106-350 Disciplinary Actions..

B. Policies for employee and contractor behavior that are subject to discipline shall include penalties for:

1. Abuse, mistreatment, neglect, or exploitation of individuals;

2. Violation of rights of individuals;

3. Violation of confidentiality rules; and

4. Violation of the provider’s policies.

Feedback: For providers that are agencies of local governments, the jurisdiction’s human resource policy prevails.  Agency staff/Executive director can recommend disciplinary action however, the authority for issuing such rests with the local government Human Resource director. This regulation, as written, is not within the scope of the licensed provider to carry out.  Re: B—consider eliminating the word “penalty” and use “appropriate corrective response” instead or at least using an “and/or” to allow for one or both options.  Certain of the listed infractions would warrant penalty but others might warrant training or counseling, depending on the nature and seriousness.

106-450 emergency transfers

A. The provider shall implement a written policy that defines the process for transitioning or discharging an individual who experiences an emergency or crisis that the provider is not equipped to serve. At a minimum the policy shall address:

1. The process the provider will follow during the emergency or crisis while the individual is still within the provider’s care;

2. The process the provider will follow to transfer or discharge the individual to the successor provider; and

3. The process and timeframe for transferring the access to the individual’s record and ISP, including the individual’s discharge summary as required by 12VAC35-106-460 F.

B. All providers shall develop a method for documenting the provision of interventions that occur during a crisis or emergency. Documentation shall comply with 12VAC35-106-500. This documentation shall occur prior to transfer of documentation required under this section.

Feedback: “Transfer” and “transitioning” are not defined terms, so this section is unclear.  Do those terms mean a change in admission status of the client within a licensed program or could they mean simply that an individual remains admitted to the licensed program but is receiving emergency services elsewhere, such as with an acute medical emergency. The language suggests that “transfer” and “transitioning” are something different than “discharge” but it is ambiguous. This should be clarified. Under B, it is not clear whether the intended meaning is that the provider is to be documenting the interventions that the provider itself offers the individual during a crisis or emergency or if the provider needs to document the interventions that a another/successor provider is offering during the emergency.  If the latter, the requirement is unrealistic as the provider may not have ready access to detailed information about another/successor provider’s interventions.