Panel reviews bill to permit parent‑designated adults to give emergency injections for students with adrenal insufficiency

The House Education Committee heard House Bill 1709, a bill that would permit parent‑designated adults (PDAs) to provide necessary care for students with adrenal insufficiency, including administering emergency injectable cortisol when a nurse or parent is not available.

Damien Morden Snipper, nonpartisan staff, briefed members on how current statutory requirements limit schools’ ability to administer injectable medication except when specifically authorized and explained the existing PDA framework used for diabetes and seizure disorders. He described adrenal insufficiency (including congenital adrenal hyperplasia) as a condition in which the body does not produce enough cortisol; in acute adrenal crisis, low cortisol can present “an imminent risk of shock or death.” Snipper said injectable cortisol can be a life‑saving emergency treatment.

Representative Lisa Kallen, the bill’s sponsor, told the committee the measure mirrors existing PDA statutory language for epilepsy and diabetes so that parents can rely on trained, designated adults when a nurse or parent is not present. “The impact of not having a PDA access in our schools is children are limited,” Kallen said, noting parents often must attend every field trip or remove their child from activities to ensure prompt care.

Family testimony described past emergencies and practical gaps in coverage. Mark Harper, a firefighter and father whose son has congenital adrenal hyperplasia, recounted a home adrenal crisis: “When he was 7 years old, he had an adrenal crisis... Fortunately, my wife was there to give the shot of Solucortef. That saved his life.” Parents said many schools share nurses across buildings, and that calling 911 can be too slow because paramedics are not always immediately available.

Parents and school health leaders urged passage as an equity and safety measure. A parent from Issaquah said she has sometimes had to work from her car to be available when the school nurse was not on site; “Waiting isn't an option and it's unnecessary,” she told the committee after describing administering the emergency injection herself.

School nursing organizations supported the bill but recommended an amendment to allow a registered nurse to delegate administration to a trained staff member when the nurse is not available. Liz Pray, Washington state director of the National Association of School Nurses, asked the committee to modify language so that the life‑saving medication could be “delegated by a registered nurse in the school setting,” noting other states have adopted similar delegation models.

Committee members did not vote on the bill. Questions included how common the diagnosis is (witnesses could not provide statewide counts) and whether broader medical providers such as EMTs should be authorized; firefighters and witnesses noted EMT scope does not universally permit the medication while paramedics can administer it. Sponsors and staff said they would follow up with requested background information.

Why it matters: advocates and families framed the bill as a narrow, safety‑focused change that would allow trained adults designated by parents to deliver time‑sensitive, potentially life‑saving injections when school nurses or paramedics are not immediately available. School nursing groups asked for language that explicitly allows RN delegation to trained staff as a practical alternative.