DBHDS Proposed Risk Management Guidance Document

Overall Comment: This guidance document, instead of offering clarity in the regulations, actually increases the restrictions of the regulations by intensifying the requirements, increasing administrative burden, and financial burden on agencies that are already stretched thin.

Crosswalk or Guidance documents have been requested by different state/provider work groups, but when the guidance adds additional requirements and additional guidelines they no longer serve the purpose of support and rather hinder the ability of provider agencies to actually provide the direct care to the people in services.

With regards to the risk manager training and the additional fire safety training noted below, what will be DBHDS's guidance related to tracking of completion?  How is competence being defined?  Will DBHDS provide tests at the end of required training that will require a certain passing score?  Will there be required timelines for these new trainings?  Would this be required of those already in these roles and how long would agencies have to satisfy this requirement?

12VAC35-105-520. Risk Management

(A) The guidance identifies department approved training, which will require, DBHDS to develop, maintain, and update training online as well as offer the ability to review trainings developed by provider agencies prior to implementation.  Increasing the burden on DBHDS as well as provider agencies.  By adding the noted guidance to the already stated proposed regulation the way this is written, leaves the requirement open to allow DBHDS to add additional training requirements to provider agencies and the person identified to manage the risk management function.  This should be deleted as the proposed regulation already states department approved training.

(C) 3 Staff Competence and adequacy of staffing;

In this guidance document, there has been a required training added that is not anywhere else and something that has not been widely distributed to the provider community

-All employees have completed initial and annual fire safety training.

Is this a training DBHDS will distribute?  Will current staff have to satisfy this requirement as well?

(C) 5 A Review of Serious Incidents

Clarification is needed as to whether the following is another added requirement in addition to the regulation?

The provider has an updated policy that defines who has the authority and responsibility to
act when a serious incident or a pattern of serious incidents indicates that an individual is
at risk; and

In the following statement within the guidance, generally, an agency or team determine if appropriate follow-up occurs, but the wording of this guidance appears to indicate that DBHDS may be the entity that will determine this?

Serious incidents and patterns of serious incidents are reviewed and appropriate follow-up
is conducted or implemented to address individual or system-level risks.