106-250 Full and Part-time Employee Records
Employers are shifting to 3rd party vendors for primary source verification of education history which are more reliable than transcripts. Add this as an option. Allow for driver’s licenses from other states; these are valid across the U.S., Virginia boarders on several states and employees may reasonably live in them, heavy Military presence in Virginia and family members may maintain license from a different state. People may relocate. Undue barrier to employment to limit to VA
Specify if assessment for TB is sufficient. In recent years, there has been a shortage of serum needed to do TB testing, affecting ability to have all certified as TB free; rather assess and determine if warrant actual TB test. Redundant of 106-320.
Draft Reg.5. Three job-related references supporting the knowledge, skills, and abilities of the minimum qualifications according to the job description; Comments: This should be reduced to two, if a person has worked one place for a long time it may be difficult to get three. Two is reasonable. Also, should allow for a performance evaluation in lieu of a reference. We do not want to hinder hiring a person because they can’t come up with three references when we are already experiencing a shortage.
Draft Regs: results shall be placed within a file in accordance with 12VAC35-106 230 D within three business days of being received by the provider from the department; Comments: Not everyone uses the Department for background checks, those board that are part of County government use their county. Language needs adjusting to allow for that.
Draft regs: A record of participation in employee development activities, including orientation, training, and the results of employee’s competency testing. Comments: Further define competency testing with expectations for inclusion and evaluation of such testing.
106-260 Contracted Employees
Employers are shifting to 3rd party vendors for primary source verification of education history as they are more reliable than transcripts. Add this as an option
Allow for driver’s licenses from other states; these are valid across the U.S., Virginia boarders on several states and employees may reasonably live in them, heavy Military presence in Virginia and family members may maintain license from a different state. People may relocate. Undue barrier to employment to limit to VA
TB results – not specified. Request same as above. OR 106-320
Retention of contracted manpower employee records. For people hired via temp agency (vs. independent contract) within CSB/public sector entity, they are not considered the employees of the provider, but of the temp agency.
106-270: Students and Volunteers
Does this mean no TB assessment for students & volunteers? OR 106-320
106-300: Employee Training
Draft Reg: Required initial training: Within 7 business days following an employee or contractor’s start date, each employee or contractor responsible for supervision of individuals receiving services shall receive basic orientation and training regarding: a) the provider’s behavior intervention policies procedures and techniques regarding less restrictive interventions, timeout, and physical restraint; b) Cardiopulmonary resuscitation (CPR) and first aid training issued by the American Red Cross, the American Heart Association, or comparable authority in standard first aid and CPR.
Comments: Does this training apply to Admin staff as well or only individuals working directly with the person served. It’s not possible to provide First Aid and CPR training within the first 7 days. CPR, First Aid, Medication Administration, and Behavior intervention such as TO/CPI are among more difficult trainings to obtain. Define what is meant by “basic orientation”. Also, impact on employers when small number of employees are onboarding concurrently. Consider to move to within 30 days.
(B)(4) All new employees, contractors, volunteers and students shall be supervised until completing all orientation and training required…. What does “supervision” mean specifically? Does this mean they cannot be alone with individuals until completing the requirements?
(C)Annual training requirement from all items in 106-300 “basic orientation” a) behavioral intervention policies procedures and techniques regarding less restrictive interventions, timeout, and physical restraint; b) CPR and First Aid c) medication administration including basic pharmacology and medication side effects. What is meant by “basic orientation”. Is this for all staff, including administrative staff?
106-310 Notification of Policy Changes
Draft Regs B. The provider shall notify the department of any changes to policies required by this regulatory chapter prior to implementation of the change. B. The provider shall notify the department of any changes to policies required by this regulatory chapter prior to implementation of the change.
Notification to OL of changes to policies prior to implementation places undue burden on both OL and providers. Slows the process of updating and increases overall administrative burden. What is the turnaround time for OL response? What about need to respond to other changes quickly (e.g. laws). Recommend that review of policies be integrated more routinely into site visits by Licensing Specialists.
106-320 Tuberculosis Screening
Specify if assessment for TB is sufficient. In recent years, there has been a shortage of serum needed to do TB testing, affecting ability to have all certified as TB free; rather assess and determine if warrant actual TB test.
106-350 Disciplinary Actions
(B)(1-4) Policies for employee and contractor that lists discipline and penalties for abuse, neglect, exploitation and violation of client rights or providers policies. This policy will wind up being relatively vague as our Human Resources Department has a “it depends” approach. Will most likely use language like “up to and including”. Contractors are not employees.
106-380 Regular Business Hours
Draft reg. C. The provider shall submit their regular business hours to the department. Comment: If the provider posts their hours on their website this should be sufficient public notice for the department. Submitting regular business hours seems micro managing.
106-400 Mission Statement
Draft reg. Anytime there is a modification to the mission statement Comments: If the provider posts their mission statement on their website and keeps it current is that sufficient notice to the Department? Does a change or update require a service modification form? How is the Department notified and to whom a licensing specialist?
106-410 Fee Schedule
Draft reg. and the provider shall publish, post, and make available the fee schedule to individuals Comments: Suggest this is changed to make available as opposed to publishing and posting all service fees
106-430 Cessation of Services
Documentation that written notification of information such as intent to cease operations would be documented in a progress note, not a treatment plan. A treatment plan would be updated to note the date services are ended.
106-460 Discharge
Added (F)(2) in the written discharge summary, “Description of the individual’s or authorized representative’s participation in discharge planning and documentation of informed choice by the individual or his authorized representative as applicable in the decision to and planning for the discharge.” What does this look like?
106-480 Policies
Draft Reg: 18. A traffic pattern for center-based services that establishes a safe process for drop-off and pick-up of individuals who are transported by motor vehicle with site-specific application; Comments: this needs more clarification of what you are expecting in a policy.
104-490 Emergency Medical Information
Draft Reg. The provider shall maintain the following emergency medical information on a completed face sheet and updated for each individual when changes occur and any medical protocols for those problems or conditions; For individuals who are pregnant, the expected date of delivery and the name of the hospital to provide delivery services to the individual; Comments: Every provider has a different way of setting up their record. To prescribe where information should be placed in the medical record is too prescriptive. It should be available in the individual’s record, not regulating that it is on the face sheet. (A)(6) indicates that the provider must maintain the following information “significant medical problems or conditions and any medical protocols for those problems or conditions”. This seems excessive. Where does this begin and end? Is this important for someone receiving outpatient services? Is this per client’s report?
106-510 Service Description Requirements
Draft Reg The provider shall publish, post, and make available to individuals, and if applicable, their authorized representatives, service descriptions. The provider shall make the service descriptions available for public review. Comments: Recommend original language of making the service descriptions available as opposed to publishing and posting.
106-520 Medication Management
Need disability specific chapters to appropriately comment
106-530 Behavior Interventions and supports
No comment without seeing the disability specific licensing regulations
106-550 Privacy
Draft Reg 5. A prohibition on staff visitors. Request clarification of 550 – 5 – is the intent for the policy to prohibit staff members from receiving visitors while at work in any manner that could violate privacy?
106-560 Transportation
Draft Reg 1. The check of the employees’ or contractors’ driving record shall occur at the time of employment and annually thereafter. Comment: This is for HAMHDS need to check if we do annual checks or sampling after time of employment.
106-570 Reporting to the department
Draft Reg: A root cause analysis shall be conducted by the provider within 30 days of discovery of Level II serious incidents and any Level III serious incidents that occur during the provision of a service or on the provider's premises. Comment: Request moving RCA to read 30 business days.
106-590 Monitoring and Evaluating Service Quality
Comment: Clarification is needed as to what types of complaints are associated with licensure regulations that are not human rights, is this not a Department requirement for providers? This is confusing. It reads like another process similarly to human rights. This is a new system structure added to providers with no funding for the staff to implement this new structure. What are the examples of how this would be implemented? Internally staff report on each other and it is investigated when a licensure regulations is not implemented? Not sure what this means.
106-600 Individual records
Draft Reg - Notice to individuals receiving services and their authorized representatives of where all individual records will be located. Comment: So, if its and electronic record that is required to be shared with the individual?
106-630 Human Rights
Comments: Does this imply that violations of human rights will now become CAPS?
106-650 Choice of Provider
Consider requesting does not apply to services provided in jail. Also, define provider. Individuals have the choice between provider agencies, but does this extend to choice of specific practitioner? Specific case manager, for example.
106-690 Building and Grounds
Is the provision of outdoor recreation space required for all types of service locations? Specify where this is required.
106-700 Floor Plans and Building Modifications
Draft Reg Within the service modification application to be submitted to the department as required by 12VAC35-106-80, The provider shall submit building plans and specifications for any planned construction at a new location, changes in the use of existing locations, and any structural modifications or additions including renovations.
Comments: Consider requesting clarification regarding renovations/examples (e.g. counter top replacement?) If there is no impact to individuals served is a service modification needed? Siding on the house is a service modification needed?
106-710 Traffic Pattern
Draft Reg Each provider shall submit a site specific traffic pattern at the time of initial application, as required by 12VAC35-106-40 and each time a service location is added in accordance with 12VAC35-106-80. Comments: All programs or just day programs. This would not be consistent with normative life to submit for a group home setting. What are the expectations for enforcing this?