As a professional nurse, I have never been required to have a provider's authorization on a written care plan. Part of my responsibility to the patient, is that I will develop a plan of care with a goal(s), provide care, then measure if the goal was met. Virginia will not mandate nurses in our schools but who is going to complete all of these requirements for Medicaid billing if we aren't here to do it? This would consume additional time that would be taken from providing nursing care and supervision. Our children are ensured the ability to attend school and be provided with the safest and most optimal setting. Consuming time by shuffling unnecessary paperwork will not allow us to provide what we are promising.