The Hopkins House Board of Trustees appreciates the opportunity to comment on the Virginia Department of Education’s proposed amendments to 8VAC20-780 (Standards for Licensed Child Day Centers) and 8VAC20-790 (Child Care Program).

Hopkins House, a nonprofit organization founded in 1939, operates two preschools in Northern Virginia, serving 199 children, ages 6 weeks to 5 years old. Both preschools are accredited by the National Association for the Education of Young Children (NAEYC), participate in Virginia’s VQB5, and accept government and military childcare subsidies.

We recognize that these proposed changes are being advanced in response to new state law (§22.1-289.059 of the Code of Virginia) and are intended to strengthen emergency response capacity in cases of anaphylaxis.

However, after careful review, the Hopkins House Trustees must respectfully express our opposition to these amendments as currently drafted. While we fully support child health and safety, the proposed requirements impose significant financial, operational, and liability burdens on childcare providers and the working families they serve.

Summary of What the Proposed Amendments Require

If adopted, the amendments to 8VAC20-780 and 8VAC20-790 would require:

Licensed Child Day Centers to:

• Maintain an appropriate weight-based stock dosage of epinephrine, stored in a locked or otherwise inaccessible container.

• Ensure that at least one trained and authorized individual — a school nurse, a center employee, or a local health department employee — has continuous access to this medication during all operating hours.

• Implement policies outlining the possession, storage, and administration of epinephrine for any child believed to be experiencing an anaphylactic reaction.

Family Day Homes to:

• Ensure the provider or another caregiver is trained in epinephrine administration.

• Notify all parents whether the family day home stores an appropriate weight-based epinephrine dosage in the residence.

• Implement policies enabling administration of epinephrine to any child believed to be experiencing anaphylaxis.

Programs Participating in the Child Care Subsidy Program (Child Day Centers + Family Day Homes):

• To implement all of the requirements listed above, applicable to the type of provider.

Increased Unfunded Burden on Childcare Providers

While well-intentioned, these proposed new mandates substantially expand the responsibilities of childcare providers — many of whom do not employ clinical staff — without offering the financial or operational support needed to implement them safely or effectively:

1. Significant New Costs for Childcare Providers: Requiring providers to obtain and maintain weight-based epinephrine — costing $290 to $850 per device — creates a sizeable new financial obligation. Childcare programs already face rising operating costs, workforce shortages, and constrained budgets; absorbing this expense is unrealistic for many. And, if providers pass these costs onto parents, it will further restrict access to affordable childcare, especially for financially stressed working families.

2. Increased Liability and Insurance Premiums: Administering prescription medication — particularly in emergency scenarios — introduces substantial new liability exposure. Liabilities of this nature may drive up insurance premiums, which are already a major cost pressure for childcare programs. Educators are not clinicians, yet the proposed regulations require them to be prepared to interpret symptoms and administer a prescription medication. Pediatricians have cautioned that administering epinephrine for conditions other than an allergic reaction can have dangerous consequences, further underscoring the risk.

3. No Federal or State Funding Supports Implementation: At present, there is no funding to support the cost of medication, training, policy development, or increased liability coverage. Unfunded mandates of this scale threaten the financial stability of early childhood programs across the Commonwealth.

4. Challenges Obtaining Stock Epinephrine: Because epinephrine is a prescribed medication, providers may face difficulties securing stock or undesignated doses, particularly in the weight-based formulations required for young children.

5. Limited Utility in Urban Settings: While the amendments may help children in areas with limited access to medical professionals, families in urban regions such as Northern Virginia can readily obtain individualized prescriptions from their pediatricians. Making this new requirement universal in the Commonwealth would impose costs and risks without proportional benefit in many communities.

Impact on Hopkins House Preschool Academy

While the cost to individual providers is difficult to estimate, based on current enrollment patterns and the limited guidance available from the VDOE, Hopkins House estimates that the proposed policy could add at least $8,500 per year in potential direct medication costs for every ten children enrolled in our preschool academy who have medical conditions requiring epinephrine treatment. This substantial annual cost does not reflect the variability that occurs from year to year as the number of enrolled children with medical conditions requiring epinephrine, nor does it account for the additional operational expenses the policy would trigger.

Staff training — required to ensure that at least one trained individual is always onsite — would introduce both direct training costs and indirect personnel expenses associated with staff time. Hopkins House also anticipates higher liability insurance premiums, reflecting the increased risk associated with administering prescription medication in emergency situations.

Taken together, these factors could raise the annual operating expenses for Hopkins House and other childcare providers across the Commonwealth by thousands of dollars, creating a recurring and unpredictable financial burden at a time of significant fiscal uncertainty for Virginia’s childcare sector.

Conclusion

Hopkins House strongly supports safeguarding children’s health and well-being. However, these proposed amendments — without public funding, medical oversight, or considerations for program capacity — place substantial burdens on childcare providers and families, risk increasing childcare costs, and introduce significant liability concerns.

For this reason, the Hopkins House Trustees strongly oppose these proposed amendments to Virginia’s childcare regulations.

We respectfully urge the Virginia Department of Education to reconsider, revise, or delay implementation of these amendments and to engage childcare providers, medical professionals, and families in crafting a more workable policy solution.

Thank you for the opportunity to comment.

Submitted on behalf of the Hopkins House Board of Trustees

By the Public Policy & Advocacy Committee