Title of Regulation: 18VAC76-40. Regulations Governing Emergency Contact Information (amending 18VAC76-40-10).

Statutory Authority: § 54.1-2506.1 of the Code of Virginia.

Public Hearing Information: No public hearings are scheduled.

Public Comment Deadline: November 5, 2014.

Effective Date: November 20, 2014.

Agency Contact: Elaine J. Yeatts, Senior Policy Analyst, Department of Health Professions, 9960 Mayland Drive, Suite 300, Richmond, VA 23233-1463, telephone (804) 367-4688, FAX (804) 527-4475, or email elaine.yeatts@dhp.virginia.gov.

Basis: The statutory authority for promulgation of 18VAC76-40-10 by the Director of the Department of Health Professions is found in § 54.1-2506.1 of the Code of Virginia, which requires the director to adopt regulations "...that identify those licensed, certified or registered persons to which the requirement to report shall apply and the procedures for reporting." The authority for the initial promulgation of regulation is mandatory; the authority for amending the regulation to add another profession is discretionary.

Purpose: As the emergency contact information (ECI) is being increasingly used by the Department of Health to disseminate public health information as well as to issue notices of a public health emergency, it is important to reach those health care professionals who have responsibility for the health and safety of a vulnerable population in assisted living facilities and nursing homes. Having those practitioners in the ECI system will help ensure that information is reaching the administrators of those facilities. Dental hygienists are often the practitioners who have primary responsibility for the maintenance of dental health; having them appropriately informed about public health information or a public health emergency will benefit the health and safety of the general public.

Rationale for Using Fast-Track Process: This regulatory action is taken at the request of the one of regulated professions who will be affected by it. In addition, the need to implement the emergency contact system to inform health care professionals about a public health emergency could definitely affect the populations at assisted living facilities or nursing homes, so those administrators will benefit from a notification from the Department of Health as soon as possible. Therefore, the director believes the action should have no objection.

Substance: The amendments add dental hygienists, assisted living facility administrators, and nursing home administrators to the listing of professions who are required to report emergency contact information in 18VAC76-40-10.

Issues: The primary advantage to the public is the addition of groups of health care professionals available for contact and assistance in case of a public health emergency or disaster. There are no disadvantages. The Department of Health and the Department of Emergency Management would have access to additional health care workers in case of a public health emergency and would have a direct link to assisted living facilities and nursing homes to disseminate information about an outbreak of a communicable disease. There are no disadvantages.

Small Business Impact Review Report of Findings: This regulatory action serves as the report of the findings of the regulatory review pursuant to § 2.2-4007.1 of the Code of Virginia.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. As a result of a periodic review, the Department of Health Professions (DHP) proposes to add nursing home administrators, assisted living facility administrators and dental hygienists to the list of licensees that must provide emergency contact information so that they can be contacted for the purposes of disseminating information in the case of a public health emergency.

Result of Analysis. Benefits likely outweigh costs for these proposed regulatory changes.

Estimated Economic Impact. DHP maintains a list of contact information for licensed health care professionals who are required to provide such information so that they can be contacted in the instance of a public health emergency in the Commonwealth. DHP staff reports that the required information is collected at the same time, and on the same form, as license renewal information. DHP proposes to add three new groups of licensees to this list: nursing home administrators, assisted living facility administrators and dental hygienists. Dental hygienists may be the main point of contact for patients seeking dental care so having them be contacted in the case of a public health emergency will allow greater dissemination of that information to those patients. Likewise, having information on hand to more easily contact nursing home and assisted living facility administrators will better allow them to protect and treat the vulnerable, older populations that they serve. Licensees affected by these regulatory changes are unlikely to incur additional costs because they only have to provide their contact information on a form they already fill out and because there is no adverse consequences for failing or forgetting to report. Populations served by these licensees, as well as anyone those populations might secondarily inform, will benefit from these licensees being able to disseminate public health emergency information.

Businesses and Entities Affected. DHP reports that there are 737 nursing home administrators, 592 assisted living facility administrators and 4,879 dental hygienists in the Commonwealth who will be affected by these regulations.

Localities Particularly Affected. No localities will be particularly affected by these proposed regulatory changes.

Projected Impact on Employment. This regulatory action will likely have little impact on employment in the Commonwealth.

Effects on the Use and Value of Private Property. This regulatory action will likely have no effect on the use or value of private property in the Commonwealth.

Small Businesses: Costs and Other Effects. No affected small business is likely to incur costs on account of these proposed regulations.

Small Businesses: Alternative Method that Minimizes Adverse Impact. No affected small business is likely to incur costs on account of these proposed regulations.

Real Estate Development Costs. This regulatory action will likely have no effect on real estate development costs in the Commonwealth.

Legal Mandate. The Department of Planning and Budget (DPB) has analyzed the economic impact of this proposed regulation in accordance with § 2.2-4007.04 of the Administrative Process Act and Executive Order Number 14 (10). Section 2.2-4007.04 requires that such economic impact analyses include, but need not be limited to, the projected number of businesses or other entities to whom the regulation would apply, the identity of any localities and types of businesses or other entities particularly affected, the projected number of persons and employment positions to be affected, the projected costs to affected businesses or entities to implement or comply with the regulation, and the impact on the use and value of private property. Further, if the proposed regulation has adverse effect on small businesses, § 2.2-4007.04 requires that such economic impact analyses include (i) an identification and estimate of the number of small businesses subject to the regulation; (ii) the projected reporting, recordkeeping, and other administrative costs required for small businesses to comply with the regulation, including the type of professional skills necessary for preparing required reports and other documents; (iii) a statement of the probable effect of the regulation on affected small businesses; and (iv) a description of any less intrusive or less costly alternative methods of achieving the purpose of the regulation. The analysis presented above represents DPB's best estimate of these economic impacts.

Agency's Response to Economic Impact Analysis: The Department of Health Professions concurs with the economic impact analysis of the Department of Planning and Budget.

Summary:

The amendments add dental hygienists, assisted living facility administrators, and nursing home administrators to the listing of health care practitioners from whom emergency contact information is obtained for the purpose of disseminating information in case of a public health emergency.

18VAC76-40-10. Requirement to report.

In accordance with provisions of § 54.1-2506.1 of the Code of Virginia, the following persons or entities who hold a license, certificate, registration or permit issued by a board within the Department of Health Professions and whose address of record is in Virginia, a contiguous state, or the District of Columbia shall report emergency contact information as required by this chapter:

1. Assisted living facility administrators;

2. Athletic trainers;

2. 3. Certified massage therapists;

3. 4. Clinical psychologists;

4. 5. Clinical social workers;

5. 6. Dentists;

7. Dental hygienists;

6. 8. Funeral service licensees, embalmers and funeral directors;

7. 9. Licensed acupuncturists;

8. 10. Licensed practical nurses;

9. 11. Licensed professional counselors;

10. 12. Medical equipment suppliers;

13. Nursing home administrators;

11. 14. Pharmacists;

12. 15. Pharmacy technicians;

13. 16. Physical therapists;

14. 17. Physician assistants;

15. 18. Radiologic technologists;

16. 19. Registered nurses;

17. 20. Respiratory care practitioners;

18. 21. Surface transportation and removal service registrants;

19. 22. Veterinarians; and

20. 23. Wholesaler distributors of pharmaceuticals.