Read the full stored bill text
SECOND REGULAR SESSION
HOUSE BILL NO. 2249
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE EAL Y .
5912H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal section 196.990, RSMo, and to enact in lieu thereof two new sections relating to
aller gies in child care facilities.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 196.990, RSMo, is repealed and two new sections enacted in lieu
2 thereof, to be known as sections 196.990 and 210.225, to read as follows:
196.990. 1. As used in this section, the following terms shall mean:
2 (1) "Administer", the direct application of an epinephrine [ auto-injector ] delivery
3 device to the body of an individual;
4 (2) "Authorized entity", any entity or or ganization at or in connection with which
5 aller gens capable of causing anaphylaxis may be present including, but not limited to,
6 qualified first responders, as such term is defined in section 321.621, restaurants, recreation
7 camps, youth sports leagues, child car e facilities, amusement parks, and sports arenas.
8 "Authorized entity" shall not include any public school or public charter school;
9 (3) "Epinephrine [ auto-injector ] delivery device ", a single-use device used for the
10 [ automatic injection ] delivery of a premeasured dose of epinephrine into the human body;
11 (4) "Physician", a physician licensed in this state under chapter 334;
12 (5) "Provide", the supply of one or more epinephrine [ auto-injectors ] delivery
13 devices to an individual;
14 (6) "Self-administration", a person's discretionary use of an epinephrine [ auto-
15 injector ] delivery device .
16 2. A physician may prescribe epinephrine [ auto-injectors ] delivery devices in the
17 name of an authorized entity for use in accordance with this section, and pharmacists,
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
18 physicians, and other persons authorized to dispense prescription medications may dispense
19 epinephrine [ auto-injectors ] delivery devices under a prescription issued in the name of an
20 authorized entity .
21 3. An authorized entity may acquire and stock a supply of epinephrine [ auto-
22 injectors ] delivery devices under a prescription issued in accordance with this section. Such
23 epinephrine [ auto-injectors ] delivery devices shall be stored in a location readily accessible
24 in an emer gency and in accordance with the epinephrine [ auto-injector's ] delivery device's
25 instructions for use and any additional requirements established by the department of health
26 and senior services by rule. An authorized entity shall designate employees or agents who
27 have completed the training required under this section to be responsible for the storage,
28 maintenance, and general oversight of epinephrine [ auto-injectors ] delivery devices acquired
29 by the authorized entity .
30 4. An authorized entity that acquires a supply of epinephrine [ auto-injectors ] delivery
31 devices under a prescription issued in accordance with this section shall ensure that:
32 (1) Expected epinephrine [ auto-injector ] delivery device users receive training in
33 recognizing symptoms of severe aller gic reactions including anaphylaxis and the use of
34 epinephrine [ auto-injectors ] delivery devices from a nationally recognized or ganization
35 experienced in training laypersons in emer gency health treatment or another entity or person
36 approved by the department of health and senior services;
37 (2) All epinephrine [ auto-injectors ] delivery devices are maintained and stored
38 according to the epinephrine [ auto-injector's ] delivery device's instructions for use;
39 (3) Any person who provides or administers an epinephrine [ auto-injector ] delivery
40 device to an individual who the person believes in good faith is experiencing anaphylaxis
41 activates the emer gency medical services system as soon as possible; and
42 (4) A proper review of all situations in which an epinephrine [ auto-injector ] delivery
43 device is used to render emer gency care is conducted.
44 5. Any authorized entity that acquires a supply of epinephrine [ auto-injectors ]
45 delivery devices under a prescription issued in accordance with this section shall notify the
46 emer gency communications district or the ambulance dispatch center of the primary provider
47 of emer gency medical services where the epinephrine [ auto-injectors ] delivery devices are to
48 be located within the entity's facility .
49 6. No person shall provide or administer an epinephrine [ auto-injector ] delivery
50 device to any individual who is under eighteen years of age without the verbal consent of a
51 parent or guardian who is present at the time when provision or administration of the
52 epinephrine [ auto-injector ] delivery device is needed. Provided, however , that a person may
53 provide or administer an epinephrine [ auto-injector ] delivery device to such an individual
54 without the consent of a parent or guardian if the parent or guardian is not physically present
HB 2249 2
55 and the person reasonably believes the individual shall be in imminent danger without the
56 provision or administration of the epinephrine [ auto-injector ] delivery device .
57 7. The following persons and entities shall not be liable for any injuries or related
58 damages that result from the administration or self-administration of an epinephrine [ auto-
59 injector ] delivery device in accordance with this section that may constitute ordinary
60 negligence:
61 (1) An authorized entity that possesses and makes available epinephrine [ auto-
62 injectors ] delivery devices and its employees, agents, and other trained persons;
63 (2) Any person who uses an epinephrine [ auto-injector ] delivery device made
64 available under this section;
65 (3) A physician that prescribes epinephrine [ auto-injectors ] delivery devices to an
66 authorized entity; or
67 (4) Any person or entity that conducts the training described in this section.
68
69 Such immunity does not apply to acts or omissions constituting a reckless disregard for the
70 safety of others or willful or wanton conduct. The administration of an epinephrine [ auto-
71 injector ] delivery device in accordance with this section shall not be considered the practice
72 of medicine. The immunity from liability provided under this subsection is in addition to and
73 not in lieu of that provided under section 537.037. An authorized entity located in this state
74 shall not be liable for any injuries or related damages that result from the provision or
75 administration of an epinephrine [ auto-injector ] delivery device by its employees or agents
76 outside of this state if the entity or its employee or agent is not liable for such injuries or
77 related damages under the laws of the state in which such provision or administration
78 occurred. No trained person who is in compliance with this section and who in good faith and
79 exercising reasonable care fails to administer an epinephrine [ auto-injector ] delivery device
80 shall be liable for such failure.
81 8. All basic life support ambulances and stretcher vans operated in the state shall be
82 equipped with epinephrine [ auto-injectors ] delivery devices and be staff ed by at least one
83 individual trained in the use of epinephrine [ auto-injectors ] delivery devices .
84 9. The provisions of this section shall apply in all counties within the state and any
85 city not within a county .
86 10. Nothing in this section shall be construed as superseding the provisions of section
87 167.630.
210.225. 1. This section shall be known and may be cited as "Elijah's Law".
2 2. (1) Befor e July 1, 2028, each licensed child car e pro vider shall adopt a policy
3 on allergy prev ention and res ponse with priority given to addr essing potentially deadly
HB 2249 3
4 food-borne allergies. Such policy shall contain, but shall not be limited to, the following
5 elements:
6 (a) Distinguishing between building-wide, r oom-level, and individual appr oaches
7 to allergy pr evention and management;
8 (b) Pr oviding an age-appr opriate r esponse to building-level and room-l evel
9 allergy education and preven tion;
10 (c) Describing the role of child care facility staff in determining how to manage
11 an allergy pr oblem, whether thr ough a plan prepa red for a child under Section 504 of
12 the Rehabilitation Act of 1973, as amended, for a child with an allergy that has been
13 determined to be a disability , an individualized health plan for a child who has an
14 allergy that is not disabling, or another allergy management plan;
15 (d) Describing the role of other children and par ents in cooperating to pr event
16 and mitigate allergies;
17 (e) Addr essing confidentiality issues involved with sharing medical information,
18 including specifying when par ental permission is req uired to make medical information
19 available; and
20 (f) Coordinating with the department of elementary and secondary education,
21 local health authorities, and other appr opriate entities to ensure efficient promulg ation
22 of accurate information and to ensure that existing child care facility safety and
23 envir onmental policies do not conflict.
24 (2) Such policies may contain information fr om or links to child car e facility
25 allergy pr evention information furnished by the Food Allergy & Anaphylaxis Network
26 or equivalent organization with a medical advisory board that has allergy specialists.
27 3. The department of elementary and secondary education shall, in cooperation
28 with any appr opriate profes sional association, develop a model policy or policies before
29 July 1, 2027.
✔
HB 2249 4