| Action | Three Waivers (ID, DD, DS) Redesign |
| Stage | Proposed |
| Comment Period | Ended on 4/5/2019 |
 |
| Regulation Number/Section | Comments/Concerns |
| 12VAC30-50-440 A. | States target group is individuals with Intellectual Disability; however, there is no definition of Intellectual Disability noted in the Regs |
| 12VAC30-50-440 D. | Definition of Services Inconsistent with 12VAC30-490D. Why are they different? |
| 12VAC30-50-440 E.3. | Qualifications for support coordinators for individuals with Intellectual disability are inconsistent with qualifications for support coordinators for individuals with a Developmental Disability listed in 12VAC30-50-490. E.6 There is no mention of requiring a degree to provide services. |
| 12VAC30-50-440 E.3.b.2, 6 | Clarification regarding what the expectation is for #2 Negotiating with individuals and service providers & #6 Coordinating the provision of services by diverse public & private providers. |
| 12VAC30-50-490 A. | This definition of the "Target group" needs to be clarified, as, by itself it does not exclude individuals with Intellectual Disabilities. Additionally, if that is indeed the intended definition, are we to then assume that all sections below 12VAC30-50-490 and up to 12VAC30-122 apply only to individuals without a diagnosis of Intellectual Disability? Based on the definition, those under the age of 6 are excluded, does this mean those with DD under six cannot receive Waiver/be on Waitlist? |
| 12VAC30-50-490 A.1 | Indicates a Face-to-Face every 3 months; however, 12VAC30-440A.1. indicate Face-to-Face every 90 days. These need use same time frame/language for defining timeframe. |
| 12VAC30-50-490 A.2 | This section states that individuals will be placed on a waiting list. If the intention is that section 12VAC30-50-490 applies only to Non-ID individuals, then these regulations provide no guidance that individuals with ID can be placed on the waiting list, as there is no corresponding text in 12CAC30-50-440 |
| 12VAC30-50-490 A.4 | Clarification needing regarding what constitutes a special service need. |
| 12VAC30-50-490 C. | States CSBs/BHAs SHALL contract with private support coordinators/case managers. This needs to be changed to MAY contract with private support coordinators/case managers; change to match language in 12VAC30-50-490 E.1. and 12VAC30-50-490 F. 1 |
| 12VAC30-50-490 D. | Definition of Services Inconsistent with 12VAC30-440D. Why are they different? |
| 12VAC30-50-490 E. 2 and 3 | These sections list restrictions on who can provide support coordination, restrictions that do not appear under the qualification in section 12VAC30-50-440. Are we to assume these restrictions apply only to support coordinators providing services to individuals without an Intellectual Disability? What is meant by otherwise related by business or organization to the direct care staff person in E. 2 iii? This seems very broad and concerning with all DD support coordination being under the CSB. Does this mean if a person has a child needing Waiver services, the person will have to quite their job or refuse to get individual services at the CSB. |
| 12VAC30-50-490 E.5 | This section states that an individual providing support coordination needs to have a degree in human services. As this requirement is listed only under 12VAC30-50-490, and not under 12VAC30-50-440, are we to assume this is a requirement only for individuals providing support coordination for clients without an ID diagnosis? |
| 12VAC30-50-490 E.6 | Qualifications for support coordinators for individuals with Intellectual disability are inconsistent with qualifications for support coordinators for individuals with a Developmental Disability listed in 12VAC30-50-440. E.3 |
| 12VAC30-50-490 E.7 a-f | This section describes supervisory requirement, and there is no corresponding text in 12VAC30-50-440. Are we to assume these supervisory requirements apply only to support coordinators providing services to clients without an ID diagnosis? For E.7. a: please define Human Service Degree. |
| 12VAC30-50-490 E.8 | There is no corresponding section in 12VAC30-50-440 requiring one hour of documented supervision every 3 months. Are we to assume this requirement applies only to support coordinators providing services to clients without an ID diagnosis? |
| 12VAC30-50-490 E.9 | There is no corresponding section in 12 VAC30-50-440 requiring support coordinators to receive 8 hours of training annually. Are we to assume this requirement applies only to support coordinators providing services to clients without an ID diagnosis? |
| 12VAC-30-122-20 | Defines "Support Coordinator" as the person who provides support coordination services to an individual in accordance with 12VAC30-50-455. Section 12VAC30-50-455 is repealed. "Immediate family member" definition references (12 VAC 30-50-455 ), which is no longer in effect |
| 12VAC-30-122-30 B | References the Elderly and Disabled Waiver and the Technology Assisted waiver, neither of which exist. |
| 12VAC30-122-50 A.2 | What is needed to document needing level of care on the annual basis? |
| 12VAC30-122-70 | Recent audits by DBHDS have wanted to see that individuals put on the Waitlist agreed to receipt of services within 30 days if awarded the slot. Is this a requirement? If so, where is this to be documented? |
| 12VAC30-122-70 H. | Should reference DBHDS responsibility for collecting the forms and sending to CSBs/BHAs. |
| 12VAC30-122-80 C.5.b. | Retain slot used to be 180 days now 120 days; Suggest this changes back to 180 days. |
| 12VAC30-122-80 C.6.a | The statement "The plan for supports shall also contain the steps for mitigating any identified risks" is a concern. There are times individuals do not want to take steps to mitigate risks. They have the right to refuse, with choice and dignity of risk. This statement should be revised to indicate "The plan for supports shall also contain the steps for mitigating any identified risks or document the person's refusal of mitigating actions." |
| 12VAC30-122-90 E.3 | Clarification that regional WSAC is for BI only (not for other Waivers) and clarification on why indicates regional WSAC? |
| 12VAC30-122-90 G.2.a | Emergency Slot Clarification on number of emergency slots, what is 10% based upon? |
| 12VAC30-122-100 D. | An amendment is needed for statement "When an individual is transitioning to a different provider, the former provider that served said individual shall, at the request of the provider, provide all medical records and documentation of services to the new provider to ensure high quality continuity of care and service provision." This statement must include caveat as permitted by confidentiality regulations including HIPAA, 42 CFR and Human Rights. |
| 12VAC30-122-40 B | States individuals with DD who are inpatient may receive Support Coordination as described in 12VAC30-50-440. That section referred to only applies to individuals with ID. |
| 12VAC30-122-70.H | Does the DBHDS process of sending letters meet this requirement of annual contact? |
| 12VAC30-122-120 A. 10.e.1 | Concern with implications of Standardized or Formulaic notes being considered unacceptable. Clarification that templates are acceptable to ensure notes contain appropriate information. |
| 12-VAC30-122-120 A. 10.g.3 | Concern regarding matching language of support plan needs with licensing regulations Clarification regarding services rendered schedule and timetable |
| 12-VAC30-122-120 A. 14 | Why do you report APS issues to DARS? This is a potential HIPAA concern. |
| 12-VAC30-122-120 A. 16 | Is requirement that providers "must read and write in English" related to literacy or meant to mean must read and write in English? |
| 12-VAC30-122-120 B | Clarification on where the objective documentation must be maintained. Is this in the provider record and/or Support Coordination record? |
| 12-VAC30-122-150 A. 2.e | Concern regarding ensuring Conflict Free Case Management with statement "The individual's support coordinator/case manager may also function as the service facilitator." Suggest adding, if the support coordination/case manager agency has a provider agreement with DMAS to provide such service. |
| 12VAC30-122-180 E. 4 | The regulations state that new hires have to complete competencies in 180 days. Is this the same requirement for supporting individual with a Leve 6 or 7? |
| 12-VAC30-122-190 A.6 | Support Coordinators shall conduct and document a minimum of quarterly visits to all other individuals at least one annually occurring in the home. It used to be that we alternate visits occurring in the home. Also asking for consistency between 90 day visit, 3 month visit and quarterly visit |
| 122VAC30-122.190.C.2.c | This states a Medical Exam for children up to age 21 shall be completed according to frequency recommended by EPSDT. Whose responsibility is it to ensure these are completed (service provider, SC, parent?) |
| 12-VAC30-122-200 A.1 | Indicates SIS stops at age 72. How are those older than 72 assessed for intensive support needs to ensure ability of providers to continue to serve individuals? |
| 12VAC30-122.200.A.2.b | Clarification is needed about who completes the Brigance Inventory, Vineland, or COACH. Clarification is needed regarding if the Brigance Inventory, Vineland, or COACH is needed every two years for those 5-15 without tiered services. Clarification is needed regarding how often a SIS must be completed for individuals 5-15 years who do not receiving tiered services. |
| 12VAC30-122-210 C.3 | Inconsistent with 12VAC122-360 For Electronic Home based services, 12VAC30-122-210 C.3 indicates is the $5000 limit per calendar year while 12VAC30-122-360 C. 1. indicates limit is $5000 per ISP plan year? |
| 12 VAC30-122-270 B.2.a | Service Requirements states done in least expensive, cost effective manner. Who determines least expensive cost effective manner? |
| 12 VAC30-122-270 D.5 | Clarification needed if the "start date of the authorization" means date authorized? |
| 12VAC30-122-290 E.2 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-310 E.2 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-320 E.2 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-340 C.8 | Concern that a non-sponsor family member living in the same home cannot provide CD services. There may be limited circumstances where this may be the only option. Recommend this must be done with Objective Documentation this is the option. |
| 12VAC30-122-340 C.9 | Concern that a family member cannot provide CD services. There may be limited circumstances where this may be the only option. Recommend this must be done with Objective Documentation this is the option. |
| 12VAC30-122-350 E.2 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-360 C.1 | Inconsistent with 12VAC122-210 For Electronic Home based services, 12VAC30-122-210 C.3 indicates is the $5000 limit per calendar year while 12VAC30-122-360 C. 1. indicates limit is $5000 per ISP plan year? |
| 12VAC30-122-370 B.1. b | Clarification if possible to receive Environmental modification on multiple vehicles (i.e. one at the residence and possible another that an person uses to give the individual a ride to appointments). |
| 12VAC30-122-380 D.5 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-390 D.5 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-410 D.4 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-420 D.5 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-460 D.4.b | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-490 D.4.b | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-530 D.5 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |
| 12VAC30-122-540 A. | Clarification on what constitutes "an apartment setting". Could this be a townhome or house with private entrances for multiple individuals? |
| 12VAC30-122-540 D.4 | Reference to 12VAC35-105 seems to miss part of the licensing regulation reference. |