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Virginia Regulatory Town Hall
Agency
Department of Behavioral Health and Developmental Services
Guidance Document Change: This is a new guidance document regarding the current requirement for 90 days of operating expenses per the Rules and Regulations for Licensing Providers by the Department of Behavioral Health and Developmental Services (12VAC35-105).
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9/4/19  10:14 pm
Commenter: Kevin Stoy, MVLE

Concern regarding new policy
 

I am a member of MVLE's Board of Directors and believe that Virginia Department of Behavioral Health and Developmental Services Office of Licensure Guidance Document requiring all DBHDS licensed service providers to have "90 days of operating expenses," is unreasonable and counter-productive to sustaining and growing Virginia's intellectual and developmental disability (IDD) service system capacity.

MVLE, a non-profit, has served individuals with intellectual and developmental disabilities in the Northern Virginia region for over 45 years. MVLE is licensed, CARF accredited, a member of the United Way of the National Capital Area, Ability One vendor, Virginia DMAS provider and contract service provider for employment and day support services to DARS and CSBs in Northern Virginia. Annually, MVLE supports more than 400 individuals.

DBHDS Office of Licensure's intention to require all licensed service providers to have “90-days of operating expenses" is excessive and if implemented will reduce resources needed to maintain much less create programs and services.

Placing aside a dedicated 90-day operating expense reserve, is the equivalent of creating an escrow account for the Department's sole use. To create accounts as required would reduce existing services to individuals already being served.

This requirement would add to the existing problems with the IDD service delivery system i.e. low reimbursement Medicaid rates and the DSP workforce crisis of recruitment and retention.

There are many ways the Department can monitor the fiscal viability of an organization other than requiring a reserve of 90 days of operating expenses or a line of credit equivalent to 90 days of operating expenses. Here are a few methods that don't impose the equivalent of an unusable escrow —holding tank account to set aside 90 days operating expenses:

DBHDS could require licensed organizations provide a copy of their most recent financial review and/or audit along with the accompanying letter or statement from a certified accounting firm stating that the accounting firm is certified and was hired to audit the financial statements of the stated organization. These fiscal reviews and audits attest to prior year and current year revenue and expenses These reviews also include professional statements by third-party auditor specific to whether or not the review found that that an organizations conform with generally accepted auditing standards related to the scope and timeframe of the audit. "Audit Letters" accompanying audits review and address Qualitative Aspects of the audited agency's Accounting Practices

•             Waive the requirement if an organization is CARF Accredited or a United Way Member. CARF accreditation requires fiscal policy and operation standards. An agency that is CARF accredited conforms with CARF fiscal standards; United Way members must submit as part of the annual application copies of annual audits and 990's that are reviewed for administrative costs and expense to income. United Way members already complete an annual audit review;

 

DBHDS can subscribe and use GuideStar to assess and research the annual audits and/or 990's of licensed nonprofits. Guidestar gathers, organizes, and distributes information about U.S nonprofits in their data base.

•             The DBHDS could subscribe to Dun and Bradstreet to obtain credit alerts on organizations. The Department would receive credit alert changes regarding organizations as part of Dun and Bradstreet's risk management and credit 

Please reconsider the drastic implications that the 90-day fiscal reserve policy interpretation and implementation would have on Virginia's service delivery system. Given the outcomes of implementing this policy, does the proposed regulatory interpretation reflect good public policy implementation that supports services to the IDD Community? Please consider the key factors and assumptions used to develop this requirement. Several alternatives exist that can provide creditable, clear and neutral fiscal assessments of an organization's fiscal health and sustainability without removing millions in service dollars that are needed to grow Virginia's IDD service system capacity.


Respectfully, 

 

CommentID: 76016