Department of Behavioral Health and Developmental Services
State Board of Behavioral Health and Developmental Services
Rules and Regulations For Licensing Providers by the Department of Behavioral Health and Developmental Services [12 VAC 35 ‑ 105]
|Action||Compliance with Virginia’s Settlement Agreement with US DOJ|
|Comment Period||Ends 7/22/2020|
Commenter: Daniel Key, Key Living Options, Inc.
CAPs, CHRIS reporting, support
CAPs, CHRIS reporting, support
What tools will be provided to the provider in order to help streamline the processes of root cause analysis, CAP, risk management, etc? Will there be added features to the CHRIS system in order to have automatic notifications when say a person needs an in-person team meeting for their root cause analysis after two incidents have occurred in six months? Will more remuneration/time be given to Licensing in order to help conduct these meetings? While it may seem that providers should have one compliance officer for CHRIS, root cause, CAP, Human Rights, in a small provider this is not always possible and tasks are shared by many different employees. In regards to the language about CAPs, there is no possible way to prevent recurrence of certain incidents that may technically violate regulations. This is an unrealistic and restrictive phrase that could potentially drive reputable providers into provisional or lesser licenses and potentially eventually lessen the availability of service providers in our already strapped state.
Has the state considered the implications of making reporting requirements more onerous and more punitive (i.e. many more CAPs)? In my opinion this will "drive providers underground" and keep them from reporting important incidents to the state. While this is always a balancing act, it seems that so many CAPs will be issued under new regulations that they will either become meaningless or they will burden the provider until they stop providing services.
In re: provider accountability there seems to be a trend of trying to hold providers more and more accountable without looking at how other agencies might support providers more in their service provision. Risk assessments, Quality Improvement plans, root cause analyses, Corrective Action Plans, etc. are all very good on paper, but how are other agencies to be empowered to assist the providers on the ground? Will Case Management services be adequately funded to provide the necessary support? Will the Office of Licensing be providing supportive troubleshooting and risk assessment services? I highly doubt it. These issues always fall to the provider.
This is not a new grievance but I will continue to state that CHRIS reporting within 24 hours time of a serious incident is an undue burden on the provider. Many times in a small provider the person reporting is also the person dealing with the crisis. If they are not the person dealing with the crisis then many times follow up gets dropped because our priority is always the individuals and not the paperwork. At least on weekends there should be a 72 hour timeline for reporting. Licensing and Human Rights specialists/advocates typically do not even review these reports until weeks after the incident so the timeline seems particularly onerous on providers.