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EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
SECOND REGULAR SESSION
SENATE BILL NO. 1260
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR LEWIS.
4650S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 196.990, RSMo, and to enact in lieu thereof two new sections relating to allergies
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Section A. Section 196.990, RSMo, is repealed and two new 1
sections enacted in lieu thereof, to be known as sections 2
196.990 and 210.225, to read as follows:3
196.990. 1. As used in this section, the following 1
terms shall mean: 2
(1) "Administer", the direct application of an 3
epinephrine [auto-injector] delivery device to the body of 4
an individual; 5
(2) "Authorized entity", any entity or organization at 6
or in connection with which allergens capable of causing 7
anaphylaxis may be present including, but not limited to, 8
qualified first responders, as such term is defined in 9
section 321.621, restaurants, recreation camps, youth sports 10
leagues, child care facilities, amusement parks, and sports 11
arenas. "Authorized entity" shall not include any public 12
school or public charter school; 13
(3) "Epinephrine [auto-injector] delivery device", a 14
single-use device used for the [automatic injection] 15
delivery of a premeasured dose of epinephrine into the human 16
body; 17
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(4) "Physician", a physician licensed in this state 18
under chapter 334; 19
(5) "Provide", the supply of one or more epinephrine 20
[auto-injectors] delivery devices to an individual; 21
(6) "Self-administration", a person's discretionary 22
use of an epinephrine [auto-injector] delivery device. 23
2. A physician may prescribe epinephrine [auto- 24
injectors] delivery devices in the name of an authorized 25
entity for use in accordance with this section, and 26
pharmacists, physicians, and other persons authorized to 27
dispense prescription medications may dispense epinephrine 28
[auto-injectors] delivery devices under a prescription 29
issued in the name of an authorized entity. 30
3. An authorized entity may acquire and stock a supply 31
of epinephrine [auto-injectors] delivery devices under a 32
prescription issued in accordance with this section. Such 33
epinephrine [auto-injectors] delivery devices shall be 34
stored in a location readily accessible in an emergency and 35
in accordance with the epinephrine [auto-injector's] 36
delivery device's instructions for use and any additional 37
requirements established by the department of health and 38
senior services by rule. An authorized entity shall 39
designate employees or agents who have completed the 40
training required under this section to be responsible for 41
the storage, maintenance, and general oversight of 42
epinephrine [auto-injectors] delivery devices acquired by 43
the authorized entity. 44
4. An authorized entity that acquires a supply of 45
epinephrine [auto-injectors] delivery devices under a 46
prescription issued in accordance with this section shall 47
ensure that: 48
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(1) Expected epinephrine [auto-injector] delivery 49
device users receive training in recognizing symptoms of 50
severe allergic reactions including anaphylaxis and the use 51
of epinephrine [auto-injectors] delivery devices from a 52
nationally recognized organization experienced in training 53
laypersons in emergency health treatment or another entity 54
or person approved by the department of health and senior 55
services; 56
(2) All epinephrine [auto-injectors] delivery devices 57
are maintained and stored according to the epinephrine [auto- 58
injector's] delivery device's instructions for use; 59
(3) Any person who provides or administers an 60
epinephrine [auto-injector] delivery device to an individual 61
who the person believes in good faith is experiencing 62
anaphylaxis activates the emergency medical services system 63
as soon as possible; and 64
(4) A proper review of all situations in which an 65
epinephrine [auto-injector] delivery device is used to 66
render emergency care is conducted. 67
5. Any authorized entity that acquires a supply of 68
epinephrine [auto-injectors] delivery devices under a 69
prescription issued in accordance with this section shall 70
notify the emergency communications district or the 71
ambulance dispatch center of the primary provider of 72
emergency medical services where the epinephrine [auto- 73
injectors] delivery devices are to be located within the 74
entity's facility. 75
6. No person shall provide or administer an 76
epinephrine [auto-injector] delivery device to any 77
individual who is under eighteen years of age without the 78
verbal consent of a parent or guardian who is present at the 79
time when provision or administration of the epinephrine 80
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[auto-injector] delivery device is needed. Provided, 81
however, that a person may provide or administer an 82
epinephrine [auto-injector] delivery device to such an 83
individual without the consent of a parent or guardian if 84
the parent or guardian is not physically present and the 85
person reasonably believes the individual shall be in 86
imminent danger without the provision or administration of 87
the epinephrine [auto-injector] delivery device. 88
7. The following persons and entities shall not be 89
liable for any injuries or related damages that result from 90
the administration or self-administration of an epinephrine 91
[auto-injector] delivery device in accordance with this 92
section that may constitute ordinary negligence: 93
(1) An authorized entity that possesses and makes 94
available epinephrine [auto-injectors] delivery devices and 95
its employees, agents, and other trained persons; 96
(2) Any person who uses an epinephrine [auto-injector] 97
delivery device made available under this section; 98
(3) A physician that prescribes epinephrine [auto- 99
injectors] delivery devices to an authorized entity; or 100
(4) Any person or entity that conducts the training 101
described in this section. 102
Such immunity does not apply to acts or omissions 103
constituting a reckless disregard for the safety of others 104
or willful or wanton conduct. The administration of an 105
epinephrine [auto-injector] delivery device in accordance 106
with this section shall not be considered the practice of 107
medicine. The immunity from liability provided under this 108
subsection is in addition to and not in lieu of that 109
provided under section 537.037. An authorized entity 110
located in this state shall not be liable for any injuries 111
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or related damages that result from the provision or 112
administration of an epinephrine [auto-injector] delivery 113
device by its employees or agents outside of this state if 114
the entity or its employee or agent is not liable for such 115
injuries or related damages under the laws of the state in 116
which such provision or administration occurred. No trained 117
person who is in compliance with this section and who in 118
good faith and exercising reasonable care fails to 119
administer an epinephrine [auto-injector] delivery device 120
shall be liable for such failure. 121
8. All basic life support ambulances and stretcher 122
vans operated in the state shall be equipped with 123
epinephrine [auto-injectors] delivery devices and be staffed 124
by at least one individual trained in the use of epinephrine 125
[auto-injectors] delivery devices. 126
9. The provisions of this section shall apply in all 127
counties within the state and any city not within a county. 128
10. Nothing in this section shall be construed as 129
superseding the provisions of section 167.630. 130
210.225. 1. This section shall be known and may be 1
cited as "Elijah's Law". 2
2. (1) Before July 1, 2028, each licensed child care 3
provider shall adopt a policy on allergy prevention and 4
response with priority given to addressing potentially 5
deadly food-borne allergies. Such policy shall contain, but 6
shall not be limited to, the following elements: 7
(a) Distinguishing between building-wide, room-level, 8
and individual approaches to allergy prevention and 9
management; 10
(b) Providing an age-appropriate response to building- 11
level and room-level allergy education and prevention; 12
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(c) Describing the role of child care facility staff 13
in determining how to manage an allergy problem, whether 14
through a plan prepared for a child under Section 504 of the 15
Rehabilitation Act of 1973, as amended, for a child with an 16
allergy that has been determined to be a disability, an 17
individualized health plan for a child who has an allergy 18
that is not disabling, or another allergy management plan; 19
(d) Describing the role of other children and parents 20
in cooperating to prevent and mitigate allergies; 21
(e) Addressing confidentiality issues involved with 22
sharing medical information, including specifying when 23
parental permission is required to make medical information 24
available; and 25
(f) Coordinating with the department of elementary and 26
secondary education, local health authorities, and other 27
appropriate entities to ensure efficient promulgation of 28
accurate information and to ensure that existing child care 29
facility safety and environmental policies do not conflict. 30
(2) Such policies may contain information from or 31
links to child care facility allergy prevention information 32
furnished by the Food Allergy and Anaphylaxis Network or 33
equivalent organization with a medical advisory board that 34
has allergy specialists. 35
3. The department of elementary and secondary 36
education shall, in cooperation with any appropriate 37
professional association, develop a model policy or policies 38
before July 1, 2027. 39
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