TITLE 22. SOCIAL SERVICES
Title of Regulation: 22VAC30-80. Auxiliary Grants
Program (amending 22VAC30-80-10, 22VAC30-80-20,
22VAC30-80-30, 22VAC30-80-45 through 22VAC30-80-70; adding 22VAC30-80-35).
Statutory Authority: §§ 51.5-131 and 51.5-160 of the
Code of Virginia.
Effective Dates: January 9, 2017, through July 8, 2018.
Agency Contact: Tishaun Harris-Ugworji, Program
Consultant, Department for Aging and Rehabilitative Services, 8004 Franklin
Farms Drive, Richmond, VA 23229, telephone (804) 662-7531, or email
The second enactment of Chapter 567 of the 2016 Acts of
Assembly directed the Commissioner of the Department for Aging and
Rehabilitative Services to promulgate regulations for the provision of
supportive housing for individuals receiving auxiliary grants within 180 days.
Therefore, emergency regulations are needed to meet this requirement.
Currently, the Auxiliary Grants Program regulations address
standards for the two settings, assisted living facility (ALF) and adult foster
care home (AFC), in which an individual has traditionally received the
auxiliary grant. The intent of this emergency action is to (i) add supportive
housing, which is a new living arrangement that individuals who receive
auxiliary grant payments may choose, as a third setting in which individuals
may receive the auxiliary grant, (ii) define requirements to participate in the
supportive housing setting, (iii) clarify providers' responsibilities for each
setting, and (iv) update terminology and guidelines for the Auxiliary Grant
Program. As ALF and AFC placements are limited, amending the auxiliary grant
regulations to allow supportive housing settings will assist individuals who
may be unable to locate an ALF or AFC placement to meet their needs. Adding
supportive housing as an approved setting for the auxiliary grant will protect
the health, safety, and welfare of individuals who choose this living
arrangement by ensuring that they will receive safe, high quality support to
meet their daily living needs.
The following words and terms when used in this chapter shall
have the following meanings unless the context clearly indicates otherwise:
"Adult foster care" or "AFC" means a
locally optional program that provides room and board, supervision, and special
services to an adult who has a physical or mental health need. Adult foster
care may be provided for up to three adults by any one provider who is approved
by the local department of social services.
"Assisted living care" means a level of service
provided by an assisted living facility for adults who may have physical or
mental impairments and require at least moderate assistance with the activities
of daily living. Included in this level of service are individuals who are
dependent in behavior pattern (i.e., abusive, aggressive, disruptive) as
documented on the Uniform Assessment Instrument.
"Assisted living facility" or "ALF"
means, as defined in § 63.2-100 of the Code of Virginia, any congregate
residential setting that provides or coordinates personal and health care
services, 24-hour supervision, and assistance (scheduled and unscheduled) for
the maintenance or care of four or more adults who are aged, infirm or disabled
and who are cared for in a primarily residential setting, except (i) a facility
or portion of a facility licensed by the State Board of Health or the
Department of Behavioral Health and Developmental Services, but including any
portion of such facility not so licensed; (ii) the home or residence of an
individual who cares for or maintains only persons related to him by blood or
marriage; (iii) a facility or portion of a facility serving infirm or disabled
persons between the ages of 18 and 21, or 22 if enrolled in an educational
program for the handicapped pursuant to § 22.1-214 of the Code of Virginia,
when such facility is licensed by the department as a children's residential
facility under Chapter 17 (§ 63.2-1700 et seq.) of Title 63.2 of the Code of
Virginia, but including any portion of the facility not so licensed; and (iv)
any housing project for persons 62 years of age or older or the disabled that
provides no more than basic coordination of care services and is funded by the
U.S. Department of Housing and Urban Development, by the U.S. Department of
Agriculture, or by the Virginia Housing Development Authority. Included in this
definition are any two or more places, establishments or institutions owned or
operated by a single entity and providing maintenance or care to a combined
total of four or more aged, infirm or disabled adults. Maintenance or care
means the protection, general supervision and oversight of the physical and
mental well-being of an aged, infirm or disabled individual. Assuming
responsibility for the well-being of individuals residing in an ALF, either
directly or through contracted agents, is considered "general supervision
"Auxiliary Grants Program" or "AG" means
a state and locally funded assistance program to supplement income of an individual
receiving Supplemental Security Income (SSI) or adult who would be eligible for
SSI except for excess income, who resides in an ALF
or in, an AFC,
or a supportive housing setting with an established rate. The total
number of individuals within the Commonwealth of Virginia eligible to receive
AG in a supportive housing setting shall not exceed the number designated in
the signed agreement between the department and the Social Security
"Certification" means a form provided by the department
and prepared by
the an ALF or a supportive housing provider.
Each ALF shall annually certifying certify that the ALF
it has properly managed the personal funds and personal needs allowances
of individuals residing in the ALF and is in compliance with program
regulations and appropriate licensing regulations. Each supportive housing
provider shall annually certify that it is in compliance with the regulations
for the administration of the auxiliary grants programs (22VAC30-80).
"Department" means the Department for Aging and
"DBHDS" means the Department of Behavioral
Health and Developmental Services.
"Established rate" means the rate as set forth in
the appropriation act or as set forth to meet federal maintenance of effort
"Personal needs allowance" means an amount of money
reserved for meeting the adult's personal needs when computing the amount of
the AG payment.
"Personal representative" means the person
representing or standing in the place of the individual for the conduct of his
affairs. This may include a guardian, conservator, attorney-in-fact under
durable power of attorney, next-of-kin, descendent, trustee, or other person
expressly named by the individual as his agent.
"Personal toiletries" means hygiene items provided
to the individual by the ALF or AFC home including deodorant, razor, shaving
cream, shampoo, soap, toothbrush, and toothpaste.
"Program" means the Auxiliary Grant Program.
"Provider" means an ALF that is licensed by the
Department of Social Services or an AFC provider that is approved by a local
department of social services or a supportive housing provider as defined in
§ 37.2-421.1 of the Code of Virginia.
"Provider agreement" means a
agreement that the ALF ALFs and supportive housing providers
must complete and submit to the department when requesting to be approved
for admitting approval to admit individuals receiving AG.
"Qualified assessor" means an individual who is
authorized by 22VAC30-110 to perform an assessment, reassessment, or change in
level of care for an individual applying for AG or residing in an ALF or a
supportive housing setting. For individuals receiving services from a community
services board or behavioral health authority, a qualified assessor is an
employee or designee of the community services board or behavioral health
"Rate" means the established rate.
"Residential living care" means a level of service
provided by an ALF for adults who may have physical or mental impairments and
require only minimal assistance with the activities of daily living. Included
in this level of service are individuals who are dependent in medication
administration as documented on the Uniform Assessment Instrument (UAI).
"Supportive housing" or "SH" means a
residential setting with access to supportive services for an AG recipient in
which tenancy as described in § 37.2-421.1 of the Code of Virginia is provided
or facilitated by a provider licensed to provide mental health community
support services, intensive community treatment, programs of assertive
community treatment, supportive in-home services, or supervised living
residential services that has entered into an agreement with the DBHDS pursuant
to § 37.2-421.1 of the Code of Virginia.
"Uniform Assessment Instrument" or "UAI"
means the department-designated assessment form. It is used to record
assessment information for determining the level of service that is needed.
A. In order to receive payment from the program for care in
an ALF or in AFC, an individual applying for AG shall have been assessed by a
qualified assessor using the UAI and determined to need residential or assisted
living care or AFC.
B. As a condition of eligibility for the program, a UAI shall
be completed on an individual prior to admission, except for an emergency
placement as documented and approved by a Virginia adult protective services
worker, at least once annually, and whenever there is a significant change in
the individual's level of care, and a determination is made that the individual
needs residential or assisted living care in an ALF or AFC.
C. The ALF or AFC provider is prohibited from charging a
security deposit or any other form of compensation for providing a room and
services to the individual. The collection or receipt of money, gift, donation
or other consideration from or on behalf of an individual for any services
provided is prohibited.
D. In order to receive payment from the AG program for
care in the SH setting, an individual shall be evaluated by a qualified
assessor in accordance with § 51.5-160 E of the Code of Virginia. Eligible
individuals shall be notified of the SH setting option and the availability of
approved SH providers at the time of their annual level of care assessment.
22VAC30-80-30. Basic services in an assisted living facility
or an adult foster care home.
A. The rate established under the program for the
ALF setting shall cover the following services:
1. Room and board.
a. Provision of a furnished room;
b. Housekeeping services based on the needs of the individual;
c. Meals and snacks provided in accordance with 22VAC40-72
including, but not limited to food service, nutrition, number and timing of
meals, observance of religious dietary practices, special diets, menus for
meals and snacks, and emergency food and water. A minimum of three
well-balanced meals shall be provided each day. When a diet is prescribed for
an individual by his physician, it shall be prepared and served according to
the physician's orders. Basic and bedtime snacks shall be made available for
all individuals desiring them and shall be listed on the daily menu. Unless
otherwise ordered in writing by the individual's physician, the daily menu,
including snacks, for each individual shall meet the guidelines of the U.S.
Department of Agriculture's Food
Guide Pyramid guidance system or the
dietary allowances of the Food and Nutritional Board of the National Academy of
Sciences, taking into consideration the age, sex, and activity of the resident.
Second servings shall be provided, if requested, at no additional charge. At
least one meal each day shall include a hot main dish; and
d. Clean bed linens and towels as needed by the individual and
at least once a week.
2. Maintenance and care.
a. Minimal assistance with personal hygiene including bathing,
dressing, oral hygiene, hair grooming and shampooing, care of clothing,
shaving, care of toenails and fingernails, arranging for haircuts as needed,
and care of needs associated with menstruation or occasional bladder or bowel
b. Medication administration as required by licensing
regulations including insulin injections;
c. Provision of personal toiletries including toilet paper;
d. Minimal assistance with the following:
(1) Care of personal possessions;
(2) Care of personal funds if requested by the individual and
provider policy allows this practice, and in compliance with 22VAC40-72-140 and
, Standards for Licensed Assisted Living Facilities;
(3) Use of the telephone;
(4) Arranging transportation;
(5) Obtaining necessary personal items and clothing;
(6) Making and keeping appointments; and
e. Securing health care and transportation when needed for
f. Providing social and recreational activities; and
g. General supervision for safety.
B. The AFC provider shall adhere to the standards in
22VAC30-80-35. Basic services in supportive housing
A. The rate established under the program for SH, as defined
in 22VAC30-80-10, shall cover a residential setting with access to SH services
1. Development of individualized SH service plans;
2. Access to skills training;
3. Assistance with accessing available community-based
services and supports;
4. Initial identification and ongoing review of the level
of care needs; and
5. Ongoing monitoring of services described in the
individual's individualized SH plan.
B. The residential setting covered under the program for
SH, as defined in 22VAC30-80-10, shall be the least restrictive and most
integrated setting practicable for the individual and shall:
1. Comply with federal habitability standards;
2. Provide cooking and bathroom facilities in each unit;
3. Afford dignity and privacy to the individual; and
4. Include rights of tenancy pursuant to the Virginia
Residential Landlord and Tenant Act (§ 55-248.2 et seq. of the Code of
22VAC30-80-45. Conditions of participation in the program.
A. Provider agreement for ALF.
1. As a condition of participation in the program, the ALF
provider is required to complete and submit to the department a signed provider
agreement as stipulated
below in this section. The agreement is
to be submitted prior to the ALF accepting AG payment for qualified individuals.
A copy of the ALF's current license must be submitted with the provider
2. The ALF provider shall agree to the following conditions in
the provider agreement to participate in the program:
a. Provide services in accordance with all laws, regulations,
policies, and procedures that govern the provision of services in the facility;
b. Submit an annual certification form by October 1 of each
c. Care for individuals with AG in accordance with the
requirements herein at the current established rate;
d. Refrain from charging the individual, his family, or his
authorized personal representative a security deposit or any other form of
compensation as a condition of admission or continued stay in the facility;
e. Accept the established rate as payment in full for services
f. Account for the personal needs allowances in a separate
bank account and apart from other facility funds and issue a monthly statement
to each individual regarding his account balance;
g. Provide a 60-day written notice to the regional licensing
office in the event of the facility's closure or ownership change;
h. Provide written notification of the date and place of an
individual's discharge or the date of an individual's death to the local
department of social services determining the individual's AG eligibility and
to the qualified assessor within 10 days of the individual's discharge or
i. Return to the local department of social services
determining the individual's AG eligibility, all AG funds received after the
death or discharge date of an individual in the facility.
B. As a condition of participation in the program, the AFC
provider shall be approved by a local department of social services and comply
with the requirements set forth in 22VAC30-120.
C. Provider agreement for SH. As a condition of
participating in the AG program, the SH provider shall enter an agreement with
DBHDS pursuant to § 37.2-421.1 of the Code of Virginia. The SH provider shall
submit a copy of the executed agreement and a copy of its current DBHDS license
prior to the SH provider receiving payments from the AG program on behalf of
qualified individuals. The SH provider shall provide SH services for each
individual in accordance with § 37.2-421.1 of the Code of Virginia and all other
applicable laws, regulations, and policies and procedures.
22VAC30-80-50. Establishment of rate.
The established rate for individuals authorized to reside in
or in, an AFC, or a supportive housing setting is
the established rate as set forth in the appropriation act or as set forth by
changes in the federal maintenance of effort formula. The AG payment is
determined by adding the rate plus the personal needs allowance minus the
individual's countable income. The effective date is the date of the
individual's approval for AG by the local department of social services.
A. Any moneys contributed toward the cost of
services as defined in 22VAC30-80-30 and 22VAC30-80-35 pending AG
eligibility determination shall be reimbursed to the individual or contributing
party by the ALF or, AFC, or SH provider once eligibility
for AG is established and that payment received. The payment shall be made
payable to the individual, who will then reimburse the provider for care
appropriate providers for basic services. If the individual is not
capable of managing his finances, his personal representative is responsible
for reimbursing the provider.
B. In the event an ALF is closed, the facility shall prorate
the rate up to the date of the individual's discharge and return the balance to
the local department of social services that determined the individual's
eligibility for the grant. If the facility maintained the individual's personal
needs allowance, the facility shall provide a final accounting of the
individual's personal needs allowance account within 60 days of the
individual's discharge. Verification of the accounting and of the reimbursement
to the individual shall be mailed to the case management agency responsible for
the individual's annual reassessment. In the event of the individual's death,
the provider shall give to the individual's personal representative a final
accounting of the individual's funds within 60 calendar days of the event. All
AG funds received after the death or discharge date shall be returned to the
local department of social services responsible for determining the
individual's AG eligibility as soon as practicable. Providers who do not comply
with the requirements of this regulation may be subject to adverse action.
ALFs ALF and SH providers shall submit to
the department an annual certification form by October 1 of each year for
the preceding state fiscal year. The certification shall include the following:
identifying information about the ALF provider, census
information including a list of individuals who resided in the facility or
SH setting and received AG during the reporting period and personal needs
allowance accounting information if such personal needs accounting
information is required by the setting. If a provider fails to submit an
annual certification form, the provider will not be authorized to accept
additional individuals with AG.
B. All information reported by an ALF or SH provider
on the certification form shall be subject to audit by the department.
Financial information that is not reconcilable to the provider's general ledger
or similar records could result in establishment of a liability to the
provider. Records shall be retained for three years after the end of the
reporting period or until audited by the department, whichever is first.
C. All records maintained by an AFC provider, as required by
22VAC30-120, shall be made available to the department or the approving local
department of social services upon request. All records are subject to audit by
the department. Financial information that is not reconcilable to the provider's
records could result in establishment of a liability to the provider. Records
shall be retained for three years after the end of the reporting period or
until audited by the department, whichever is first.
VA.R. Doc. No. R17-4816; Filed December 16, 2016, 4:22 p.m.