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Department of Medical Assistance Services
Board of Medical Assistance Services
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10/20/21  12:23 pm
Commenter: john humphreys

administrative requirement concerns -residential

Developmental Disabilities Waivers – Chapter 2 page 4fingerprint verifications – the 1st subitem in this section indicates that providers "must retain" "documentation" to verify that fingerprints were "obtained and sent" to the company (presumably DBHDS in this case). Recent changes in the DBHDS system to require that the FIELDPRINT system be used for fingerprint checks has reduced the ability of the provider to document the required information for this verification process. Specifically, the provider no longer takes the fingerprints nor has any control over their actually being sent which means the provider generates no independent information or actions that can be used to meet these verification requirements; rather they would be completely dependent on what FIELDPRINT reports on their website post a new employee's appointment. Unfortunately, FIELDPRINT does not always provide accurate information on their website and have demonstrated little to no interest in correcting inaccurate information when it appears. We have only had to use the FIELDPRINT process 3 times for new employees; however, on one of these 3 occasions the field print report indicated the employee had canceled the appointment, the fingerprints were not taken and thus not sent – – when in fact none of these things were true and the letter declaring that employee eligible did arrive shortly thereafter. This indicates a 33% failure rate for accurate reporting which would not be as serious an issue if you are able to obtain corrections; however, customer service at FIELDPRINT has not been amenable to contact or corrections – leaving us with an employee who has a letter stating their eligibility from DBHDS but unable to meet the verification requirement listed in the proposed manual. This should not be a surprise, since FIELDPRINT gets paid the same whether the appointment is kept and reported accurately or not, leaving them with no incentive whatsoever to accurately report or make corrections once an accurate report is identified under the current required system.

Recommendations: several avenues which could address this concern 1) return to the old system giving the ability to meet this requirement back to the provider, 2) replace FIELDPRINT with a more reliable provider of the services, 3) remove the requirement to retain documentation that the fingerprints were “taken/sent” and allow the letter of eligibility from DBHDS to meet the requirement (which presumably does document the requirement was met or they would have no basis for issuing a letter) and/or 4) require FIELDPRINT (with penalties for noncompliance) to provide more reliable customer service options to obtain corrections when they are in error (but again this with leaves the provider no recourse if they reverted back to their current way of doing business or refused to make the correction).


Developmental Disabilities Waivers – Chapter 4 page 153 & 175; Chapter 6 page 12 - Review/submission of quarterly report within 10 calendar days – In the updated DBHDS licensing regulations that went into effect August 2020, section 12 VAC 35 – 105 – 675 changed the submission deadline for quarterly reports to 15 calendar days. This additional latitude was welcome relief for many of the significantly increased onerous administrative burdens now faced by providers and there were no clear objections to the change in the comments posted during the regulatory review period for the regulation when it was proposed. However, the DMAS manual posted for comments appears to retain the 10 day deadline for review/submission of quarterly reports, which would supersede the states relaxed requirement, making it moot, as the 10 day deadline would still be required to be in regulatory compliance. As the change in the state deadline makes clear the 10 day requirement was an arbitrary number with no clear rationale for its inclusion. Specifically, the only individuals impacted by the additional 5 day relaxed standard would be support coordinators who would have less time to review provider quarterly reports turned in on the final day of the deadline. This change would not create any undue burden for support coordinators and it would provide for equal treatment between the provider and the support coordinator, as now both would have the same amount of time 15 calendar days to prepare/submit their reports (in fact on 31 day months the support coordinator would still get an extra day, that more than offsets the 1 or 2 day loss in February). In the interest of fairness, improved management of administrative burdens, regulatory consistency and equal treatment of all stakeholders in the system, it is recommended that the proposed DMAS manual changes be revised to include the 15 day deadline for review/submission of quarterly reports now enshrined in the DBHDS regulations.

Developmental Disabilities Waivers – Chapter 6 page 19 - Although I'm sure the confusion is due to my limited understanding of legalese in the regulation, I have since the inception of services 22 years ago always been troubled by the phrase that requires providers to keep records for review for "a period not less than 6 years from the Individuals last date service" and in the same section "and not less than 6 years after the date of discharge". While I assume that these statements mean we only need to retain 6 years of information on an individual at any one time, I have never been confident of this assumption and as a result have retained 18 years of records for 2 individuals that we currently and have continuously served for this length of time. As new records are generated, I would really like to shred/destroy the 1st 10 years of these records to reduce the secure/protected storage space burden created by other aspects of the regulations. However, I remain reluctant to do so because I'm not exactly sure what this phrase means------- please clarify either in the regulation or a statement of intent for the regulation.

CommentID: 116541