A review of 32.1-248.4.A.4 provides enabling authority to the Department to develop "hardship" guidelines.  There is no clear definition or legal term identified as "guidelines" with the statutory or regulatory framework.  Generally speaking, a "guideline" is a "rule" (see 32.1-127.01 as an example)

VDH's course of action, to develop this rule through policy, is contrary to legal authority under 32.1-2.2 et seq.

The hardship guidelines should clearly be part of, and included within, a REGULATION - either an existing regulation or a newly created regulation duly promulgated by the BOARD of HEALTH following the full Administrative Process Act.

VDH cannot regulate by policy. Policy is uninforceable as law.