House Bill 397 expands North Carolina law to allow epinephrine nasal spray to be used alongside traditional epinephrine auto-injectors in school and non-school emergency settings. The bill updates multiple statutes to replace the narrower term “epinephrine auto-injector” with “epinephrine delivery system,” and defines that term to include nasal sprays as well as spring-activated injectors. It also revises school health provisions so students with asthma or anaphylactic conditions may possess and self-administer prescribed epinephrine delivery systems, and so schools must maintain a supply of emergency epinephrine delivery systems for trained personnel to use in anaphylaxis emergencies.
The bill further amends the law governing authorized entities such as camps, colleges, day care facilities, youth sports leagues, restaurants, workplaces, and sports arenas. These entities may obtain a prescription for and stock epinephrine delivery systems, train designated staff, and provide or administer the medication in good faith to individuals believed to be experiencing anaphylaxis. The measure also extends immunity protections for entities, prescribers, dispensers, trainers, and trained users acting under the statute, while preserving liability for willful, wanton, or intentional misconduct. The bill takes effect when it becomes law, with the school-related provisions applying beginning with the 2025-2026 school year.
HB397 would change North Carolina’s school health and emergency allergy-response laws by broadening the statutory framework from epinephrine auto-injectors to epinephrine delivery systems, expressly including nasal spray products. It would require local boards of education, charter schools, regional schools, and laboratory schools to comply with the updated emergency epinephrine requirements, maintain supplies, and train personnel, while also updating the law for authorized non-school entities to stock and use these products. The bill would also revise related immunity and liability provisions in Chapter 90 to cover the expanded delivery systems and their use in anaphylaxis emergencies.
The available legislative record shows no recorded votes or committee transcript debate, but the bill’s text suggests a broadly supportive, public-health-oriented measure aimed at improving emergency response options for severe allergic reactions. Its committee substitute favorable status indicates it advanced with committee support. Overall, the bill appears noncontroversial in purpose, focusing on access, flexibility, and safety in schools and other public settings.
The main policy issue is the expansion from traditional auto-injectors to nasal spray delivery systems, which requires conforming changes across multiple statutes and raises implementation questions for schools and other entities about training, storage, prescriptions, and emergency procedures. Another possible point of concern is the scope of immunity for authorized entities and trained individuals, though the bill preserves liability for willful, wanton, or intentional misconduct. No specific opposition is documented in the provided materials, so any contention appears to be limited to operational and legal adjustments rather than the underlying goal of treating anaphylaxis.