On behalf of the Early Care and Education Consortium (ECEC), I am writing to oppose 8 VAC 20-780 in its current form. ECEC is a national non-profit alliance of multisite, multi-state child care providers, education service providers, and state associations. In Virginia specifically, ECEC members operate 323 centers, employing over 5,500 educators and staff, with the capacity to serve over 41,500 children. ECEC members serve as a collective voice for providers of high-quality programs and services that support families and children from diverse cultural, socio-economic, and geographic backgrounds.

ECEC strongly supports policies that protect children’s health and safety, including those that will effectively protect children from severe allergic reactions. However, we respectfully but firmly oppose this revised regulation in its current form and urge its removal from the fast-track process.

The regulation would require non-medical child care staff to assess symptoms and administer a powerful prescription drug to children without a diagnosed allergy. Child care professionals would be required to perform functions that are beyond the scope of their expertise, which could lead to serious health repercussions for children should errors occur. While the Virginia Department of Education (VDOE) is working to offer training in the administration of epinephrine free of charge to providers, there is no indication that the training would cover how to determine when to administer epinephrine to a child without a diagnosed allergy.

The requirement highlighted above would also significantly increase liability exposure for providers and their employees. The early care and education industry is already struggling with skyrocketing liability insurance premiums, and this new risk could drive premiums higher and threaten the financial viability of child care programs throughout the state.

The revised regulation also requires providers to obtain and store appropriate weight-based dosage(s) of stock or undesignated epinephrine, which range from $290-$850 per device. Further, replacements would be needed every 12-18 months, and providers would also need to consider sharps disposal and long-term stocking of medication. As there is no available federal or state funding to support implementation of the regulation at this time, the aforementioned requirements would impose significant unfunded costs on providers.

For the reasons above, we urge VDOE to withdraw the proposal from fast-track consideration and pursue standard rulemaking, which will allow for collaboration with stakeholders in developing alternatives that enhance safety without jeopardizing the stability of Virginia’s child care system.