Bill Text: NJ A4789 | 2026-2027 | Regular Session | Introduced
Bill Title: Concerns food allergy safety, emergency preparedness, and anaphylaxis response in child care settings.
Sponsorship: Partisan Bill (Democrat 2)
Status: (Introduced) 2026-03-19 - Introduced, Referred to Assembly Children, Families and Food Security Committee [A4789 Detail]
Download: New_Jersey-2026-A4789-Introduced.html
Sponsored by:
Assemblywoman CARMEN THERESA MORALES
District 34 (Essex)
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.
