12VAC35-107-80.A.1 ISP Requirements  Comment: Is the documentation that the individual's needs require a provider operated home and non-center based setting a medical certification?  Is is required for waiver group homes? 

12VAC35-107-80.B.1 Comment: Does the documentation obtained for the Initial ISP that the individual's needs require a provider operated home and no-center based setting satisfy the requirement for the same in the Comprehensive ISP?  Is it required for waiver group homes?

12VAC35-107-80.E Comment: Employees/contractors responsible for implementing the ISP already meet minimum requirements as outlined in job descriptions.  They receive required orientation training and ongoing supervision both of which are documented.  The Developmental Disabilities DSP and Supervisors Competencies Checklist documents proficiency in required competency areas including: Describing outcomes, support activities, and instructions on Plans for Supports for Individuals supported; and Conveys a basic understanding of the health information for the people they support.  It is reasonable that employees/contractors responsible for implementing the ISP are able to demonstrate a working knowledge of the objectives and strategies contained in the individual's current ISP, including detailed health and safety protocols, simply by reviewing the ISP as written.  This working knowledge could be verified by staff signature attached to the working copy of the ISP on site. 

ISPs that are truly person-centered may change frequently in small ways for short periods of time.  Developing and proctoring tests for multiple staff for each change would take away from time available to provide direct services.  Processes are already in place to signal changes to ISP to all staff, such as PCP Change Notes, electronic and direct verbal communication.  Working knowledge of ISP changes could be verified by staff signature attached to the working copy of the ISP on site. 

Documentation of training and supervision is already retained in supervisory notes, staff meeting minutes, and personnel training records.  Retaining documentation in the Personnel file of formal testing of each individual's ISP, including each change, would be cumbersome and require significant coding to protect the individual's confidential information, which should not be part of a Personnel file.  The usefulness of such documentation toward an ultimate goal of ensuring staff working knowledge of ISPs is minimal and would only serve as a personnel intervention, after the fact.  Current processes in place provide more immediate and timely action to ensure staff working knowledge of ISPs.  Please remove this draft regulation for formal testing. 

12VAC35-107-150 Comment:  Guidance is needed as to what "staff requirements" means specifically. 

12VAC35-107-170.A  Comment:  Is this a written protocol for each individual that is updated, or a policy/procedure?

12VAC35-107-170.B.7 Comment: Please clarify that/how the individual's right to make personal dietary choices may supersede the menu being prepared in advance (-170.B.2) and followed (-170.B.3). 

12VAC-107-200.4  Comment:  Please clarify that all actions taken by employees/contractors may be documented in the incident reports, and referenced in the progress notes.