12VAC35-105-20. Definitions.
“Direct care position” means any position that includes responsibility for: (i) treatment, case management, health, safety, development, or well-being of an individual receiving services or (ii) immediately supervising a person in a position with this responsibility.
Comment: The Case management role being defined as a component of the definition of Direct Care Position seems to contradict the CMS definition of Case Management. It is unclear how this new definition will be applied to service provision, and credential and training requirements across all disabilities.
CMS definition of case management
•Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.
"Missing" means a circumstance in which an individual is at any time not physically present when and where he is expected or is supposed to be.
Comment: This definition is entirely too broad if applicable in all programs. Many individuals “no show” outpatient appointments and are not at any clinical risk. Submitting incident reports for these types of non-events would be unnecessarily burdensome.
"Qualified Mental Health Professional-Adult (QMHP-A)" means a person in the human services field who is trained and experienced in providing psychiatric or mental health services to individuals adults who have a mental illness; including (i) a doctor of medicine or osteopathy licensed in Virginia; (ii) a doctor of medicine or osteopathy, specializing in psychiatry and licensed in Virginia; (iii) an individual with a master's degree in psychology from an accredited college or university with at least one year of clinical experience; (iv) a social worker: an individual with at least a bachelor's degree in human services or related field (social work, psychology, psychiatric rehabilitation, sociology, counseling, vocational rehabilitation, human services counseling or other degree deemed equivalent to those described) from an accredited college and with at least one year of clinical experience providing direct services to individuals with a diagnosis of mental illness; (v) a person with at least a bachelor's degree from an accredited college in an unrelated field that includes at least 15 semester credits (or equivalent) in a human services field and who has at least three years of clinical experience; (vi) a Certified Psychiatric Rehabilitation Provider (CPRP) registered with the United States Psychiatric Rehabilitation Association (USPRA); (vii) a registered nurse licensed in Virginia with at least one year of clinical experience; or (viii) any other licensed mental health professional.
Comment: This definition is contradictory with Emergency Regulations effective 12/17/2017 (see below)
"Qualified mental health professional" or "QMHP" means a person who by education and experience is professionally qualified and registered by the board to provide collaborative mental health services for adults or children. A QMHP shall not engage in independent or autonomous practice. A QMHP shall provide such services as an employee or independent contractor of the DBHDS or a provider licensed by the DBHDS.
"Qualified mental health professional-adult" or "QMHP-A" means a registered QMHP who is trained and experienced in providing mental health services to adults who have a mental illness. A QMHP-A shall provide such services as an employee or independent contractor of the DBHDS or a provider licensed by the DBHDS.
"Qualified Mental Health Professional-Child (QMHP-C)" means a person in the human services field who is trained and experienced in providing psychiatric or mental health services to children who have a mental illness. To qualify as a QMHP-C, the individual must have the designated clinical experience and must either (i) be a doctor of medicine or osteopathy licensed in Virginia; (ii) have a master's degree in psychology from an accredited college or university with at least one year of clinical experience with children and adolescents; (iii) have a social work bachelor's or master's degree from an accredited college or university with at least one year of documented clinical experience with children or adolescents; (iv) be a registered nurse with at least one year of clinical experience with children and adolescents; (v) have at least a bachelor's degree in a human services field or in special education from an accredited college with at least one year of clinical experience providing direct services to with children and adolescents with a diagnosis of mental illness, or (vi) be a licensed mental health professional.
Comment: This definition is contradictory with Emergency Regulations effective 12/17/2017 (see below)
"Qualified mental health professional-child" or "QMHP-C" means a registered QMHP who is trained and experienced in providing mental health services to children or adolescents who have a mental illness. A QMHP-C shall provide such services as an employee or independent contractor of the DBHDS or a provider licensed by the DBHDS.
"Level III serious incident" means a serious incident whether or not the incident occurs while in the provision of a service or on the provider’s premises and results in:
Any death of an individual;
A sexual assault of an individual;
A serious injury of an individual that results in or likely will result in permanent physical or psychological impairment;
A suicide attempt by an individual admitted for services that results in a hospital admission.
Comment: While we would support the reporting of a sexual assault that occurs or originates during the provision of a service or on the premises of the provider or for individuals for whom we have 24-hour responsibility, we do not support the reporting of other types of sexual assault. Knowing these will be reported to DBHDS would inhibit victims and perpetrators from seeking needed treatment.
We would also support the reporting of a serious injury that occurs or originates during the provision of a service or on the premises of the provider or for individuals for whom we have 24-hour responsibility, we do not support the reporting of other types of serious injuries. Injuries that result from another source – like a motor vehicle accident – are outside our span of control and purview to investigate.