Allergy & Asthma Laws by Year

Requires drug labels for human use to clearly identify any ingredient derived from a major food allergen or gluten-containing grain; drugs without disclosure deemed misbranded.

Establishes a federal grant program for first responder agencies to obtain epinephrine auto-injectors and train police, firefighters, and emergency personnel to recognize and treat anaphylaxis.

Requires private health insurers to provide epinephrine products without deductibles, copayments, or coinsurance.

Establishes enforceable limits on toxic heavy metals in infant and toddler food and strengthens testing and transparency requirements for manufacturers.

A pending Massachusetts bill that would require restaurants to designate an allergy-knowledgeable server liaison for allergic customers.

Requires parity in the mental and physical health treatment of the residents of New York state; provides that both mental and physical health will be matters of public concern and provision therefor shall be made by the state.

Prevents discrimination by insurers based on an individual's mental health or substance use disorder; incorporates into state law federal enforcement rules set forth in the federal Mental Health Parity and Addiction Equity Act of 2008.

Relates to establishing residential treatment facilities as an alternative to incarceration designated by the commissioner for the care and treatment of persons with serious mental illness who are accused of at least one felony level crime.

Amends title XVIII of the Social Security Act to provide Medicare coverage for medical nutrition therapy services for individuals with certain diseases, which can include conditions like celiac disease or severe food allergies requiring specialized diets.

Proposed legislation to provide civil liability protection for entities and individuals that maintain and use stock epinephrine in emergencies, expanding the scope beyond schools to public places including aircraft.

Proposed legislation to allow schools to maintain a stock supply of albuterol and other asthma rescue medications for emergency use by students experiencing respiratory distress.

A pending bill intended to further codify and potentially expand the ability or requirement for schools to maintain a stock supply of epinephrine auto-injectors.

Updates school health codes to permit the stocking and administration of any FDA-approved epinephrine formulation, such as nasal sprays, for treating anaphylaxis.

Requires clear labeling of barley, rye, and oats as major allergens on packaged foods, and orders federal health studies on celiac disease prevalence and treatment.

Allows schools to stock and administer single-dose nasal epinephrine in addition to injectable auto-injectors for treating anaphylaxis.

Expands the definition of approved epinephrine for school and entity stocking to include all FDA-approved premeasured delivery systems, including nasal sprays.

This bill broadens the mechanisms permitted for the emergency administration of epinephrine in schools, institutions of higher education, and youth camps.

This bill establishes food allergy safety and anaphylaxis response protocols in licensed child care centers and family day care homes.

Permits a pharmacist to distribute pre-measured doses of epinephrine to a school for emergency medication kits.

Mandates the Cabinet for Health and Family Services add alpha-gal syndrome to the state list of noncommunicable diseases that healthcare providers and facilities must report.

Bans copay accumulator adjustment policies that prevent manufacturer copay assistance from counting toward patient deductibles and out-of-pocket maximums.

Provides legal protection to trained Good Samaritans who administer epinephrine in emergencies, particularly in schools, to reduce preventable deaths from anaphylaxis.

Requires group health plans to establish a transparent exceptions process (24-72 hours) for step therapy protocols, allowing doctors to override insurer fail-first requirements when medically necessary.

This bill allows child care facilities to stock epinephrine and designate personnel to administer it during emergencies.

This bill expands the types of epinephrine devices permitted in schools and camps to include nasal sprays.

This bill increases access to epinephrine auto-injectors in public venues by allowing authorized entities to stock and administer them.

To amend the Federal Food, Drug, and Cosmetic Act to include gluten-containing grain in the definition of a major food allergen.

Amends existing stock epinephrine laws to include needle-free nasal spray delivery systems for treating anaphylaxis in schools.

Requires the New York State Department of Health to include Alpha-gal syndrome on the list of reportable tick-borne diseases to track its spread.

Proposed legislation to establish emergency medication administration protocols for asthma inhalers and epinephrine delivery systems in public schools.

Requires clear labeling of barley, rye, and oats as major food allergens on all packaged foods, so Americans with celiac disease can easily identify whether a food is safe to eat. Brings U.S. labeling standards in line with 87 other countries that already require this.

Establishes a structured, science-based approach to improving indoor air quality in schools to reduce exposure to asthma triggers like mold and poor ventilation.

If passed, New Jersey food service businesses (restaurants, cafes, delis, coffee shops, convenience stores, grocery stores, food trucks, movie theaters, cafeterias) would have to list the major food allergens in each menu item — either on the menu itself, via a QR code linking to a website, or on separate written materials like a chart or booklet.

Designates May 2026 as Asthma and Allergy Awareness Month to increase public understanding of these chronic conditions.

Amends statutes to allow private schools to maintain a supply of FDA-approved epinephrine delivery devices for emergency use by trained personnel.

This bill mandates a school nurse in every school, requires staff training on anaphylaxis, requires medical action plans for students with food allergies, and prohibits food at school celebrations.

Establishes a structured, science-based approach to addressing indoor air quality in school buildings to mitigate environmental asthma triggers.

Requires schools to maintain stock supplies of undesignated epinephrine and FDA-approved asthma rescue inhalers for emergency administration by trained personnel.

Mandates that Maryland restaurants provide written disclosures identifying major food allergens present in menu items and establishes compliance standards and penalties.

Proposed legislation to allow childcare facilities to stock undesignated epinephrine and train staff to administer it in emergencies, similar to the existing school laws.

Proposed legislation requiring Missouri restaurants to provide written notification of major allergens on menus or via digital QR codes.

Sets health and safety standards for childcare facilities, including protocols for medication storage and emergency response.

Permits schools to maintain a supply of stock emergency-use epinephrine for administration to any student experiencing anaphylaxis.

Directs the Secretary of Health to update anaphylaxis guidelines. It requires schools to maintain an anaphylaxis policy and plan, and clarifies that schools may maintain a stock of epinephrine autoinjectors via a standing order.

Requires school districts to allow students to self-carry and self-administer medication for asthma or anaphylaxis if they have a treatment plan and have demonstrated the necessary skill level to the school nurse.

Allows public and nonpublic schools to procure and maintain a supply of epinephrine auto-injectors. It permits trained school employees to administer the medication to any student or person experiencing anaphylaxis, provided the school has adopted a formal policy.

Proposes that private health insurance plans in Michigan must cover epinephrine products without any out-of-pocket costs like copays or deductibles.

Requires childcare facilities to collect and maintain supplemental health information, including allergy details, for all enrolled children.

Requires local boards of education to provide a supply of emergency epinephrine delivery systems (including nasal sprays) on school property for use by trained personnel.

Directs the Virginia Department of Health to require retail food establishments to display food allergy awareness notices and include consumer allergy notification prompts on menus.

Requires schools to adopt and notify parents of policies regarding the use and storage of epinephrine auto-injectors or nasal sprays.

Authorizes school personnel to administer epinephrine to students experiencing anaphylaxis, regardless of prior diagnosis or prescription.

Mandates training for designated school personnel on recognizing anaphylaxis and administering epinephrine auto-injectors or nasal sprays.

Mandates that restaurants display food allergy awareness notifications for customers and back-of-house staff to mitigate allergen cross-contact risks.

Requires restaurants altering food for consumer-identified food allergies to affix an identifying marker on delivery and carryout food packaging.

Virginia's updated food regulations require food establishments to disclose allergens on menus (via words, icons, or numbers with a legend) and provide a Food Allergen Notice. The 2026 update also introduces a new produce safety regulatory program.

Governs how licensed early learning providers handle medications. While it permits administration of prescribed epinephrine or inhalers with parental consent and training, it does not provide a mechanism or requirement for UNDESIGNATED stock medication.

Sets the general rules for school staff administering any medication to students. It includes requirements for labeling, storage, and specialized training for staff who are not nurses.

Requires schools to allow students to carry and use their own asthma inhalers if the school has received written parental authorization and the student's inhaler is properly labeled.

Requires Montana childcare centers to maintain and post a list of children's food allergies in food preparation areas.

Establishes clinical protocols for the use of stock epinephrine in Kentucky schools for students with or without a known diagnosis.

Provides updated mandatory guidance for Texas school districts to adopt and administer policies for students with diagnosed food allergies at risk for anaphylaxis.

Tennessee schools may now administer any prescribed form of epinephrine (not only auto-injectors) to a student believed to be having a life-threatening allergic or anaphylactic reaction.

Requires child care centers to develop and implement a written plan for the prevention of and response to food and allergic reactions.

Allows school districts and private schools to maintain a supply of epinephrine auto-injectors for use by trained personnel on any student having an anaphylactic reaction, regardless of a prior prescription. It requires a policy and provides immunity from liability for good faith administration.

Allows school nurses to delegate the administration of epinephrine to trained unlicensed staff and permits schools to maintain a stock supply of epinephrine for use in life-threatening emergencies for any student.

Specifically authorizes schools to stock and administer epinephrine via nasal spray in addition to traditional auto-injectors.

Allows schools to maintain a stock of albuterol inhalers and spacers and permits trained staff to administer them during respiratory distress.

Requires local school boards to have policies for the possession and administration of stock epinephrine auto-injectors. It also permits (but does not require) schools to stock undose-designated albuterol inhalers for emergency use. The law mandates training for school personnel and provides civil immunity for those who administer the medication in good faith. It also protects the rights of students with diagnosed conditions to self-carry and self-administer their own rescue medications with provider and parental consent.

This general statute provides broad immunity for school staff who administer prescribed medications (including epinephrine and inhalers) to students in accordance with the law. It establishes the training standards required for non-nursing staff to give medications.

Allows schools to stock and administer needle-free nasal spray epinephrine and vials for injection to increase flexibility in emergency allergy response.

Permits school districts and public charter schools to maintain a supply of bronchodilators (rescue inhalers) and allows trained staff to administer them to students in respiratory distress. It also protects the right of students to self-carry and self-administer their own prescribed asthma or allergy medication.

Requires all public and approved independent schools to allow students with life-threatening allergies or asthma to possess and self-administer their own prescribed emergency medication, including on school buses and at school-sponsored activities.

Authorizes schools to stock asthma inhalers for use in emergency situations. Trained staff may administer the inhaler to a student who has a prescription on file or to any student they believe is experiencing respiratory distress.

Ensures students are permitted to carry and use asthma inhalers while at school, on a school bus, or at school-sponsored activities, provided the required parental and medical authorizations are submitted to the school.

Defines the training and authorization requirements for unlicensed personnel to administer medications in schools and childcare settings.

Ensures that school districts cannot prohibit students with life-threatening allergies or respiratory diseases from carrying and using their own prescribed epinephrine auto-injectors or inhalers.

Allows authorized entities and public venues to stock epinephrine auto-injectors and use them in anaphylaxis emergencies.

Updates Illinois law to recognize all FDA-approved epinephrine treatments, including non-needle options like the Neffy nasal spray, so schools, camps, after-school programs, law enforcement, home health care, and insurers are no longer restricted to needle-based auto-injectors.

Designates October as Eczema Awareness Month to increase understanding of atopic dermatitis and support research into causes and treatments.

Federal bill to add alpha-gal to the definition of 'major food allergen' under the Federal Food, Drug, and Cosmetic Act, requiring labeling of alpha-gal in food products.

New York bill S8587A requiring child day care centers to have epinephrine devices and staff trained to use them on site in case of anaphylaxis or other severe allergic reaction.

Pennsylvania's Elijah's Law (HB 928) to ensure childcare employees have access to and training on epinephrine devices, passed the House in June 2025 and is now pending in the Senate.

California SB 1347 authorizing schools to provide emergency stock albuterol inhalers and explicitly authorizing pharmacies to furnish them to local educational agencies.

Authorizes EPA grants to help communities upgrade air quality systems and protect vulnerable populations, including children with asthma, from hazardous wildfire smoke and extreme heat.

Allows public schools to store and use epinephrine nasal sprays in addition to traditional auto-injectors.

Requires healthcare providers to report cases of alpha-gal syndrome to the Tennessee Department of Health.

Assesses feasibility of in-state manufacturing of insulin, naloxone, albuterol, and epinephrine.

Relates to epinephrine injectors and their administration.

Emergency stock supply of epinephrine in schools with cost coverage.

Allows entities to be prescribed epinephrine for immediate administration.

Mandates insurance coverage at no cost for epinephrine injectors for minors.

Caps the price of epinephrine auto-injectors through insurance regulation.

Requires stock supply of non-patient specific epinephrine in schools.

To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to establish requirements with respect to cost sharing for epinephrine delivery systems under group health plans and group and individual health insurance coverage, capping cost sharing at $60 per package of 2 delivery systems without applying a deductible.

A bill to protect children with food allergies.

Catalogs activities and requires reports concerning federal and state asthma prevention, management, and surveillance, and expands support for asthma control programs.

Establishes a federal grant program to provide epinephrine products and training to law enforcement officers to improve their ability to respond to anaphylactic emergencies. It also mandates a public awareness campaign regarding the symptoms of anaphylaxis.

Ensures that all payments made by or on behalf of a patient, including copay assistance from manufacturers, count toward a patient's deductible and out-of-pocket maximum.

Requires federal health programs (Medicare, Medicaid, CHIP, FEHB) to cover medically necessary foods and vitamins for individuals with digestive or metabolic disorders, including Eosinophilic Esophagitis (EoE).

Formal resolution recognizing the health risks of particulate matter pollution, which include exacerbating asthma and other chronic lung diseases.

Requires group health plans to implement a clear and transparent process for patients to request exceptions to step therapy protocols, ensuring timely access to prescribed medications for chronic conditions like asthma.

Establishes a presumption of service connection for veterans exposed to toxins at the Pentagon Reservation who developed specific diseases, including asthma and other respiratory conditions.

The Senate companion to H.R. 5684, this bill expands coverage for medically necessary food and formulas under Medicare, Medicaid, and other federal health programs.

A comprehensive bill to update food labeling requirements to ensure transparency and clarity for consumers, including provisions that overlap with major allergen declarations and gluten labeling.

Senate companion to H.R. 5509, requiring group health plans to establish a clear and transparent process for patients to seek an exception to step therapy protocols, ensuring quicker access to medically necessary treatments.

Pending New York legislation (S.5381 / A.6558A) sponsored by Senator Pete Harckham and Assemblymember Lunsford that would require allergen labeling to help protect consumers with food allergies and celiac disease.

Updates school self-administration laws to explicitly include newly FDA-approved epinephrine delivery systems, such as nasal sprays.

If passed, Michigan food service establishments would have to give consumers a written notice listing the major food allergens present in each unpackaged food item they serve or sell (via menus, brochures, table tents, deli-case notices, or other written means).

If passed, beginning January 1, 2028, Illinois restaurant owners must put clear notices on menus and online menus identifying which menu items contain a major food allergen, with $500 fines for violations and possible shutdown after repeated inspection failures.

Would require food service establishments to provide written notification (on menus, placards, or electronically) of the presence of major food allergens in unpackaged food items.

Expressing support for the designation of May 2025 as National Asthma and Allergy Awareness Month.

Requires all food service permit holders in Michigan to provide written physical or electronic notification of any FDA-designated major food allergens used in unpackaged food items served or sold to consumers.

This bill updates Vermont law to allow schools to maintain a stock supply of intranasal epinephrine.

This bill requires first responders to be trained in recognizing and treating severe allergic reactions and to carry epinephrine delivery systems.

Proposes use of epinephrine nasal spray in schools as alternative to auto-injectors.

Requires first responders to be trained to administer epinephrine delivery systems.

Requires social services to provide Medicaid coverage for allergen introduction dietary supplements for infants.

Amending auto-injector language and potentially adding epinephrine to school environments.

Enables trained and authorized school personnel to administer epinephrine.

Ensures safe medication administration including epinephrine in emergencies.

Enables trained and authorized school personnel to administer epinephrine.

Allows police to receive, possess, and administer epinephrine auto-injectors.

Ensures safe medication administration including epinephrine in emergencies.

Would require food facilities to display allergen awareness posters for staff and provide menu notices requesting customers inform staff of allergies.

Proposes to add alpha-gal syndrome and Lyme disease to the state's list of mandatory reportable conditions for tracking and resource allocation.

A bill to amend the Federal Food, Drug, and Cosmetic Act to add alpha-gal to the definition of major food allergen.

Requires pharmaceutical companies to clearly label common allergens and gluten-containing grains present in medications, addressing a gap where inactive ingredients often cause reactions in patients.

Amends the Social Security Act to include penicillin allergy verification and evaluation as part of the initial preventive physical examination and annual wellness visits under the Medicare program.

Directs the Medicare Payment Advisory Commission to study and report on Medicare payment for emergency medical services, specifically including treatments involving epinephrine and albuterol administered by EMS.

This act revises requirements for milk provided by the National School Lunch Program, reversing restrictions to allow schools to serve whole or 2% milk. It also permits schools to offer non-dairy milk options and requires them to honor parental requests for non-dairy milk without requiring a doctor's note.

Incentivizes states to allow any trained 'Good Samaritan' to carry and administer epinephrine in schools during emergencies. It provides civil liability protection for trained responders and prioritizes federal grant funding for states that implement these policies.

Amends the Richard B. Russell National School Lunch Act to require schools to offer plant-based milk alternatives alongside cow's milk. The bill aims to accommodate students with lactose intolerance or dairy allergies and ensures non-dairy beverages meet nutritional standards.

House companion to S. 1236. Requires schools participating in the national school lunch program to provide fluid milk substitutes (plant-based milk) that meet USDA nutritional standards to accommodate children who are lactose intolerant or have dairy allergies.

Proposes to allow schools to maintain a stock supply of intranasal epinephrine and authorizes school personnel to administer it for life-threatening allergic reactions.

Adds single-use epinephrine nasal spray to the list of medications that schools may stock and that students may self-administer for chronic conditions like anaphylaxis.

Updates the existing school stock epinephrine statute to include epinephrine nasal spray as an approved delivery method for anaphylaxis emergencies.

A bill to include alpha-gal as an allergen.

Requires restaurants and other retail food facilities in Pennsylvania to post food-allergy-awareness posters in employee areas and to warn customers on menus about allergens used in the facility, asking customers to inform staff of their food allergies. Also updates the state Food Code to the 2022 FDA edition.

The standardized state form required for managing a child's asthma in licensed childcare and school environments.

Provides for the maintenance of a stock supply of epinephrine auto-injectors and emergency administration protocols.

Requires restaurants to disclose the presence of the nine most common food allergens in menu items to enhance consumer safety.

Authorizes school nurses and trained employees to administer epinephrine or albuterol to students in respiratory distress under standing physician protocols.

Mandates that school districts adopt an anaphylaxis policy ensuring that allergic students can self-carry epinephrine or have immediate, unlocked access to epinephrine delivery systems in close proximity during the instructional day, backed by individualized healthcare plans.

Authorizes a practitioner to prescribe epinephrine to an "authorized entity" (e.g., restaurants, sports arenas) for emergency use on any individual believed to be experiencing anaphylaxis.

Updates school health management protocols for students with asthma and food allergies, including self-administration and staff-administration of medication.

Revises pharmacy provisions and clarifies the authority for schools to acquire and maintain a stock of epinephrine auto-injectors.

Allows authorized entities and trained individuals to obtain, stock, and administer epinephrine delivery systems to any person believed in good faith to be experiencing anaphylaxis.

Authorizes school districts and charter schools to obtain and possess undesignated stock epinephrine delivery systems under a standing protocol from the Commissioner of Health, allowing designated staff to administer doses to any individual believed to be suffering anaphylaxis.

Authorizes entities including recreation camps, colleges, and universities to obtain, store, and use epinephrine auto-injectors for emergency use.

Expands emergency medical services personnel authority to administer epinephrine through any approved route, including intranasal sprays, during an anaphylactic emergency.

Authorizes schools to obtain and use stock epinephrine, glucagon, and albuterol for students experiencing respiratory or anaphylactic emergencies.

Authorizes school nurses and trained employees to administer stock epinephrine and other emergency medications to any student, employee, or visitor experiencing a life-threatening emergency.

Limits patient out-of-pocket costs for a two-pack of epinephrine auto-injectors to no more than $60 for covered individuals.

Incentivizes states to allow any trained individual to carry and use epinephrine devices at schools during allergy emergencies with liability protections.

Mandates allergen disclosure and real-time menu updates for food prepared, prepacked, and sold on the same premises in delis and bakeries.

Requires all K-8 Florida public school staff to be trained and prepared to administer emergency stock epinephrine auto-injectors to students experiencing anaphylaxis.

Caps out-of-pocket insurance copayments for a two-pack of medically necessary epinephrine auto-injectors at $60 starting January 1, 2026, and directs state agencies to create model anaphylaxis response policies for public schools and licensed child care programs.

Requires public school districts employing a nurse to maintain stock epinephrine, broadens statutory definitions from auto-injectors to include all epinephrine delivery devices (including nasal sprays), permits cross-individual emergency use, and authorizes recreation camps and colleges to possess stock supplies.

Mandates that school districts develop individualized health plans for students with prescribed epinephrine and ensures immediate access to epinephrine delivery systems during the instructional day.

Arkansas law requiring child care providers to manage food allergies, including emergency protocols for epinephrine administration. Named for Elijah-Alavi Silvera who died in November 2017 after being fed a grilled cheese sandwich at his NYC daycare despite a known dairy allergy.

Broadens the legal definition of epinephrine in school health codes to include non-injectable 'epinephrine delivery systems' like nasal sprays.

Encourages public and charter schools to stock bronchodilator rescue inhalers for emergency use on students appearing to experience respiratory distress.

Requires public and charter schools to provide food allergy training to food service employees and develop a comprehensive anaphylaxis action plan.

This statute permits students to possess and self-administer asthma inhalers while at school.

Requires allergen labeling for prepackaged foods to improve safety for individuals with life-threatening food allergies.

Permits trained non-medical individuals to possess and administer epinephrine.

Mandates specific ambulances be equipped with epinephrine auto-injectors.

Requires training for school personnel in treating severe allergies and anaphylaxis.

Requires certified school nurses to create individualized health care plans for students with severe allergies.

This law reauthorizes the FAA and includes specific requirements for the agency to update protocols and contents of airplane medical kits to better address anaphylaxis emergencies, including medications that can be used by flight crews.

Mandates that food establishments prominently display signage advising customers to notify staff of food allergies and providing allergen awareness information for employees.

This bill establishes requirements with respect to cost-sharing for epinephrine injectors under group health plans and group and individual health insurance coverage, effectively capping out-of-pocket costs at $60 for a two-pack of epinephrine auto-injectors.

Allows individuals with personal epinephrine prescriptions to administer to others in emergencies.

Allows trained school bus drivers to administer epinephrine to students.

Mandates health insurers cover epinephrine for individuals 18 or younger.

Equips first responders with epinephrine and allows bulk purchasing for municipalities.

To direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, to include alpha-gal syndrome on the list of nationally notifiable diseases.

Requires California State University and requests University of California campuses to maintain stock epinephrine auto-injectors.

Requires child care centers to maintain stock epinephrine auto-injectors and establishes training standards for daycare staff.

Requires health plans to provide coverage for medically necessary food and amino acid-based formulas for eosinophilic esophagitis (EoE) and FPIES.

A bill to protect children with food allergies.

This bill seeks to improve antibiotic stewardship by adding penicillin allergy verification and evaluation as a component of the 'Welcome to Medicare' and annual wellness visits.

To amend the Federal Food, Drug, and Cosmetic Act to include alpha-gal in the definition of a major food allergen for purposes of food labeling requirements.

To amend the Public Health Service Act to give a preference, with respect to project grants for preventive health services, for States that allow all trained individuals to carry and administer epinephrine, and for other purposes.

A bill to amend the Federal Food, Drug, and Cosmetic Act to add alpha-gal to the definition of major food allergen.

Requires licensed child care centers and family day care homes to implement food allergy management policies and maintain stock epinephrine administration devices.

Updates New Hampshire statutes regarding the storage and administration of stock epinephrine in schools to include newer delivery methods and clarified training requirements.