FOR IMMEDIATE RELEASE
Alexandria, VA – Today, the Hopkins House Trustees announced that they submitted public comments to the Virginia Department of Education (VDOE), expressing strong opposition to proposed regulatory amendments that would require childcare providers to obtain, store, and administer weight-based stock epinephrine at their own expense.
The proposed changes to 8VAC20-780 (Standards for Licensed Child Day Centers) and 8VAC20-790 (Child Care Program) are being advanced in response to new state law (§22.1-289.059 of the Code of Virginia). While recognizing the intent to strengthen emergency response capacity when a child is experiencing anaphylaxis, Hopkins House warns that the proposed rules create a significant unfunded mandate that will place unsustainable burdens on early childhood programs and the working families they serve.
In their comments to VDOE, the Trustees noted:
“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 Concerns Raised by the Trustees
The public comment submitted by Hopkins House outlines several key reasons for opposing the amendments:
Unfunded Cost Burden: Stock epinephrine currently costs $290 to $850 per device, creating a sizeable recurring expense for providers already struggling with rising operating costs and workforce shortages.
Increased Liability and Insurance Costs: Administering prescription medication in emergency scenarios exposes providers to greater liability risk, which may lead to higher insurance premiums.
No State or Federal Funding: The proposal includes no resources to cover the cost of medication, staff training, or expanded insurance coverage needed to implement the mandate.
Not Clinically Appropriate: Educators are not clinicians, yet the proposal would require them to interpret symptoms and administer prescription medication. Pediatricians have cautioned that administering epinephrine when symptoms are not allergy-related could have serious medical consequences.
Limited Benefit in Urban Areas: Families in Northern Virginia have ready access to pediatricians who can prescribe individualized doses of epinephrine based on medical needs. A statewide universal mandate would impose costs that do not reflect local healthcare access.
Estimated Impact on Hopkins House
Based on current enrollment patterns, Hopkins House estimates that the proposed rule could add at least $8,500 per year in new medication costs for every 10 children with medical conditions requiring epinephrine treatment. This does not include staff training, operational changes, or expected increases in liability insurance.
“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.”
A Call for Revision
The Hopkins House Trustees are urging VDOE to reconsider, revise, or delay implementation of the proposed amendments and to work collaboratively with medical professionals, childcare providers, and families to develop a more balanced, medically appropriate, and financially supported policy.
“Hopkins House strongly supports safeguarding children’s health and well-being,” the Trustees wrote. “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.”
