☰ Revisor of Missouri

There are multiple enactments of 196.990

Title XII PUBLIC HEALTH AND WELFARE

Chapter 196

< > Effective - 28 Aug 2026, 3 histories, see footnote    bottom

  196.990.  Epinephrine delivery systems, authorized entities may stock supply — definitions — procedure — immunity from liability — applicability. — 1.  As used in this section, the following terms shall mean:

  (1)  "Administer", the direct application of an epinephrine delivery system to the body of an individual;

  (2)  "Authorized entity", any entity or organization at or in connection with which allergens capable of causing anaphylaxis may be present including, but not limited to, qualified first responders, as such term is defined in section 321.621, facilities licensed under chapter 198, restaurants, recreation camps, youth sports leagues, child care facilities, amusement parks, and sports arenas.  Authorized entity shall not include any public school or public charter school;

  (3)  "Epinephrine  delivery system ", a single-use device or system used for the delivery of a premeasured dose of epinephrine into the human body;

  (4)  "Physician", a physician licensed in this state under chapter 334;

  (5)  "Provide", the supply of one or more epinephrine delivery systems to an individual;

  (6)  "Self-administration", a person's discretionary use of an epinephrine delivery system.

  2.  A physician may prescribe epinephrine delivery systems in the name of an authorized entity for use in accordance with this section, and pharmacists, physicians, and other persons authorized to dispense prescription medications may dispense epinephrine delivery systems under a prescription issued in the name of an authorized entity.

  3.  An authorized entity may acquire and stock a supply of epinephrine delivery systems under a prescription issued in accordance with this section.  Such epinephrine delivery systems shall be stored in a location readily accessible in an emergency and in accordance with the epinephrine delivery system's instructions for use and any additional requirements established by the department of health and senior services by rule.  An authorized entity shall designate employees or agents who have completed the training required under this section to be responsible for the storage, maintenance, and general oversight of epinephrine delivery systems acquired by the authorized entity.

  4.  An authorized entity that acquires a supply of epinephrine delivery systems under a prescription issued in accordance with this section shall ensure that:

  (1)  Expected epinephrine delivery system users receive training in recognizing symptoms of severe allergic reactions including anaphylaxis and the use of epinephrine delivery systems from a nationally recognized organization experienced in training laypersons in emergency health treatment or another entity or person approved by the department of health and senior services;

  (2)  All epinephrine delivery systems are maintained and stored according to the epinephrine delivery system's instructions for use;

  (3)  Any person who provides or administers an epinephrine delivery system to an individual who the person believes in good faith is experiencing anaphylaxis activates the emergency medical services system as soon as possible; and

  (4)  A proper review of all situations in which an epinephrine delivery system is used to render emergency care is conducted.

  5.  Any authorized entity that acquires a supply of epinephrine delivery systems under a prescription issued in accordance with this section shall notify the emergency communications district or the ambulance dispatch center of the primary provider of emergency medical services where the epinephrine delivery systems are to be located within the entity's facility.

  6.  No person shall provide or administer an epinephrine delivery system to any individual who is under eighteen years of age without the verbal consent of a parent or guardian who is present at the time when provision or administration of the epinephrine delivery system is needed.  Provided, however, that a person may provide or administer an epinephrine delivery system to such an individual without the consent of a parent or guardian if the parent or guardian is not physically present and the person reasonably believes the individual shall be in imminent danger without the provision or administration of the epinephrine delivery system .

  7.  The following persons and entities shall not be liable for any injuries or related damages that result from the administration or self-administration of an epinephrine delivery system in accordance with this section that may constitute ordinary negligence:

  (1)  An authorized entity that possesses and makes available epinephrine delivery systems and its employees, agents, and other trained persons;

  (2)  Any person who uses an epinephrine delivery system made available under this section;

  (3)  A physician that prescribes epinephrine delivery systems to an authorized entity; or

  (4)  Any person or entity that conducts the training described in this section.

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Such immunity does not apply to acts or omissions constituting a reckless disregard for the safety of others or willful or wanton conduct.  The administration of an epinephrine delivery system in accordance with this section shall not be considered the practice of medicine.  The immunity from liability provided under this subsection is in addition to and not in lieu of that provided under section 537.037.  An authorized entity located in this state shall not be liable for any injuries or related damages that result from the provision or administration of an epinephrine delivery system by its employees or agents outside of this state if the entity or its employee or agent is not liable for such injuries or related damages under the laws of the state in which such provision or administration occurred.  No trained person who is in compliance with this section and who in good faith and exercising reasonable care fails to administer an epinephrine delivery system shall be liable for such failure.

  8.  All basic life support ambulances and stretcher vans operated in the state shall be equipped with epinephrine delivery systems and be staffed by at least one individual trained in the use of epinephrine delivery systems.

  9.  The provisions of this section shall apply in all counties within the state and any city not within a county.

  10.  Nothing in this section shall be construed as superseding the provisions of section 167.630.

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(L. 2017 S.B. 139 merged with S.B. 501, A.L. 2020 H.B. 1682, A.L. 2026 H.B. 2372)


---- end of effective  28 Aug 2026 ----

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Effective End
196.990 8/28/2026
196.990 8/28/2020 8/28/2026
196.990 8/28/2017 8/28/2020

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