In 2023, the General Assembly passed Section 1 legislation (HB2255 (Hodges)/SB1155 (Mason) and SB1544 (Rouse)) directing DBHDS to collaborate with stakeholders to review regulations that impact providers licensed by the Department of Behavioral Health and Developmental Disabilities (DBHDS) to identify reforms to increase efficiency, reduce redundancy, and decrease regulatory burdens on providers. The bills specifically required DBHDS to seek stakeholder input to consider:

1) how relief from licensing requirements may be authorized for providers that are accredited by recognized national accreditation bodies (this process is known as “deemed accreditation");

2) adjustments to the frequency of licensing inspections for providers with triennial licenses that have had no health or safety violations or complaints for the previous year; and

3) requirements of providers licensed by DBHDS to report allegations of abuse, neglect, and exploitation, and incidents classified as Level II and Level III.

DBHDS extensively researched deemed accreditation programs operating in other states, sought stakeholder input through a broadly distributed survey (see Appendix B), convened workgroup meetings, facilitated extensive workgroup member discussion at each meeting, and provided time for written and oral public comment at each meeting.

Discussion of alleviating provider burden included a consideration of the timeframe of serious incident and abuse/neglect complaint reporting, the frequency of inspections, and how deemed accreditation works in other states and how such a program might be implemented within the Commonwealth. The workgroup considered additional suggestions for reducing administrative burden that included leveraging inspections from multiple state agencies to reduce the number of inspections and creating a shared document portal to reduce the number of document requests. The workgroup received presentations from DBHDS regarding the results of the stakeholder survey, how deemed accreditation works within other states, and how DBHDS currently uses provider reports to help ensure the health and safety of individuals receiving services, including information about oversight provided by other state agencies. The workgroup also received a presentation by the Commission on Accreditation of Rehabilitation Facilities (CARF). CARF is a nationally recognized accreditation body recognized in 48 states. Finally, the members worked together to draft recommendations and draft recommendations were circulated to members (see Appendix C). The recommendations were in three main categories: reporting requirements, annual inspections, and accreditation.

Importantly, there is significant interest from both the provider population, DBHDS, and the Administration to reduce the existing administrative burden. However, the Commonwealth is currently under a Settlement Agreement with the U.S. Department of Justice (DOJ) which includes provisions that stipulate reporting and inspection requirements. DBHDS cannot make regulatory changes to these requirements while the related Settlement Agreement provisions are in effect. In addition, because the Settlement Agreement requires annual inspections, it is not clear if implementing an accreditation process could reduce provider burden without conflicting with provisions in the Agreement.