Children’s asthma treatment grants program
Authority to make grants
In general
In addition to any other payments made under this chapter or title V of the Social Security Act [42 U.S.C. 701 et seq.], the Secretary shall award grants to eligible entities to carry out the following purposes:
To provide access to quality medical care for children who live in areas that have a high prevalence of asthma and who lack access to medical care.
To provide on-site education to parents, children, health care providers, and medical teams to recognize the signs and symptoms of asthma, and to train them in the use of medications to treat asthma and prevent its exacerbations.
To decrease preventable trips to the emergency room by making medication available to individuals who have not previously had access to treatment or education in the management of asthma.
To provide other services, such as smoking cessation programs, home modification, and other direct and support services that ameliorate conditions that exacerbate or induce asthma.
11 So in original. Two pars. (2) have been enacted. Certain projects
In making grants under paragraph (1), the Secretary may make grants designed to develop and expand the following projects:
Projects to provide comprehensive asthma services to children in accordance with the guidelines of the National Asthma Education and Prevention Program (through the National Heart, Lung and Blood Institute), including access to care and treatment for asthma in a community-based setting.
Projects to fully equip mobile health care clinics that provide preventive asthma care including diagnosis, physical examinations, pharmacological therapy, skin testing, peak flow meter testing, and other asthma-related health care services.
Projects to conduct validated asthma management education programs for patients with asthma and their families, including patient education regarding asthma management, family education on asthma management, and the distribution of materials, including displays and videos, to reinforce concepts presented by medical teams.
1 Award of grants
Application
In general
Required information
Requirement
Definition of eligible entity
Coordination with other children’s programs
An eligible entity shall identify in the plan submitted as part of an application for a grant under this section how the entity will coordinate operations and activities under the grant with—
other programs operated in the State that serve children with asthma, including any such programs operated under title V, XIX, or XXI of the Social Security Act [42 U.S.C. 701 et seq., 1396 et seq., 1397aa et seq.]; and
one or more of the following—
the child welfare and foster care and adoption assistance programs under parts B and E of title IV of such Act [42 U.S.C. 620 et seq., 670 et seq.];
the head start program established under the Head Start Act (42 U.S.C. 9831 et seq.);
the program of assistance under the special supplemental nutrition program for women, infants and children (WIC) under section 1786 of this title;
local public and private elementary or secondary schools; or
public housing agencies, as defined in section 1437a of this title.
Evaluation
An eligible entity that receives a grant under this section shall submit to the Secretary an evaluation of the operations and activities carried out under the grant that includes—
a description of the health status outcomes of children assisted under the grant;
an assessment of the utilization of asthma-related health care services as a result of activities carried out under the grant;
the collection, analysis, and reporting of asthma data according to guidelines prescribed by the Director of the Centers for Disease Control and Prevention; and
such other information as the Secretary may require.
Preference for States that allow students to self-administer medication to treat asthma and anaphylaxis
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:
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—
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;
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;
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
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.
Scope
An authorization granted under subparagraph (A) must allow the student involved to possess and use his or her medication—
while in school;
while at a school-sponsored activity, such as a sporting event; and
in transit to or from school or school-sponsored activities.
Duration of authorization
An authorization granted under subparagraph (A)—
must be effective only for the same school and school year for which it is granted; and
must be renewed by the parent or guardian each subsequent school year in accordance with this subsection.
Backup medication
Maintenance of information
School personnel administration of epinephrine
In determining the preference (if any) to be given to a State under this subsection, the Secretary shall give additional preference to a State that provides to the Secretary the certification described in subparagraph (G) and that requires that each public elementary school and secondary school in the State—
permits trained personnel of the school to administer epinephrine to any student of the school reasonably believed to be having an anaphylactic reaction;
maintains a supply of epinephrine in a secure location that is easily accessible to trained personnel of the school for the purpose of administration to any student of the school reasonably believed to be having an anaphylactic reaction; and
has in place a plan for having on the premises of the school during all operating hours of the school one or more individuals who are trained personnel of the school.
Civil liability protection law
Rule of construction
Definitions
For purposes of this subsection:
The terms “elementary school” and “secondary school” have the meaning given to those terms in section 7801 of title 20.
The term “health care practitioner” means a person authorized under law to prescribe drugs subject to section 353(b) of title 21.
The term “medication” means a drug as that term is defined in section 321 of title 21 and includes inhaled bronchodilators and auto-injectable epinephrine.
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.
The term “trained personnel” means, with respect to an elementary or secondary school, an individual—
who has been designated by the principal (or other appropriate administrative staff) of the school to administer epinephrine on a voluntary basis outside their scope of employment;
who has received training in the administration of epinephrine; and
whose training in the administration of epinephrine meets appropriate medical standards and has been documented by appropriate administrative staff of the school.
Authorization of appropriations
Source
(July 1, 1944, ch. 373, title III, § 399L, as added Pub. L. 106–310, div. A, title V, § 501,Notes
References in Text
Prior Provisions
Amendments
Effective Date of 2015 Amendment
Effective Date of 2004 Amendment
Findings of 2004 Amendment
Asthma is a chronic condition requiring lifetime, ongoing medical intervention.
In 1980, 6,700,000 Americans had asthma.
In 2001, 20,300,000 Americans had asthma; 6,300,000 children under age 18 had asthma.
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.
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).
In 2000, there were 465,000 asthma-related hospitalizations (214,000 of these involved children under 18 years of age).
In 2000, 4,487 people died from asthma, and of these 223 were children.
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.
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.
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.
Tragic refusals of schools to permit students to carry their inhalers and auto-injectable epinephrine have occurred, some resulting in death and spawning litigation.
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.
No school should interfere with the patient-physician relationship.
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.
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.”