FIRST REGULAR SESSION
SENATE BILL NO. 783
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR LEWIS.
3083S.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 rep ealed 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 to the body of an individual; 4
(2) "Authorized entity", any entity or organization at 5
or in connection with which allergens capable of causing 6
anaphylaxis may be present including, but not limited to, 7
qualified first responders, as such term is defined in 8
section 321.621, restaurants, recreation camps, youth sports 9
leagues, child care facilities, amusement parks, and sports 10
arenas. "Authorized entity" shall not include any public 11
school or public charter school; 12
(3) "Epinephrine auto-injector", a single-use device 13
used for the automatic injection of a premeasured dose of 14
epinephrine into the human body; 15
(4) "Physician", a physician licensed in this state 16
under chapter 334; 17 SB 783 2
(5) "Provide", the supply of one or more epinephrine 18
auto-injectors to an individual; 19
(6) "Self-administration", a person's discretionary 20
use of an epinephrine auto -injector. 21
2. A physician may prescribe epinephrine auto - 22
injectors in the name of an authorized entity for use in 23
accordance with this section, and pharmacists, physicians, 24
and other persons authorized to dispense prescription 25
medications may dispense epinephrine auto -injectors under a 26
prescription issued in the name of an authorized entity. 27
3. An authorized entity may acquire and stock a supply 28
of epinephrine auto-injectors under a prescription issued in 29
accordance with this section. Such epinephrine auto - 30
injectors shall be stored in a location readily accessible 31
in an emergency and in accordance wi th the epinephrine auto - 32
injector's instructions for use and any additional 33
requirements established by the department of health and 34
senior services by rule. An authorized entity shall 35
designate employees or agents who have completed the 36
training required under this section to be responsible for 37
the storage, maintenance, and general oversight of 38
epinephrine auto-injectors acquired by the authorized entity. 39
4. An authorized entity that acquires a supply of 40
epinephrine auto-injectors under a pre scription issued in 41
accordance with this section shall ensure that: 42
(1) Expected epinephrine auto -injector users receive 43
training in recognizing symptoms of severe allergic 44
reactions including anaphylaxis and the use of epinephrine 45
auto-injectors from a nationally recognized organization 46
experienced in training laypersons in emergency health 47
treatment or another entity or person approved by the 48
department of health and senior services; 49 SB 783 3
(2) All epinephrine auto -injectors are maintained and 50
stored according to the epinephrine auto -injector's 51
instructions for use; 52
(3) Any person who provides or administers an 53
epinephrine auto-injector to an individual who the person 54
believes in good faith is experiencing anaphylaxis activates 55
the emergency medical services system as soon as possible; 56
and 57
(4) A proper review of all situations in which an 58
epinephrine auto-injector is used to render emergency care 59
is conducted. 60
5. Any authorized entity that acquires a supply of 61
epinephrine auto-injectors under a prescription issued in 62
accordance with this section shall notify the emergency 63
communications district or the ambulance dispatch center of 64
the primary provider of emergency medical services where the 65
epinephrine auto-injectors are to be located within the 66
entity's facility. 67
6. No person shall provide or administer an 68
epinephrine auto-injector to any individual who is under 69
eighteen years of age without the verbal consent of a parent 70
or guardian who is present at the time when provision or 71
administration of the epinephrine auto -injector is needed. 72
Provided, however, that a person may provide or administer 73
an epinephrine auto-injector to such an individual without 74
the consent of a parent or guardian if the parent o r 75
guardian is not physically present and the person reasonably 76
believes the individual shall be in imminent danger without 77
the provision or administration of the epinephrine auto - 78
injector. 79
7. The following persons and entities shall not be 80
liable for any injuries or related damages that result from 81 SB 783 4
the administration or self -administration of an epinephrine 82
auto-injector in accordance with this section that may 83
constitute ordinary negligence: 84
(1) An authorized entity that possesses and m akes 85
available epinephrine auto -injectors and its employees, 86
agents, and other trained persons; 87
(2) Any person who uses an epinephrine auto -injector 88
made available under this section; 89
(3) A physician that prescribes epinephrine auto - 90
injectors to an authorized entity; or 91
(4) Any person or entity that conducts the training 92
described in this section. 93
Such immunity does not apply to acts or omissions 94
constituting a reckless disregard for the safety of others 95
or willful or wanton conduct . The administration of an 96
epinephrine auto-injector in accordance with this section 97
shall not be considered the practice of medicine. The 98
immunity from liability provided under this subsection is in 99
addition to and not in lieu of that provided under section 100
537.037. An authorized entity located in this state shall 101
not be liable for any injuries or related damages that 102
result from the provision or administration of an 103
epinephrine auto-injector by its employees or agents outside 104
of this state if the entity or its employee or agent is not 105
liable for such injuries or related damages under the laws 106
of the state in which such provision or administration 107
occurred. No trained person who is in compliance with this 108
section and who in good faith and e xercising reasonable care 109
fails to administer an epinephrine auto -injector shall be 110
liable for such failure. 111 SB 783 5
8. All basic life support ambulances and stretcher 112
vans operated in the state shall be equipped with 113
epinephrine auto-injectors and be staffed by at least one 114
individual trained in the use of epinephrine auto -injectors. 115
9. The provisions of this section shall apply in all 116
counties within the state and any city not within a county. 117
10. Nothing in this section shall be construed as 118
superseding the provisions of section 167.630. 119
210.225. 1. (1) Before July 1, 2027, each licensed 1
child care provider shall adopt a policy on allergy 2
prevention and response with priority given to addressing 3
potentially deadly food-borne allergies. Such policy shall 4
contain, but shall not be limited to, the following elements: 5
(a) Distinguishing between building -wide, room-level, 6
and individual approaches to allergy prevention and 7
management; 8
(b) Providing an age-appropriate response to building - 9
level and room-level allergy education and prevention; 10
(c) Describing the role of child care facility staff 11
in determining how to manage an allergy problem, whether 12
through a plan prepared for a child under Secti on 504 of the 13
Rehabilitation Act of 1973, as amended, for a child with an 14
allergy that has been determined to be a disability, an 15
individualized health plan for a child who has an allergy 16
that is not disabling, or another allergy management plan; 17
(d) Describing the role of other children and parents 18
in cooperating to prevent and mitigate allergies; 19
(e) Addressing confidentiality issues involved with 20
sharing medical information, including specifying when 21
parental permission is required to make medical information 22
available; and 23 SB 783 6
(f) Coordinating with the department of elementary and 24
secondary education, local health authorities, and other 25
appropriate entities to ensure efficient promulgation of 26
accurate information and to ensure th at existing child care 27
facility safety and environmental policies do not conflict. 28
(2) Such policies may contain information from or 29
links to child care facility allergy prevention information 30
furnished by the Food Allergy & Anaphylaxis Network or 31
equivalent organization with a medical advisory board that 32
has allergy specialists. 33
2. The department of elementary and secondary 34
education shall, in cooperation with any appropriate 35
professional association, develop a model policy or policies 36
before July 1, 2026. 37