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HB 433

State Fiscal Recovery Fund/NC Pandemic Recovery Office Revisions.

2025-2026 Session Introduced by Eric Ager and 43 co-sponsors

HB 433 mandates North Carolina schools employ at least one full-time registered nurse per school to manage student health services and emergency medical care.

Pres. To Gov. 5/12/2026
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Bill Summary · HB 433

Legislative bill overview

HB 433 requires North Carolina public schools to employ at least one full-time registered nurse (RN) per school or establish a shared nursing services arrangement between schools. The bill mandates minimum staffing ratios and establishes standards for school nurse qualifications and responsibilities in managing student health services.

Why is this important

School nurses are primary healthcare providers for students during the school day, managing chronic conditions, medications, emergency response, and health screenings. Currently, many schools rely on part-time nurses, LPNs, or health aides, which can leave gaps in care—especially critical for students with diabetes, asthma, seizures, or severe allergies. This bill directly affects student safety, health outcomes, and school district budgets.

Potential points of contention

  • Cost burden: School districts would face significant expenses hiring additional RNs; smaller rural districts may struggle to comply, potentially requiring state funding support or tax increases
  • Implementation timeline: Unclear transition period for schools currently below staffing requirements; districts may face compliance challenges if effective date is soon
  • Shared services feasibility: The alternative of shared nursing between schools may be impractical in geographically dispersed districts and doesn't guarantee on-site nurse availability during emergencies

Compiled from official sources — confirm details with the bill’s official record.

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