Concerns food allergy safety, emergency preparedness, and anaphylaxis response in child care settings.

S3624

SENATE, No. 3624

STATE OF NEW JERSEY

222nd LEGISLATURE

�

INTRODUCED FEBRUARY 19, 2026

Sponsored by:

Senator� ANDREW ZWICKER

District 16 (Hunterdon, Mercer, Middlesex and Somerset)

Co-Sponsored by:

Senator Diegnan

SYNOPSIS

���� Concerns food allergy safety, emergency preparedness,
and anaphylaxis response in child care settings.

CURRENT VERSION OF TEXT

���� As introduced.

��

An Act
concerning food allergy safety, emergency preparedness,
and anaphylaxis response in licensed child care settings and supplementing
Title 30 of the Revised Statues.

����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:

���� 1.� This act shall be known
and may be cited as �Elijah�s Law.�

���� 2.� The Legislature finds and
declares that:

���� a.� Food allergies affect
millions of children nationwide, including infants and young children enrolled
in licensed child care centers and family day care homes.

���� b. Anaphylaxis is a severe and
life-threatening allergic reaction that can occur within minutes of exposure to
an allergen and requires immediate treatment with epinephrine.

���� c. One in ten allergic
reactions occur in child care centers demonstrating that these environments are
common locations for emergency allergic events.

���� d. Up to one-third of allergic
reactions in child care settings occur in children with no prior allergy
diagnosis or when staff were unaware of the child�s allergy, making
preparedness essential for early childhood professionals.

���� e. Young children in child
care settings are often unable to recognize symptoms or self-advocate during a
medical emergency.

���� f. In rural and low-access
areas, emergency medical services may experience extended response times,
making immediate on-site access to epinephrine and trained staff critical to
preventing serious injury or death.

���� g. Timely administration of
epinephrine using FDA-approved epinephrine delivery devices, administered at
appropriate weight-based doses, is the first-line treatment for anaphylaxis.

���� h. Elijah-Alavi Silvera was a
young child with known food allergies who tragically lost his life while
attending his licensed child care center in New York City. �Despite clear
documentation of his allergies, he was given food he was known to be allergic
to. �When he experienced a severe allergic reaction, the child care setting was
not adequately prepared to respond in time. �His death was preventable and
revealed critical gaps in food allergy awareness, staff training, emergency
preparedness, and access to life-saving epinephrine.

���� i. Clear statutory authority,
consistent training, access to undesignated stock epinephrine, mandatory
emergency protocols, and strong good samaritan liability protections are
essential to ensuring rapid and confident emergency response to emergency
allergic events in child care settings.

���� j.� To ensure preparedness,
clarity, and accountability in protecting children from food allergy
emergencies in licensed child care centers and registered family day care
homes, it is necessary to establish a regulatory framework requiring licensed
child care centers and registered family day care homes to provide an
anaphylaxis training program for staff and to maintain an epinephrine
administration device approved by the United States Food and Drug
Administration for emergency use.

���� 3. �As used in this act:

���� �Anaphylaxis� means a severe,
potentially life-threatening allergic reaction.

���� �Child care center� means a
child care center licensed pursuant to the provisions of P.L.1983, c.492
(C.30:5B-1 et seq.).

���� �Epinephrine administration
device� means a device approved by the United States Food and Drug
Administration for the administration of epinephrine.

���� �Family day care home� means a
family day care home registered pursuant to the provisions of P.L.1987, c.27
(C.30:5B-16 et seq.).

���� �Undesignated stock
epinephrine� means epinephrine maintained for emergency use that is not
prescribed to a specific individual.

���� �Weight-based dose� means the
epinephrine dosage appropriate for the individual�s weight, consistent with FDA
labeling.

���� 4.��� a.�
The Department of Health, in consultation with the
Department of Children and Families, shall develop an allergy and
anaphylaxis training program
that child care centers
licensed by the Department of Children and Families and family day care homes registered
with the Department of Children and Families shall require all staff to
complete annually.

���� b. The allergy and anaphylaxis
training program developed pursuant to this section shall include, at a
minimum, instruction on the following topics as they relate to both children
and adults in licensed child care centers and registered family day care home:

���� (1) food allergy awareness;

���� (2) recognition of the signs
and symptoms of allergic reactions and anaphylaxis;

���� (3) emergency response
procedures, including the administration of epinephrine;

���� (4) strategies to reduce
allergen exposure and prevent cross-contact; and

���� (5) weight-based dosing
guidelines.

���� 5.� a.� A child care center or
a family day care home licensed or registered by the Department of Children and
Families, respectively, is authorized to obtain and maintain for, and
administer to, using FDA-approved epinephrine delivery devices in appropriate
weight-based doses, undesignated stock epinephrine to any child who is
reasonably believed to be experiencing anaphylaxis.

���� b.� Undesignated stock
epinephrine shall be administered only by a staff member who has successfully
completed an allergy and anaphylaxis training program developed by the
Department of Health, pursuant to section 4 of this act.

���� c. Each licensed child care
center and registered family day care home shall develop, implement, and
maintain written emergency action policies and guidelines governing food
allergy management and anaphylaxis response, consistent with the requirements
of subsection a. of section 6 of this act.

���� d.� A licensed child care
center, a registered family day care provider, an assistant or substitute
provider and any staff member of a child care center or family day care home acting
in good faith and in accordance with this section shall not be liable for civil
damages resulting from the administration of undesignated stock epinephrine,
except in cases of gross negligence or willful misconduct.

���� e.� The authorization to
obtain, maintain, and administer undesignated stock epinephrine provided under
this section shall not be construed to replace or eliminate the requirement to
maintain and administer epinephrine prescribed for an individual child when
such medication has been provided by a parent or guardian.

���� 6.� a.���������� In the event
that a child is reasonably believed to be experiencing an anaphylactic
reaction, the licensed child care center or registered family day care home
shall ensure that staff or the provider immediately:

���� (1) administer to the child
undesignated stock epinephrine, or in the case of a child prescribed
epinephrine, administer to the child the prescribed epinephrine provided by the
child�s parent or legal guardian;

���� (2) contact emergency medical
services by calling 911 without delay;

���� (3) notify the child�s parent
or legal guardian as soon as practicable after emergency response procedures
are initiated; and

���� (4) continuously monitor the
child until emergency medical services arrive.

���� b. Notification to a parent or
legal guardian pursuant to subsection a. of this section shall include
confirmation that emergency medical services were contacted and whether
epinephrine was administered to the child.

���� c. Following the
administration of epinephrine, the licensed child care center or registered
family day care home shall document the incident resulting in the
administration of epinephrine, including, at a minimum:

���� (1) the date and time of the
incident;

���� (2) the symptoms observed and
actions taken;

���� (3) whether epinephrine was
administered, including whether undesignated stock epinephrine or epinephrine
prescribed for an individual child was administered, the dosage, and time of
administration;

���� (4) the time emergency medical
services were contacted and arrived; and

���� (5) the date and time the
parent or legal guardian was notified.

���� d. Incident documentation
required pursuant to subsection d. of this section shall be maintained on file
and made available to the Department of Children and Families or the Department
of Health upon request, in accordance with applicable recordkeeping
requirements.

���� 7.� The Department of Health
and Children and Families may utilize available federal funds, including funds
made available pursuant to the Child Care and Development Block Grant Act of
1990, 42 U.S.C. s.9858 et seq., to assist licensed child care centers and registered
family day care homes in the implementation of the provisions of this act.

���� 8.� The Commissioner of Health
and Children and Families shall adopt rules and regulations, pursuant to the
�Administrative Procedure Act,� P.L.1968, c.410 (C.52:14B-1 et seq.), to
implement the provisions of this act.

���� 9.� This act shall take effect
on the first day of the second month following enactment.

STATEMENT

���� This bill concerns food
allergy safety, emergency preparedness, and anaphylaxis response in child care
settings and establishes �Elijah�s Law.�

���� This bill defines �Epinephrine
administration device� to mean a device approved by the United States Food and
Drug Administration for the administration of epinephrine.� �Undesignated stock
epinephrine� means epinephrine maintained for emergency use that is not
prescribed to a specific individual.

���� Food allergies affect millions
of children nationwide, including infants and young children enrolled in
licensed child care centers and family day care homes.� Anaphylaxis is a severe
and life-threatening allergic reaction that can occur within minutes of
exposure to an allergen and requires immediate treatment with epinephrine.�

���� The Department of Health, in
consultation with the Department of Children and Families, is to develop an
allergy and anaphylaxis training program that child care centers licensed by
the Department of Children and Families and family day care homes registered by
the Department of Children and Families are to require all staff to complete
annually.� The allergy and anaphylaxis training program developed pursuant to
this section is to include, at a minimum, instruction on the following topics
as they relate to both children and adults in licensed child care centers and
registered family day care home: (1) food allergy awareness; (2) recognition of
the signs and symptoms of allergic reactions and anaphylaxis; (3) emergency
response procedures, including the administration of epinephrine; (4)
strategies to reduce allergen exposure and prevent cross-contact; and (5)
weight-based dosing guidelines.

���� A child care center or a
family day care home licensed or registered by the Department of Children and
Families, respectively, is authorized to obtain and maintain for, and
administer to, using FDA-approved epinephrine delivery devices in appropriate
weight-based doses, undesignated stock epinephrine to, to any child who is
reasonably believed to be experiencing anaphylaxis.� Undesignated stock
epinephrine is to be administered only by a staff member who has successfully
completed an allergy and anaphylaxis training program developed by the
Department of Health, in consultation with the Department of Children and
Families.

���� Following the administration
of epinephrine, the licensed child care center or registered family day care
home shall document the incident resulting in the administration of
epinephrine, including, at a minimum: (1) the date and time of the incident;
(2) the symptoms observed and actions taken; (3) whether epinephrine was
administered, including whether undesignated stock epinephrine or epinephrine
prescribed for an individual child was administered, the dosage, and time of
administration; (4) the time emergency medical services were contacted and
arrived; and (5) the date and time the parent or legal guardian was notified.