12VAC35-105-210. F- Making the amendments suggested significantly puts residents of residential programs at risk.  Not having an appropriate audit by a CPA or having someone oversee the program that is bonded and indemnified is bad business practice and in fact is NOT the same thing as indemnity coverage of a business as a whole.  It is suggested that DBHDS does a little more research than removing this language.  There are several times where residential providers, specifically of ID/DD are intermingling the residents own funds (personal, SS, etc.) with the companies funds, which in accounting practices is considered not in GAAP appropriate practices.  Holding providers accountable with maintaining practices that protect those they serve should be considered.  

2VAC35-105-430

This removal and changes within this section claim to be duplicative, which they are not.  This regulations is what is required in the personnel record.  The other regulations just state they have to be done, not that it has to be in the record.  Without saying that something needs to specifically be in the personnel record, DBHDS cannot cite a provider for not having it.  

As a provider, I appreciate the state’s initiative to simplify regulations. This is a positive first step, but it is clear that much more needs to be done to streamline and clarify the regulatory framework. Many providers, especially those who are just starting out or operating with minimal administrative support due to limited funding, find the current regulations overwhelming, difficult to interpret, and even more challenging to manage.

There is a widespread consensus among providers that the system is convoluted, repetitive, and over-regulated, while at the same time underfunded. Our shared goal is to deliver the highest quality care, ensuring that the individuals we serve can lead fulfilling lives. While these initial changes are welcome, a comprehensive overhaul is essential if we are to create a system that not only functions effectively but thrives—allowing providers to establish sustainable operations that guarantee the long-term stability and well-being of those we support

We are appreciative of the efforts to streamline the Licensing regulations. We specifically would like to recognize the implementation of VDH guidance related to replacing annual certification of being tuberculosis free with education on self-presentation if exposed. Regarding records management 870.E, the stated approach to making corrections is appropriate for providers using paper records. Electronic health records use other mechanisms to identify and track corrections; these are driven by the functionality of those systems. Please consider adding brief clarification

The current edits stop short of addressing a major gap in current regulations related to the operation of Sponsored Homes with MORE than 2 Individuals. Although these environments proliferate throughout the State, current regulations are silent regarding such environments, in any capacity.

The lack of a regulatory framework for these (hybrid locations) is a disservice to potential new providers of such services, and gives rise to misinformation that may lead to regulatory sanctions.