Recommendations for Adult Day Care regulations.

Submitted by:

Carla C. Groff

Bedford Adult Day Center

1617 Oakwood Street

Bedford, VA 24523

Phone: 540-586-8424

10/22/2019

22VAC 40-61-330 Part D: Activities.

Comment:

Current regulations have no requirement for a “designated staff person” responsible for activities. Adding the requirement for a “designated” activity staff will create hardship on providers from a financial perspective as well as a staffing perspective.

The proposed regulations on who can meet the qualifications as a “designated” activities staff person are too restrictive from an educational as well as experiential perspective. The requirements will be difficult for facilities to meet from a budgetary standpoint as well the standpoint of securing qualified staff.

1. According to the Bureau of Labor Statistics, a therapeutic recreation specialist has annual wages of $45,890, an occupational therapist has annual wages of $80,150, and an occupational therapy assistant has annual wages of $57,870. ADHC facilities who serve publicly funded individuals would be unable to sustain these wages on the current all-inclusive Medicaid reimbursement rate of $57.04 per day which amounts to an hourly rate of $5.70 for centers what are open 10 hours per day.
2. The option to utilize a qualified activities professional is not only expensive, but the training is difficult to obtain for employees in rural communities. According to the Virginia Health Care Association website, the activities professional course is only offered in a week-long once yearly course with a training fee of $695. It would require applicants to travel and make overnight accommodations.
3. The requirement for having at least an Associates degree in” a discipline focusing on the provision of activities for adults” is unclear. (Section D4).
4. The requirement for 1-year experience in an activities program in an adult care setting   would also be difficult to meet in small communities that only support 1 or 2 long term care settings.

5. Assisted Living regulations also have an option for 40-hour department-approved activities training.  This would also be a good option for ADHC

    

   Recommendation:

    The proposed regulations 22VAC10-61-330 Activities, Part D should either be eliminated in its entirety or changed as follows.

22VAC10-61-330 Activities, Part D

1. Be a qualified therapeutic recreation specialist, activities professional, or related creative arts specialist, or related health care clinician.

2. Be eligible for certification as a therapeutic recreation specialist, activities professional or related creative arts specialist, or related health care clinician.

3.No change.

4. Have a least an Associates degree in a human service, health care, education, physical education, humanities, psychology, social sciences, social work, disability studies, fine arts, or related field.

5.Have one-year full-time experience within the last five years in a health care or disability services program. (omit activities program). or

6. Prior to or within six months or employment, have successfully completed 40 hours of department-approved training in adult group activities and in recognizing and assessing the activity needs of participant.

22VAC 40-61-160. First Aid and CPR certification.

Part A. First Aid.

Comment:    This regulation is contradictory.

Recommendation: The regulation should read as follows:

1. There shall be at least one direct care staff member on premises at all times who has current certification in first aid from the American Red Cross, American Heart Association, National Safety Council, American Safety and Health Institute, community college, hospital, volunteer rescue squad, or fire department.  The certification must either be in adult first aid or include adult first aid. To be considered current, the certification shall have been issued win the past three years.
2. A direct care staff member who is a registered nurse or licensed practical nurse does not have to meet the requirements of subdivisions 1 and 2 of this subsection.

22VAC40-61-1: Definitions:

Comment:

To clarify who would count as direct care staff, and who would need direct care staff training, the definition of “Direct Care Staff” needs clarification.

Recommendation:

“Direct Care Staff” means supervisors, assistants, aides, or other staff of a center who assist participants win the performance of personal care or ADLS and are counted in the staff to participant ratio.

Respectfully Submitted:

Carla C. Groff