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An Open Letter to NYS Governor Andrew Cuomo

The hard work of getting legislation passed to allow public venues to stock and administer epinephrine in an emergency was accomplished in June of this year. But it’s not over “till the fat lady sings,” as they say in baseball. Governor Cuomo has yet to sign the bill so our association is sending him the following letter. Please send the governor an e-mail encouraging to Please Sign EATA Now!

Jon Terry, founder Allergy Advocacy Association New York Govenor Andrew Cuomo
NY Govenor Andrew Cuomo (l)
Jon Terry, founder Allergy Advocacy Association (r)

The Honorable Andrew M. Cuomo
Governor of New York State

Jon Terry, founder
Allergy Advocacy Association

The Emergency Allergy Treatment Act

July 7, 2016

Dear Governor Andrew Cuomo;

Greetings. The Allergy Advocacy Association respectfully requests that you please sign S6800 the Emergency Allergy Treatment Act into law immediately.

This law is sponsored by Assemblyman Tom Abinanti and Senator Kemp Hannon. The bill would authorize, but not mandate, public venues such as restaurants, youth organizations, sports leagues, theme parks, sport arenas, day care and educational facilities to stock and administer epinephrine auto-injector (EAI) devices in an emergency to individuals who appear to experience anaphylactic symptoms.

Governor, now that this bill has passed the Assembly and the Senate with broad-based bipartisan support, if you sign it into law you just might save the life of one of the many individuals who have been identified as being at risk for anaphylaxis. In October 2013, the Journal of Allergy and Clinical Immunology (JACI) published a landmark survey by the Asthma and Allergy Foundation of America (AAFA), which found that severe life-threatening allergic reactions – anaphylaxis – are common in the U.S. According to the survey of 1,000 adults, anaphylaxis very likely occurs in nearly 1-in-50 Americans (1.6%), and the rate is probably higher, close to 1-in-20 (5.1%).

An attack of anaphylaxis can include closure of the airways, a precipitous drop in blood pressure, vomiting and shock. Death from anaphylaxis may occur if there is any delay in administering epinephrine after accidental exposure. The largest number of allergic reactions occurs among children and adolescents. Food Allergies Research and Education (FARE), a nationwide NFP supporter of similar bills, notes that one in every 13 children in the U.S. under the age of 18 has a food allergy. Other studies show that sixteen to 18% of food allergic reactions happen in school. And the number of children with life-threatening food allergies has increased by approximately 50% from 1997 to 2011.

Are other states working to improve public access to epinephrine? Yes they are. With the passage of EATA New York is now actively participating in a positive public health initiative that is trending all across America. Since 2013 over half the states in our country have taken legislative action to improve public access to Epi-Pens[^TM^](http://www.mylan.com/en/products/product-catalog/product-profile-page?id=6749373C-9FB4-4E2B-A856-3771B31F68F3). Twenty-eight states have already passed laws authorizing “entity stocking” of epinephrine in case of anaphylaxis emergencies. Those states include Colorado, Florida, Michigan, North Carolina, Ohio and Wisconsin. It is important to note that here in NY the provisions of the EATA bill are very similar to what other states have already approved.

Does the stocking of non-specifically prescribed epinephrine save lives? It certainly seems to do so in public schools. The Nurse Authorize Stock Epinephrine Act (NASE) allows school districts to maintain a supply of undesignated epinephrine auto-injectors and have trained personnel to recognize and respond to anaphylaxis of any person that the staff member believes is having an anaphylactic reaction. NASE makes EAI devices available as a stocked emergency medicine readily available for school nurses to administer. It has already been enacted in 49 states.

Earlier this month, the Illinois State Board of Education released new data on the use of undesignated or “stock” epinephrine (i.e. epinephrine not prescribed for a specific child) in Illinois schools for the 2014-2015 school year. Among the findings:

  • Seventeen districts representing 59 public schools reported 65 administrations of undesignated epinephrine.
  • Six school districts reported more than 1 undesignated epinephrine administration while six individual schools reported at least 2 administrations.
  • Among the students and staff members who received epinephrine, 27 (41.5 percent) had a previously-known diagnosis of a severe allergy, while 38 (58.5 percent) were not previously diagnosed with a severe allergy.

This new report confirms that the availability of stock epinephrine has been critical to the health and well-being of students with unknown allergies at risk for a possibly fatal attack of anaphylaxis. With continuing improved public access to Epi-Pens via NASE and “entity stocking,” our association firmly believes that the lives of individuals with life-threatening allergies will be much better protected.

How difficult will it be to implement EATA? There already exists public access to life-saving emergency medical equipment in many public buildings. Regarding acute myocardial infarction (AMI) or heart attacks, many public venues in New York State have already taken action to assist individuals experiencing AMI symptoms by installing automated external defibrillator (AED) devices in easily accessible locations. With simple audio and visual commands, AEDs are designed to be easy for a layperson to operate, and the use of AEDs is taught in many first aid, certified first responder, and basic life support (BLS) level cardiopulmonary resuscitation (CPR) classes. According to the National Institutes of Health, about one million people have a heart attack each year in the United States. Protocols for implementation of EATA would hopefully follow in the footsteps of existing regulations for AEDs.

Our association remains committed to supporting improved access to life-saving epinephrine for individuals with life-threatening allergies throughout New York State. The vision of the Allergy Advocacy Association is a clear and direct one. “Not another life lost to anaphylaxis; not another life lost to ANY life-threatening allergies!”

Gov. Cuomo, please sign the Emergency Allergy Treatment Act NOW! Thank you for your time and attention. Best wishes! 

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