HB 397 North Carolina House · 2025-2026 Session

Use of Epinephrine Nasal Spray.

HB 397 allows schools in North Carolina to use epinephrine nasal spray as an emergency treatment option alongside traditional auto-injectors for students experiencing anaphylaxis. The bill amends school health policies to include nasal spray devices in the definition of "epinephrine auto-injector delivery systems," requiring all schools to maintain at least two emergency epinephrine supplies (now including nasal spray) in secure but accessible locations. Schools must train staff to recognize anaphylaxis symptoms, store devices properly, and follow emergency action plans developed with school nurses. This applies to public schools, charter schools, and regional schools starting in the 2025-2026 school year. The policy directly affects school staff, students with severe allergies, and school health protocols.
Bill status passed 3 of 5 stages cleared
Introduction
Mar 2025
Committee Review
Apr 2025
House Passage
Apr 2025
Senate Passage
Governor
Introduced Mar 13, 2025 Last action Apr 10, 2025
Maddy AI version diff · 2 comparisons

What changed between versions

Edition 1 Edition 2 · 3 edits
MINOR
This bill was amended to clarify its title and remove unnecessary sponsor information. The substantive policy content regarding epinephrine nasal spray use in schools remains unchanged, with the bill still authorizing schools to use both auto-injectors and nasal spray for students with asthma or anaphylaxis conditions.
Scope change
The bill's scope remains focused on allowing epinephrine nasal spray in addition to auto-injectors in North Carolina schools. No changes were made to the eligibility criteria, funding, or operational requirements.
TECHNICAL

Short title was simplified from 'Use of Epinephrine Nasal Spray in Schools' to 'Use of Epinephrine Nasal Spray'.

Sponsor information and committee referral details were removed from the header section.

Committee Substitute Favorable date (4/1/25) was added to indicate the bill version.

Floor votes · House Apr 9, 2025

How they voted

1140
Passed · 7 other
Total votes 121
Apr 9, 2025
D Democratic46
44 Yea 2
95% Yea
I Independent2
2 Yea
100% Yea
R Republican73
68 Yea 5
93% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
16
Key actions
4
Committee
7
Apr 10, 2025
Committee
Ref To Com On Rules and Operations of the Senate
upper
Apr 9, 2025
Lower · Passed
Passed 3rd Reading
lower
Apr 3, 2025
Lower · Passed
Reptd Fav
lower
Apr 1, 2025
Committee
Re-ref Com On Rules, Calendar, and Operations of the House
lower
Apr 1, 2025
Lower · Passed
Reptd Fav Com Substitute
lower
Mar 25, 2025
Committee
Re-ref Com On Education - K-12
lower
Mar 25, 2025
Lower · Passed
Reptd Fav
lower
Mar 17, 2025
Committee
Ref to the Com on Health, if favorable, Education - K-12, if favorable, Rules, Calendar, and Operations of the House
lower
Mar 13, 2025
Introduced
Filed
lower
1 primary · 19 co-sponsors

Sponsors