Allergy Awareness & Elijah’s Law

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Child care professionals play a critical role in protecting the health and safety of the children in their facilities, which includes allergy awareness. The US Centers for Disease Control and Prevention (CDC) estimates that 1 in 13 children is impacted by allergies. Allergies have the potential to create a life-threatening situation. Anaphylaxis (a severe, life-threatening allergic reaction) must be treated right away. By learning about allergies and preventing anaphylaxis, child care providers can save lives.

In November 2017, 3-year-old Elijah Silvera from New York City was given a grilled cheese sandwich while at day care despite having a known severe dairy allergy; Elijah went into anaphylaxis and died.

In 2019 New York State adopted new legislation called Elijah’s Law. Elijah’s Law impacts all child care facilities and requires them to follow state food allergy guidelines to prevent, recognize and respond to life-threatening anaphylactic reactions.

Child Care Facility Requirements

All licensed and registered OCFS facilities must have a comprehensive Health Care Plan that includes the prevention of allergic reactions and the recognition of and prompt response to anaphylaxis.

This plan must be reviewed as required by regulation and updated when circumstances, conditions or activities change or as required.

The section(s) of the plan related to anaphylaxis must address the following elements:

  • Anaphylaxis prevention through screening and identification of children with allergies
  • Individual Allergy and Anaphylaxis Emergency Plans for children known to have food or other allergies that include clear instructions of action to take when an allergic reaction occurs
  • Training program for child day care personnel to prevent, recognize and respond to food and other allergic reactions and anaphylaxis
  • Strategies to reduce risk of exposure to allergic triggers
  • Communication plan for intake and dissemination of information among staff and volunteers regarding children with food or other allergies (including risk reduction)
  • Annual notification to parents of anaphylaxis plan

View OCFS’ most recent version of the Health Care Plan (HCP).

Note: The most recent Health Care Plan contains allergy & anaphylaxis specific content that all child care facilities are required to have.

Anaphylaxis Policy

A comprehensive, coordinated approach among child care program staff, volunteers, families and children, and the children’s medical providers is needed for the effective prevention and management of allergies and allergic reactions, including anaphylaxis. Child day care program leadership is necessary not only to guide planning and implementation of the policy and procedures but also to monitor ongoing compliance, with special attention being paid to educating new staff and volunteers, and updating current staff and volunteers.

Anaphylaxis Policy for Child Day Care Programs

Non-Patient Specific Auto Injector Initiative

Child care providers play an important role in the health and well-being of the children. Children with a diagnosed allergy rely on their caregivers to prevent exposure to allergens and to have a plan in place in the event of allergic reaction. Many of the children in your program are experiencing events for the first time, including new foods and insect bites. There is no way to predict when a child will have an allergic reaction. If it were to occur, do you and your staff know what to do?

Epinephrine is the first line drug of choice for the emergency treatment of severe allergic reactions. It is a safe medication. There is no medical reason for trained, designated staff to withhold administration of an auto injector in an emergency if anaphylaxis is suspected.

The goal of this initiative is to spread allergy awareness to all caregivers and families, thus preventing further tragedy. Having a non-patient specific auto injector a day care program’s emergency tool kit, and the knowledge on how to use it, is a potentially lifesaving investment. OCFS strongly encourages all childcare programs to take advantage of this exciting opportunity! Thank you for your commitment to the well-being of children.

OCFS is thrilled to partner with Health First, the authorized distributor of AUVI-Q, an epinephrine auto injector for all age groups! Each participating program will receive a no cost package containing up to 3 doses of two non-patient specific auto injectors and one training device.

Participation in this potentially life-saving initiative is simple! Join the thousands of other day care programs by completing 3 easy steps:

  1. Designate at least one individual per program who successfully completed an approved epinephrine training course (such as OCFS’s Identifying and Responding to Anaphylaxis no cost training – found on ECETP website). During the training, participants will be asked if they would like to participate and which doses they would like to receive. OCFS strongly encourages all caregivers to take the training and request all doses, but to be eligible for the auto injectors, at least one person per program is required to complete the training.
  2. Update your Health Care Plan:
    1. Complete Appendix J indicating you are participating & agreeing to comply with the terms.
    2. Complete Appendix H - Record each individual who has successfully completed the approved epinephrine course.
  3. Submit the updated HCP to your Regulator and HCC (as applicable).

Upon successful completion of these steps, Health First will reach out to the child care program to verify the name of the designated individual, and the shipping address of the program. Health First will NOT ask for any sensitive information. Health First will ship a package containing two non-patient specific auto injectors and one training device directly to the child care program. Once received, the child care program will confirm receipt via email.

Child Care Provider Testimonials

See what the day care community is saying about the non-patient specific auto injector initiative!


Health Care Plan Forms

Individual Plan Forms

  • OCFS-LDSS-7006 - Individual Health Care Plan for a Child with Special Health Care Needs
  • OCFS-6029 - Individual Allergy and Anaphylaxis Emergency Plan

Consent Forms

Yellow Card

  • OCFS-0792A - Individual Allergy and Anaphylaxis Emergency Action Card


Identifying and Responding to Anaphylaxis training can be found on the ECETP website under “E-Learning”

This training is available in English and Spanish.

After selecting eLearning from the top menu, scroll down until you find the listing for Identifyign and Responsing to Anaphylaxis
The Identifying and Responding to Anaphylaxis should take approximately 90 minutes to complete. Select the Proceed to Register button to register for the course.

Additional Training Resources

The following organizations offer online training to anyone who has an interest an epinephrine and anaphylaxis training and information.

Resources and Information

Dear Provider Letters

Stay current with the most recent information regarding all things allergy awareness in child care.

April 4, 2023 - Non-Discreet Strategies & new OCFS Form-0792A, the “Yellow Card”
August 10, 2022 - Non-Patient Specific Auto Injector Expansion – 2 Additional Doses
October 13, 2021 - Regulation, Health Care Plan Changes & Requirements, Training information
August 19, 2021 - Introduction to: Anaphylaxis Policy, Regulations, Training, Auto Injector Initiative
March 15, 2021 - Policy, Forms, Regulation, Training, Auto Injector Initiative

Anaphylaxis Wall Poster

Downloadable poster on identifying anaphylaxis in infants
Programs parents can download and print a PDF of this anaphylaxis wall poster.

Best Practices in the Classroom

Use a placemat for children with known allergies.
Example allergy alert placemat

Make placemats for children with allergies, listing their allergies for other care staff.

Hang STOP Allergy Sign outside classroom doors.
Example allergy alert stop sign

Make signs to notify people that children in your classroom may have allergy issues.

Obtain permission from parents to use non-discreet strategies around the classroom.

Make sure you get permissions from parents to use non-discrete strategies. The approval box is part of form OCFS-LDSS-7006 - Individual Health Care Plan for a Child with Special Health Care Needs.

Other Resources for Parents and Providers

From Food Allergy Research and Education (FARE)

Other Allergy Information Sites

Child-Friendly Videos

Contact Us

Elijah’s Law General Questions Mailbox
If you have any additional questions about Elijah’s Law, please email:

Social Media Guide

This guide is designed to help raise allergy awareness and to increase provider participation in the NYS Non-Patient Specific Auto-Injector Initiative through the power of social media. Please feel free to use any or all of the assets found in this guide to help us spread the word on your own social media channels.

Images for Social Media


Did You Know?