Virginia Regulatory Town Hall
Agency
Department of Social Services
 
Board
State Board of Social Services
 
chapter
Minimum Standards for Licensed Private Child-Placing Agencies [22 VAC 40 ‑ 131]
Action Adopt new standards for licensed private child-placing agencies.
Stage Proposed
Comment Period Ended on 4/1/2011
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3/31/11  1:58 pm
Commenter: Krystal Thompson, FFTA-VA Chapter Chair

General comment on proposed LCPA standards
 

The Foster Family-based Treatment Association - Virginia Chapter appreciates the time and effort involved in revision of the minimum standards for licensure. The proposed standards 22VAC40-131 are indicative of Virginia’s ongoing commitment to delivering quality services to children and families.

 
Proposed Section 22VAC40-131-10
“Short term foster care” – Question: Could successive short term placements of a child be considered one on-going open case as opposed to opening a new case each time the child is placed in that home? For example the child who is placed for a weekend every month in the same short term foster home.
 
22VAC40-131 -90 Policy and Procedures
D.4. – Question: Implementing the child’s emergency back up plan when the placement disrupts. Can this be met through a general statement such as “another approved provider home within the agency” or is a specific home necessary? The requirement of another specific home would be unrealistic as the needs of children placed in a foster home fluctuate as does the capacity of the foster home provider.
 
22VAC40-131-140 Personnel: Staff composition and qualifications
H.2. – Question: Regulation as proposed requires a doctorate or masters in social work to supervise interns; should the requirement not follow E.4.b related to supervising staff? The MSW requirement is inconsistent with accepted credentials for staff supervision.
 
 
22VAC40-131-150 Staff development
B.1. & 2 – Question: Regulations as proposed require initial orientation training to be completed prior to the staff person assuming responsibilities of his position and within 30 days of the date of employment. There are some job responsibilities that could be successfully completed during the staff persons 30 day orientation and training period i.e. making referrals and linking to resources, monitoring service delivery, and obtaining progress updates from foster parents. This requirement would also seem excessive when the newly hired worked has previous experience in service delivery to foster children. Could the “prior to assuming the responsibilities” verbiage be stricken while maintaining the 30 day requirement?
 
22VAC40-131-180 Home study requirement
B & C – Question: These sections focus on the completion of the home study application before gathering and assessing information for use in the final decision. Is it necessary for the entire application to be completed before assessment begins? Completion of the application is part of the process of gathering information needed to make a final decision as to approval. A suggestion would be to combine B&C and strike the word completion.  “Upon receipt of a provider application, the licensee shall notify the applicant of the status of the application. The licensee shall then begin the process of gathering and assessing information for use in the final decision related to whether the applicant and home meets all required elements for approval.”
 
G – Question: Current proposed standard requires at least one of three references be non-relative. Best practice would suggest a larger ratio of references be provided by non-relatives. Would a revision be considered requiring at least two references from non-relatives?
 
J.1.b. – Question: Tuberculosis screenings is referenced in this regulation. To maintain consistency with other standards could this be revised to say tuberculosis tests or screenings?
 
22VAC40-131-190 Home environment
E. - Question: Regulation requires access to a working telephone in the home. Could we receive clarification on what is required to meet this standard? Ex. Cell or landline.
 
O. 1 & 4  - Question: Regulation requires detailed written emergency preparedness and response plan. The requirements to be addressed in O 1 & O 4 in order to be valid and employable would need to be specific to situation and emergency; it is unrealistic to require a plan for every foreseeable and unforeseeable emergency. O 2, 3, 5, 6, 7 appear to adequately address the need for emergency preparedness. Could O 1 and O 4 be stricken?
 
R. - Question: Regulation requires knowledge of federal, state and local ordinances related to firearms. Administering this regulation would be difficult at best, due to the different requirements by locality. Could R 1, 2, & 3 adequately serve to monitor the possession of weapons? Could there be clarification provided as to what constitutes a weapon that requires locked storage?
 
S. - Question: Regulation requires knowledge of laws pertaining to household pets which vary by locality. Some inoculations and tests have no bearing on welfare of children in the home. This standard would be very hard to administer, as written, due to the variances in local ordinances. Could 22VAC40-131-190 T be amended to “the applicant shall ensure that household pets have a current rabies vaccination, are safe to be around children, and present no health hazard to children in the home” and adequately serve to meet the intention of the standard?
 
22VAC40-131-200 Initial approval or disapproval
H & H 1  - Question: H states “following approval of an applicant, the licensee shall provide the following services and requirements: H.1. The licensee shall provide orientation and on-going training for each provider. Can orientation be stricken from H 1 and be included in 22VAC40-131-210 A as per the following suggestion? “The licensee shall ensure that orientation and pre-service training is provided for resource, foster, treatment foster, short term foster, and adoptive family home providers.” The general process of orientation of potential foster/adoptive families is part of the approval process. Reaction to and acceptance of agency policy and procedure is part of the assessment process.
 
 
22VAC40-131-210 Provider training and development
 B. - Question: Regulation as proposed requires as a condition of initial approval and renewals of approvals the licensee shall require each home provider to complete all required training. Training shall be relevant to the needs of children and families. Does this mean before each re-evaluation/renewal of approval each family would be required to complete all pre-service training over again? Suggestion would be “prior to renewal of approval, training should be provided relevant to the needs of the family and children served, as appropriate.”
 
22VAC40-131-230 Monitoring and re-evaluation of provider homes
K. 1 & 2 - Question: Regulation requires documentation in the provider’s file of each visit, contact and home visit. For providers with children placed in their home this would create unnecessary redundancy and inefficiency as those contacts are documented in the child’s file. Could K be amended to state “The licensee shall maintain in the provider’s file documentation of each contact with the provider when no children are placed in the provider home”?
 
22VAC40-131-240 Capacity of provider home
B. - Question: Regulation requires written justification when more than two children are placed in a treatment foster home. Could placement of a sibling group be exempt from the written justification?
 
22VAC40-131-250 Intake, acceptance and placement 
D. - Question: Independent living services is referenced in this section. Should the reference be to “Independent Living Placement” services?
 
H & P – Question: Regulation states 250 H. 1 – 8 need to be documented before accepting a child for placement. 250 P states all of the required elements in 250 H need to be in the child’s file within 30 days of the placement. Could we receive clarification on the time requirements related to this documentation? Some of the information required is not always available from the LDSS prior to acceptance, especially in emergency placement situations. Suggested verbiage would be 250 H “Prior to accepting a child for placement in a foster care home, treatment foster home, short-term foster care home, or an independent living arrangement the licensee shall attempt to gather, review and document the following in the child’s file:”; 250 P would remain as it is currently written. This suggested verbiage would result in all documentation required in H being in the child’s file within 30 days (as required by P) but allow both the LDSS and LCPA time to gather information.
 
S. 7. - Questions: Regulation requires documentation of parent or legal custodial reactions to each topic discussed with them. Could clarification be provided as this seems vague especially regarding documentation of each topic discussed? Is this ongoing or just during initial meeting?
 
 
 
22VAC40-131-260 Social history
A.1. - Question: For children in foster care who exit care of the licensee prior to 15 days, and there is no plan for re-entry, could the social history requirement be waived?  The information documented on the social history of the licensee generally serves as an aid in treatment planning, which would be immaterial for short term placements. The LDSS would be responsible for providing most of the required information and would already have it in their child’s record. It is an extra burden to both the LDSS and LCPA which adds little value for short term placements of children in the care and custody of LDSS.
 
B.8 & 9 - Question: If a social history is required for “short term” placements that exit care prior to 30 days could the education, occupation, medical and psychiatric history information be required only for parents and siblings and/or other custodians? It can, at times, be quite difficult and time consuming to research the information for aunts, uncles and grandparents, unless they were direct custodians of the child. This might be extremely difficult to accomplish within 30 days and would have little relevancy to treatment planning for a short term placement. Possible alternative verbiage would be “should attempt to gather” the above information on these family members.
 
 
22VAC40-131-280 Foster home agreements
A.10 & 11 - Question: Proposed regulation requires permission for out-of-state travel and permission for the child to participate in any fund-raising activities. Could these two requirements be stricken as they usually are dealt with on a case-by-case basis and custodial agencies may not be willing to give “blanket” permission?
 
 
22VAC40-131-290 Medical, dental, and psychiatric examinations and care
A. 1. - Question: Could there be clarification given with regards to children placed in an emergency situation that stay fewer than 60 days? If the child leaves prior to 60 days, is the requirement to obtain the physical waived? This would cover cases where a physical had been scheduled within the 60 day requirement but was unable to be kept prior to the child exiting care.
C. 11 - Suggestion: It was noted that the word “handicapping” might be changed to “disabling” to maintain consistency with terminology used currently in the field.
K through M Suggestion: These items concern the providers/foster parents and would be more reasonably accessed in the section 22VAC40-131-180 for Home Study Requirement.
 
 
22VAC40-131-320 Reports and policies to protect children
D.2. and E. - Suggestion: It was noted that the requirement in D. 2 for notifying the offices of licensing about a child’s death includes the phrase “no later than the end of the next business day following the child’s death.” However, in standard 320 E. serious incidents, accidents or injuries to the child, while including 24 hour notice to legal guardians, etc. also require 24 hour notice to the department’s licensing representative. It seems that these incidents should be congruent with the standard for notification of death, the next business day, to department licensing representatives. Additionally, clarification/definitions of a “serious incident” are necessary, otherwise, the department licensing representative will be overloaded with reports on school suspensions, etc., as serious incident is defined in many contracts with localities and the definition of serious incident is extensive on many contracts.
 
 
22VAC40-131-330 Visitation and continuing contact with children
F. - Question: Could the verbiage be changed to “More than one half of the minimum required contacts the licensee makes with a child in any calendar year shall be conducted in the child’s placement setting.”? If a child has need of many additional contacts outside the provider home, for example 5-10 per month in the school setting to meet his/her service needs; this would require the licensee to make half that many contacts in the placement setting. This standard as currently proposed would be significantly encumbering to the child, foster home provider and LCPA staff.
G. 1. - Suggestion: The requirement of seven days between face-to-face contacts needs an exception: if child is placed during the last seven days of the month, two visits may occur within seven days, to be no closer than 24 hours apart. This would satisfy the DMAS requirement of two visits in a month that are necessary to bill for Medicaid TFC Case Management.
 
22VAC40-131-370 Case record requirements
A. and O. - Question: The regulation proposed in A. requires a separate case file for the child’s birth parents whereas the regulation proposed in O. states if services are provided to the child’s birth family a file shall be maintained. O. goes on to state the child’s birth parents file may be separate or combined with the child’s file. Could we receive clarification on what seem to be contradictory requirements? 
 
22VAC40-131-460 Children placed in treatment foster care
4.c. - Question: Regulation as proposed “Provides for at least one full time professional staff and part time staff whose hours are equivalent to a full time position”. Should this regulation read “Provides for at least one full time professional staff or part-time staff whose hours are equivalent to a full time position”? 
D. – Question: Regulation as proposed requires a written plan for back-up emergency care if placement disrupts. Can this be met through a general statement such as “another approved provider home within the agency” or is a specific home necessary? The requirement of another specific home would be unrealistic as the needs of children placed in a provider home fluctuate as does foster home provider capacity.
 
22VAC40-131-510 Provisions for adopting children with special needs
A. - Question: “The licensee shall ensure that children with special needs who are legally free for adoption are registered with AREVA.” Could this be amended to say “If the licensee holds custody of a child with special needs who is legally free for adoption they shall ensure the child is registered with AREVA”? Children who are legal custodians of LDSS’s are registered with AREVA by the local department. It is unduly burdensome to ask licensee’s who do not hold custody to ensure the custodial agency has completed this process for their legal custodians.
B. – Question: Many agencies approve their foster home providers as resource families. Would this apply to resource families as well as adoptive families? Many resource families are solely interested in adopting children placed in their home through foster care. Could they have a choice whether to be registered with AREVA?
 
CommentID: 16375