Virginia subcommittee weighs shorter, blended rewrite of school diabetes law; debate over training, liability and stock glucagon continues

The Senate School Health Services Subcommittee met in Richmond to hear testimony and debate two substitute drafts of Senate Bill 13‑03, a proposal to update Virginia law governing diabetes care in public schools that advocates say is 26 years out of date.

Sponsor Senator McPike framed his 12‑page substitute as a narrowed, targeted update that modernizes references to insulin administration and wearable diabetes devices, clarifies prescriber authorization in schools, creates an intermediate 30‑day period for resolving disagreements about what authorized care school staff can provide, strengthens a nurse liability exemption and requires a stock, undesignated supply of glucagon in schools. "The purpose is really to to focus on updating the 26 year old code section, about diabetes care in schools and modernizing language and definitions," Senator McPike said when presenting the substitute.

Why it matters: The existing statutory language dates to the late 1990s and, critics say, assumes most students still receive insulin via syringe. Testimony at the meeting said current practice has shifted toward pumps, smart pens and continuous glucose monitors and that unclear code language has left nurses and school attorneys uncertain about delegation, supervision and liability.

Advocates and concerns

Carrie Murphy, identified as founder and executive director of an advocacy organization for families of students with type 1 diabetes, urged passage of the fuller changes McPike proposed. Murphy said SB 13‑03 seeks to correct persistent misinterpretations of earlier legislation and to require schools to make glucagon widely available. "The fact is allowing school boards to decide whether students with diabetes get the same access to life saving medications as their peers is discrimination under federal laws," Murphy said.

Stacy Haney of the Virginia School Boards Association told the subcommittee she continues to prefer the shorter substitute because the longer draft contains more specific requirements on training and staffing that could be difficult for school divisions to implement. "I continue to have concerns around the training, staffing, the level of requirements," Haney said, and urged the panel to consider the shorter vehicle.

Staff and fiscal questions

Ryan Brimmer, staff to the subcommittee, said some provisions — notably a requirement that schools carry undesignated stock glucagon and added directives for the Virginia Department of Education (VDOE) and Virginia Department of Health (VDH) to prepare materials and training — could create local and state fiscal impacts. He recommended conferring with appropriations staff to estimate costs.

Existing law and implementation

Committee discussion referenced current code sections and agency guidance. A staff speaker cited Code §22.1‑274 (education‑title provisions on training and disciplinary limits) and Code §54.1‑3408 (prescriber authorization and training for unlicensed personnel) as existing authorities that already require some training and prescriber authorization for insulin or glucagon administration. Senator McPike and multiple witnesses said the problem is inconsistent interpretation and implementation at the division level, not always the absence of statutory language.

Points of substantive debate

- Device language and technology: McPike's substitute replaces the outdated term "insulin injection" with language that covers insulin pumps, connected diabetes technology and other modern delivery systems.

- Prescriber authorization and a 30‑day resolution window: The substitute clarifies that staff may provide authorized care they are trained for, requires documentation when authorized care cannot be provided, and sets an intermediate 30‑day period for parties to resolve differences between prescriber authorization and what the school can provide.

- Nurse liability exemption: The substitute tightens wording to make explicit that trained unlicensed staff act under prescriber authorization and are not automatically covered by a nurse's professional license; it also seeks to protect nurses from liability for actions of trained employees when proper training was provided.

- Undesignated glucagon: The substitute would require — rather than permit — schools to maintain undesignated stock glucagon, analogous to past acts that required stocking epinephrine and albuterol. Advocates said making glucagon permissive has resulted in few school divisions acquiring it.

Staffing and training concerns

Several committee members and witnesses raised concerns about whether school divisions have enough personnel or nurses in every building to meet a more prescriptive statutory mandate. Senator Favola and others favored the shorter, less prescriptive substitute with a strong enactment clause directing VDOE and VDH to update and publish guidance and training materials that school divisions would use in division‑wide plans. Senator McPike acknowledged the staffing realities but maintained that clearer statutory language is necessary to overcome conservative legal interpretations by school board attorneys that have prevented some divisions from implementing existing law.

Next steps and committee direction

The subcommittee did not take a formal vote. Members directed DLS staff to draft a blended approach that would combine the shorter substitute's latitude for localities with the key clarifications in Senator McPike's version and to present that draft at a follow‑up subcommittee meeting in October. The chair said staff would "encapsulate what we've said today" and noted the committee will poll members to schedule the next meeting.

Ending

No formal action was taken at the meeting; committee members agreed to continue negotiations and to reconvene for further work in October.