TITLE 2. AGRICULTURE
BOARD OF AGRICULTURE AND CONSUMER SERVICES
Agency Decision
Title of Regulation: 2VAC5-685. Regulations Governing Pesticide Applicator Certification under Authority of Virginia Pesticide Control Act.
Statutory Authority: § 3.2-3906 of the Code of Virginia.
Name of Petitioner: Virginia Pest Management Association.
Nature of Petitioner's Request: The petitioner requests that the Board of Agriculture and Consumer Services promulgate regulations that (i) create a new category or subcategory of pesticide certification for commercial applicators who conduct public health pest control measures in non-public applications and (ii) adjust training and examination requirements between this new category or subcategory and the area-wide applications made or directed by public agencies in support of area-wide public health pest control objectives to best reflect the unique applications intended and expected pursuant to each such category or subcategory.
Agency Decision: Request granted.
Statement of Reason for Decision: The board has voted to grant the petitioner's request for rulemaking because creating a separate category for mosquito applications in non-public settings will increase the number of applicators who are properly trained and certified for this particular type of application and remove unnecessary exam material and training.
Agency Contact: Kevin Schmidt, Board Secretary, Department of Agriculture and Consumer Services, Oliver Hill Building, 102 Governor Street, Suite 219, Richmond, VA 23219, telephone (804) 786-1346, or email kevin.schmidt@vdacs.virginia.gov.
VA.R. Doc. No. PFR26-18; Filed September 25, 2025, 10:39 a.m.
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TITLE 12. HEALTH
STATE BOARD OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
Agency Decision
Title of Regulation: 12VAC35-105. Rules and Regulations for Licensing Providers by the Department of Behavioral Health and Developmental Services.
Statutory Authority: §§ 37.2-203 and 37.2-400 of the Code of Virginia.
Name of Petitioner: R.C. Carter.
Nature of Petitioner's Request: The petitioner requests that the State Board of Behavioral Health and Developmental Services amend 12VAC35-105-1840 C 3 to allow crisis stabilization units to base nursing coverage on an individualized services plan driven, two-tier nursing model.
According to the petitioner:
This amendment will align the Department of Behavioral Health and Developmental Services (DBHDS) regulations with Department of Medical Assistance Services (DMAS) standards, which base nursing coverage on the initial nursing assessment and ISP, and will help ensure that crisis stabilization services remain both safe and financially sustainable across the Commonwealth.
Nursing Requirement and Financial Impact Analysis.
Under the DMAS Comprehensive Crisis Services Manual (Appendix G), crisis stabilization units must provide in-person nursing services 24 hours a day, seven days a week when required by the initial nursing assessment and individualized service plan (ISP). However, a detailed financial review demonstrates that meeting this standard for every client, regardless of actual clinical need, creates unavoidable deficits when all required professionals are considered.
A registered nurse (RN) or licensed practical nurse (LPN) paid between $35 and $40 per hour costs about $840 to $960 per day, or $4,200 to $4,800 over a five-day stay. In addition, a qualified mental health professional (QMHP) at roughly $20 per hour adds about $160 per day ($800 per five days); a certified substance abuse counselor (CSAC) at $25 per hour adds $200 per day ($1,000 per five days); and a licensed mental health professional (LMHP) at $30 per hour adds $240 per day ($1,200 per five days). Together, these staff drive a combined direct cost of roughly $1,440 per day (or $7,200 over five days) before any employer burden such as payroll taxes, overtime differentials, benefits, workers' compensation, or professional liability insurance is applied.
When compared with the fixed DMAS reimbursement of $847.04 per day (about $4,235 for five days), even the most conservative scenario falls short. For example, an RN at $30 per hour yields a narrow daily surplus of about $127 before fringe costs. But at more realistic market wages, which are around $40 per hour in line with Bureau of Labor Statistics data, the nursing expense alone creates a daily loss of more than $112, or about $41,230 annually per client. Once the required QMHP, CSAC, and LMHP staffing is included, the gap widens dramatically. With modest employer overhead (approximately 30% for taxes, benefits, and insurance), the daily cost climbs toward $1,875, producing a loss of over $1,000 per day, or $5,000 for each five-day admission.
This analysis confirms three critical points. First, the true breakeven wage for 24 hours per day, seven days per week nursing is approximately $35.29 per hour, and even at that rate, sustainability disappears when employer costs and additional staff are added. Second, the DMAS reimbursement structure cannot absorb market-based wages and required professional coverage. Third, aligning staffing with the results of the initial nursing assessment and each client's ISP, as DMAS already permits, is the only way to preserve both safety and financial viability.
In summary, when all required professionals, that is, RN/LPN, QMHP, CSAC, and LMHP, are included, the actual cost of a single five-day crisis stabilization stay far exceeds DMAS reimbursement. Without regulatory flexibility to implement an ISP-driven, two-tier nursing model, providers face unavoidable and continuing losses, placing essential crisis services and timely access to care at risk throughout the Commonwealth.
Agency Decision: Request denied.
Statement of Reason for Decision: At its meeting on December 10, 2025, the State Board of Behavioral Health and Developmental Services voted to take no action on the petition because 12VAC35-105-1840 is already aligned with Medicaid standards. The licensing regulations are not more stringent than DMAS policy regarding 24-hour a day, seven-days per week, in-person, onsite nursing coverage for crisis stabilization units.
Agency Contact: Susan Puglisi, Regulatory Research Specialist, Department of Behavioral Health and Developmental Services, Jefferson Building, 1220 Bank Street, Fourth Floor, Richmond, VA 23219, telephone (804) 975-0538, or email susan.puglisi@dbhds.virginia.gov.
VA.R. Doc. No. PFR26-16; Filed September 26, 2025, 3:52 p.m.
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TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY
Initial Agency Notice
Title of Regulation: 18VAC30-21. Regulations Governing Audiology and Speech-Language Pathology.
Statutory Authority: § 54.1-2400 of the Code of Virginia.
Name of Petitioner: American Academy of Audiology.
Nature of Petitioner's Request: The petitioner requests that the Board of Audiology and Speech-Language Pathology amend 18VAC30-21-60 A to include American Board of Audiology certification as an accepted pathway for audiologists applying for licensure in Virginia.
Agency Plan for Disposition of Request: The petition for rulemaking will be published in the Virginia Register of Regulations on January 12, 2026. The petition will also be published on the Virginia Regulatory Town Hall to receive public comment, which opens January 12, 2026, and closes February 11, 2026. The board will consider the petition and all comments in support or opposition at the next meeting after the close of public comment. That meeting is currently scheduled for April 21, 2026. The petitioner will be notified of the board's decision after that meeting.
Public Comment Deadline: February 11, 2026.
Agency Contact: Kelli Moss, Executive Director, Board of Audiology and Speech-Language Pathology, 9960 Mayland Drive, Suite 300, Henrico, VA 23233, telephone (804) 597-4132, or email kelli.moss@dhp.virginia.gov.
VA.R. Doc. No. PFR26-17; Filed December 17, 2025, 8:29 a.m.
Agency Decision
Title of Regulation: 18VAC30-21. Regulations Governing Audiology and Speech-Language Pathology.
Statutory Authority: § 54.1-2400 of the Code of Virginia.
Name of Petitioner: Melanie-Joy Dorn.
Nature of Petitioner's Request: The petitioner requests the Board of Audiology and Speech-Language Pathology eliminate 18VAC30-21-60 A 2 c, which was part of a recently created pathway to licensure in Virginia that was made as part of the board's regulatory reduction goal of reducing requirements to obtain a license in Virginia. This pathway became effective in February 2025 and allows an applicant to qualify for licensure without holding a certificate of clinical competence from the American Speech-Language-Hearing Association.
Agency Decision: Request denied.
Statement of Reason for Decision: At its December 9, 2025, meeting, the board voted to take no action on the petition as the board believes that the requirements contained in 18VAC30-21-60 A are appropriate and necessary for licensure.
Agency Contact: Kelli Moss, Executive Director, Board of Audiology and Speech-Language Pathology, 9960 Mayland Drive, Suite 300, Henrico, VA 23233, telephone (804) 597-4132, or email kelli.moss@dhp.virginia.gov.
VA.R. Doc. No. PFR25-15; Filed June 17, 2025, 2:08 p.m.
BOARD OF DENTISTRY
Initial Agency Notice
Title of Regulation: 18VAC60-21. Regulations Governing the Practice of Dentistry.
Statutory Authority: § 54.1-2400 of the Code of Virginia.
Name of Petitioner: Alayna Smiley, MD, DMD.
Nature of Petitioner's Request: The petitioner requests that the Board of Dentistry amend 18VAC60-21-350 and 1860-21-370 to exempt oral and maxillofacial surgeons who perform non-surgical cosmetic procedures from (i) the requirement for American Board of Oral and Maxillofacial Surgery board eligibility or certification and (ii) the requirement to hold active hospital privileges.
Agency Plan for Disposition of Request: The petition for rulemaking will be published in the Virginia Register of Regulations on January 12, 2026. The petition will also be published on the Virginia Regulatory Town Hall to receive public comment, which opens January 12, 2026, and closes February 11, 2026. The board will consider the petition and all comments in support or opposition at the next meeting after the close of public comment, currently scheduled for March 6, 2026. The petitioner will be notified of the board's decision after that meeting.
Public Comment Deadline: February 11, 2026.
Agency Contact: Jamie Sacksteder, Executive Director, Board of Dentistry, 9960 Mayland Drive, Suite 300, Henrico, VA 23233, telephone (804) 367-4581, or email jamie.sacksteder@dhp.virginia.gov.
VA.R. Doc. No. PFR26-14; Filed December 09, 2025, 12:51 p.m.