105 – 170 – E – corrective action plans – should include a deadline (number of business days) for the DBHDS response and require the department response be in writing, this is necessary to prevent providers from being held in limbo and to provide the documentation they need to address licensing agent change (either personnel or evolving standard) and to prepare for implementation of the appeals process.

105 – 440 – 15 days to complete orientation – there are multiple factors that could make meeting this requirement extremely problematic Recommendations: 1st – eliminate the burden and remove the 15 day completion requirement entirely; if they feel it necessary, language could you be included which prevents the provision of independent/billable/direct or some other word for services/contact with individuals served until the orientation has been completed, which would appear to resolve any of the state’s concerns without imposing the burden. 2nd – exempt small businesses from the requirement and/or utilize other mechanisms contained in section 2.2 – 4007.1 of the Administrative Process Act to reduce the burden on small business or 3rd failing all of that at least change the requirement to 30 days which would reduce the burden. 4^th- Include language that indicates the training and expertise required is relative to the size/complexity of the operations of the business and the data sets they develop or indicate in the regulation that completion of a state-sponsored training in these areas (individually or in conjunction) is sufficient to meet the requirement and then provide that training to assure a standardized process that provides equal treatment across providers and reduces the onerous burden of the unfunded mandate.

400 -The statement should read “C. The provider shall submit all information required by the department to comply with the Code of Virginia to complete . . . “

And Add “D. 2. . . . memoranda from the department transmitting the results to the provider, if applicable, . . . “

105 – 520 – The language requires that the provider “incorporate uniform risk triggers and thresholds as defined by the department;”   have these been published ?

A – qualifications for risk manager – the phrase “training and expertise in conducting investigations, root cause analysis and data analysis” is too vague, overly restrictive, creates significant unfunded mandates and is a significant unique and unnecessary burden for small businesses. 1st – too vague, there is no indication of how “expertise” would be established and it is a phrase which is subject to widely varying interpretations;  2nd – overly restrictive – as written it would require specific training in each of these areas when all of the knowledge, skills and abilities necessary to accomplish these functions can be obtained from a wide variety of other education, training and experiential sources – this creates the potential to disqualify individuals who have clearly and empirically demonstrated all of these abilities but cannot demonstrate that they’ve had these narrowly focused trainings and it creates a significant unfunded mandate as an already qualified individual has to take additional specific trainings just to meet the standard in the regulations. 3rd – unnecessary small business burden – the requirement for training and expertise in data analysis, assumes some large data set, multiple inputs and a complicated interrelationship of variables that simply does not occur in small businesses. The data analysis for our current risk program only requires an individual to be able to analyze less than or greater than (thresholds) and calculate percentages (for some data), which does not require any more training and/or expertise in data than is typically found in an individual graduating elementary school.

105 – 59 – C7 – this section provides the QDDP definition and then adds “Experience may be substituted for the educational requirement.” This final sentence adds an entire class of individuals to the regulations without providing any clarity whatsoever as to their title, roles, rights and privileges. The guidance document for determining functional equivalency provided some standards but was wholly inadequate by itself for the effective identification, verification and use of this class of individuals – functional equivalents.