House education committee advances diabetes-care bill after debate over medical plans and training

The Virginia House Education Committee voted 15-0 to report Senate Bill 13-03 as substituted after extended debate over how doctors'authored diabetes medical management plans (DMMPs) are implemented in schools and which staff must receive training.

The substitute adds a statutory connection between a student'specific DMMP and the school'created individualized health plan (IHP), sets a 30'day window for DMMP modification and IHP coordination, and places a special enactment clause sending the measure to the School Health Services Committee for further review with a report back by Nov. 1, 2025.

Why it matters: Advocates and school officials told the committee that in some divisions a DMMP can be received and then effectively ignored; the substitute aims to ensure the doctor'issued plan is reviewed and implemented at the school level. Lawmakers and education groups expressed split concerns about scope and training requirements in the bill.

Senator McPike, the bill's patron, told the committee the substitute addresses a gap in practice: "Right now, the school system can refuse to do anything with the DMMP," he said. "What the substitute does is provide 30 days also for DMMP modification. That goes then into the IHP, the individual health plan that the school is, how they will implement that." (Senator McPike)

Representatives of school governance and nursing groups said the substitute still incorporates the existing diabetes manual and that training language in the manual remains part of the statutory text. A VSBA representative summarized the existing practice and raised concerns about how the substitute incorporates the manual: "Under the substitute for this bill, the DMMP is delivered to the school and then the school is mandated to implement it," the representative said, adding that current practice has school nurses review the DMMP and develop the IHP.

Committee members pressed for clarity on who chooses who receives higher'level training and whether schools would be required to ensure a set number of "level 3" trained staff. A committee member cited the bill language requiring three level'3 trained staff in any school with a student who has diabetes and asked how permissive language in the bill would operate if staff decline training.

The committee adopted five line amendments from the patron clarifying exclusions, technical language and an enactment clause requested by Delegate Cherry and stakeholder groups. After debate and the adoption of a section'1 substitute that carries the fifth enactment clause and the Nov. 1, 2025 review date, the full committee voted to report the bill as substituted; the clerk recorded the final committee report "with substitute 15 to 0." (Clerk)

Discussion and next steps: Committee members and the patron said they expect to continue working with the School Health Services Committee and stakeholders on training language and the relationship between the DMMP, the IHP and who actually implements or is assigned responsibilities in schools. The substitute sends the issue on with an explicit request that the School Health Services Committee examine implementation and return with findings by Nov. 1, 2025.

Supporting details and clarifications: The substitute (as described on the record) restores a reference to the individualized health care plan but directs that the DMMP be provided to the school and implemented; it also creates a 30'day mechanism for modifications and directs a statutory review by the School Health Services Committee. The bill drew testimony or input referenced from the Virginia Education Association and school nurse interests during the committee exchange.

Ending: With the committee'level substitute adopted and a unanimous committee report, SB 13-03 will move forward in the legislative process with the additional oversight and reporting requirement directed to the School Health Services Committee.