Virginia Regulatory Town Hall
Agency
Department of Medical Assistance Services
 
Board
Board of Medical Assistance Services
 
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11/20/25  9:22 am
Commenter: Rappahannock Area Community Services Board

Staffing and Billable Service Constraints
 
  • The maximum staff-to-member ratio of 1:15 is unrealistic for programs already operating near capacity (e.g., 7 staff for 85 members) and would limit growth unless staffing expands—an expensive and impractical requirement.
  • If billing is allowed only for direct intervention rather than general presence or support, it would be very difficult to meet billing expectations for large daily attendance (e.g., 30 members present).
  • Non-billable categories include in-house educational opportunities, despite clubhouse standards (e.g., Standard 25) explicitly supporting such programming.
CommentID: 237839