Protecting Children in Day Care From Anaphylaxis

TMA Written Testimony for HB 1849

House Public Health Committee
HB 1849 by Rep. Klick

March 13, 2019

The Texas Medical Association and the Texas Pediatric Society, representing more than 53,000 physician and medical students, support House Bill 1849 by Rep. Stephanie Klick with recommendations that will align physician requirements in existing statute. Representative Klick recognizes that while we have come far in protecting our young Texans at risk of anaphylaxis by providing access to lifesaving epinephrine in schools, and soon to colleges across the state, our youngest Texans in day care settings are still at risk.

Anaphylaxis is a severe, whole-body allergic reaction, and can be fatal. An anaphylactic reaction requires immediate medical response that would include an injection of epinephrine and a visit to an emergency department. Immediate access to epinephrine during anaphylaxis is critical. And epinephrine is the only treatment for anaphylaxis.

Food allergies are a common cause of anaphylaxis. An estimated one in 13 U.S. children – about 160,000 in Texas – have food allergies.  Up to 25 percent of children could have a serious reaction without having a history or diagnosis of food allergy.  Insect stings are another cause of anaphylaxis, along with medications and latex.

Emergencies happen everywhere in our communities and the Texas Legislature has addressed this issue in our public and private schools, and in our institutions of higher education. Our youngest Texans should have the same protection. This legislation would ensure young children placed in day care settings would have access to epinephrine for an anaphylactic emergency.

This bill addresses the issue and provides clear guidance in establishing this in the Human Resources Code, however we request that the author and committee consider including the following items in statute to align with the existing law for schools in Chapter 38 of the Education Code:  

  1. A person authorized and trained to administer an epinephrine auto-injector must be present during all hours the facility is open.
  2. The epinephrine auto-injectors must be stored in a secure location and be easily accessible to persons authorized and trained to administer epinephrine auto-injectors.
  3. There is a reporting requirement that the administration of an epinephrine auto-injector must be reported to certain entities, such as the school (in this case, it would be the facility owner), the physician who prescribed it, and the commissioner of state health services. 
  4. Day care staff must notify the child’s parents if the EpiPen has been administered.

Thank you, Representative Klick, and the committee for addressing this issue – and know that we are ready to assist in this important lifesaving effort.

Last Updated On

March 13, 2019

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