Thank you for the opportunity to comment on the proposed fast-track regulation mandating that child day centers possess, store, and permit administration of stock epinephrine auto-injectors.

As a licensed child care provider, I strongly support protecting children from severe allergic reactions. However, I respectfully but firmly oppose this mandate in its current form and urge its removal from the fast-track process.

1. Existing regulations already adequately protect children with known allergies through required individualized health care plans, parent-provided epinephrine, staff training, and physician-authorized administration.

2. Mandating non-medical child care staff to assess symptoms and administer a powerful prescription drug to children without a diagnosed allergy significantly increases liability exposure. In an industry already struggling with skyrocketing liability insurance premiums, this new risk will drive premiums even higher — further threatening the financial viability of small, rural, nonprofit, and family child care programs.

3. The regulation imposes substantial unfunded costs ($290–$850 per device + frequent replacements every 12–18 months), diverting scarce resources from staff wages, facility needs, and serving low-income families.

4. It inappropriately shifts medical decision-making and pharmacological responsibilities onto early childhood educators who lack clinical training and oversight (unlike K-12 settings with school nurses).

5. A one-size-fits-all mandate fails to account for the extreme diversity of Virginia’s child care settings — from large centers to small family homes — creating logistical, storage, privacy, and operational burdens with minimal added safety for the rare undiagnosed case.

6. Current protocols — parent/physician-provided epinephrine for known allergies + immediate 911 activation for any suspected reaction — are proven, targeted, and sufficient. Voluntary programs, subsidies, or enhanced recognition training would achieve the same goal without punishing providers.

This proposal is highly controversial due to its significant cost, liability, insurance-premium, and equity implications. Fast-tracking bypasses the thorough stakeholder engagement, cost-mitigation exploration, and standard rulemaking process that such a resource-intensive mandate requires. Rushing forward risks program closures and reduced access in underserved communities.

I urge you to withdraw this proposal from fast-track consideration, pursue standard rulemaking, and work collaboratively with child care providers, insurers, and medical experts to develop sustainable, fully funded, or voluntary alternatives that enhance safety without jeopardizing the stability of Virginia’s child care system.

I welcome continued dialogue and can be reached at cmacon@primroseedinburghcommons.com or 757.410.8622.

Thank you for your consideration.

Sincerely,  
Claudia Macon
Primrose School at Edinburgh Commons

Chesapeake, VA 23322