NOTICES OF INTENDED REGULATORY ACTION
Vol. 33 Iss. 19 - May 15, 2017

TITLE 9. ENVIRONMENT
Water Quality Standards
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the State Water Control Board intends to consider amending 9VAC25-260, Water Quality Standards. The purpose of the proposed action is to amend Virginia's antidegradation policy, part of the Water Quality Standards Regulation, by designating a portion of Laurel Fork as exceptional state waters (ESW) in 9VAC25-260-30 A 3 c. The ESW category of the antidegradation policy allows the State Water Control Board to designate waters that display exceptional environmental settings and either exceptional aquatic communities or exceptional recreational opportunities for added protection. ("Tier III" is how the public commonly refers to those waters that are protected from water quality degradation through a prohibition on new or increased point source discharges. The equivalent regulatory terms are "outstanding national resource waters" for the federal Environmental Protection Agency and "exceptional state waters" for Virginia.)

Once designated, the antidegradation policy provides that no water quality degradation would be allowed in the ESW (i.e., no new, additional, or increased point source discharge of sewage, industrial wastes, or other pollution would be allowed into waters designated as ESW). The only exception would be temporary, limited impact activities, with the provision that after a minimal period of time the waters are returned or restored to conditions equal to or better than those existing just prior to the temporary source of pollution. The goal is to protect these special waters at their present quality for use and enjoyment by future generations of Virginians.

The section of Laurel Fork under consideration for possible exceptional state waters designation is Laurel Fork in Highland County, from approximately 0.33 miles upstream of the confluence with Collins Run (Latitude N38.490051, Longitude W79.666039) downstream to a point approximately 0.5 miles upstream from the confluence of Mullenax Run (Latitude N38.508322, Longitude W79.652757).

The agency does not intend to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 62.1-44.15 of the Code of Virginia; 33 USC § 1251 et seq. of the Clean Water Act; 40 CFR Part 131.

Public Comment Deadline: June 14, 2017.

Agency Contact: David Whitehurst, Department of Environmental Quality, 629 East Main Street, P.O. Box 1105, Richmond, VA 23218, telephone (804) 698-4121, FAX (804) 698-4032, or email david.whitehurst@deq.virginia.gov.

VA.R. Doc. No. R17-5021; Filed April 20, 2017, 9:05 a.m.
TITLE 12. HEALTH
Virginia Emergency Medical Services Regulation
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the State Board of Health intends to consider repealing 12VAC5-31, Virginia Emergency Medical Services Regulation, and promulgating 12VAC5-32, Virginia Emergency Medical Services Regulations. The purpose of the proposed action is to replace the current chapter with a new chapter governing emergency medical services (EMS). The new EMS regulations will be designed for easier use by regulants and the public. Changes being considered include incorporating language to reflect current national certification levels and the testing process, updating equipment requirements for all vehicles, updating standards to reflect changes in the ambulance industry, reorganizing provisions for financial assistance for emergency medical services, and amending provisions regarding criminal history, the regional council, and Medevac. Additional changes may be proposed as a result of input received from the public.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: §§ 32.1-12 and 32.1-111.4 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Michael Berg, Regulatory and Compliance Manager, Department of Health, 1001 Technology Park Drive, Glen Allen, VA 23059-4500, telephone (804) 888-9131, or email michael.berg@vdh.virginia.gov.

VA.R. Doc. No. R17-5100; Filed April 14, 2017, 11:46 a.m.
TITLE 12. HEALTH
Virginia Emergency Medical Services Regulations
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the State Board of Health intends to consider repealing 12VAC5-31, Virginia Emergency Medical Services Regulation, and promulgating 12VAC5-32, Virginia Emergency Medical Services Regulations. The purpose of the proposed action is to replace the current chapter with a new chapter governing emergency medical services (EMS). The new EMS regulations will be designed for easier use by regulants and the public. Changes being considered include incorporating language to reflect current national certification levels and the testing process, updating equipment requirements for all vehicles, updating standards to reflect changes in the ambulance industry, reorganizing provisions for financial assistance for emergency medical services, and amending provisions regarding criminal history, the regional council, and Medevac. Additional changes may be proposed as a result of input received from the public.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: §§ 32.1-12 and 32.1-111.4 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Michael Berg, Regulatory and Compliance Manager, Department of Health, 1001 Technology Park Drive, Glen Allen, VA 23059-4500, telephone (804) 888-9131, or email michael.berg@vdh.virginia.gov.

VA.R. Doc. No. R17-5100; Filed April 14, 2017, 11:46 a.m.
TITLE 12. HEALTH
Amount, Duration, and Scope of Medical and Remedial Care and Services
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Medical Assistance Services intends to consider amending 12VAC30-50, Amount, Duration, and Scope of Medical and Remedial Care and Services. The purpose of the proposed action is to amend 12VAC30-50-165, Durable medical equipment (DME) and supplies suitable for use in the home. The amendments are intended to (i) update coverage and documentation requirements to better align them with best practices and Centers for Medicare and Medicaid guidance and (ii) eliminate unnecessary elements that create confusion among DME providers. Specifically, these proposed changes include elements around enteral nutrition, implantable pumps, delivery ticket components, and replacement DME after a natural disaster.

The agency does not intend to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.

Public Comment Deadline: June 14, 2017.

Agency Contact: Emily McClellan, Regulatory Supervisor, Policy Division, Department of Medical Assistance Services, 600 East Broad Street, Suite 1300, Richmond, VA 23219, telephone (804) 371-4300, FAX (804) 786-1680, or email emily.mcclellan@dmas.virginia.gov.

VA.R. Doc. No. R17-5024; Filed April 14, 2017, 12:13 p.m.
TITLE 13. HOUSING
Manufactured Housing Licensing and Transaction Recovery Fund Regulations
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Manufactured Housing Board intends to consider amending 13VAC6-20, Manufactured Housing Licensing and Transaction Recovery Fund Regulations. The purpose of the proposed action is to review issues related to licensing requirements for the manufactured housing industry members that will provide better protection to consumers without imposing unnecessary regulatory burdens on the licensees. The amended regulations will better define the parameters for warranties on homes, when and what disclosures must be given to buyers, and define and implement a substantial identity of interest to restrict repeated violations. The board will receive suggestions and review other requirements or restrictions in the regulations to address any perceived problems and improve the regulations for consumers and regulants.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 36-85.18 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Elizabeth Rafferty, Policy and Legislative Director, Department of Housing and Community Development, 600 East Main Street, Suite 300, Richmond, VA 23219, telephone (804) 371-7011, FAX (804) 371-7090, TTY (804) 371-7089, or email elizabeth.rafferty@dhcd.virginia.gov.

VA.R. Doc. No. R17-5104; Filed April 21, 2017, 11:40 a.m.
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
Regulations Governing the Practice of Dentistry
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Dentistry intends to consider amending 18VAC60-21, Regulations Governing the Practice of Dentistry. The purpose of the proposed action is to consider regulations for dentists prescribing medications containing opioids and for continuing education for prescribers of controlled substances to address the opioid abuse crisis in Virginia. Regulations for the management of acute pain may include requirements for the evaluation of the patient, limitations on quantity and dosage, and recordkeeping. Management of chronic pain may require either referral to a pain management specialist or adherence to regulations of the Board of Medicine. All dentists who prescribe Schedules II through IV drugs may be required to take two hours of continuing education on pain management during the renewal cycle following the effective date of the regulations.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: §§ 54.1-2400 and 54.1-2708.4 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Sandra Reen, Executive Director, Board of Dentistry, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4437, FAX (804) 527-4428, or email sandra.reen@dhp.virginia.gov.

VA.R. Doc. No. R17-5064; Filed April 17, 2017, 9:25 a.m.
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
Regulations Governing the Practice of Dentistry
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Dentistry intends to consider amending 18VAC60-21, Regulations Governing the Practice of Dentistry, 18VAC60-25, Regulations Governing the Practice of Dental Hygiene, and 18VAC60-30, Regulations Governing the Practice of Dental Assistants. A revision of the American Dental Association (ADA) Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry was published in October 2016. Currently, Board of Dentistry regulations specify that education and training for conscious/moderate sedation must be consistent with the ADA Guidelines. With the revision, certain training requirements and uses of terminology are now inconsistent with the guidelines, now titled "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students."

Consequently, the board is considering (i) amending the use of the term conscious/moderate sedation throughout the chapters to refer to moderate sedation, (ii) changing the name of the guidelines consistent with the 2016 version, and (iii) eliminating the training for a dentist to administer moderate sedation by the enteral method only, as the guidelines no longer make a distinction for enteral administration, and specifying the same training for all who administer moderate sedation.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Sandra Reen, Executive Director, Board of Dentistry, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4437, FAX (804) 527-4428, or email sandra.reen@dhp.virginia.gov.

VA.R. Doc. No. R17-4975; Filed April 17, 2017, 7:52 a.m.
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
Regulations Governing the Practice of Dental Hygiene
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Dentistry intends to consider amending 18VAC60-21, Regulations Governing the Practice of Dentistry, 18VAC60-25, Regulations Governing the Practice of Dental Hygiene, and 18VAC60-30, Regulations Governing the Practice of Dental Assistants. A revision of the American Dental Association (ADA) Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry was published in October 2016. Currently, Board of Dentistry regulations specify that education and training for conscious/moderate sedation must be consistent with the ADA Guidelines. With the revision, certain training requirements and uses of terminology are now inconsistent with the guidelines, now titled "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students."

Consequently, the board is considering (i) amending the use of the term conscious/moderate sedation throughout the chapters to refer to moderate sedation, (ii) changing the name of the guidelines consistent with the 2016 version, and (iii) eliminating the training for a dentist to administer moderate sedation by the enteral method only, as the guidelines no longer make a distinction for enteral administration, and specifying the same training for all who administer moderate sedation.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Sandra Reen, Executive Director, Board of Dentistry, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4437, FAX (804) 527-4428, or email sandra.reen@dhp.virginia.gov.

VA.R. Doc. No. R17-4975; Filed April 17, 2017, 7:52 a.m.
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
Regulations Governing the Practice of Dental Assistants
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Dentistry intends to consider amending 18VAC60-21, Regulations Governing the Practice of Dentistry, 18VAC60-25, Regulations Governing the Practice of Dental Hygiene, and 18VAC60-30, Regulations Governing the Practice of Dental Assistants. A revision of the American Dental Association (ADA) Guidelines for Teaching the Comprehensive Control of Anxiety and Pain in Dentistry was published in October 2016. Currently, Board of Dentistry regulations specify that education and training for conscious/moderate sedation must be consistent with the ADA Guidelines. With the revision, certain training requirements and uses of terminology are now inconsistent with the guidelines, now titled "Guidelines for Teaching Pain Control and Sedation to Dentists and Dental Students."

Consequently, the board is considering (i) amending the use of the term conscious/moderate sedation throughout the chapters to refer to moderate sedation, (ii) changing the name of the guidelines consistent with the 2016 version, and (iii) eliminating the training for a dentist to administer moderate sedation by the enteral method only, as the guidelines no longer make a distinction for enteral administration, and specifying the same training for all who administer moderate sedation.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Sandra Reen, Executive Director, Board of Dentistry, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4437, FAX (804) 527-4428, or email sandra.reen@dhp.virginia.gov.

VA.R. Doc. No. R17-4975; Filed April 17, 2017, 7:52 a.m.
TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
Regulations of the Board of Funeral Directors and Embalmers
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Board of Funeral Directors and Embalmers intends to consider amending 18VAC65-20, Regulations of the Board of Funeral Directors and Embalmers. The purpose of the proposed action is to incorporate the board's guidance on the statutory requirements for express permission to embalm a body and for refrigeration of a dead human body into the board's regulations so if necessary, compliance can be enforced through a disciplinary proceeding.

The agency intends to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: §§ 54.1-2400 and 54.1-2803 of the Code of Virginia.

Public Comment Deadline: June 14, 2017.

Agency Contact: Corie Tillman Wolf, Executive Director, Board of Funeral Directors and Embalmers, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4479, FAX (804) 527-4471, or email fanbd@dhp.virginia.gov.

VA.R. Doc. No. R17-5042; Filed April 17, 2017, 8:06 a.m.
TITLE 22. SOCIAL SERVICES
Provision of Vocational Rehabilitation Services
Notice of Intended Regulatory Action

Notice is hereby given in accordance with § 2.2-4007.01 of the Code of Virginia that the Department for Aging and Rehabilitative Services intends to consider amending 22VAC30-20, Provision of Vocational Rehabilitation Services. The purpose of the proposed action is to reduce the priority categories for order of selection for persons determined to be eligible for services from four to three. The Rehabilitation Services Administration, the federal agency that regulates the state-federal vocational rehabilitation program, is requiring a reduction in the number of categories for the order of selection, based on a determination that the current categories II and III are not different enough to warrant being two separate categories.

The agency does not intend to hold a public hearing on the proposed action after publication in the Virginia Register.

Statutory Authority: § 51.5-131 of the Code of Virginia.

Public Comment Deadline: June 15, 2017.

Agency Contact: Vanessa S. Rakestraw, Ph.D., CRC, Policy Analyst, Department for Aging and Rehabilitative Services, 8004 Franklin Farms Drive, Richmond, VA 23229, telephone (804) 662-7612, FAX (804) 662-7663, TTY (800) 464-9950, or email vanessa.rakestraw@dars.virginia.gov.

VA.R. Doc. No. R17-4951; Filed April 14, 2017, 3:41 p.m.