Initial Draft NEW Center Based Service Chapter of the Licensing Regulations:

1. 12VAC35-109-10 Definitions: Please clarify if there is a definitional difference from DBHDS between “episodic” and “periodic” in the definition of Center-based respite care services. This language occurs later in the regulations in terms staff supervision and clarity is needed. If the DBHDS meaning of the two terms is the same, please eliminate one of them.
2. 12VAC35-109-40.A.2 Screening:  This language requires a policy/procedure regarding the identification, qualification, training and duties of employees responsible for screening.  Please reference what qualifications and training DBHDS requires (if they are specified) for employees who conduct screenings.
3. 12VAC35-109 -60.G.5:  Comprehensive assessment:  the language that the comprehensive assessment must “include unsuccessful interventions, and outcomes, and the provider shall ensure previous assessments are utilized to note these interventions as required” should be indicated as required “if applicable.”   Does this imply that new respite providers doing a comprehensive assessment must confer with other providers to gather information on unsuccessful interventions and outcomes? If so, that administrative and communication barrier is extremely high.
4. It would be extremely helpful if DBHDS clearly distinguished between an ISP developed with the support coordinator and a Plan of Care which is developed by a provider and submitted as Part V of the ISP in WAMS.  Using the term ISP for most of the regulatory provisions raises questions as to applicability for providers.  For example:12VAC35-109-80.A.5:  requires “identification of employees or contractors responsible for coordination and integration of services, including employees of other agencies.” It is reasonable for a support coordinator to manage “coordination and integration of services,” but it is not reasonable for a provider to do so.  This language appears again in 12VAC35-109-80.B.10.
5. 12VAC35-109-80.E.2. “After each training (on the ISP), providers shall test the employee’s or contractor’s knowledge, competency, or both and retain documentation of the test of the employee’s or contractor’s knowledge, competency, or both within the employee’s or contractor’s employment file.” This is an unworkable requirement.  As a center-based respite center serving individuals on a periodic basis, Jill’s House would be required to test and file test results in the employee file DSP knowledge of individual service plans on an almost weekly basis.
6. 12VAC35-109-90.F:  Quarterly Reports.  Please clarify that Quarterly Reports are not due to support coordinator for quarters during which the service was not provided.  Center-based respite is periodic in nature and may happen only 3 times a year.
7. 12VAC35-109-90.F.4.b.c.: requires that the quarterly review of the ISP shall note the individuals progress towards discharge and discharge planning;  Respite does not work toward discharge from services.  This should be “if applicable.”
8. 12VAC35-109-110.D:  Staffing “The supervisor shall have documented experience developing, conducting, and approving assessments and ISPs or treatment plans.”  This is an unnecessary requirement. Jill’s House floor/shift supervisors have experience reading, interpreting, and implementing services plans and are trained to supervise the DSPs providing the direct care in accordance with the ISP.  Our administrative staff and licensed QMHP’s develop and approve the ISP’s and treatment plans. Shift supervisors don’t need to know how to write the ISPs. They need to know how to read, understand, and implement it.