After the loss of their son to anaphylaxis triggered by food at his child-care center in 2017, Thomas Silvera and Dina Hawthorne-Silvera launched a cross-country movement. Determined never to see a similar tragedy occur in preschool again, they started a foundation and began working to enact “Elijah’s Law” in every state. Bills are not easy to get passed, but in a short space of time, the Silveras have gained an impressive list of successes, and they keep pressing forward.
The laws named for their son require departments of health to create anaphylaxis policies that mandate training staff at preschools and daycares in food allergy preparedness and how to respond to anaphylaxis, including administering epinephrine and calling 911. As well, the centers must keep epinephrine auto-injectors on hand for emergency use.
In March 2022, Virginia became the latest state to sign on. Both houses of Virginia’s legislature passed versions of a bill (Senate Bill 737), and now it simply awaits the signature of Governor Glenn Youngkin. Virginia will then join New York, the Silveras’ home state and Illinois, where similar bills have been signed into law. [Update: on April 11, Youngkin signed the bill, making Elijah’s Law official in Virginia, too.]
The Silveras, founders of the Elijah-Alavi Foundation, are gratified by the progress of Elijah’s Laws, and the support they’ve gained. Along the way, they have gotten help from legislators, fellow food allergy parents, and food allergy advocacy groups. The Asthma and Allergy Foundation of America (AAFA), which is working with the Silveras, recently released a report with a state-by-state assessment of food allergy policies at child-care centers. It finds 27 of 50 states scored 4 or less out of 9 on a scorecard of food allergy management.
The second part of AAFA’s report is a toolkit to assist would-be advocates for an Elijah’s Law, so grassroots organizers can lobby to get an “Elijah’s Law” passed in their own states.
“We do an ‘honor roll’ report every year examining the progress of legislation in food allergy,” explains Jenna Riemenschneider, AAFA’s director of advocacy and special projects. “The report and toolkit are a logical extension of that.”
The Lobby for California
Next up for the Silveras is Pennsylvania, where a House bill is headed to the education committee, and the biggest state of them all, California.
California, with 12 percent of the U.S. population, has nearly 37,000 licensed child-care facilities and 2.4 million children under the age of 5. The impact of Elijah’s Law in California would be felt by hundreds of thousands of children. “Having Elijah’s Law enacted in California is so crucial,” says Silvera. “It’s about putting policies in place to protect the lives of children who are the most vulnerable when it comes to food allergies.”
The sponsor of the California bill (Assembly Bill 2042) is Assemblyman Carlos Villapudua of Stockton. California requires all K-12 schools to stock epinephrine auto-injectors but, as in other states, child-care centers that work with children under age 5 are not included in these requirements. Villapudua explains the logic behind his bill for this young and vulnerable population: “Why can we have it (epinephrine) in a high school and not at a daycare? That’s where it’s most needed.” He is optimistic about the bill’s passage, calling it “common sense.”
But despite common sense and a lot of successes, California’s history of food allergy legislation has not always been smooth. A measure similar to Elijah’s Law, aimed at bringing food allergy protocols to child-care centers, was attempted in 2020. And current law requiring K-12 schools to stock epinephrine, failed in the legislature before it was eventually passed in 2016.
People close to those efforts note the importance of patience and perseverance. “So much legislation in California is timing, and in the case of epinephrine in schools it really was the way the stars aligned,” says Heid Hannaman, a Senate staffer who was intimately involved in efforts to pass legislation requiring epinephrine in schools, and other measures. ”I could have had a list 100 miles long of food allergy bills. We have done so much, and yet so much needs to be done,” she told Allergic Living.
The Push Required to Win
Regarding the multiple efforts it took to put epinephrine in all California schools, Hannaman was “surprised” that teachers’ union leadership was not supportive initially. The union was concerned about putting a burden on teachers to learn epinephrine administration on top of their other duties. Hannaman and colleagues, working for Senator Bob Huff, sponsor of the bill for stock epinephrine availability, worried that other objectors would come out of the woodwork.
“Ultimately our strategy was to go to every legislator, every staff member,” she says. Her advice to advocates who wish to move forward food allergy legislation is to understand the landscape, the possible opponents – even if the bill seems logical – and the competing demands on a legislator’s time. “Just because the idea of a new law seems like common sense, doesn’t mean that it is seen that way by all,” says Hannaman.
Villapudua agrees, noting that it is important to appeal to the legislators’ interests, to take the long view, that sometimes it takes several attempts to get a bill passed, to work with stakeholders and be open to compromise.
In social media, Silvera is urging Californians to ask their state representatives to support Assembly Bill 2042 – Elijah’s Law. AAFA has also posted an easy form here that Californians can sign to tell the Assembly they want the bill passed.
Villapudua and the Silveras recently gained important support from Joanne and Louis Giorgi, parents of Natalie Giorgi, who lost her life to peanut anaphylaxis in 2013. Joanne Giorgi’s powerful testimony to a California Senate committee helped to propel the state’s stock epinephrine bill through.
The mother recently told a Sacramento TV reporter: “We are honored and grateful to know and work alongside Thomas Silvera and Dina. Together we can do great things in memory of Natalie and Elijah.”
Onward to More States
AAFA’s Riemenschneider sees the possibility of Elijah’s Law being replicated in still more states. “We’ve gotten a lot of interest in our toolkit. We have advocated for this bill in Illinois, I testified in Virginia, we are prepared to help in California and elsewhere.” She notes the importance of advocates being prepared, and the toolkit provides much of that preparation.
“Across the country, too many children with food allergies still lack the necessary protections to grow and thrive in early child care,” says Silvera. “If individuals call their representatives to introduce Elijah’s Law, and adults who work with children begin to take food allergies seriously, learn to spot the signs, and treat the symptoms of severe anaphylaxis, we can all ensure that my son’s impact lives on.
“So many families will feel safer when dropping their kids off at their child-care centers,” he says.
Note: Interested in advocating to get an Elijah’s Law in your state? Then contact Thomas Silvera at: [email protected].
Jen Jobrack is an expert on food allergy policy, and the founder of Food Allergy Pros.