Anthony Sandifer -Essential Family Services

 ***If a notice to reference the “applicable law” is refenced, the associated law(s) should be included within the body of the document or in a guidance document. ***

 Section 30, (is not clearly written or easily understandable)

B. “Providers shall be licensed to provide specific services as defined in this chapter or as determined by the commission.

– The list of services needs updating to reflect support available in the waiver Redesign.

- “…or as determined by the commission” should either be better defined to remove the ambiguity as to the purpose or removed from the regulation.

 Section 40-2A & Section 210A, (does not minimize the economic impact on small business in a manner consistent with stated objectives of applicable law)

- The requirement for 90 days funds or line of credit is unreasonable and unnecessary in a fee-for-service environment

-The ability to obtain a line of credit is dependent on factors that are difficult for small providers to meet or maintain.

 Section 50-3A, (is not clearly written or easily understandable)

Specifically, ‘The length of the license shall be in the sole discretion of the commissioner.”

-Leaving the decision of the length of a license to the sole discretion of the commissioner creates the possibility of inconsistent and biased licensing practices.

-The decision for the length of license should be predicated on clearly defined criteria to ensure all providers receive equal consideration in this decision.

-How is it determined if a provider is granted a 1yr, 2yr or 3yr license?

-What measurable data is used?

 Section 60, (does not minimize the economic impact on small business in a manner consistent with stated objectives of applicable law)

-Does not provide guidance on the timeframe for response from commissioner on a modification application

- Does not establish grievance procedure for denied applications

-If response not received from licensing specialist within defined period, consideration should be given to automatically grant requested modification

B. “Approval of such request shall be at the sole discretion of the commissioner.” This creates an opportunity for inconsistent and bias licensing practices. A transparent and standardized approval criterion should be considered.

 Section 150, (is not clearly written or easily understandable)

-Guidance should be provided to identify the specific areas of each applicable law that is subject to review by licensing.

-The range of applicable law and the application of the law is varied depending on the law, the service provided, the entity, etc.

- Streamlined guidance specific to DBHDS oversight is needed.

 Section 170 – A/E, (does not minimize the economic impact on small business in a manner consistent with stated objectives of applicable law)

- After the investigation is complete, how long does the specialist have to submit their findings in writing to the provider?

-The section does not outline either the requirement of a response form licensing or the period in which the licensing specialist shall respond to the Corrective Action Plan submitted by the provider

- Both the provider and the licensing specialist should be held to a consistent transparent layer of accountability.

-If the specialist does not respond within the defined period, provider must have a defined grievance procedure

-Consideration should be given to invalidate a review that is not conducted within a defined period.

 Section 180-B, (does not minimize the economic impact on small business in a manner consistent with stated objectives of applicable law)

-There is no response time for the specialist to approve or deny the requested change

-The lack of an accountability standard for the licensing specialist has the potential to put a provider at risk of challenges associated with operating a business

-The licensing specialists should have a defined response time

-If response not received in the period provider needs a defined and immediate grievance procedure

-Failure of a specialist to respond within the defined period should give provider the ability to make changes necessary to ensure the continued stability of its business

 Section 180-E (does not minimize the economic impact on small business in a manner consistent with stated objectives of applicable law)

-No reciprocal requirements for notification to provider of individuals intent to end services

(see Section 1240 also)

-Support coordinator responsibility to communicate with Providers?

-Support coordinators state client privacy as reason for not advising the provider that family/individual is seeking alternative support

-Providers notified the day of or the day before services are ended

a. Adds to the challenge to recruit, retain and stabilize staffing

b. Creates opportunities for exploitation (i.e. Support Coordinators paid for connecting individuals with certain providers)

-In addition to defined period to notify providers that their services are ending; also require a documented “mediated” event to determine if the concerns can be worked out between the provider and the individual

 Section 250-A (does not ensure protection of public health, safety and welfare or ensure economic performance of important governmental functions and does not minimize the economic impact on small business in a manner consistent with stated objectives of applicable law)

-Overlooks the unethical practice of direct marketing via staff. (i.e. A DSP working for my company meets a manager from another company. The DSP is told they will be paid .50-$1.00 per hour more if they get the individual to switch providers. This is manipulation and coercion. Not in the best interest of the individual but for the service provider)

-Does not address the unethical practice unsolicited direct marketing to individuals or the families. (i.e. going to homes telling individuals or families they can guarantee increased number of support hours if they switch services. Family/individual are told to tell support coordinator they found a new provider and they want to exercise their freedom of choice. This is manipulation and coercion. Not in the best interest of the individual but for the service provider.

-This section fails to close loops holes for exploitation.

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