaphylaxis in the
school setting are first time reactions
Four states “mandate” that schools have and
use stock epinephrine
22 states “authorize” schools to stock
epinephrine
6 states have pending legislation

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

7
States with Stock Epinephrine Laws

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

8








The School Access to Emergency Epinephrine
Act
Passed by the House of Representatives
Passed the U.S. Senate S.1503 on Oct. 31.
Encourages states to adopt laws to require
schools to stock epinephrine for emergency
use.
Incentives (in the form of preferences in the
competition for federal asthma control
program grants) for states to pass mandatory
epinephrine stocking laws.

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

9
AAFA/KFA Position:




S. 1503 sends the right message from the
federal government about the gravity of
anaphylaxis and the importance of
epinephrine stocking.
The School Access to Emergency Epinephrine
Act will be a great asset in the effort to make
sure all children are safe in every school
across the nation.

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

10






Big step in the right direction!
This bill is not a mandate to put epinephrine
in schools
The lion’s share of work still lay ahead for
advocates to get stock epinephrine mandates
passed in their states.

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

11
State Guidelines
Federal Guidelines

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

12
• All are voluntary (not mandatory)
• Many are modeled after the
guidelines developed by the first state
to develop guidelines (Massachusetts)
• State guidelines incorporate
applicable state law into the guidelines
(self-carry, nurse practice law, good
Samaritan provisions, etc.)

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

13
•The scope of the problem of childhood food allergies
and anaphylaxis.
•Types of detailed policies and protocols that should be
in place in every school to help prevent allergic reaction
emergencies and deaths from anaphylaxis,
•The systematic planning and multi-disciplinary team
approach needed prior to school entry by the student
with life-threatening food allergies,
•The school’s role in preventing exposure to specific
allergens,
•Emergency management should a life-threatening
allergic event occur, and
•The roles of specific staff members in the care of the
student with a life-threatening allergic condition.
Ref: Massachusetts Dept. of Education: Managing
Life-Threatening Food Allergies in Schools.

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

14
11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

15
• Part of Food Safety and
Modernization Act, 2010
• Voluntary (not mandatory)
• States without guidelines can adopt
as their own and modify based upon
state law (self-carry, nurse practice
law, etc.)
• Federal guidelines do not pre-empt
state laws such as self-carry, etc.

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

16
Released on October 30

• Voluntary Guidelines for Managing Food
Allergies In Schools and Early Care and Education
Programs
• Food Allergy Guidelines FAQs
Download at:
http://www.cdc.gov/healthyyouth/foodallergies/

11/2/2013

Kids With Food Allergies A division of the Asthma and Allergy
Foundation of America

17
Purpose
• To support implementation of food allergy
management and prevention practices in schools and
early childhood education (ECE) programs
• To provide, practical information, planning steps
and strategies for reducing allergic reactions and
responding to life-threatening reactions
• To educate parents, district administrators, school
administrators and staff, and ECE program
administrators and staff
• Guide improvements in existing food allergy
management plans and practices
• To help schools and ECE programs develop a plan
where none exists
Ref: CDC Food Allergy Guidelines FAQs
11/2/2013

Kids With Food Allergies A division of the Asthma and Allergy
Foundation of America

18
• Individualized plan
• Communication strategies
• Risk reduction strategies
• Dissemination of general info about life-threatening nature
of food allergy to staff, parents, children
• Training
• Authorize use and training for epinephrine auto-injectors
• Provisions for timely accessibility of epi when school nurse is
not available
• Plans for field trips, extra-curricular activities, before and
after school programs
• Record keeping for epinephrine administration
• Does not pre-empt state laws
https://www.govtrack.us/congress/bills/111/s510/text
(see section 112)
11/2/2013

Kids With Food Allergies A division of the Asthma and Allergy
Foundation of America

19
• If you are in a state that has guidelines already, your “local
education agency” will likely develop and use policy on those
state guidelines
• If you are in a state without guidelines, state departments of
education and “local education agencies” may adopt the federal
guidelines and modify to include any state-specific laws
• If you are in a state without guidelines, “local education
agencies” may choose to follow these federal guidelines to
develop school policies for food allergy management and in doing
so, will be eligible for funding incentives to assist with training,
materials, etc. *
• You can advocate for your local school agencies to voluntarily
adopt these guidelines
• If your school adopts these guidelines, you can get involved to
help shape the policies that get developed and implemented.

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

20
www.StateHonorRoll.org
Asthma and Allergy Foundation of
America
11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

21




Review of state-level laws and policies in
place to protect students with asthma,
allergies and anaphylaxis
Covers:
◦
◦
◦
◦

Medication policies
Awareness policies
School nurse staffing ratios
Environmental quality policies

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

22
AAFA State Honor Roll 2013

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

23








Sign up for AAFA’s advocacy center
Email list for advocacy updates
Tools to look up and send correspondence to
legislators
Learn about bills
AAFA has advocacy staff to assist you
cqrcengage.com/aafa/

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

24
Founder and Senior Director
lmitchell@kidswithfoodallergies.org
Kidswithfoodallergies.org
Facebook.com/kidswithfoodallergies
@kfatweets

11/2/2013

Kids With Food Allergies
A division of the Asthma and Allergy Foundation of America

25

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School Laws Protecting Students with Food Allergies

  • 2. To Increase Your Understanding of Existing and Pending Laws regarding: • Epinephrine in Schools • School Food Allergy Management Guidelines • Other State Laws What You Can Do as an Advocate 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 2
  • 3. State Epinephrine Self Carry Laws State Stock Epinephrine Laws Federal Bill for Stocking Epinephrine 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 3
  • 4.     Allows for students to self-carry their prescribed epinephrine auto-injectors Requires written order by licensed practitioner Every state except New York Many state laws use language “self-carry to self-inject” 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 4
  • 5. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 5
  • 6.     Allows schools to get epinephrine by order of designated clinicians Allow designated clinicians to order for a school or school district Allows state school board to set up processes and specific rules “Good Samaritan” provisions 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 6
  • 7.      Authorizes staff to use a stock epinephrine auto-injector if someone suffers anaphylaxis in the school setting. ~ 25% of episodes of anaphylaxis in the school setting are first time reactions Four states “mandate” that schools have and use stock epinephrine 22 states “authorize” schools to stock epinephrine 6 states have pending legislation 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 7
  • 8. States with Stock Epinephrine Laws 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 8
  • 9.      The School Access to Emergency Epinephrine Act Passed by the House of Representatives Passed the U.S. Senate S.1503 on Oct. 31. Encourages states to adopt laws to require schools to stock epinephrine for emergency use. Incentives (in the form of preferences in the competition for federal asthma control program grants) for states to pass mandatory epinephrine stocking laws. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 9
  • 10. AAFA/KFA Position:   S. 1503 sends the right message from the federal government about the gravity of anaphylaxis and the importance of epinephrine stocking. The School Access to Emergency Epinephrine Act will be a great asset in the effort to make sure all children are safe in every school across the nation. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 10
  • 11.    Big step in the right direction! This bill is not a mandate to put epinephrine in schools The lion’s share of work still lay ahead for advocates to get stock epinephrine mandates passed in their states. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 11
  • 12. State Guidelines Federal Guidelines 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 12
  • 13. • All are voluntary (not mandatory) • Many are modeled after the guidelines developed by the first state to develop guidelines (Massachusetts) • State guidelines incorporate applicable state law into the guidelines (self-carry, nurse practice law, good Samaritan provisions, etc.) 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 13
  • 14. •The scope of the problem of childhood food allergies and anaphylaxis. •Types of detailed policies and protocols that should be in place in every school to help prevent allergic reaction emergencies and deaths from anaphylaxis, •The systematic planning and multi-disciplinary team approach needed prior to school entry by the student with life-threatening food allergies, •The school’s role in preventing exposure to specific allergens, •Emergency management should a life-threatening allergic event occur, and •The roles of specific staff members in the care of the student with a life-threatening allergic condition. Ref: Massachusetts Dept. of Education: Managing Life-Threatening Food Allergies in Schools. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 14
  • 15. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 15
  • 16. • Part of Food Safety and Modernization Act, 2010 • Voluntary (not mandatory) • States without guidelines can adopt as their own and modify based upon state law (self-carry, nurse practice law, etc.) • Federal guidelines do not pre-empt state laws such as self-carry, etc. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 16
  • 17. Released on October 30 • Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs • Food Allergy Guidelines FAQs Download at: http://www.cdc.gov/healthyyouth/foodallergies/ 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 17
  • 18. Purpose • To support implementation of food allergy management and prevention practices in schools and early childhood education (ECE) programs • To provide, practical information, planning steps and strategies for reducing allergic reactions and responding to life-threatening reactions • To educate parents, district administrators, school administrators and staff, and ECE program administrators and staff • Guide improvements in existing food allergy management plans and practices • To help schools and ECE programs develop a plan where none exists Ref: CDC Food Allergy Guidelines FAQs 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 18
  • 19. • Individualized plan • Communication strategies • Risk reduction strategies • Dissemination of general info about life-threatening nature of food allergy to staff, parents, children • Training • Authorize use and training for epinephrine auto-injectors • Provisions for timely accessibility of epi when school nurse is not available • Plans for field trips, extra-curricular activities, before and after school programs • Record keeping for epinephrine administration • Does not pre-empt state laws https://www.govtrack.us/congress/bills/111/s510/text (see section 112) 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 19
  • 20. • If you are in a state that has guidelines already, your “local education agency” will likely develop and use policy on those state guidelines • If you are in a state without guidelines, state departments of education and “local education agencies” may adopt the federal guidelines and modify to include any state-specific laws • If you are in a state without guidelines, “local education agencies” may choose to follow these federal guidelines to develop school policies for food allergy management and in doing so, will be eligible for funding incentives to assist with training, materials, etc. * • You can advocate for your local school agencies to voluntarily adopt these guidelines • If your school adopts these guidelines, you can get involved to help shape the policies that get developed and implemented. 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 20
  • 21. www.StateHonorRoll.org Asthma and Allergy Foundation of America 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 21
  • 22.   Review of state-level laws and policies in place to protect students with asthma, allergies and anaphylaxis Covers: ◦ ◦ ◦ ◦ Medication policies Awareness policies School nurse staffing ratios Environmental quality policies 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 22
  • 23. AAFA State Honor Roll 2013 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 23
  • 24.      Sign up for AAFA’s advocacy center Email list for advocacy updates Tools to look up and send correspondence to legislators Learn about bills AAFA has advocacy staff to assist you cqrcengage.com/aafa/ 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 24
  • 25. Founder and Senior Director lmitchell@kidswithfoodallergies.org Kidswithfoodallergies.org Facebook.com/kidswithfoodallergies @kfatweets 11/2/2013 Kids With Food Allergies A division of the Asthma and Allergy Foundation of America 25