HOUSE BILL NO. 2249 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE EALY.
5912H.01I JOSEPH ENGLER, Chief Clerk
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Section A. Section 196.990, RSMo, is repealed and two new sections enacted in lieu 2 thereof, to be known as sections 196.990 and 210.225, to read as follows: 196.990. 1.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 organization at or in connection with which 5 allergens 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 care 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,
EXPLANATION — 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. HB 2249 2
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 emergency 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 allergic reactions including anaphylaxis and the use of 34 epinephrine [auto-injectors] delivery devices from a nationally recognized organization 35 experienced in training laypersons in emergency 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 emergency 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 emergency 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 emergency communications district or the ambulance dispatch center of the primary provider 47 of emergency 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 3
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 staffed 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) Before July 1, 2028, each licensed child care provider shall adopt a policy 3 on allergy prevention and response with priority given to addressing potentially deadly HB 2249 4
4 food-borne allergies. Such policy shall contain, but shall not be limited to, the following 5 elements: 6 (a) Distinguishing between building-wide, room-level, and individual approaches 7 to allergy prevention and management; 8 (b) Providing an age-appropriate response to building-level and room-level 9 allergy education and prevention; 10 (c) Describing the role of child care facility staff in determining how to manage 11 an allergy problem, whether through a plan prepared 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 parents in cooperating to prevent 16 and mitigate allergies; 17 (e) Addressing confidentiality issues involved with sharing medical information, 18 including specifying when parental permission is required to make medical information 19 available; and 20 (f) Coordinating with the department of elementary and secondary education, 21 local health authorities, and other appropriate entities to ensure efficient promulgation 22 of accurate information and to ensure that existing child care facility safety and 23 environmental policies do not conflict. 24 (2) Such policies may contain information from or links to child care facility 25 allergy prevention 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 appropriate professional association, develop a model policy or policies before 29 July 1, 2027. ✔
Statutes affected: