1. (a) Self-administration of a stress dose medication by a public school student.

   1. (1) Self-administration of a stress dose medication by a public school student with adrenal insufficiency while the student is at his or her public school, on his or her public school grounds, or at an activity related to his or her public school may be permitted:

      1. (A) With the authorization of the public school student’s:

2. (i) Parent, legal guardian, or person standing in loco parentis; and

   1. (ii) Treating physician; and

      1. (B) The public school student’s parent, legal guardian, or person standing in loco parentis provides written authorization for the public school student to carry a stress dose medication while he or she is at:

         1. (i) Public school;
         2. (ii) An on-site school-related activity; or
         3. (iii) An off-site school-sponsored activity.

   2. (2) The written authorization required in subdivision (a)(1) of this section shall be:

      1. (A) Valid only for the duration of the school year for which it is provided; and

      2. (B) Renewed:

         1. (i) For each subsequent school year for which the parent, legal guardian, or person standing in loco parentis intends to authorize the self-administration of a stress dose medication; and
         2. (ii) If the public school student transfers to another public school in this state.

   3. (3) A parent, legal guardian, or person standing in loco parentis who provides written authorization under subdivision (a)(1) of this section shall:

      1. (A) Include with his or her written authorization written orders from his or her public school student’s treating physician that the public school student:

         1. (i) Is capable of completing the proper method of self-administration of the stress dose medication; and
         2. (ii) Has been instructed on the details of his or her medical condition and the events that may lead to an adrenal crisis; and

      2. (B) Sign an individualized healthcare plan developed by the school nurse for the public school in which his or her child with an adrenal insufficiency is enrolled that outlines the plan of care for his or her child and includes without limitation notification of the self-administration of a stress dose medication to the:

         1. (i) School nurse;
         2. (ii) Teacher of the class in which the public school student is enrolled during an adrenal crisis; and
         3. (iii) Administrator of the public school.

   4. (4) A parent, legal guardian, or person standing in loco parentis who provides written authorization for his or her child’s self-administration of a stress dose medication shall sign a statement:

      1. (A) Acknowledging the public school district is not liable as a result of any injury arising from the self-administration of a stress dose medication by the public school student; and
      2. (B) Indemnifying and holding harmless the public school employees and public school district in which his or her child is enrolled against any claims arising as a result of the self-administration of a stress dose medication by the public school student.

3. (b) Administration of an emergency dose medication by volunteer public school personnel.

   1. (1) Public school personnel may volunteer to and may be permitted to administer an emergency dose medication to a public school student who is diagnosed with an adrenal insufficiency with the authorization of the parent, legal guardian, or person standing in loco parentis of the public school student:

      1. (A) If the public school personnel are trained to administer an emergency dose medication using the appropriate delivery equipment;
      2. (B) If a public school nurse is unavailable;
      3. (C) At school, on school grounds, or at a school-related activity; and

      4. (D) If the public school student’s parent, legal guardian, or person standing in loco parentis provides written authorization for the trained public school personnel to administer an emergency dose medication while the public school student is at:

         1. (i) A public school;
         2. (ii) An on-site school-related activity; or
         3. (iii) An off-site school-sponsored activity.

   2. (2) The written authorization required in subdivision (b)(1) of this section shall be:

      1. (A) Valid only for the duration of the school year for which it is provided; and

      2. (B) Renewed:

         1. (i) For each subsequent year for which the parent, legal guardian, or person standing in loco parentis intends to authorize trained public school personnel to administer an emergency dose medication to his or her child; and
         2. (ii) If the public school student transfers to another public school in this state.

   3. (3) A parent, legal guardian, or person standing in loco parentis who provides written authorization under subdivision (b)(1) of this section shall:

      1. (A) Include with his or her written authorization written orders from his or her public school student’s treating physician that the public school student requires the administration of an emergency dose medication under certain conditions; and

      2. (B) Sign an individualized healthcare plan developed by the school nurse for the public school in which his or her child with an adrenal insufficiency is enrolled that:

         1. (i) Outlines the plan of care for his or her child; and
         2. (ii) Includes without limitation a description of the required care following the administration of an emergency dose medication while the public school student is at:
4. (a) (a) School;

5. (b) (b) An on-site school-related activity; or

   1. (c) (c) An off-site school-sponsored activity.

   2. (4) A parent, legal guardian, or person standing in loco parentis who provides written authorization for the administration by trained public school personnel of an emergency dose medication to his or her child shall sign a statement:

      1. (A) Acknowledging the public school district is not liable as a result of any injury arising from the administration of an emergency dose medication by trained public school personnel; and
      2. (B) Indemnifying and holding harmless the public school employees and the public school district in which his or her child is enrolled against any claims arising as a result of the administration of an emergency dose medication by trained public school personnel.

   3. (5) Education and training on the treatment of adrenal insufficiency and adrenal crisis shall be conducted annually to public school personnel who volunteer to administer an emergency dose medication by the school nurse for the public school at which the public school personnel are employed and shall include without limitation:

      1. (A) General information about adrenal insufficiency and the associated triggers;
      2. (B) Recognition of signs and symptoms of a public school student experiencing an adrenal crisis;
      3. (C) The types of medications for treating adrenal insufficiency and adrenal crisis; and
      4. (D) The proper administration of medication used to treat an adrenal crisis.

   4. (6) The Division of Elementary and Secondary Education shall develop guidance and education for school nurses to train volunteer public school personnel as required under subdivision (b)(1) of this section.

      1. (c) Records.
   5. (1) Records of volunteer training shall be kept on file at each school.

   6. (2)

      1. (A) For each student diagnosed with an adrenal insufficiency who attends a school, the school district shall maintain a:

         1. (i) Copy of the student’s individualized healthcare plan;
         2. (ii) List of school personnel who have volunteered and been trained to administer an emergency dose medication; and
         3. (iii) Copy of the written authorization of the student’s parent, guardian, or person acting in loco parentis.

      2. (B) The list of volunteer school personnel and a copy of the written authorization shall be:

         1. (i) Updated annually; and
         2. (ii) Attached to the student’s individualized healthcare plan.

   7. (3)

      1. (A) The list of volunteer school personnel shall include only the names of personnel who successfully completed the required training as set forth in subdivision (b)(1) of this section.
      2. (B) This list of volunteer school personnel should be published and made known to all school personnel.
   8. (4) The principal of each school, in conjunction with each school nurse, shall properly maintain all such records.

Codification Notes: This section as promulgated prior to codification into the Code of Arkansas Rules provided as follows: “Adopted: June 15, 2024”