Read the full stored bill text
SECOND REGULAR SESSION
HOUSE COMMITTEE SUBSTITUTE FOR
HOUSE BILL NOS. 2365, 2490 & 2249
103RD GENERAL ASSEMBL Y
5652H.03C 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Section A. Section 196.990, RSMo, is repealed and two new sections enacted in lieu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 system 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 system ", a single-use [ device ] system used
10 for the [ automatic injection ] delivery of a premeasured dose of epinephrine into the human
11 body;
12 (4) "Physician", a physician licensed in this state under chapter 334;
13 (5) "Provide", the supply of one or more epinephrine [ auto-injectors ] delivery
14 systems to an individual;
15 (6) "Self-administration", a person's discretionary use of an epinephrine [ auto-
16 injector ] delivery system .
17 2. A physician may prescribe epinephrine [ auto-injectors ] delivery systems in the
18 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.
19 physicians, and other persons authorized to dispense prescription medications may dispense
20 epinephrine [ auto-injectors ] delivery systems under a prescription issued in the name of an
21 authorized entity .
22 3. An authorized entity may acquire and stock a supply of epinephrine [ auto-
23 injectors ] delivery systems under a prescription issued in accordance with this section. Such
24 epinephrine [ auto-injectors ] delivery systems shall be stored in a location readily accessible
25 in an emer gency and in accordance with the epinephrine [ auto-injector's ] delivery system's
26 instructions for use and any additional requirements established by the department of health
27 and senior services by rule. An authorized entity shall designate employees or agents who
28 have completed the training required under this section to be responsible for the storage,
29 maintenance, and general oversight of epinephrine [ auto-injectors ] delivery systems acquired
30 by the authorized entity .
31 4. An authorized entity that acquires a supply of epinephrine [ auto-injectors ] delivery
32 systems under a prescription issued in accordance with this section shall ensure that:
33 (1) Expected epinephrine [ auto-injector ] delivery system users receive training in
34 recognizing symptoms of severe aller gic reactions including anaphylaxis and the use of
35 epinephrine [ auto-injectors ] delivery systems from a nationally recognized or ganization
36 experienced in training laypersons in emer gency health treatment or another entity or person
37 approved by the department of health and senior services;
38 (2) All epinephrine [ auto-injectors ] delivery systems are maintained and stored
39 according to the epinephrine [ auto-injector's ] delivery system's instructions for use;
40 (3) Any person who provides or administers an epinephrine [ auto-injector ] delivery
41 system to an individual who the person believes in good faith is experiencing anaphylaxis
42 activates the emer gency medical services system as soon as possible; and
43 (4) A proper review of all situations in which an epinephrine [ auto-injector ] delivery
44 system is used to render emer gency care is conducted.
45 5. Any authorized entity that acquires a supply of epinephrine [ auto-injectors ]
46 delivery systems under a prescription issued in accordance with this section shall notify the
47 emer gency communications district or the ambulance dispatch center of the primary provider
48 of emer gency medical services where the epinephrine [ auto-injectors ] delivery systems are to
49 be located within the entity's facility .
50 6. No person shall provide or administer an epinephrine [ auto-injector ] delivery
51 system to any individual who is under eighteen years of age without the verbal consent of a
52 parent or guardian who is present at the time when provision or administration of the
53 epinephrine [ auto-injector ] delivery system is needed. Provided, however , that a person may
54 provide or administer an epinephrine [ auto-injector ] delivery system to such an individual
55 without the consent of a parent or guardian if the parent or guardian is not physically present
HCS HBs 2365, 2490 & 2249 2
56 and the person reasonably believes the individual shall be in imminent danger without the
57 provision or administration of the epinephrine [ auto-injector ] delivery system .
58 7. The following persons and entities shall not be liable for any injuries or related
59 damages that result from the administration or self-administration of an epinephrine [ auto-
60 injector ] delivery system in accordance with this section that may constitute ordinary
61 negligence:
62 (1) An authorized entity that possesses and makes available epinephrine [ auto-
63 injectors ] delivery systems and its employees, agents, and other trained persons;
64 (2) Any person who uses an epinephrine [ auto-injector ] delivery system made
65 available under this section;
66 (3) A physician that prescribes epinephrine [ auto-injectors ] delivery systems to an
67 authorized entity; or
68 (4) Any person or entity that conducts the training described in this section.
69
70 Such immunity does not apply to acts or omissions constituting a reckless disregard for the
71 safety of others or willful or wanton conduct. The administration of an epinephrine [ auto-
72 injector ] delivery system in accordance with this section shall not be considered the practice
73 of medicine. The immunity from liability provided under this subsection is in addition to and
74 not in lieu of that provided under section 537.037. An authorized entity located in this state
75 shall not be liable for any injuries or related damages that result from the provision or
76 administration of an epinephrine [ auto-injector ] delivery system by its employees or agents
77 outside of this state if the entity or its employee or agent is not liable for such injuries or
78 related damages under the laws of the state in which such provision or administration
79 occurred. No trained person who is in compliance with this section and who in good faith and
80 exercising reasonable care fails to administer an epinephrine [ auto-injector ] delivery system
81 shall be liable for such failure.
82 8. All basic life support ambulances and stretcher vans operated in the state shall be
83 equipped with epinephrine [ auto-injectors ] delivery systems and be staf fed by at least one
84 individual trained in the use of epinephrine [ auto-injectors ] delivery systems .
85 9. The provisions of this section shall apply in all counties within the state and any
86 city not within a county .
87 10. Nothing in this section shall be construed as superseding the provisions of section
88 167.630.
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
HCS HBs 2365, 2490 & 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.
✔
HCS HBs 2365, 2490 & 2249 4