Comments - General Chapter 12VAC35-107

12VAC35-107-10. Definitions

• Please include the definition of Residential Crisis Stabilization Services that matches forthcoming definitions being developed between DMAS and DBHDS. 

12VAC35-107-60.F.2.d Assessments.

Please revise to note the provider shall attempt to obtain BAC or administer a breathalyzer to reflect that individuals have the right to choice.

12VAC35-107-60.G Assessments.

Thank you for recognizing that there are situations where the initial assessment meets the requirements of a comprehensive assessment and that an update is not required.  This increases alignment with DMAS expectations for many services.

12VAC35-107-60.H. Assessments.

Revise to reflect for a minimum of six years after the individual’s discharge, as there are other factors affecting how long records must be retained.

12VAC35-107-80.B.14 ISP requirements.

Change to projected discharge date “or” estimated length of stay, to reflect that some services are anticipated to be the individual’s home for many years.B5 uses the language “defects”; perhaps it’s deficiencies.

12VAC35-107-80.E ISP requirements.

While staff members should be knowledgeable about the contents of ISPs for individuals served, establishing an expectation to train and test all staff members involved with service delivery is an unrealistic expectation that will significantly detract from service delivery.  Observations of competency in and knowledge about providing services is part of the supervisory and evaluation process.  Promoting this is likely to result in providers making fewer updates to ISPs to avoid retraining and testing staff.  For short-term services, a person could potentially be discharged before testing of all staff members (typically three shifts) could occur.  There is no realistic way to document this knowledge and competency without documentation of confidential information about individuals served, which should not be part of a Personnel File.  This also places an undue burden on Human Resources staff members who maintain personnel files.  File sizes would become unmanageable.

12VAC35-107-90.C. Reassessments and ISP reviews.

Remove, as this is not applicable for residential services, which are inherently not medication-only in nature.

12VAC35-107-100.A Progress notes or other documentation.

The intent of this is unclear.  Certainly, the format of progress notes across all locations of one service is desirable. However, the format of notes across the various services operated under a single organizational license may need to differ in order to reflect the unique nature of each service and affiliated requirements from pay sources.  Revise to reflect that the format of progress notes is to be consistent across all locations of the same service type.

12VAC35-107-180.A.3 Community participation.

Specify an exemption for short-term programs that typically do not have individuals leave the milieu, such as substance use treatment programs 30-days or less in duration.