AllergyHome proudly introduces our guest contributor, Charlotte W. Collins, JD. Ms. Collins is Senior Vice President for Policy and Programs for Asthma and Allergy Foundation of America. She is a fierce advocate and leader in food allergy and asthma advocacy efforts, including laws regarding stock epinephrine in US schools.Thank you Charlotte for joining us.

 Victory is not complete until every school in every state stocks epinephrine auto-injectors for appropriate use by trained, responsible adults.

“The journey of a thousand miles begins with a single step” 

When Lao-tse said “The journey of a thousand miles begins with a single step”, he was not referring to the steps of the state capitol, yet that image emerges as I look back on major food allergy victories in 2013.  Lawmakers in 17 states enacted new requirements for schools to keep stock epinephrine auto-injectors on hand just in case someone has a severe allergic reaction while at school.  These laws will save the lives of children with food and other allergies.

Epinephrine availability

Currently, parents in virtually every state can take comfort that their school-aged child may self-administer epinephrine auto-injectors at school.  Yet, not every child who needs an epinephrine auto injector has one available at school.  At-risk children may not have a severe allergy diagnosis; the first reaction may take place at school.  Others may have a prescribed epinephrine auto injector, yet they may have left it at home, on a school bus or elsewhere.  Laws meant to protect children in the “war on drugs” had the unintended impact of preventing well meaning adults from using another person’s prescribed medicine on a child experiencing an emergency.

Getting stock epinephrine laws passed in over half the states did not just happen

Getting stock epinephrine laws passed in over half the states did not just happen.  Someone, a parent, teacher, school nurse or administrator, took the first step.  They told a representative in their state’s general assembly (where laws are made) that their schools are not equipped to save a child’s life if anaphylaxis occurs. They soon found out that in order to allow schools to stock epinephrine for emergencies, states had to change the law.  These changes include:  allowing school authorities to order epinephrine directly and to maintain a supply at schools, allowing responsible adults to use the medicine on a child during an emergency, and protecting those who help from lawsuits.

Rather than give up because of complex lawmaking required, advocates persevered.  Moving a step further, they included important provisions in their proposed stock epinephrine laws, like emergency procedures in cases of severe allergies, staff training to recognize signs and symptoms of anaphylaxis, and training to administer the drug.

First Steps in Establishing Stock Epinephrine Laws

Getting a law passed is a series of challenging steps.  Finding a sponsor is a major milestone.  Ideally, a sponsor is someone who is strong enough to get a bill passed through a number of committees even before a full vote by all members.  In most states, this has to be done both in the state house of representatives and in the state senate.  Going to hearings, meeting with representatives in their offices, traveling to the state capitol, persuading and organizing others to go along, too, are all part of the process for advocates.  Then, there are the emails, fighting for media coverage, overcoming fear of public speaking to tell your story, and knowing when to fight or compromise.

Resource for Stock Epinephrine Advocacy

At the Asthma and Allergy Foundation of America, we support the essential work of these advocates with resources and advocacy efforts, alerting others in the states where these laws are proposed, providing a statement that advocates could use when they contact their elected representative and more.  We let legislators know that we support these laws, track progress and celebrate victories.

A stock epinephrine law is passed. Now what?

For the 17 states that passed school stocking laws in 2013, the next step is pull through.  Laws simply highlight that a problem exists.  Schools will have to solve it by implementing emergency protocols and procedures for ordering and maintaining a supply of epinephrine auto injectors.  Training and awareness is critical.  Paying for the medication, training, and awareness activity is implied, but not presumed.

We cannot rest

Tragically, anaphylaxis kills children every year, including some who suffer allergic reactions while at school.  School boards and district staff have many priorities.  Parents and others who organize to advocate consistently and diligently will keep the focus on school children with allergies.  Victory is not complete until every school in every state stocks epinephrine auto-injectors for appropriate use by trained, responsible adults.

At the end of 2014, not every school will meet this standard.  However, with strength, focus and determination, we will take the next meaningful steps.

For more information about stock epinephrine in schools see:

1) AAFA Resources, Stocking Epinephrine in Schools

2)Kids With Food Allergies Foundation Webinar, “Epinephrine in Schools: What you need to know”

Click here to sign up to receive action alerts from AAFA.

Charlotte W. Collins, JD is Senior Vice President of Policy and Programs for the Asthma and Allergy Foundation of America (AAFA).  Before joining AAFA, she taught graduate courses in public health, law, policy and management at the George Washington and Georgetown Universities.  For over a decade, she worked with advocates to expand health coverage for the uninsured in the State of Tennessee, acted as general counsel, and ran government relations for a safety net hospital system in Memphis.

She is principal investigator for several projects at AAFA including the State Honor Roll of Asthma and Allergy Policies for Schools.  Since 2008, Collins has worked with fellow patient organization colleagues advocating the patient’s perspective in designing and conducting comparative effectiveness research.  In 1995, she won the Nelson Mandela Award for Health and Human Rights from the Henry J. Kaiser Family Foundation.  She received a JD from Georgetown University Law Center. The Baltimore native now resides with her husband in nearby Elkridge, Maryland.