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HB 397

Use of Epinephrine Nasal Spray.

2025-2026 Session Introduced by Amber Baker and 19 co-sponsors

Schools must stock and train for nasal epinephrine in emergencies, with at least two devices on campus and a formal emergency action plan.

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Bill Summary · HB 397

Summary — HB 397 (Use of Epinephrine Nasal Spray in Schools) — North Carolina (2025)

Status: Introduced; committee substitute filed. Effective when enacted and applies beginning with the 2025–2026 school year. Sponsor: Rep. Lambeth.

This summary describes HB 397 as amended (committee substitute) — the North Carolina bill titled “Use of Epinephrine Nasal Spray in Schools,” which amends existing school health statutes.

Purpose / Intent

To expressly authorize and integrate epinephrine nasal spray formulations into the set of emergency epinephrine “delivery systems” that schools must stock and to require schools (including charter, regional, and laboratory schools) to maintain supplies, train personnel, and adopt emergency procedures for use in anaphylactic emergencies.

Key provisions

  • Expands statutory definitions:
    • Revises “epinephrine auto‑injector delivery system” to encompass nasal epinephrine sprays as well as traditional spring‑activated injectors with concealed needles.
  • School supply requirement:
    • Each school must maintain a supply of emergency epinephrine delivery systems and shall store a minimum of two devices in a secure, unlocked, and easily accessible location on school property. (“School property” excludes transportation to/from school.)
  • Personnel, prescriptions, and training:
    • The principal must designate one or more school personnel to receive initial training and annual retraining from a school nurse or qualified local health department representative on storage and emergency use.
    • Trained personnel shall obtain a non‑patient‑specific prescription for epinephrine delivery systems from a physician, physician assistant, or nurse practitioner at the local health department.
  • Emergency action plan:
    • Schools must develop an emergency action plan covering storage/use procedures, recognition of anaphylaxis, emergency follow‑up (call 911; notify parent/physician), and CPR instruction/certification.
  • Special rules:
    • Stocked school supplies may not be relied upon as the sole medication for students known to require their own prescribed epinephrine; those students may still possess and self‑administer personal medication under existing law.
  • Applicability:
    • Requires compliance by charter schools, regional schools, and laboratory schools (statutory cross‑references updated accordingly).

Who is affected

  • Local boards of education, charter/regional/lab schools, school principals and designated staff, school nurses, local health departments, students at risk of anaphylaxis, and parents/guardians.

Potential impact

  • Operational: Schools must adopt or update policies, hold/secure at least two epinephrine devices on campus, designate and train personnel, and obtain non‑patient‑specific prescriptions through local health departments.
  • Fiscal: Costs may include purchase of epinephrine devices (injectors or nasal spray), training time, and administrative coordination. The bill text does not appropriate state funding; costs would generally fall to local school administrative units and charter/regional/lab schools.

Effective timing

  • Becomes law on enactment and applies beginning with the 2025–2026 school year.

If you’d like, I can draft a one‑page checklist for school administrators summarizing required actions and timeline to comply with this bill.

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

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