Regulation

Description of Concern

Change Suggested

12VAC35-115-100 B5

The additional requirement of LHRC approval may have negative consequences.  The current approval process has had negative consequences as it is difficult to get approval between the quarterly LHRC meetings.  The following potential negative consequences for individuals will be increased with the implementation as written:

1. Disrupting placements.
2. Postponing discharge for higher levels of care.
3. Placing individuals’ safety and therapeutic needs at risk.

Requiring agency’s to maintain the following documentation in each case:

1. Behavior Plan completed by qualified professional, which includes all of the elements indicated within the regulations.
2. Signatures of appropriate parties agreeing to restrictions.
3. Date reviewed and approved by Independent Review Committee.

12VAC35-115-105 E.

Those qualified to write behavior treatment plans are now identified within the regulations.  The regulations also establish the Independent Review Committee.  LHRC members are not trained to review all aspects of behavior plans, nor do LHRC committees have the time within meetings to review every plan.  The implementation of this regulation leaves the individual open to the same negative consequences as listed above.  At times finding LHRC members can be difficult, if there is such a large increase in demands on volunteers’ time, there is also the potential for more issues with establishing and maintaining LHRCs.

Limit and carefully define the plans that LHRC’s must review prior to implementation.  Then require that agency’s provide a quarterly report of other plans being implemented.  Include that the LHRC may review any behavior plan, which includes restrictions.

Investigation and Reporting Section

Requirement of notification for abuse, neglect and exploitation within 24 hours.

Requirement of notification for abuse, neglect and exploitation within 24 hours.

These often come in on holidays or weekends from direct care staff.  Having direct care staff pulled to enter information in the state reporting system places the individuals at risk of further harm.  Further, there are often times that incidents are submitted and it is not until they are reviewed that it is determined to be an allegation of abuse, neglect or exploitation.

Change this timeframe to be the same as that indicated within the Complaint process, the Next Business Day.

Investigation and Reporting Section

Requirement of Investigation Report being provided to the Director and Human Rights Advocate at the same at time (within 10 working days.)

The Director should have the opportunity to review the report, follow up for more information, if needed, and consider appropriate actions to be taken, prior to others having the report.  Implementing as written can cause confusion and frustration as the director has not had an opportunity to make a determination when the Human Rights Advocate may want information about corrective actions.

Change to require the investigation report and determination letter to be sent to the Human Rights advocate together.

12VAC35-115-90

The regulations indicates that the individual can have the “authorized insurer” of his choice review the record if access is limited or refused.  However, there is not a definition of “authorized insurer” provided

Define Authorized Insurer