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.