Virginia health committee considers mandating licensed nurses in every school

Virginia schools could be required to place a licensed nurse in every building beginning in 2028 under a proposal that advanced through discussion at the state’s School Health Services Committee this week.

State law already allows school divisions to hire nurses but does not require it. About 8 percent of Virginia schools currently operate without one. Supporters say a mandate would close health-care gaps for students with complex medical needs and free teachers and principals from serving as de facto clinic staff.

As drafted, the policy would require each school board to provide at least one licensed school nurse per building or per 325 students. The requirement would take effect July 1, 2028. Districts that can show a good-faith hiring effort could seek two-year waivers if shortages persist.

“School nursing is public health,” said Paula Nichols, school health administrator at Washington County Public Schools, speaking to the committee by video. She described how school nurses stepped beyond classroom walls during Hurricane Helene — wading through high water with cases of bottled water and medical supplies, running community drives with local partners, and checking on households that had lost power and access to care. “When the next emergency comes, and we know they always do, we need those relationships already in place,” Nichols said.

Workforce reality is the sticking point. Schools compete with hospitals, clinics, universities, and nursing homes for the same licensed nurses, according to Virginia Department of Health Professions data. Stacy Haynie, a lobbyist for the Virginia School Boards Association, said her members support the goal but worry a hard mandate will collide with empty applicant pools. Even boards ready to hire, she said, often cannot find candidates. She urged lawmakers not to lose sight of the statewide nursing shortage regardless of how the bill is written.

Senate Education and Health Committee Chair Barbara Favola, D-Arlington, who also chairs the school health services panel, called the proposal a compromise and a core reason the committee exists. She said teachers and administrators need to teach and run schools while nurses manage rising student health needs. “At the end of the day, we have to allow our teachers and school administrators to teach and manage the school, and having a nurse allows them to do their job,” Favola said.

Committee member Betsy Looney pushed back on the stereotype that school nurses only hand out bandages. “School nursing is not band-aids and ice packs,” she said. “A nurse in every public school is not an additional service layered into the educational system. It is the professional infrastructure necessary to safely and effectively implement the health responsibilities Virginia has already placed on its schools.”

Those responsibilities have grown. Schools manage diabetes care plans, seizure protocols, allergy emergencies, mental health crises, and medication regimens that once stayed in clinics. Without a nurse on site, a trained aide or administrator may be the only adult available when minutes matter. Rural divisions such as Washington County argue the nurse is also a community health node — visible, trusted, and already embedded when disasters hit.

Urban and suburban divisions face different math: more buildings, higher caseloads, and competition from hospital systems that can outbid teacher-scale salaries. The per-building or per-325-students formula is meant to scale with enrollment, but waiver language will determine whether shortage counties become permanent exceptions.

The committee is scheduled to vote at its Nov. 18 business meeting on whether to send the proposal to the General Assembly for the session that begins in January. A yes vote would start the bill-drafting and fiscal-impact gauntlet familiar to any school mandate — questions about state vs. local funding, how waivers are judged, and whether the 2028 start date gives nursing programs and school budgets enough runway.

For parents, the policy debate is simpler: whether every school day includes a licensed professional who knows their child’s care plan. For boards, it is a hiring and budget puzzle layered onto existing teacher shortages. For Favola’s committee, it is an attempt to write into law a staffing floor many divisions already treat as best practice.

If the November vote advances the measure, expect school nurses, boards, and nursing schools to dominate the winter lobbying calendar. The 8 percent of schools now without a nurse are the clearest baseline. Closing that gap by 2028 will take more than a statute — it will take applicants willing to trade hospital shifts for clinic rooms off the cafeteria hallway.

Email the Washington County School Board:
Jenny Nichols, jnichols@wcs.k12.va.us,
Debbie Anderson, danderso@wcs.k12.va.us,
Sandra Frederick, sandyf@wcs.k12.va.us,
Sanders Henderson, shenderson@wcs.k12.va.us,
Crystal Rasnake, cdrasnake@wcs.k12.va.us,
Adam Wilson, awilson@wcs.k12.va.us,
Andy Puckett, andyp@wcs.k12.va.us,