Pennsylvania Childcare Adds Anaphylaxis Training Rules
Childcare staff will need anaphylaxis training and centers will have epinephrine access under a law taking effect in April 2027.
Updated on Nov. 3, 2026 in Allergies
Pennsylvania Gov. Josh Shapiro signed Elijah's Law (HB 928) on November 3, 2026, requiring childcare staff to receive anaphylaxis training and giving childcare centers access to epinephrine. The law takes effect 180 days after signing, in mid-April 2027, and will affect childcare centers and families across Pennsylvania.
Why it matters
The law was named after Elijah-Alavi Silvera, a 3-year-old with a severe dairy allergy who died after his preschool caregivers gave him a grilled cheese sandwich. For families of children with food allergies, the law targets a gap in childcare settings, where staff may not be prepared to recognize and respond to a severe allergic reaction quickly.
Elijah's Law is a state statute enacted by signature, not a study finding, and it is tied to one documented fatality in a 3-year-old with a severe dairy allergy. The extraction does not include outcome data showing how the training and epinephrine access requirements will change allergic-reaction outcomes in Pennsylvania childcare settings.
The players
Pennsylvania Gov. Josh Shapiro
Governor of Pennsylvania who signed Elijah's Law into state law.
State Rep. Bridget M. Kosierowski (D-Lackawanna)
Pennsylvania state representative who sponsored HB 928, the bill that became Elijah's Law.
State Rep. Kristin Marcell (R-Bucks)
Pennsylvania state representative who co-sponsored HB 928, the bill that became Elijah's Law.
The details
The law requires childcare staff to complete anaphylaxis training so they can recognize and respond to a severe allergic reaction. It also gives childcare centers access to epinephrine, the emergency medication used to treat anaphylaxis, and requires that educational materials be provided to families. Anaphylaxis can progress within minutes, which is why trained staff and immediate access to epinephrine are central to the law's approach.
Timeline
Elijah-Alavi Silvera died after a grilled cheese sandwich at preschool on a date not specified in the source.
Gov. Josh Shapiro signed Elijah's Law (HB 928) on November 3, 2026.
Elijah's Law takes effect in mid-April 2027, 180 days after signing.
Health Landscape
Elijah's Law is spreading as a template: New York City and Kansas City have adopted it as local ordinances, and New York, Illinois, Virginia, Maryland, Missouri, and California have adopted it at the state level. Pennsylvania's enactment places the state in a growing group of jurisdictions that require childcare staff to be trained for severe allergic reactions and to have epinephrine available.
If you have a child in a Pennsylvania childcare center, the law means staff will be trained to recognize and respond to anaphylaxis and families will receive educational materials about food allergies. Parents of children with known allergies may find it worth discussing an emergency action plan with the child's physician and the childcare provider once the law takes effect.
The takeaway
The core insight is that trained staff and quick access to epinephrine are the two safeguards this law adds to childcare settings. Families who want to know how their child's center will prepare for an allergic emergency can ask the center directly and bring the question to their child's physician.
What happens next
The law takes effect in mid-April 2027, 180 days after its November 3, 2026 signing, at which point childcare centers will be required to comply with the training and epinephrine access provisions.
Further reading
For more background on how severe reactions are managed, see our Allergies section.
Source note: This article includes information reported by Healio.
