In review of the proposed regulation updates the following areas have been noted to be of concern, resulting in the comments outlined;

12VAC35-105-320. Fire inspections.

The provider shall document at the time of its original application and annually thereafter that buildings and equipment in residential service locations serving more than eight individuals are maintained in accordance with the Virginia Statewide Fire Prevention Code (13VAC5-51). This section does not apply to correctional facilities or home and noncenter-based or sponsored residential home services. The provider shall evaluate each individual and, based on that evaluation, shall provide appropriate environmental supports and adequate staff to safely evacuate all individuals during an emergency.

The classification of all service settings within this single regulation does not appear to be appropriate. Sponsored Residential services have been excluded from this section in the past (prior to recent emergency regulation updates), as these settings take place within a family home dwelling and mirrors that of true community placement. In this agency’s experience, this additional requirement has been interpreted as having a Fire Marshall conduct a visit and grant approval at the service setting, which does not often occur due to the inability of the Fire officials to actually conduct this type of visit and approval for a residential home setting. Additionally, there is an additional requirement of evaluation required for each individual; however there is no notation regarding what is acceptable in terms of this evaluation, can this be observed, how is this to be documented, how often should this review and evaluation be completed, etc. to allow for clear guidance in the responsibilities of service Providers upholding this requirement.

12VAC35-105-520. Risk management.

A. The provider shall designate a person responsible for the risk management function who has training and expertise in conducting investigations, root cause analysis, and data analysis.

The above noted regulation is vague in that it does not provide a basis of what is considered acceptable “training and expertise”. This vagueness will result in the inconsistency in the adherence and enforcement of this regulation.

12VAC35-105-460. Emergency medical or first aid training.

There shall be at least one employee or contractor on duty at each location who holds a current certificate (i) issued by the American Red Cross, the American Heart Association, or comparable authority in standard first aid and cardiopulmonary resuscitation (CPR) or (ii) as an emergency medical technician. A licensed medical professional who holds a current professional license shall be deemed to hold a current certificate in first aid, but not in CPR. The certification process shall include a hands-on, in-person demonstration of first aid and CPR competency.

There is the potential that between the release of this regulation and the new chapter 106 that both of the organizations listed above will stop the requirement of “in-person” meaning at the same location due to the prevalence and growth of video conferencing. Some systems are already using video conferencing as the “in-person” part of the process. Will this language allow that to be used as “in-person” as these programs grow and change between now and the next release of regulations. We do not want to be stuck without the ability to use these trainings if they should evolve beyond the language we have placed in regulations.