Commenter:
Holly Rhodenhizer, Lutheran Family Services of Virginia
LFSVA Comments
Page 6 – Group Home Definition – services meet the needs outlined in the ISP. If the individuals do not require 24-hour direct support, we should not be required to provide 24-hour awake staff. Please consider least restrictive environment and not mandate 24/7 support for those who do not require that level of supervision.
Page 14 – 3. An emergency room visit – Why was “in lieu of Primary Care” removed?
Page 21 – Files ready within one hour of request – We will do the best we can, at times we are limited by file location as we are a statewide organization. We also have limitations in the event that the EHR would have a service lapse and we would not be able to produce records, this is rare, but has happened.
Page 23 – History of abuse/neglect – please further define as many agencies have founded cases.
Page 23 – Any changes that cause a provider to be unable to provide services to any individual for a significant period of time – please clarify what “significant period of time” means as well as who to report this information.
Page 30 – The provider’s full-time executive director or administrator shall be on the premises during regular business hours. In his absence a professional staff person shall be designated to act in his place. The provider shall ensure the designee has the contact information for the administration in the event of an emergency. – This is not feasible for agencies with multiple locations.
Page 32 – The documentation necessary to conduct the criminal history background check shall be submitted no later than the first date of employment – Please clarify, does this mean we simply need to set up their appointment in FieldPrint or actually complete the fingerprinting?
Page 32 – No employee or contractor shall be permitted to work in a position that involves direct contact with an individual until an original criminal history background check and registry check has been received by the provider, unless such person works under the direct supervision of another employee for whom a criminal history background check and registry check has been completed in accordance with this section – We would be unable to hire and retain staff. We cannot pay staff while we are awaiting background checks to be returned and therefore, we would not be able to retain them. Staff pay relies on services being provided. We factor in training; however, this regulation has potential to be far more than typical training hours.
Page 33 – The provider shall have a policy related to the periodic performance of criminal history background checks of employees and contractors after the initial check performed pursuant to 12VAC35-106-240(A)(1). The policy shall require that the provider conduct background checks on a minimum of 20% of all existing employees annually. – There is a cost associated with this, is DBHDS planning to cover the cost? Please provide further clarification, is this a random sample, can this be new hires, just program staff or including administrative staff, etc.?
Page 33 – A copy of any official transcripts or degrees and training history – Please clarify, is this in reference to higher education degrees? This will be costly for employees and time consuming for providers. Will a diploma suffice as many people do not have transcripts? Is this for all new hires or do we have to request for all employees prior to the date the new regulations go into effect?
Page 33 – Reasonable verification of employment history – Please clarify the expectation and reasoning.
Page 33 – Evidence of a Virginia driver’s license and driving record by the Virginia Department of Motor Vehicles for employees transporting individuals – Please clarify, does this mean we cannot employ military who are, by law, permitted to maintain their home state license?
Page 36 – Required Initial Training – This would be impossible to accomplish and detrimental to learning and retention of information. Medication training is typically conducted over the course of 4 days, CPR/FA is 1 day, and Safety Care is 2 days. Training is scheduled at various times throughout the month to allow time for the employees to retain the information trained as well as for our trainers to plan and maintain their other responsibilities.
Page 37 – All new employees, contractors, volunteers and students shall be supervised until completing all orientation and training required under 12VAC35-106-300 (B) (1)- (3) and demonstrating competency through testing. All new employees, contractors, volunteers and students shall complete all orientation and training required under 12VAC35-106-300 (B)(1)-(3) and demonstrate competency through testing prior to carrying out job responsibilities without supervision. Documentation of competency testing shall be kept in the employee or contractor’s personnel file – This would prevent in-home services from starting within the 30-day timeframe. True competency can take months, if we cannot allow staff to work without supervision to gain the competency necessary, we will not be able to maintain fiscal viability. We cannot staff every case with a supervisor overseeing a DSP until competency is demonstrated.
Page 37 – The provider shall notify the department of any changes to policies required by this regulatory chapter prior to implementation of the change – Please clarify, who do we report, is this in reference to all policies, this would be very time consuming for OL staff?
Page 39 – A. The provider shall establish regular business hours for each of the provider’s offices. The provider shall publish, post, and make available the business hours to individuals receiving services and, if applicable, their authorized representatives – At times all employees are out in the field working, some of our smaller locations do not have full time office-based personnel which may at times prevent someone from being available.
Page 39 – 12VAC35-106-390. Office and service locations – We have multiple locations across the state, we have many files stored in secure storage units. – At times, purged files will not be present, are those files included in this definition?
Page 48 – 1. The check of the employees’ or contractors’ driving record shall occur at the time of employment and annually thereafter. Documentation of the latest check of the employee or contractors’ driving record shall be placed within their personnel record – We have a system that tracks all employees and contractors and alerts us to violations, suspension of license, failure to renew a license, etc. This system replaces the need for us to run annual checks, would this be acceptable to DBHDS?
Page 48 – Require head counts at each stop – Please provide clarification for what constitutes a stop and any required documentation. Please be specific and state when the head count starts and ends. This has potential to result in distracted driving.
Page 48 – Include provisions to ensure that in case of an emergency any employees or contractors with a conviction for operating or driving a vehicle under the influence or reckless driving whom are employed for reasons other than transportation are not utilized to transport individuals – Why does this not stipulate the two-year time limit stated under B.
Page 56 – 12VAC35-106-710. Traffic pattern – Which services does this apply? This is not “normalization” for community-based services. Day programs are often in office parks and we don’t have authority to dictate traffic patterns.
Page 56 – Lighting in halls shall be adequate and shall be continuous at night – This does not allow for choice if someone likes their home dark when they sleep. Environments should be set up based on the needs of the person.
Page 58 – 12VAC35-106-800. Computers and Internet Access. All licensed service locations shall be equipped with the appropriate technology, including computer and internet access, to comply with the regulatory requirements contained within this chapter and the service specific chapters, including serious incident reporting into the department's web-based reporting application as required by 12VAC35-106-570. – Please clarify, some people can do everything they need to do from a Smart Phone or tablet. There are some places in the state that do not have proper internet service available. What is the reasoning behind this regulation?
Page 59 – An analysis and prioritization of vulnerability of all services and locations to various hazards that may impact the provider. Vulnerability is a combination of the likelihood and severity of hazard occurrence – Please clarify
Page 59 – Annexes dedicated to the highest-priority hazards as indicated by the vulnerability analysis which include documentation of specific plans, policies, and procedures to prevent, mitigate, prepare for, respond to, and recover from the hazards most likely to disrupt provider operations – Please clarify
Page 59 – Documented, current Memoranda of Understanding (MOU) or Memoranda of Agreement (MOA) or other arrangement (e.g. hotel accommodation) with local/regional sites that could function as evacuation locations or stop-over points – This would be very difficult and likely not feasible. Hotels cannot guarantee rooms, they are businesses and will sell anything available. We can provide a list of resources; however, with each emergency shelters are likely to change. We will provide our staff with tools to determine where shelters are located based on the specific emergency.
Page 62 – A. Telephones A landline telephone shall be accessible for emergency purposes. The telephone shall be a line capable of operating during a power outage. – Some providers have moved away from landlines, this would be a monthly financial burden to place on providers who have chosen to not utilize landlines.
Page 62 – This section does not apply to home and noncenter-based services and correctional facilities. – Please clarify, there is no longer a definition of “home” in this draft of regulations.
