Current wording:   F. A registered nurse or licensed practical nurse shall be available during all hours that personal care services are being provided.

Comment.....Would like a clear description/role of the LPN involving supervision of home care cases with personal care aides (PCAs), nurse aides (NAs), certified nurse adies (CNAs) following the (registered nurse) RNs directed Plan of Care (POC).

DMAS has outlined supervisory notes somewhat clarifying the LPN role with certain supervisory visits.  With Licensure there needs to be clarification regarding the LPN's role with consideration to current DMAS language.  This makes it less confusing since both DMAS and Licensure play daily roles with the actual delivery of services for home care throughout VA.   Below is current information for DMAS.........

DEPARTMENT OF MEDICAL ASSISTANCE

Title of Regulation: 12VAC30-120. Waivered Services (amending 12VAC30-120-900, 12VAC30-120-920, 12VAC30-120-925, 12VAC30-120-930; adding 12VAC30-120-905, 12VAC30-120-924, 12VAC30-120-935, 12VAC30-120-945, 12VAC30-120-990, 12VAC30-120-995; repealing 12VAC30-120-910, 12VAC30-120-940 through 12VAC30-120-980).     Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq. Effective Date: February 12, 2015.

Specifically:   12VAC30-120-935. Participation standards for specific covered services.

F. Agency-directed personal care services. The personal care provider agency shall hire or contract with and directly supervise a RN who provides ongoing supervision of all personal care aides and LPNs. LPNs may supervise, pursuant to their licenses, personal care aides based upon RN assessment of the waiver individuals' health, safety, and welfare needs.

Comment:  this is not the complete standard as there is addtional information with the DMAS reg.

Thank you for your time with review of my comment.  Any clarification or guidance you offer me is greatly appreciated if I have not reviewed all of the OLC HCO regulation to support this comment.

Respectfully submitted,

Christy Glynn

To my knowledge there is currently no avenue offered to report unlicensed home care aides, also referred to as Personal Care aides (PCA) or Nurse Aides (NAs) that have never tested with the Board of Nursing or other state goverened reporting agency.

OLC require agencies to have a policy for reporting licensed employees, however, home care employees delivering unskilled home care support/companion/custodial services are not required to be state licensed and there should not be such requirement.  Should a PCA commit a reportable offense that would be reportable if they were otherwise licensed, who should oversee this level of home care companion reporting?

Thank you

Christy Glynn