Governor Gavin Newsom signed California Elijah’s Law on September 25, 2024, requiring three state agencies to create an anaphylaxis policy for daycare centers. The legislation is designed to protect thousands of young children with food allergies, in a state with about 2.2 million residents under the age of 5.
Under the bill (AB 2317), the California Department of Social Services must create guidelines to direct trained staff at childcare facilities on how to prevent and respond to anaphylaxis. The procedures must be established with the California Emergency Medical Services Authority and the State Department of Education by July 1, 2027.
California’s Elijah’s Law “authorizes,” but does not “require,” the state’s childcare facilities to implement the anaphylaxis policy. Centers that opt in will be required to include training to recognize and treat symptoms of anaphylaxis. As well, they must have emergency protocols that include how to administer epinephrine auto-injectors.
Thomas Silvera, executive director of the Elijah-Alavi Foundation (EAF), was overjoyed about the governor’s signing. “We have achieved a transformative victory – not just for our son Elijah, but for every child in California living with food allergies. This law will be a monumental step for the safety of children,” he told Allergic Living. “It provides hope for the safety of the most vulnerable.”
Elijah’s Law is named for Silvera and Dina Hawthorne’s son Elijah-Alavi. They co-founded the foundation after the 3-year-old died of severe anaphylaxis in 2017. The boy was served a grilled cheese sandwich at his New York City preschool, despite having a known dairy allergy. The daycare then failed to call 911. (New York was the first state to pass an Elijah’s Law in 2019.)
Hawthorne, EAF’s president, called Elijah’s Law “a promise kept. A promise that no child will ever have to face the dangers of food allergies alone.”
Reducing the Parent’s Burden
The law in California will help to ensure the safety of children with food allergies, says Kenneth Mendez, president and CEO of the Asthma and Allergy Foundation of America (AAFA). “We commend Governor Newsom and the California State Legislature for enacting this law that will save lives,” Mendez told Allergic Living.
California Assembly Member Stephanie Nguyen introduced the anaphylaxis legislation in February 2024, and became the bill’s champion. It passed the state Assembly in May 2024, and in the state Senate in August 2024. The state has nearly 37,000 licensed childcare facilities that will be able to opt into the anaphylaxis policy, both daycare centers and home daycares.
Childcare facilities can adopt the policy starting on January 1, 2028. The time span relates to an in-depth consultation process with numerous stakeholders to create California’s daycare anaphylaxis policy. Silvera’s foundation will now work alongside lawmakers, state agencies, physicians, childcare administrators, and other allergy non-profits to craft the policy’s details.
In adopting the Elijah’s Law policy, California centers must notify parents or guardians upon enrollment of the new allergy guidelines.
The notification requirement will help raise awareness about food allergies, Heidi Hannaman, senior policy analyst at the California State Senate, tells Allergic Living. Also, it carries more weight when information about allergy protocols to the parents comes from the daycare administration.
“It takes away the burden to communicate that often falls on the food allergy parent,” she says.
California Elijah’s Law: The Specifics
Once final, the state guidelines will provide direction to childcare centers on the prevention and response of anaphylaxis. Under AB 2317, the policy must include:
- A process for a daycare to seek staff volunteers who will train on providing emergency care, including administering epinephrine auto-injectors.
- Emergency protocols and treatment plans for trained staff to respond to anaphylaxis, including having access to epinephrine auto-injectors on site.
- A training course that educates staff on preventing, recognizing and responding to anaphylaxis. Training must also include procedures for storage and use of epinephrine auto-injectors. Follow-up procedures, such as calling 911 and contacting caregivers and physicians, are also required.
- Guidelines for creating an individual emergency plan for children with an allergy at each daycare.
- Strategies to reduce the risk of exposure to allergens.
- A process for each center to receive a parent’s prior written consent to the trained staff administering epinephrine.
The state EMS agency will review training standards on epinephrine use. The training will align with the Centers for Disease Control and Prevention’s well-known resource, the Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs.
“Elijah’s Law will make childcare centers safer and provide peace of mind for food-allergic families,” Mendez says.
California Elijah’s Law: Will They Opt In?
The victory in the most populous state comes two years after Newsom vetoed the first version of an Elijah’s Law bill in 2022.
The legislation faced less opposition this time in part because it “authorizes,” but does not “require” childcare centers to adopt the anaphylaxis policy.
That caveat does not deter Silvera. He notes that parents will now have a tool to bring to their daycare providers to suggest implementing the policy. Hannaman agrees the law will raise awareness of food allergies, and provide a pathway to show how easy it is to implement protocols and use lifesaving medication.
“For the food allergy community, so much of the work is education and demystifying how to properly use epinephrine auto-injectors,” she says. As a Senate staffer, Hannaman pushed to get the state’s K-12 stock epinephrine bill passed in 2016.
In addition, Hannaman thinks a childcare center that chooses not to adopt the anaphylaxis policy could be more vulnerable to legal action if a tragic anaphylactic incident occurred. A parent could make an argument for liability because the center chose not to adopt a tool that could have prevented anaphylaxis, she says.
“I think a good amount of centers will adopt the policy,” Hannaman says. “It’s common sense.”
AAFA’s Mendez says California childcare centers should note the policy’s benefits in keeping children safe. “Standardizing practices helps centers and their employees effectively manage food allergies,” Mendez says.
Finding Consensus in California
After the governor’s 2022 veto, Silvera and Hawthorne vowed to rework the bill so that it could pass in California. Newsom acknowledged the importance protecting young children at risk of anaphylaxis. But he’d cited implementation concerns, and a lack of consensus among the entities involved.
Silvera says this time around, there were constructive discussions with everyone involved. This led to a smoother process, resulting in consensus on the bill’s language.
The Department of Social Services, Child Care Providers United-California, Service Employees International Union, the Department of Education and the Emergency Medical Services Authority, all had a stake in the negotiations.
“I am proud of the part we had in fostering that agreement,” Silvera says. Mendez says his organization worked “to address concerns around the previous version of the bill, while ensuring Elijah’s Law remained impactful.”
AAFA partnered with the Elijah-Alavi Foundation and other advocates to help bring Elijah’s Law to fruition in California and other states. AAFA encouraged food-allergic families to reach out to lawmakers. Other key advocacy supporters include FARE (Food Allergy Research and Education), the Natalie Giorgi Sunshine Foundation, the Allergy & Asthma Network, Allergy Strong, and the auto-injector maker Kaléo.
Silvera notes that many allergy families and bloggers also rallied for this bill. “This journey has demanded perseverance, courage, and the unwavering support of countless advocates and organizations,” he says. “Everyone involved played such a vital role in making this happen.”
Hawthorne says: “This victory wasn’t won in isolation, but through the collective strength of advocates and organizations who fought tirelessly to protect our children. Together, we’ve proven that, when we stand as one, we can accomplish the extraordinary. This is our shared triumph.”
Elijah’s Law: Other States
California becomes the fifth state to pass an Elijah’s Law. Maryland, New York, Illinois and Virginia previously passed similar laws that mandate anaphylaxis protocols in childcare centers.
Other states considering an Elijah’s Law to protect anaphylactic youngsters include Pennsylvania, Kansas, Michigan and Missouri. State-specific bills will be reintroduced in the last three during the next legislative session, Silvera says.
In Pennsylvania, State Representative Bridget Kosierowski plans to introduce Elijah’s Law (House Bill 2082) this session and soon. Kosierowski, who’s a nurse, recently spoke on the daycare bill’s importance. “Mistakes can happen,” she told state lawmakers. “So that’s why it’s really important for us to understand how important it is to think about access to emergency care.”
Mendez says: “We are hopeful Elijah’s Law’s passage will continue building momentum, to provide key protections for children with food allergies in childcare centers across the country.”
Related Reading:
Elijah’s Law in Maryland Hailed, Other States Consider
Food Allergies at School: How to Get What You Need
