106-250.A.2

Verified education history can be done for people with college degrees or higher.  What are expectations for people with only a high school education?

Any expectations for when the education history cannot be obtained when an applicant owes the school money?  Currently, schools are not issuing transcripts in those cases.

106-250 A. 6

This is subjective and difficult to receive. Many employers have policies prohibiting supplying this information to new employers.

106-250.A.8

By requiring a valid VA driver’s you are limiting anyone working in another state (WV, MD, KY, NC) and military spouses who have retained their previous driver's license.

If this is not requiring only a VA driver’s license, the language needs to be adjusted to clarify any license is accepted and driving records from the appropriate state are maintained.

106-250.D

Does this only apply to an independent contractor, vs. staff hired via a temp agency?

106-280

D. Job descriptions shall include minimum knowledge, skills, and abilities, professional
qualifications and experience appropriate to the duties and responsibilities required of the
position and the population served.

A position may be entry-level such that the person doesn’t have experience in the population served or there could be a general position such as a clinician job description that didn’t specify the population served. The staffing across the state is short and this will have an impact on providing services if providers have shortages due to increased requirements.

106-290.B

We have a large group of admin staff who do not work directly with individuals. The way B. 1. Is worded, this is only required of employees working with individuals. Suggest B.1. be required for all employees, First Aid/CPR for those working directly with individuals, and Med Administration for those working in a program who has responsibility for administering medications.

1.a – is this meant to include training in behavior interventions, too (e.g., CPI, TO, Mandt, etc.)?  If so, increase this to 90 business days.  Or denote that behavior intervention policies are to be reviewed within 15 business days while allowing 90 business days to provide training for any approved hands-on emergency interventions.

Please reflect that a currently valid certification from a previous source before employment is acceptable.

Recommend changing timeframe to 90 calendar days for First Aid/CPR, behavior intervention, and MAR training.  This requirement puts an undue burden on providers – the cost of training more of staff as trainers or contracting with a trainer or travel expenses to get the soonest class regardless of distance.

1.f. Thank you for moving orientation on grievance policy to this section

B.2.c – specify that this is only for staff whose positions involve medication administration. This reads as though all staff members need to complete this training, regardless of whether or not medication administration is a job duty.

B.2 – specify that providers may exempt students and volunteers from needing to have CPR/First Aid training.  Per regulations students and volunteers are not to be part of the staffing plan.  Having too many training requirements decreases opportunities to have students and volunteers.  Students are known to have limited schedules and days to be at a provider location and it is often not realistic to expect them to engage in extensive orientations and training.

C. All employees, contractors, students, and volunteers shall complete an annual training
that shall include:
1. Retraining of all the elements required within 12VAC30-106-290 B 1-2, with the
exception of CPR training which will occur on a biennial basis;

Not all training in B1-2 needs annual retraining.

106-300.B

Vague as written and DBHDS can access policies and procedures at any time.  Unclear whether this means that DBHDS has to approve policy changes.

106-310

Actual TB test or screening and TB test if indicated?

The additional administrative burden with additional annual training.

B. Is “self-presentation” intended to mean that a staff member will self-report if they have been diagnosed with TB?  Please clarify/rephrase.

106-320.A

Does the contractor include members of the workforce hired via a temporary agency (vs. independent contractor)?  These individuals are not the provider’s staff, rather they are employed by the staffing agency.

Can the review of the contract be used as the evaluation for contractors?

106-340

Personnel policies at CSBs may be held at a higher authority (e.g., County Government Dept of HR) and often do not have jurisdiction over revising or the ability to have provider-level procedures. As a county agency, we do not have the ability to have the policy to spell out the requirements of section B.

106-370.

Section B. What does “The business hours shall also include enough time for the department to conduct unannounced inspections and investigations” mean? The department should specify the hours to expect an unannounced inspection and investigation.

C. - Instead of submitting regular business hours can providers submit at the request of DBHDS?  These would be included in the initial application process.

106-390

How are providers expected to publish and post the fee schedule?

106-460.B

If the procedure mentioned is related to Rights, then it should match relevant sections of 115-175, as outlined in 106-590.F.

106-470.1

Succession Plan – This does not apply to all agencies; specifically, this does not apply to a government agency.

106-480.6

Including details of medical protocols on a face sheet can make this document unwieldy and more difficult for emergency medical personnel to use.  Recommend this be revised so that the face sheet lists the types of protocols a person may have, but that the details be maintained separately and be readily available for EMS personnel.

106-480.9

Is documenting pregnancy needed as it is a situation that will change after 9 months? This is excessive and only applicable to residential services. 

106-490.B

Providers would like to request more time as 1 business day is restrictive

106-500

Consider revising so that service descriptions be readily available for people to review, without implying a need to post on the walls in residential settings such as ICF/IIDs and Group Homes, as this detracts from having the environment look and feel like a typical home in a community-based setting.

106-520.E

Revise to include read, “Injuries resulting from or occurring during the implementation of seclusion or restraint shall be reported to the department as provided…” 

106-550

There are policies listed hereunder privacy that is not listed in the Policy section.

106-570.B.1 and 3

B.1 Specify that reporting of allegations of abuse or neglect to the Office of Licensing is only needed when the definition of a Level II or Level III incident is met.  This reads as though duplicative reporting is required for all allegations, although those events may not meet the definition of Level II or Level III incidents.

B.3 Similarly, specify that instances of seclusion or restraint are only reported to the Office of Licensing if the definition of a Level II or Level III incident is met. 

106-560

B. Would employees or contractors who have no client contact need to have their driving record checked annually?

B2. Does this apply to all employees? What about those who do not drive clients?

C.5. Are two years appropriate?

106-570.B.2

Revise the notification to the department (CHRIS reporting) to 1 business day instead of 24 hours.

106-570.C

C.2.(c) – revise to match guidance that this refers to locations of the same type of license, NOT to all locations of all services across the provider’s organizational license.

106-590.G

Having both an OHR complaint process and an OL complaint process is likely to be confusing for individuals and their families.  This is highly duplicative of the existing requirements of 115/OHR, which presents the possibility of a significant increase in administrative burden on the provider for a redundant task. 

If this will remain a part of the regulations, additional information is needed. Specifically, how does this intersect when an individual complains about an issue covered under the Human Rights complaint process, which most complaints are?

106-600

Regarding A.4, specify that reasonable measures are expected.  In the event of a fire or any sudden emergency, the priority will be on protecting the lives of individuals and staff. 

106-620B

Suggest giving more time to complete as before or on the admission date is restrictive.

106-670.C.1

Allow for other cleansing mechanisms, such as the use of disinfectants and disposable, single-use underpads.

106-680

This information is more appropriate for residential and some center-based services.  Therefore, recommend moving to those service-specific chapters.

106-690

This information is more appropriate for residential and some center-based services.  Therefore, recommend moving to those service-specific chapters.

106-700

Define Service Animal or specify using the ADA definition.

106-720.B

Recommend relocation to the residential services chapter, as this has limited applicability to other services.  Or, work with OHR to have this including in Chapter 115 instead, under Freedoms of Everyday life.  In the residential chapter, consider overt allowance for limiting access during early phases of SUD/Detox types of programs or specifying this as a requirement for long-term residential services, not short-term. 

Including this for non-residential services is not applicable.  In many cases, the expectation is for individuals to be participating in the services/programming outlined in the Service Description, which would not include having people engaging in “at request” (i.e. on-demand) use of computer and internet – they are at the location to receive a specific service and there are reasonable, understood, expectations for participation in services during those hours.  For those services where the use of computers may be beneficial for service delivery, providers would be expected to provide the necessary resources for staff members to provide services appropriately.

This is unclear and can be easily misinterpreted by individuals served. A client asking for an accommodation due to a disability is one thing, vs. a client asking for a computer and internet access during IOP services is another. Are we to put computers in our lobbies?