{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/22.1-274.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/22.1-274.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/22.1-274.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/22.1-274.html"}],"law_id":82301,"edition_id":1,"section_id":82301,"structure_id":13512,"section_number":"22.1-274","catch_line":"School health services","history":"Code 1950, \u00a7 22-241; 1956, c. 656; 1980, c. 559; 1990, c. 797; 1991, c. 295; 1994, c. 712; 1997, c. 597; 1998, c. 871; 1999, cc. 570, 757; 2013, cc. 498, 530; 2021, Sp. Sess. I, c. 454; 2022, c. 355; 2023, c. 183.","full_text":"A\n\nA school board shall provide pupil personnel and support services in compliance with § 22.1-253.13:2. A school board may employ school nurses, physicians, physical therapists, occupational therapists, and speech therapists. No such personnel shall be employed unless they meet such standards as may be determined by the Board. Subject to the approval of the appropriate local governing body, a local health department may provide personnel for health services for the school division.B\n\nIn implementing subsection P of § 22.1-253.13:2, relating to providing support services that are necessary for the efficient and cost-effective operation and maintenance of its public schools, each school board may strive to employ, or contract with local health departments for, nursing services consistent with a ratio of at least one nurse per 1,000 students. In those school divisions in which there are more than 1,000 students in average daily membership in school buildings, this section shall not be construed to encourage the employment of more than one nurse per school building. Further, this section shall not be construed to mandate the aspired-to ratios.C\n\nThe Board shall monitor the progress in achieving the ratio set forth in subsection B and any subsequent increase in prevailing statewide costs, and the mechanism for funding health services, pursuant to subsection P of § 22.1-253.13:2 and the appropriation act. The Board shall also determine how school health funds are used and school health services are delivered in each locality.D\n\nWith the exception of school administrative personnel and persons employed by school boards who have the specific duty to deliver health-related services, no licensed instructional employee, instructional aide, or clerical employee shall be disciplined, placed on probation, or dismissed on the basis of such employee’s refusal to (i) perform nonemergency health-related services for students or (ii) obtain training in the administration of insulin and glucagon. However, instructional aides and clerical employees may not refuse to dispense oral medications.\n\t\t\tFor the purposes of this subsection, “health-related services” means those activities that, when performed in a health care facility, must be delivered by or under the supervision of a licensed or certified professional.E\n\nEach school board shall ensure that in school buildings with an instructional and administrative staff of 10 or more (i) at least three employees have current certification or training in emergency first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator and (ii) if one or more students diagnosed as having diabetes attend such school, at least two employees have been trained in the administration of insulin and glucagon. In school buildings with an instructional and administrative staff of fewer than 10, school boards shall ensure that (a) at least two employees have current certification or training in emergency first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator and (b) if one or more students diagnosed as having diabetes attend such school, at least one employee has been trained in the administration of insulin and glucagon. For purposes of this subsection, “employee” includes any person employed by a local health department who is assigned to the public school pursuant to an agreement between the local health department and the school board. When a registered nurse, advanced practice registered nurse, physician, or physician assistant is present, no employee who is not a registered nurse, advanced practice registered nurse, physician, or physician assistant shall assist with the administration of insulin or administer glucagon. Prescriber authorization and parental consent shall be obtained for any employee who is not a registered nurse, advanced practice registered nurse, physician, or physician assistant to assist with the administration of insulin and administer glucagon.","order_by":null,"text":{"0":{"id":294950,"text":"A school board shall provide pupil personnel and support services in compliance with § 22.1-253.13:2. A school board may employ school nurses, physicians, physical therapists, occupational therapists, and speech therapists. No such personnel shall be employed unless they meet such standards as may be determined by the Board. Subject to the approval of the appropriate local governing body, a local health department may provide personnel for health services for the school division.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":294951,"text":"In implementing subsection P of § 22.1-253.13:2, relating to providing support services that are necessary for the efficient and cost-effective operation and maintenance of its public schools, each school board may strive to employ, or contract with local health departments for, nursing services consistent with a ratio of at least one nurse per 1,000 students. In those school divisions in which there are more than 1,000 students in average daily membership in school buildings, this section shall not be construed to encourage the employment of more than one nurse per school building. Further, this section shall not be construed to mandate the aspired-to ratios.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":294952,"text":"The Board shall monitor the progress in achieving the ratio set forth in subsection B and any subsequent increase in prevailing statewide costs, and the mechanism for funding health services, pursuant to subsection P of § 22.1-253.13:2 and the appropriation act. The Board shall also determine how school health funds are used and school health services are delivered in each locality.","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"D"},"3":{"id":294953,"text":"With the exception of school administrative personnel and persons employed by school boards who have the specific duty to deliver health-related services, no licensed instructional employee, instructional aide, or clerical employee shall be disciplined, placed on probation, or dismissed on the basis of such employee’s refusal to (i) perform nonemergency health-related services for students or (ii) obtain training in the administration of insulin and glucagon. However, instructional aides and clerical employees may not refuse to dispense oral medications.\n\t\t\tFor the purposes of this subsection, “health-related services” means those activities that, when performed in a health care facility, must be delivered by or under the supervision of a licensed or certified professional.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C","next_prefix":"E"},"4":{"id":294954,"text":"Each school board shall ensure that in school buildings with an instructional and administrative staff of 10 or more (i) at least three employees have current certification or training in emergency first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator and (ii) if one or more students diagnosed as having diabetes attend such school, at least two employees have been trained in the administration of insulin and glucagon. In school buildings with an instructional and administrative staff of fewer than 10, school boards shall ensure that (a) at least two employees have current certification or training in emergency first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator and (b) if one or more students diagnosed as having diabetes attend such school, at least one employee has been trained in the administration of insulin and glucagon. For purposes of this subsection, “employee” includes any person employed by a local health department who is assigned to the public school pursuant to an agreement between the local health department and the school board. When a registered nurse, advanced practice registered nurse, physician, or physician assistant is present, no employee who is not a registered nurse, advanced practice registered nurse, physician, or physician assistant shall assist with the administration of insulin or administer glucagon. Prescriber authorization and parental consent shall be obtained for any employee who is not a registered nurse, advanced practice registered nurse, physician, or physician assistant to assist with the administration of insulin and administer glucagon.","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D"}},"ancestry":[{"id":13512,"edition_id":1,"name":"Health Provisions","identifier":"2","label":"article","depth":3,"order_by":1,"parent_id":12850,"metadata":{},"date_created":"2026-06-26 03:45:06","date_modified":"2026-06-26 03:45:06","permalink":{"id":182221,"object_type":"structure","relational_id":13512,"identifier":"2","token":"22.1\/14\/2","url":"\/22.1\/14\/2\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12850,"edition_id":1,"name":"Pupils","identifier":"14","label":"chapter","depth":2,"order_by":1,"parent_id":12823,"metadata":{},"date_created":"2026-06-26 03:43:56","date_modified":"2026-06-26 03:43:56","permalink":{"id":182133,"object_type":"structure","relational_id":12850,"identifier":"14","token":"22.1\/14","url":"\/22.1\/14\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12823,"edition_id":1,"name":"Education","identifier":"22.1","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:55","date_modified":"2026-06-26 03:43:55","permalink":{"id":180949,"object_type":"structure","relational_id":12823,"identifier":"22.1","token":"22.1","url":"\/22.1\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":83399,"structure_id":13512,"section_number":"22.1-270","catch_line":"Preschool physical examinations","url":"\/22.1-270\/","token":"22.1\/14\/2\/22.1-270","metadata":false},{"id":57306,"structure_id":13512,"section_number":"22.1-271","catch_line":"Repealed","url":"\/22.1-271\/","token":"22.1\/14\/2\/22.1-271","metadata":false},{"id":68537,"structure_id":13512,"section_number":"22.1-271.1","catch_line":"Definitions","url":"\/22.1-271.1\/","token":"22.1\/14\/2\/22.1-271.1","metadata":false},{"id":54801,"structure_id":13512,"section_number":"22.1-271.10","catch_line":"Guidelines and policies on student-athlete extreme heat safety and protection","url":"\/22.1-271.10\/","token":"22.1\/14\/2\/22.1-271.10","metadata":false},{"id":68882,"structure_id":13512,"section_number":"22.1-271.2","catch_line":"Immunization requirements","url":"\/22.1-271.2\/","token":"22.1\/14\/2\/22.1-271.2","metadata":false},{"id":80851,"structure_id":13512,"section_number":"22.1-271.3","catch_line":"Guidelines for school attendance for children infected with human immunodeficiency virus; school personnel training required; notification of school personnel in certain cases","url":"\/22.1-271.3\/","token":"22.1\/14\/2\/22.1-271.3","metadata":false},{"id":58904,"structure_id":13512,"section_number":"22.1-271.4","catch_line":"Health requirements for home-instructed, exempted, and excused children","url":"\/22.1-271.4\/","token":"22.1\/14\/2\/22.1-271.4","metadata":false},{"id":58468,"structure_id":13512,"section_number":"22.1-271.5","catch_line":"Guidelines and policies and procedures on concussions in student-athletes","url":"\/22.1-271.5\/","token":"22.1\/14\/2\/22.1-271.5","metadata":false},{"id":62863,"structure_id":13512,"section_number":"22.1-271.6","catch_line":"School division policies and procedures on concussions in students","url":"\/22.1-271.6\/","token":"22.1\/14\/2\/22.1-271.6","metadata":false},{"id":74380,"structure_id":13512,"section_number":"22.1-271.7","catch_line":"Public middle and high school student-athletes; pre-participation physical examination","url":"\/22.1-271.7\/","token":"22.1\/14\/2\/22.1-271.7","metadata":false},{"id":64618,"structure_id":13512,"section_number":"22.1-271.8","catch_line":"Sudden cardiac arrest prevention in student-athletes","url":"\/22.1-271.8\/","token":"22.1\/14\/2\/22.1-271.8","metadata":false},{"id":61392,"structure_id":13512,"section_number":"22.1-271.9","catch_line":"Cardiac emergency response or emergency action plans required","url":"\/22.1-271.9\/","token":"22.1\/14\/2\/22.1-271.9","metadata":false},{"id":60318,"structure_id":13512,"section_number":"22.1-272","catch_line":"Contagious and infectious diseases","url":"\/22.1-272\/","token":"22.1\/14\/2\/22.1-272","metadata":false},{"id":63093,"structure_id":13512,"section_number":"22.1-272.1","catch_line":"Responsibility to contact parent of student at imminent risk of suicide; notice to be given to social services if parental abuse or neglect; Board of Education to develop guidelines for parental contact","url":"\/22.1-272.1\/","token":"22.1\/14\/2\/22.1-272.1","metadata":false},{"id":64351,"structure_id":13512,"section_number":"22.1-272.1:1","catch_line":"School-connected student overdose policies; parental notification; guidelines","url":"\/22.1-272.1_1\/","token":"22.1\/14\/2\/22.1-272.1_1","metadata":false},{"id":84018,"structure_id":13512,"section_number":"22.1-272.2","catch_line":"Department; model memorandum of understanding; partnerships with community mental health services providers or a nationally recognized school-based telehealth provider","url":"\/22.1-272.2\/","token":"22.1\/14\/2\/22.1-272.2","metadata":false},{"id":73957,"structure_id":13512,"section_number":"22.1-272.3","catch_line":"Student access to telehealth services; school division policies","url":"\/22.1-272.3\/","token":"22.1\/14\/2\/22.1-272.3","metadata":false},{"id":68681,"structure_id":13512,"section_number":"22.1-273","catch_line":"Vision and hearing of student to be tested; exceptions","url":"\/22.1-273\/","token":"22.1\/14\/2\/22.1-273","metadata":false},{"id":82468,"structure_id":13512,"section_number":"22.1-273.1","catch_line":"Annual screening for scoliosis","url":"\/22.1-273.1\/","token":"22.1\/14\/2\/22.1-273.1","metadata":false},{"id":80414,"structure_id":13512,"section_number":"22.1-273.2","catch_line":"Parent educational information regarding eating disorders","url":"\/22.1-273.2\/","token":"22.1\/14\/2\/22.1-273.2","metadata":false},{"id":66325,"structure_id":13512,"section_number":"22.1-273.3","catch_line":"Parent educational information regarding tobacco and nicotine vapor products","url":"\/22.1-273.3\/","token":"22.1\/14\/2\/22.1-273.3","metadata":false},{"id":54479,"structure_id":13512,"section_number":"22.1-273.4","catch_line":"Department of Education; guidance and resources; applied behavior analysis services","url":"\/22.1-273.4\/","token":"22.1\/14\/2\/22.1-273.4","metadata":false},{"id":82301,"structure_id":13512,"section_number":"22.1-274","catch_line":"School health services","url":"\/22.1-274\/","token":"22.1\/14\/2\/22.1-274","metadata":false},{"id":87246,"structure_id":13512,"section_number":"22.1-274.01","catch_line":"Repealed","url":"\/22.1-274.01\/","token":"22.1\/14\/2\/22.1-274.01","metadata":false},{"id":62165,"structure_id":13512,"section_number":"22.1-274.01:1","catch_line":"Students who are diagnosed with diabetes; self-care; insertion and reinsertion of insulin pump","url":"\/22.1-274.01_1\/","token":"22.1\/14\/2\/22.1-274.01_1","metadata":false},{"id":62800,"structure_id":13512,"section_number":"22.1-274.02","catch_line":"Certain memorandum of agreement required","url":"\/22.1-274.02\/","token":"22.1\/14\/2\/22.1-274.02","metadata":false},{"id":61298,"structure_id":13512,"section_number":"22.1-274.1","catch_line":"Criteria to identify toxic art materials; labeling; use in certain grades prohibited","url":"\/22.1-274.1\/","token":"22.1\/14\/2\/22.1-274.1","metadata":false},{"id":78246,"structure_id":13512,"section_number":"22.1-274.2","catch_line":"Possession and administration of inhaled asthma medications, epinephrine, glucagon, and seizure rescue medications by certain students or school board employees","url":"\/22.1-274.2\/","token":"22.1\/14\/2\/22.1-274.2","metadata":false},{"id":55245,"structure_id":13512,"section_number":"22.1-274.2:1","catch_line":"Grade nine and grade 10 health education Standards of Learning; severe allergic reaction awareness training","url":"\/22.1-274.2_1\/","token":"22.1\/14\/2\/22.1-274.2_1","metadata":false},{"id":80659,"structure_id":13512,"section_number":"22.1-274.3","catch_line":"Policies regarding medication recommendations by school personnel","url":"\/22.1-274.3\/","token":"22.1\/14\/2\/22.1-274.3","metadata":false},{"id":56415,"structure_id":13512,"section_number":"22.1-274.4","catch_line":"Public elementary and secondary schools; automated external defibrillators required","url":"\/22.1-274.4\/","token":"22.1\/14\/2\/22.1-274.4","metadata":false},{"id":81947,"structure_id":13512,"section_number":"22.1-274.4:1","catch_line":"Opioid antagonist procurement, placement, maintenance, and administration; staff and faculty training; policies and requirements","url":"\/22.1-274.4_1\/","token":"22.1\/14\/2\/22.1-274.4_1","metadata":false},{"id":74919,"structure_id":13512,"section_number":"22.1-274.5","catch_line":"Topical sunscreen","url":"\/22.1-274.5\/","token":"22.1\/14\/2\/22.1-274.5","metadata":false},{"id":78903,"structure_id":13512,"section_number":"22.1-274.6","catch_line":"Seizure management and action plan; training","url":"\/22.1-274.6\/","token":"22.1\/14\/2\/22.1-274.6","metadata":false},{"id":73551,"structure_id":13512,"section_number":"22.1-274.7","catch_line":"Students with disabilities; individualized education programs; individualized accommodations and supports during emergency situations and evacuations","url":"\/22.1-274.7\/","token":"22.1\/14\/2\/22.1-274.7","metadata":false},{"id":70375,"structure_id":13512,"section_number":"22.1-274.8","catch_line":"School boards; bleeding control programs; bleeding control kits","url":"\/22.1-274.8\/","token":"22.1\/14\/2\/22.1-274.8","metadata":false},{"id":79734,"structure_id":13512,"section_number":"22.1-275","catch_line":"Protective eye devices","url":"\/22.1-275\/","token":"22.1\/14\/2\/22.1-275","metadata":false},{"id":81726,"structure_id":13512,"section_number":"22.1-275.1","catch_line":"School health advisory board","url":"\/22.1-275.1\/","token":"22.1\/14\/2\/22.1-275.1","metadata":false}],"previous_section":{"id":54479,"structure_id":13512,"section_number":"22.1-273.4","catch_line":"Department of Education; guidance and resources; applied behavior analysis services","url":"\/22.1-273.4\/","token":"22.1\/14\/2\/22.1-273.4","metadata":false},"next_section":{"id":87246,"structure_id":13512,"section_number":"22.1-274.01","catch_line":"Repealed","url":"\/22.1-274.01\/","token":"22.1\/14\/2\/22.1-274.01","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/22.1-274\/","history_text":"

The record of this law\u2019s original creation isn\u2019t available online. It has been modified 11 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1956, chapter 656; in 1980, chapter 559; in 1990, chapter 797; in 1991, chapter 295; in 1994, chapter 712<\/a>; in 1997, chapter 597<\/a>; in 1998, chapter 871<\/a>; in 1999, chapters 570<\/a> and 757<\/a>; in 2013, chapters 498<\/a> and 530<\/a>; in 2022, chapter 355<\/a>; in 2023, chapter 183<\/a>.<\/p>","references":[{"id":62165,"section_number":"22.1-274.01:1","catch_line":"Students who are diagnosed with diabetes; self-care; insertion and reinsertion of insulin pump","order_by":null,"url":"\/22.1-274.01_1\/"},{"id":72312,"section_number":"8.01-225","catch_line":"Persons rendering emergency care, obstetrical services exempt from liability","order_by":null,"url":"\/8.01-225\/"}],"refers_to":[{"id":69198,"section_number":"22.1-253.13:2","catch_line":"(Effective July 1, 2026) Standard 2. Instructional, administrative, and support personnel","order_by":null,"url":"\/22.1-253.13_2\/"}],"permalink":{"id":182311,"object_type":"law","relational_id":82301,"identifier":"22.1-274","token":"22.1\/14\/2\/22.1-274","url":"\/22.1-274\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/22.1-274\/","token":"22.1\/14\/2\/22.1-274","dublin_core":{"Title":"School health services","Type":"Text","Format":"text\/html","Identifier":"\u00a7 22.1-274","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> A school board<\/span> shall provide pupil personnel and support services in compliance with § 22.1-253.13:2<\/a>. A school board<\/span> may employ school nurses, physicians, physical therapists, occupational therapists, and speech therapists. No such personnel shall be employed unless they meet such standards as may be determined by the Board. Subject to the approval of the appropriate local governing body<\/span>, a local health department<\/span> may provide personnel for health services for the school division. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> In implementing subsection P of § 22.1-253.13:2<\/a>, relating to providing support services that are necessary for the efficient and cost-effective operation and maintenance of its public schools, each school board<\/span> may strive to employ, or contract<\/span> with local health departments<\/span> for, nursing services consistent with a ratio of at least one nurse per 1,000 students. In those school divisions in which there are more than 1,000 students in average daily membership in school buildings, this section shall not be construed to encourage the employment of more than one nurse per school building. Further, this section shall not be construed to mandate<\/span> the aspired-to ratios. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> The Board shall monitor the progress in achieving the ratio set forth in subsection B and any subsequent increase in prevailing statewide costs, and the mechanism for funding health services, pursuant to subsection P of § 22.1-253.13:2<\/a> and the appropriation act. The Board shall also determine how school health funds are used and school health services are delivered in each locality. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> With the exception of school administrative personnel and persons employed by school boards<\/span> who have the specific duty to deliver health-related services<\/span>, no licensed instructional employee<\/span>, instructional aide, or clerical employee<\/span> shall be disciplined, placed on probation<\/span>, or dismissed on the basis of such employee<\/span>’s refusal to (i) perform nonemergency health-related services<\/span> for students or (ii) obtain training in the administration of insulin and glucagon. However, instructional aides and clerical employees<\/span> may not refuse to dispense oral medications.\n\t\t\tFor the purposes of this subsection, “health-related services<\/span>” means those activities that, when performed in a health care facility, must be delivered by or under the supervision of a licensed or certified professional. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Each school board<\/span> shall ensure that in school buildings with an instructional and administrative staff of 10 or more (i) at least three employees<\/span> have current certification or training in emergency first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator and (ii) if one or more students diagnosed as having diabetes attend such school, at least two employees<\/span> have been trained in the administration of insulin and glucagon. In school buildings with an instructional and administrative staff of fewer than 10, school boards<\/span> shall ensure that (a) at least two employees<\/span> have current certification or training in emergency first aid, cardiopulmonary resuscitation, and the use of an automated external defibrillator and (b) if one or more students diagnosed as having diabetes attend such school, at least one employee<\/span> has been trained in the administration of insulin and glucagon. For purposes of this subsection, “employee<\/span>” includes any person employed by a local health department<\/span> who is assigned to the public school pursuant to an agreement between the local health department<\/span> and the school board<\/span>. When a registered nurse, advanced practice registered nurse, physician, or physician assistant is present, no employee<\/span> who is not a registered nurse, advanced practice registered nurse, physician, or physician assistant shall assist with the administration of insulin or administer glucagon. Prescriber authorization and parental consent shall be obtained for any employee<\/span> who is not a registered nurse, advanced practice registered nurse, physician, or physician assistant to assist with the administration of insulin and administer glucagon. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nSCHOOL HEALTH SERVICES (\u00a7 22.1-274)\n\nA. A school board shall provide pupil personnel and support services in\ncompliance with § 22.1-253.13:2. A school board may employ school nurses,\nphysicians, physical therapists, occupational therapists, and speech therapists.\nNo such personnel shall be employed unless they meet such standards as may be\ndetermined by the Board. Subject to the approval of the appropriate local\ngoverning body, a local health department may provide personnel for health\nservices for the school division.\n\nB. In implementing subsection P of § 22.1-253.13:2, relating to providing\nsupport services that are necessary for the efficient and cost-effective\noperation and maintenance of its public schools, each school board may strive to\nemploy, or contract with local health departments for, nursing services\nconsistent with a ratio of at least one nurse per 1,000 students. In those\nschool divisions in which there are more than 1,000 students in average daily\nmembership in school buildings, this section shall not be construed to encourage\nthe employment of more than one nurse per school building. Further, this section\nshall not be construed to mandate the aspired-to ratios.\n\nC. The Board shall monitor the progress in achieving the ratio set forth in\nsubsection B and any subsequent increase in prevailing statewide costs, and the\nmechanism for funding health services, pursuant to subsection P of §\n22.1-253.13:2 and the appropriation act. The Board shall also determine how\nschool health funds are used and school health services are delivered in each\nlocality.\n\nD. With the exception of school administrative personnel and persons employed by\nschool boards who have the specific duty to deliver health-related services, no\nlicensed instructional employee, instructional aide, or clerical employee shall\nbe disciplined, placed on probation, or dismissed on the basis of such\nemployee’s refusal to (i) perform nonemergency health-related services for\nstudents or (ii) obtain training in the administration of insulin and glucagon.\nHowever, instructional aides and clerical employees may not refuse to dispense\noral medications.\n\t\t\tFor the purposes of this subsection, “health-related services”\nmeans those activities that, when performed in a health care facility, must be\ndelivered by or under the supervision of a licensed or certified professional.\n\nE. Each school board shall ensure that in school buildings with an instructional\nand administrative staff of 10 or more (i) at least three employees have current\ncertification or training in emergency first aid, cardiopulmonary resuscitation,\nand the use of an automated external defibrillator and (ii) if one or more\nstudents diagnosed as having diabetes attend such school, at least two employees\nhave been trained in the administration of insulin and glucagon. In school\nbuildings with an instructional and administrative staff of fewer than 10,\nschool boards shall ensure that (a) at least two employees have current\ncertification or training in emergency first aid, cardiopulmonary resuscitation,\nand the use of an automated external defibrillator and (b) if one or more\nstudents diagnosed as having diabetes attend such school, at least one employee\nhas been trained in the administration of insulin and glucagon. For purposes of\nthis subsection, “employee” includes any person employed by a local\nhealth department who is assigned to the public school pursuant to an agreement\nbetween the local health department and the school board. When a registered\nnurse, advanced practice registered nurse, physician, or physician assistant is\npresent, no employee who is not a registered nurse, advanced practice registered\nnurse, physician, or physician assistant shall assist with the administration of\ninsulin or administer glucagon. Prescriber authorization and parental consent\nshall be obtained for any employee who is not a registered nurse, advanced\npractice registered nurse, physician, or physician assistant to assist with the\nadministration of insulin and administer glucagon.\n\nHISTORY: Code 1950, \u00a7 22-241; 1956, c. 656; 1980, c. 559; 1990, c. 797; 1991,\nc. 295; 1994, c. 712; 1997, c. 597; 1998, c. 871; 1999, cc. 570, 757; 2013, cc.\n498, 530; 2021, Sp. Sess. I, c. 454; 2022, c. 355; 2023, c. 183.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}