LA PLATA, Md. — Charles County Public Schools has begun updating its emergency allergy-response policy to comply with a new Maryland law requiring all public schools to stock and administer FDA-approved emergency use epinephrine treatments. These include traditional auto-injectors like EpiPen and Auvi-Q, and may now also include newly approved non-injectable options such as Neffy, a nasal spray cleared by the FDA in 2024.
Neffy was approved by the FDA in 2024, adding a new, needle-free option that delivers lifesaving medication without a shot—an addition that schools are now permitted to consider for their emergency treatment plans. However, Maryland law does not require schools to stock Neffy or any specific brand. It allows flexibility, as long as the product is FDA-approved for emergency use.
The updated policy was introduced as an informational item during the May 10 Board of Education meeting, marking the start of a statewide transition as all 24 Maryland school districts move to comply with the new law.
This change stems from House Bill 420, passed during the 2025 General Assembly session, which takes effect June 1. The legislation replaces the term “auto-injectable epinephrine” with “emergency use epinephrine” in Maryland’s education and health statutes. The updated language ensures that school systems can use the most current and appropriate FDA-approved treatments for severe allergic reactions, whether injectable or not.
According to the Centers for Disease Control and Prevention, an estimated 1 in 13 children (about 8%) have food allergies—roughly two students in every classroom. More than 15% of school-aged children with food allergies experience reactions at school, and 20%–25% of epinephrine uses involve students with no prior allergy history.
Families of students with diagnosed severe allergies are still required to submit personal prescriptions and written care plans annually. The statewide stock of emergency-use epinephrine is not intended to replace individualized health care management.
What Maryland Law Requires in Schools and Child Care Settings
Under Maryland Education Code § 7‑426.2, as amended by HB 420, all public school systems in the state must:
- Train staff to recognize the symptoms of anaphylaxis and administer emergency use epinephrine, if needed.
- Maintain emergency kits stocked with FDA-approved epinephrine devices, which may include injectable and non-injectable options, such as nasal sprays.
- Report each incident involving emergency epinephrine use and notify parents or guardians as required.
- Provide legal protections for school personnel who administer epinephrine in good faith, except in cases of willful or gross negligence.
Expanded Requirements for Maryland Child Care Providers
In addition to public schools, licensed child care centers are now included in Maryland’s emergency allergy response mandate:
- The Maryland State Department of Education (MSDE) and Maryland Department of Health (MDH) must jointly develop official guidelines to reduce exposure to major food allergens in child care environments.
- MSDE is required to publish a model allergy policy for providers, which includes:
- Protocols for administering emergency epinephrine
- Cross-contamination prevention strategies
- Notification requirements for relevant staff
- At least one free training resource must be made available to child care workers statewide
- Child care staff who act in good faith in accordance with these guidelines are protected from civil liability, except in cases of gross negligence.
What Maryland Law Requires in Schools and Child Care Settings
Under Maryland Education Code § 7‑426.2, as amended by HB 420, all public school systems in the state must:
- Train staff to recognize the symptoms of anaphylaxis and administer emergency use epinephrine.
- Maintain emergency kits stocked with FDA-approved epinephrine devices, including both injectable and non-injectable options, such as nasal sprays.
- Report each incident involving emergency epinephrine use and notify parents or guardians as required.
- Provide legal protections for school personnel who administer epinephrine in good faith, except in cases of willful or gross negligence.
Expanded Requirements for Maryland Child Care Providers
In addition to public schools, licensed child care centers are now included in Maryland’s emergency allergy response mandate:
- The Maryland State Department of Education (MSDE) and the Maryland Department of Health (MDH) must jointly develop official guidelines to reduce exposure to major food allergens in childcare environments.
- MSDE is required to publish a model allergy policy for providers, which includes:
- Protocols for administering emergency epinephrine
- Cross-contamination prevention strategies
- Notification requirements for relevant staff
- At least one free training resource must be made available to child care workers statewide; and
- Child care staff who act in good faith in accordance with these guidelines are protected from civil liability, except in cases of gross negligence.
Charles County Public Schools introduced its updated policy in alignment with these statewide mandates. As required, the draft will return to the Board of Education for further review and final adoption in upcoming sessions.
All Maryland school districts are expected to complete similar policy revisions in time for the 2025–2026 school year to remain fully compliant with state law.
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