Committee hears testimony on 'Elijah's Law' to require EpiPens, training in day care centers

Members of the House Children and Youth Committee heard testimony on House Bill 928, known as Elijah's Law, during a public hearing on the bill that would require licensed day care facilities to stock epinephrine auto‑injectors (EpiPens), adopt emergency action plans for anaphylaxis, provide annual staff training and parent information, and include liability protections for good‑faith administration.

The proposal is aimed at preventing fatal anaphylactic reactions among infants and young children in childcare settings. Testifiers included Thomas Silvera, father of Elijah Silvera and vice president/executive director and co‑founder of the Elijah Alavi Foundation; Alexa Jordan, advocacy and policy coordinator at the Asthma and Allergy Foundation of America (AFAA); Representative Bridget Kosarowski, prime sponsor of the bill; and Representative Kristen Marcel, co‑prime sponsor.

Elijah's father, Thomas Silvera, described the circumstances that prompted the legislation. "Elijah's law was created to ensure that no other children suffers due to lack of preparedness," Silvera said, recounting that his 3‑year‑old son died after being served a food containing a known allergen and that staff at the childcare center did not administer epinephrine. Silvera said the child had a documented severe dairy allergy and asthma, that a separate meal plan had been prepared for him, and that an educator gave him a grilled cheese sandwich instead. He told the committee that staff knew where epinephrine was stored but did not use it and that the incident revealed gaps in staff training and protocols.

Alexa Jordan of AFAA summarized public‑health evidence and the bill's provisions. "This legislation is more than just a childcare policy. It's a safety net for all children with food allergies, both known and unknown," Jordan said, and told the committee that young children are more likely than older children to have food allergies and that infants and toddlers may show different signs of anaphylaxis. Jordan said the bill would require stocking epinephrine, set training and storage standards, outline emergency use procedures, and provide liability protections for staff who administer epinephrine in good faith.

Representative Bridget Kosarowski, a registered nurse and the bill's prime sponsor, framed the measure as a public‑safety intervention given longer emergency‑response times in some parts of the Commonwealth and recent hospital closures. "We can stop it. It is preventable," Kosarowski said, arguing that training and immediate access to epinephrine can avert deaths.

Committee members focused on implementation details raised repeatedly in testimony: (1) the content and specificity of required training, particularly how to identify signs of anaphylaxis in infants and toddlers; (2) funding and whether day care providers would be required to stock EpiPens if no state funding stream were available; (3) liability protections for staff who administer epinephrine; (4) timelines for state agencies to produce materials; and (5) language access for families and providers.

Witnesses and sponsors said training resources already exist and can be provided at no direct cost to providers. Silvera and others pointed to training platforms used in states that have adopted similar laws and urged the committee to leverage federal funding, naming the Child Care and Development Block Grant (federal childcare block grant) as a potential source to support training and medication access. Committee members asked whether states that have enacted Elijah's Law saw measurable benefits; testimony cited New York and other states and reported that New York had documented several lives saved since enacting similar rules.

Members also asked clinical and operational questions. Representative Walsh asked whether an unnecessary epinephrine dose could harm a child; witnesses responded that epinephrine given in an emergency is considered safe and that a child given epinephrine should be taken to an emergency department for follow‑up. Sponsors and witnesses agreed to refine bill language on training to emphasize recognition of anaphylaxis in very young, often nonverbal children and to consider requiring informational materials in multiple languages; witnesses said English and Spanish materials are already available in jurisdictions that have implemented similar laws.

The bill text discussed during the hearing includes a provision (subsection d(1)) directing the state Department of Health, in consultation with the Department of Human Services (DHS), to develop informational materials for day care facilities and to distribute those materials to parents and guardians within 90 days of the subsection's effective date. Committee members asked whether 90 days is feasible; witnesses said states with existing programs have used similar timelines and offered to share materials that can be adapted.

No formal committee vote was taken at the hearing. Committee chairs said a voting meeting will be scheduled when the Legislature returns in June. Sponsors indicated they may amend the training language to specify signs and symptoms in infants and toddlers and to emphasize language access; the Department of Health and DHS were named in the bill as the implementing agencies for the informational materials.

The hearing combined personal testimony about a preventable death, advocacy from a national allergy organization, and technical questions from committee members about training, funding, and timeline. Advocates urged the committee to act to prevent further deaths; officials and sponsors emphasized implementation details that will determine whether the bill achieves its safety goals.