REQUESTED CHANGE: To clarify and amend the training and certification requirements for

Preadmission Screening Providers to allow for coordination of care with private providers under the Marcus Alert Act.

This petition for rulemaking is brought to the State Board of Behavioral Health and Developmental Services (DBHDS) under its legal authority to take the action requested pursuant to VA Codes 37.2-203, 37.2-311.3, and 12VAC35-105-30. This petition for rulemaking is filed in accordance with VA Code 2.2-4007 is to clarify and amend the Enhanced Qualifications for Preadmission Screening Clinicians and expand its reach in the spirit of public-private cooperation under the Marcus-David Peters Act.

INTRODUCTION

The Department of Behavioral Health and Developmental Services first published a memorandum explaining that the agency would be mandating enhanced qualifications for \"Community Services Boards and Behavioral Health Authorities evaluators who provide recommendations and prepare preadmission screening reports…” on March 29, 2016. On July 1, 2016, DBHDS published a document entitled Certification of Preadmission Screening Clinicians which states in part [see https://dbhds.virginia.gov/behavioral-health/mental-health-services/protocols-and-procedures/]:

\"Effective July 1, 2016, anyone conducting a preadmission screening evaluation pursuant to requirements in the Code of Virginia must hold a valid certification from DBHDS as a Certified Preadmission Prescreening Clinician…

Application for this certification must be submitted…using the designated forms and approved before the individual may independently conduct preadmission screening evaluations…

Upon submission and review of a completed application, DBHDS will issue a Certificate. The certification will be valid for one or two years and must be renewed annually or biannually as specified below. Recertification must be requested prior to the expiration of a current certificate.”

The document goes on to outline educational and precepting requirements, requirements for supervision, the need for continuing education, and quality assurance practices. DBHDS created these regulations presumably under statutory authority found in VA Code 37.2-203 and 37.2-404.

In 2021 the Marcus-David Peters Act was passed by the General Assembly and is codified in VA Code 37.2-311.1 to 37.2-312. This law mandates that DBHDS take the lead in organizing and implementing the tenants of the act including

\"...The Department shall establish additional Marcus alert and community care teams…[and] No later than July 1, 2026 all community services board and behavioral health authority geographical areas shall have established Marcus alert system that uses a community care or mobile crisis team”

–VA Code 37.2-311.1(c)3

Which allows for DBHDS to explore the use of public-private partnerships to achieve the mission set forth in the Marcus-David Peters Act. However, this is already provided for in the Community Services Performance Contract that is completed between the department and CSBs every two years under section twelve regarding contracting and subcontracting. Until the passage of the Marcus Alert Act, this was under utilized for crisis intervention services, even to the detriment of the population served by the particular Community Services Board.

Finally, multiple code sections reference the requirement of an evaluation needing to be completed by \"The community services board or its designee”(emphasis added) including:

• 16.1-340
• 16.1-340.1
• 16.1-340.1:1
• 37.2-808(b),(c),(l)
• 37.2-809(a),(d),(e),(g),(l),

Now, having established that DBHDS has and exercised statutory authority to stipulate the requirements necessary for an individual to become a Certified Preadmission Screening Clinician, that DBHDS has the responsibility under the law to form public-private partnerships for the good of the citizens of the Commonwealth, and that the law can allow for such partnerships, the present author hereby requests the Enhanced Qualifications for Preadmission Screening Clinicians be amended.

PETITION FOR RULE CHANGE

Page 1, Section 2 entitled \"Enhanced Qualifications for Certified Preadmission Screening Clinicians Beginning 01 July 2016

Present author requests that this section be amended to include a stipulation for providers that are not employed directly by a Community Services Board and requests that it read as follows:

Any licensed professional (LMHP), Qualified Mental Health Provider (QMHP), Certified Substance Abuse Clinician (CSAC), or Certified Peer Specialist(CPS) that is not employed directly by a Community Services Board may have their employer apply for certification under these guidelines provided that the employer is licensed by DBHDS as a provider of mobile crisis response, crisis stabilization, partial hospitalization, or is a licensed psychiatric hospital, and has a signed written agreement with the regional crisis hub that would serve their geographic location.

In addition, the employer must show that the individual has held a CPSC certification within the past ten years and/or that they have completed all of the other requirements set forth herein. Further, an agency that is not a Community Services Board but is licensed as a provider of mobile crisis response, crisis stabilization, partial hospitalization, or a licensed psychiatric hospital must have any employee desiring certification by this standard supervised by an LMHP and have such an individual available 24/7 to the perspective clinician regardless of their length of time serving in this capacity.

If certified, the individual will be considered a designee of the Community Services Board that serves the area where the client is physically located during the time of assessment, or that provides outpatient treatment to the client with all powers granted under applicable law.

Amendments in General

Petitioner asks that any reference to \"the Board”, CSB, or Community Services Board mentioned in the document be replaced by more neutral language such as \"agency”, \"clinic”, or \"facility”.

The State Board will consider this petition at its next regular quarterly meeting on July 13, 2022, at the DBHDS Central Office, Richmond, VA.

The board voted unanimously to deny the petition as it is outside of the scope of the board.  Specifically, the changes sought by the petitioner would require legislative changes to state law as the requirements for prescreeners are in Chapter 8 of Title 37.2 (primarily Sections 808 and 809, as the petitioner cited in part) and also, Chapter 11 of Title 16.1 (namely Sections 345 and 339).  Until the Code of Virginia is changed, the changes requested are not possible, nor could they be made in regulation as law must precede regulatory change.  Also, requirements for prescreeners are in agreement between the department and CSBs through administrative memos and in the annual Performance Contract.  These requirements for who is a prescreener and who must have a certification for them are not in regulation.  The recommendation for amendment to "Enhanced Qualifications for Certified Preadmission Screening Clinicians Beginning 01 July 2016” is an administrative memo.  Such administrative action is outside the purview of this board.   Therefore, the petition was denied as it is outside of the scope of the authority of the State Board.