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Completed by:
The Unsilenced Policy Team
Virginia Legislation Report
2022
2022
Introduction
The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.
Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.
Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.
An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.
It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.
Introduction
The ‘troubled teen’ industry is a network of residential programs that claim to provide treatment for the behavioral and developmental needs of youth. The industry’s lack of transparency and accountability has led to widespread abuse of youth, resulting in hospitalizations, prolonged trauma and death.
Today, there are an estimated 120,000 – 200,000 minors in residential programs across the United States. These youth are placed each year by state child welfare agencies, juvenile justice courts, mental health providers, refugee resettlement agencies, school districts’ individualized education programs, and by parents.
Many of these youth have trauma histories, which are only exacerbated by being removed from their communities and institutionalized. Youth with lived experience describe these programs as being carceral, harsh, and abusive.
An estimated $23 billion dollars of public funds annually are used to place youth in residential programs. Daily rates for residential treatment ranges from $250-$800, costing up to $292,000 per year, per child.
It is overwhelmingly clear that our communities and agencies are over-relying on residential placements that are negatively impacting the youth they serve.
Virginia Legislation
| General Oversight and Transparency | Department of Behavioral Health and Developmental Services |
| Oversight Agency | Department of Behavioral Health and Developmental Services |
| Which state agency oversees investigations? | Department of Behavioral Health and Developmental Services |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes. 12VAC35-46-10 et seq CHAPTER 46 STANDARDS FOR REGULATION CHILDREN’S RESIDENTIAL FACILITIES (DSS)"Children's residential facility"" or ""facility"" means a publicly or privately operated facility, other than a private family home, where 24-hour per day care is provided to children separated from their legal guardians and is required to be licensed or certified by the Code of Virginia. 22 VAC 40-151 CHAPTER 151 STANDARDS FOR LICENSED CHILDREN'S RESIDENTIAL FACILITIES (DBHBS) "Children's residential facility" or "facility" means any facility, child-caring institution, or group home that is maintained for the purpose of receiving children separated from their parents or guardians for full-time care, maintenance, protection and guidance, or for the purpose of providing independent living services to persons between 18 and 21 years of age who are in the process of transitioning out of foster care. Children's residential facility. "" except: (DBHDS) 1. A licensed or accredited educational institution whose pupils, in the ordinary course of events, return annually to the homes of their parents or guardians for not less than two months of summer vacation; 2. An establishment required to be licensed as a summer camp by § 35.1-18 of the Code of Virginia; 3. A licensed or accredited hospital legally maintained as such; and (there Hospitals are listed as licensed by DBHDS) 4. Any facility licensed by the Department of Social Services as a child caring institution as of January 1, 1987, and that receives no public funds except:(DSS) 1. Any facility licensed by the Department of Social Services as a child-caring institution as of January 1, 1987, and that receives public funds; and 2. Acute-care private psychiatric hospitals serving children that are licensed by the Department of Behavioral Health and Developmental Services under the Rules and Regulations for the Licensing of Providers of Mental Health, Mental Retardation and Substance Abuse, the Individual and Family Developmental Disabilities Support Waiver, and Residential Brain Injury Services |
| Is a list of licensed facilities available to the public? | Yes |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | Yes. (DSS) 22VAC40-151-30. Inspection of Facilities. . Representatives of the department shall make announced and unannounced inspections during the effective dates of the license. The purpose of these inspections is to monitor compliance with applicable standards. B. The department shall notify relevant local governments and placing and funding agencies, including the Office of Comprehensive Services, of multiple health and safety or human rights violations in children's residential facilities when such violations result in the lowering of the license or certificate to provisional status. (DBHDS)12VAC35-105-70. Onsite reviews. A. The department shall conduct an announced or unannounced onsite review of all new providers and services to determine compliance with this chapter. B. The department shall conduct unannounced onsite reviews of licensed providers and each service at any time and at least annually to determine compliance with these regulations. The annual unannounced onsite reviews shall be focused on preventing specific risks to individuals, including an evaluation of the physical facilities in which the services are provided. C. The department may conduct announced and unannounced onsite reviews at any time as part of the investigations of complaints or incidents to determine if there is a violation of this chapter. (DBHD)S12VAC35-46-40. Review of facilities. A. Representatives of the department shall make announced and unannounced reviews during the effective dates of the license. The purpose of these reviews is to monitor compliance with applicable regulations. B. Representatives of the department shall notify relevant local governments and placing and funding agencies, including the Office of Comprehensive Services, of multiple health and safety or human rights violations in children's residential facilities when such violations result in the lowering of the license to provisional status. |
| Are background checks required, including volunteers? | Yes. DSS OFFICE OF BACKGROUND INVESTIGATIONS (OBI) - Anyone who is hired or is approved to provide volunteer or contractual services cannot work until the criminal history background check and central registry search has been received by the facility. Children’s residential facilities cannot hire anyone who has: - a conviction or pending charges for an offense under clauses (i), (ii), (iii), or (v) of barrier crime definition in Code § 19.2-392.02 - a conviction or pending charges for an offense under clause (iv) within five years prior to application for employment/volunteer/contractual services or is still on probation/parole or has failed to pay court fees for offenses under clause (iv) founded case of child abuse or neglect. (DBHDS) 12VAC35-105-400. Criminal registry checks. A. Providers shall comply with the background check requirements for direct care positions outlined in §§37.2- 416, 37.2-506, and 37.2-607 of the Code of Virginia for individuals hired after July 1, 1999. §37.2-416. Background checks required. (vi) any person under contract with the provider to serve in a direct care position to submit to fingerprinting and provide personal descriptive information to be forwarded through the Central Criminal Records Exchange to the Federal Bureau of Investigation (FBI) for the purpose of obtaining national criminal history record information regarding the applicant. |
| Is a full-time licensed clinician required to be on staff? | Yes. (DBHDS)12VAC35-105-1370. Treatment team and staffing plan. "Program of assertive community treatment service" or "PACT" means a self-contained interdisciplinary team of at least 10 full-time equivalent clinical staff, a program assistant, and a full-time or part-time psychiatrist that: 1. PACT and ICT teams shall include the following positions: b. Nurses - PACT and ICT nurses shall be full-time employees or contractors with the following minimum qualifications: A registered nurse (RN) shall have one year of experience in the provision of mental health services to adults with serious mental illness. A licensed practical nurse (LPN) shall have three years of experience in the provision of mental health services to adults with serious mental illness. ICT teams shall have at least one qualified full-time nurse. PACT teams shall have at least three qualified full-time nurses at least one of whom shall be a qualified RN. |
| Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? | No Information |
| Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? | Yes. (DSS) 22VAC40-151-960 & (DBHDS) 12VAC35-46-1070 Serious Incident Reports. A. Any serious incident, accident or injury to the resident; any overnight absence from the facility without permission; any runaway; and any other unexplained absence shall be reported within 24 hours to the placing agency, and to either the parent or legal guardian, or both as appropriate. The provider shall make a written reference in the child's record that a report was made. |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | Yes. 12VAC35-46-765. Discharge. G. Unless discharge is ordered by a court of competent jurisdiction prior to the planned discharge date, each resident's record shall contain: 1. Documentation that discharge has been planned and discussed with the parent, if appropriate; legal guardian; child-placing agency; and resident |
| Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? | Yes. (DBHDS)12VAC35-105-1370. Treatment team and staffing plan. "Program of assertive community treatment service" or "PACT" means a self-contained interdisciplinary team of at least 10 full-time equivalent clinical staff, a program assistant, and a full-time or part-time psychiatrist that: 1. PACT and ICT teams shall include the following positions: f. Psychiatrist - one physician who is board certified in psychiatry or who is board eligible in psychiatry and is licensed to practice medicine in Virginia. An equivalent ratio to 20 minutes (.008 FTE) of psychiatric time for each individual served must be maintained. The psychiatrist shall be a fully integrated team member who attends team meetings and actively participates in developing and implementing each individual ISP. |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | Yes. 22VAC40-151-250. Staff Development. Within 30 days following their begin date, all staff working with residents shall be trained in child abuse and neglect, mandatory reporting, maintaining appropriate professional relationships and interaction among staff and residents, and suicide prevention. |
| Does the state require medical response training for all staff working with children in residential settings? | Yes. 22VAC40-151-250. Staff Development. Within 30 days following their begin date, all staff working with residents shall be enrolled in a standard first aid class and in a cardiopulmonary resuscitation class facilitated by the American Red Cross or other recognized authority, unless the individual is currently certified in first aid and cardiopulmonary resuscitation. |
| Does the state require 1:4 staffing ratio or higher? | No. 22VAC40-151-770. Staff Supervision of Residents. At all times the ratio of staff to residents shall be at least one staff to eight residents for facilities during the hours residents are awake, except when the department has approved or required a supervision plan with a different ratio based on the needs of the population served. |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes. 12VAC35-46-640. Admission procedures. A. The facility shall have written criteria for admission that shall include: 1. A description of the population to be served; 2. A description of the types of services offered; 3. Intake and admission procedures; 4. Exclusion criteria to define those behaviors or problems that the facility does not have the staff with experience or training to manage; and 5. Description of how educational services will be provided to the population being served. B. The facility shall accept and serve only those children whose needs are compatible with the services provided through the facility unless a child's admission is ordered by a court of competent jurisdiction. C. Acceptance of a child as eligible for respite care by a facility approved to provide residential respite care is considered admission to the facility. Each individual period of respite care is not considered a separate admission. D. Each facility shall provide documentation showing proof of contractual agreements or staff expertise to provide educational services, counseling services, psychological services, medical services, or any other services needed to serve the residents in accordance with the facility's program description as defined by the facility's criteria of admission. 12VAC35-46-710. Application for admission. B. Providers shall develop, and fully complete prior to acceptance for care, an application for admission that is designed to compile information necessary to determine: 1. The educational needs of the prospective resident; 2. The mental health, emotional, and psychological needs of the prospective resident; 3. The physical health needs, including the immunization needs, of the prospective resident; 4. The protection needs of the prospective resident; 5. The suitability of the prospective resident's admission; 6. The behavior support needs of the prospective resident; 7. Family history and relationships; 8. Social and development history; 9. Current behavioral functioning and social competence; |
| Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? | Yes. 12VAC35-105-690. Orientation. A. The provider shall implement a written policy regarding the orientation of individuals and their authorized representatives, if applicable to services. B. As appropriate to the scope and level of services the policy shall require the provision to individuals and authorized representatives the following information: 1. The mission of the provider or service; 2. Service confidentiality practices and protections for individuals receiving services; 3. Human rights policies and protections and instructions on how to report violations; |
| Does the State define institutional abuse and neglect? | No. Not institutional abuse. 12VAC35-105-20. Definitions and units of measurement. "Abuse" means any act or failure to act by an employee or other person responsible for the care of an individual in a facility or program operated, licensed, or funded by the department, excluding those operated by the Virginia Department of Corrections, that was performed or was failed to be performed knowingly, recklessly, or intentionally, and that caused or might have caused physical or psychological harm, injury, or death to an individual receiving care or treatment for mental illness, developmental disabilities, or substance abuse. Examples of abuse include acts such as: 1. Rape, sexual assault, or other criminal sexual behavior; 2. Assault or battery; 3. Use of language that demeans, threatens, intimidates, or humiliates the individual; 4. Misuse or misappropriation of the individual's assets, goods, or property; 5. Use of excessive force when placing an individual in physical or mechanical restraint; 6. Use of physical or mechanical restraints on an individual that is not in compliance with federal and state laws, regulations, and policies, professional accepted standards of practice, or his individualized services plan; or 7. Use of more restrictive or intensive services or denial of services to punish an individual or that is not consistent with his individualized services plan., Neglect. "Neglect" means the failure by a person, or a program or facility operated, licensed, or funded by the department, excluding those operated by the Department of Corrections, responsible for providing services to do so, including nourishment, treatment, care, goods, or services necessary to the health, safety, or welfare of an individual receiving care or treatment for mental illness, developmental disabilities, or substance abuse. |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the State prohibit mail censorship? | Yes. 12VAC35-46-920. Prohibitions. 4. Delay or withholding of incoming or outgoing mail, except as permitted by other applicable state and federal regulations or by order of a court of competent jurisdiction; Interpretation of § 920.4: Federal law prohibits the tampering with another individual’s mail. Any need to limit or prohibit communication between a resident and another person would be governed by federal postal regulations. Facility personnel may withhold mail of minors if the legal guardians document their approval of or request for withholding mail. In these instances, facilities should ask the legal guardian what to do with the unopened mail. Facilities may have the resident open mail in the presence of staff when there is a concern for the resident’s safety or well-being or an indication that contraband may be concealed. Mail must be promptly given. 22VAC40-151-820. Prohibitions.4. Delay or withholding of incoming or outgoing mail, except as permitted by order of a court of competent jurisdiction; |
| Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? | Yes. 12VAC35-46-920. Prohibitions. 2. Limitation on contacts and visits with the resident's attorney, a probation officer, regulators, or placing agency representative; 3. Bans on contacts and visits with family or legal guardians, except as permitted by order of a court of competent jurisdiction; |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? | Yes. 12VAC35-46-800. Structured program of care. A. There shall be evidence of a structured program of care designed to: 1. Meet the residents' physical and emotional needs; 2. Provide protection, guidance, and supervision; and 3. Meet the objectives of any required service plan. |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | 22VAC40-151-600. Participation of Residents in Human Research. The provider shall: 1. Implement a written policy stating that residents will not be used as subjects of human research; or 2. Document approval, as required by the department, for each research project using residents as subjects of human research, unless such research is exempt from review. |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | Yes. 12VAC35-46-970 Education & 22VAC40-151-860 Education - A. Each resident of compulsory school attendance age shall be enrolled, as provided in the Code of Virginia, in an appropriate educational program within five school business days. Documentation of the enrollment shall be kept in the resident's record. B. The provider shall ensure that educational guidance and counseling in selecting courses is provided for each resident and shall ensure that education is an integral part of the resident's total program. C. Providers operating educational programs for children with disabilities shall operate those programs in compliance with applicable state and federal statutes and regulations. D. When a child with a disability has been placed in a residential facility, the facility shall contact the division superintendent of the resident's home locality. Documentation of the contact with the resident's home school shall be kept in the resident's record. E. A provider that has an academic or vocational program that is not certified or approved by the Department of Education shall document that teachers meet the qualifications to teach the same subjects in the public schools. F. Each provider shall develop and implement written policies and procedures to ensure that each resident has adequate study time. |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | 12VAC35-46-920. Prohibitions & 22VAC40-151-820 Prohibitions - 14. Limitation on contacts and visits with advocates employed by the Virginia Office for Protection and Advocacy |
| Does the state require parental consent to all treatment received? | No |
| Is a grievance procedure required for youth and families? | Yes. 12VAC35-46-1090 Grievance procedures & 22VAC40-151-980 Grievance Procedures - A. The provider shall develop and implement written policies and procedures governing the handling of grievances by residents. If not addressed by other applicable standards, the policies and procedures shall: 1. Be written in clear and simple language; 2. Be communicated to the residents in an age or developmentally appropriate manner; 3. Be posted in an area easily accessible to residents and their parents and legal guardians; 4. Ensure that any grievance shall be investigated by an objective employee who is not the subject of the grievance; and 5. Require continuous monitoring by the provider of any grievance to assure there is no retaliation or threat of retaliation against the child. |
| Is youth consent required for all treatment received? | No |
| Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? | Yes. 12VAC35-46-420 Buildings, inspections and building plans & 22VAC40-151-360. Buildings, Inspections and Building Plans - A. All buildings and building related equipment shall be inspected and approved by the local building official. Approval shall be documented by a certificate of occupancy |
| Is there regulation on physical restraint? | Yes. 12VAC35-46-930/22VAC40-151-830. Pharmacological or Mechanical Restraints. A. Use of mechanical restraints is prohibited. B. Use of pharmacological restraints is prohibited. (2) 12VAC35-46-940.(G). Trained staff members may physically restrain a resident only after less restrictive interventions have failed or when failure to restrain would result in harm to the resident or others. (J) Providers shall ensure that restraint may only be implemented, monitored, and discontinued by staff who have been trained in the proper and safe use of restraint, including hands-on techniques. |
| Is there regulation on chemical restraint? | Prohibited. 12VAC35-46-930/22VAC40-151-830. Pharmacological or Mechanical Restraints. A. Use of mechanical restraints is prohibited. B. Use of pharmacological restraints is prohibited. (2) 12VAC35-46-940.(G). Trained staff members may physically restrain a resident only after less restrictive interventions have failed or when failure to restrain would result in harm to the resident or others. (J) Providers shall ensure that restraint may only be implemented, monitored, and discontinued by staff who have been trained in the proper and safe use of restraint, including hands-on techniques. |
| Is there regulation on mechanical restraint? | Prohibited. 12VAC35-46-930/22VAC40-151-830. Pharmacological or Mechanical Restraints. A. Use of mechanical restraints is prohibited. B. Use of pharmacological restraints is prohibited. (2) 12VAC35-46-940.(G). Trained staff members may physically restrain a resident only after less restrictive interventions have failed or when failure to restrain would result in harm to the resident or others. (J) Providers shall ensure that restraint may only be implemented, monitored, and discontinued by staff who have been trained in the proper and safe use of restraint, including hands-on techniques. |
| Is there regulation on seclusion? | Allowed |
| General Oversight and Transparency | Department of Social Services |
| Oversight Agency | Department of Social Services |
| Which state agency oversees investigations? | Department of Social Services |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes. 12VAC35-46-10 et seq CHAPTER 46 STANDARDS FOR REGULATION CHILDREN’S RESIDENTIAL FACILITIES (DSS)"Children's residential facility"" or ""facility"" means a publicly or privately operated facility, other than a private family home, where 24-hour per day care is provided to children separated from their legal guardians and is required to be licensed or certified by the Code of Virginia. 22 VAC 40-151 CHAPTER 151 STANDARDS FOR LICENSED CHILDREN'S RESIDENTIAL FACILITIES (DBHBS) "Children's residential facility" or "facility" means any facility, child-caring institution, or group home that is maintained for the purpose of receiving children separated from their parents or guardians for full-time care, maintenance, protection and guidance, or for the purpose of providing independent living services to persons between 18 and 21 years of age who are in the process of transitioning out of foster care. Children's residential facility. "" except: (DBHDS) 1. A licensed or accredited educational institution whose pupils, in the ordinary course of events, return annually to the homes of their parents or guardians for not less than two months of summer vacation; 2. An establishment required to be licensed as a summer camp by § 35.1-18 of the Code of Virginia; 3. A licensed or accredited hospital legally maintained as such; and (there Hospitals are listed as licensed by DBHDS) 4. Any facility licensed by the Department of Social Services as a child caring institution as of January 1, 1987, and that receives no public funds except:(DSS) 1. Any facility licensed by the Department of Social Services as a child-caring institution as of January 1, 1987, and that receives public funds; and 2. Acute-care private psychiatric hospitals serving children that are licensed by the Department of Behavioral Health and Developmental Services under the Rules and Regulations for the Licensing of Providers of Mental Health, Mental Retardation and Substance Abuse, the Individual and Family Developmental Disabilities Support Waiver, and Residential Brain Injury Services |
| Is a list of licensed facilities available to the public? | Yes |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | Yes. (DSS) 22VAC40-151-30. Inspection of Facilities. . Representatives of the department shall make announced and unannounced inspections during the effective dates of the license. The purpose of these inspections is to monitor compliance with applicable standards. B. The department shall notify relevant local governments and placing and funding agencies, including the Office of Comprehensive Services, of multiple health and safety or human rights violations in children's residential facilities when such violations result in the lowering of the license or certificate to provisional status. (DBHDS)12VAC35-105-70. Onsite reviews. A. The department shall conduct an announced or unannounced onsite review of all new providers and services to determine compliance with this chapter. B. The department shall conduct unannounced onsite reviews of licensed providers and each service at any time and at least annually to determine compliance with these regulations. The annual unannounced onsite reviews shall be focused on preventing specific risks to individuals, including an evaluation of the physical facilities in which the services are provided. C. The department may conduct announced and unannounced onsite reviews at any time as part of the investigations of complaints or incidents to determine if there is a violation of this chapter. (DBHD)S12VAC35-46-40. Review of facilities. A. Representatives of the department shall make announced and unannounced reviews during the effective dates of the license. The purpose of these reviews is to monitor compliance with applicable regulations. B. Representatives of the department shall notify relevant local governments and placing and funding agencies, including the Office of Comprehensive Services, of multiple health and safety or human rights violations in children's residential facilities when such violations result in the lowering of the license to provisional status. |
| Are background checks required, including volunteers? | Yes. DSS OFFICE OF BACKGROUND INVESTIGATIONS (OBI) - Anyone who is hired or is approved to provide volunteer or contractual services cannot work until the criminal history background check and central registry search has been received by the facility. Children’s residential facilities cannot hire anyone who has: - a conviction or pending charges for an offense under clauses (i), (ii), (iii), or (v) of barrier crime definition in Code § 19.2-392.02 - a conviction or pending charges for an offense under clause (iv) within five years prior to application for employment/volunteer/contractual services or is still on probation/parole or has failed to pay court fees for offenses under clause (iv) founded case of child abuse or neglect. (DBHDS) 12VAC35-105-400. Criminal registry checks. A. Providers shall comply with the background check requirements for direct care positions outlined in §§37.2- 416, 37.2-506, and 37.2-607 of the Code of Virginia for individuals hired after July 1, 1999. §37.2-416. Background checks required. (vi) any person under contract with the provider to serve in a direct care position to submit to fingerprinting and provide personal descriptive information to be forwarded through the Central Criminal Records Exchange to the Federal Bureau of Investigation (FBI) for the purpose of obtaining national criminal history record information regarding the applicant. |
| Is a full-time licensed clinician required to be on staff? | Yes |
| Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? | No Information |
| Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? | Yes. (DSS) 22VAC40-151-960 & (DBHDS) 12VAC35-46-1070 Serious Incident Reports. A. Any serious incident, accident or injury to the resident; any overnight absence from the facility without permission; any runaway; and any other unexplained absence shall be reported within 24 hours to the placing agency, and to either the parent or legal guardian, or both as appropriate. The provider shall make a written reference in the child's record that a report was made. |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | Yes. 12VAC35-46-765. Discharge. G. Unless discharge is ordered by a court of competent jurisdiction prior to the planned discharge date, each resident's record shall contain: 1. Documentation that discharge has been planned and discussed with the parent, if appropriate; legal guardian; child-placing agency; and resident |
| Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? | No |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | Yes. 22VAC40-151-250. Staff Development. Within 30 days following their begin date, all staff working with residents shall be trained in child abuse and neglect, mandatory reporting, maintaining appropriate professional relationships and interaction among staff and residents, and suicide prevention. |
| Does the state require medical response training for all staff working with children in residential settings? | Yes. 22VAC40-151-250. Staff Development. Within 30 days following their begin date, all staff working with residents shall be enrolled in a standard first aid class and in a cardiopulmonary resuscitation class facilitated by the American Red Cross or other recognized authority, unless the individual is currently certified in first aid and cardiopulmonary resuscitation. |
| Does the state require 1:4 staffing ratio or higher? | No |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes. 12VAC35-46-640. Admission procedures. A. The facility shall have written criteria for admission that shall include: 1. A description of the population to be served; 2. A description of the types of services offered; 3. Intake and admission procedures; 4. Exclusion criteria to define those behaviors or problems that the facility does not have the staff with experience or training to manage; and 5. Description of how educational services will be provided to the population being served. B. The facility shall accept and serve only those children whose needs are compatible with the services provided through the facility unless a child's admission is ordered by a court of competent jurisdiction. C. Acceptance of a child as eligible for respite care by a facility approved to provide residential respite care is considered admission to the facility. Each individual period of respite care is not considered a separate admission. D. Each facility shall provide documentation showing proof of contractual agreements or staff expertise to provide educational services, counseling services, psychological services, medical services, or any other services needed to serve the residents in accordance with the facility's program description as defined by the facility's criteria of admission. 12VAC35-46-710. Application for admission. B. Providers shall develop, and fully complete prior to acceptance for care, an application for admission that is designed to compile information necessary to determine: 1. The educational needs of the prospective resident; 2. The mental health, emotional, and psychological needs of the prospective resident; 3. The physical health needs, including the immunization needs, of the prospective resident; 4. The protection needs of the prospective resident; 5. The suitability of the prospective resident's admission; 6. The behavior support needs of the prospective resident; 7. Family history and relationships; 8. Social and development history; 9. Current behavioral functioning and social competence; |
| Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? | No |
| Does the State define institutional abuse and neglect? | No |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the State prohibit mail censorship? | Yes. 12VAC35-46-920. Prohibitions. 4. Delay or withholding of incoming or outgoing mail, except as permitted by other applicable state and federal regulations or by order of a court of competent jurisdiction; Interpretation of § 920.4: Federal law prohibits the tampering with another individual’s mail. Any need to limit or prohibit communication between a resident and another person would be governed by federal postal regulations. Facility personnel may withhold mail of minors if the legal guardians document their approval of or request for withholding mail. In these instances, facilities should ask the legal guardian what to do with the unopened mail. Facilities may have the resident open mail in the presence of staff when there is a concern for the resident’s safety or well-being or an indication that contraband may be concealed. Mail must be promptly given. 22VAC40-151-820. Prohibitions.4. Delay or withholding of incoming or outgoing mail, except as permitted by order of a court of competent jurisdiction; |
| Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? | Yes. 12VAC35-46-920. Prohibitions. 2. Limitation on contacts and visits with the resident's attorney, a probation officer, regulators, or placing agency representative; 3. Bans on contacts and visits with family or legal guardians, except as permitted by order of a court of competent jurisdiction; |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? | No |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | Yes. 12VAC35-46-970 Education & 22VAC40-151-860 Education - A. Each resident of compulsory school attendance age shall be enrolled, as provided in the Code of Virginia, in an appropriate educational program within five school business days. Documentation of the enrollment shall be kept in the resident's record. B. The provider shall ensure that educational guidance and counseling in selecting courses is provided for each resident and shall ensure that education is an integral part of the resident's total program. C. Providers operating educational programs for children with disabilities shall operate those programs in compliance with applicable state and federal statutes and regulations. D. When a child with a disability has been placed in a residential facility, the facility shall contact the division superintendent of the resident's home locality. Documentation of the contact with the resident's home school shall be kept in the resident's record. E. A provider that has an academic or vocational program that is not certified or approved by the Department of Education shall document that teachers meet the qualifications to teach the same subjects in the public schools. F. Each provider shall develop and implement written policies and procedures to ensure that each resident has adequate study time. |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | Yes |
| Does the state require parental consent to all treatment received? | No |
| Is a grievance procedure required for youth and families? | Yes. 12VAC35-46-1090 Grievance procedures & 22VAC40-151-980 Grievance Procedures - A. The provider shall develop and implement written policies and procedures governing the handling of grievances by residents. If not addressed by other applicable standards, the policies and procedures shall: 1. Be written in clear and simple language; 2. Be communicated to the residents in an age or developmentally appropriate manner; 3. Be posted in an area easily accessible to residents and their parents and legal guardians; 4. Ensure that any grievance shall be investigated by an objective employee who is not the subject of the grievance; and 5. Require continuous monitoring by the provider of any grievance to assure there is no retaliation or threat of retaliation against the child. |
| Is youth consent required for all treatment received? | No |
| Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? | Yes |
| Is there regulation on physical restraint? | Yes |
| Is there regulation on chemical restraint? | Prohibited |
| Is there regulation on mechanical restraint? | Prohibited |
| Is there regulation on seclusion? | Prohibited |
| General Oversight and Transparency | Department of Juvenile Justice |
| Oversight Agency | Department of Juvenile Justice |
| Which state agency oversees investigations? | Department of Juvenile Justice |
| Are investigations and outcomes visible to the public online? | No |
| Is this type of program required to be licensed by the state? | Yes |
| Is a list of licensed facilities available to the public? | No |
| Can complaints be filed online? Is the reporting portal easy to find? | No |
| Does the state conduct unannounced site visits? How many per year? | No |
| Are background checks required, including volunteers? | Yes |
| Is a full-time licensed clinician required to be on staff? | No |
| Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? | No Information |
| Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? | Yes |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | Yes |
| Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? | No |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | Yes |
| Does the state require medical response training for all staff working with children in residential settings? | Yes |
| Does the state require 1:4 staffing ratio or higher? | No. 1:10 |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes |
| Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? | No |
| Does the State define institutional abuse and neglect? | No |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the State prohibit mail censorship? | No |
| Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? | Yes |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? | No |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No Information |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | Yes |
| Does the state require parental consent to all treatment received? | No Information |
| Is a grievance procedure required for youth and families? | Yes |
| Is youth consent required for all treatment received? | Yes |
| Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? | Yes |
| Is there regulation on physical restraint? | Yes |
| Is there regulation on chemical restraint? | No Information |
| Is there regulation on mechanical restraint? | Allowed |
| Is there regulation on seclusion? | Allowed |
| General Oversight and Transparency | Department of Social Services |
| Oversight Agency | Department of Social Services |
| Which state agency oversees investigations? | Department of Social Services |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes |
| Is a list of licensed facilities available to the public? | Yes |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | No Information |
| Are background checks required, including volunteers? | No Information |
| Is a full-time licensed clinician required to be on staff? | Yes |
| Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? | No |
| Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? | No Information |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | No Information |
| Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? | No |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No Information |
| Does the state require medical response training for all staff working with children in residential settings? | No Information |
| Does the state require 1:4 staffing ratio or higher? | No. 1:10 |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes |
| Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? | No Information |
| Does the State define institutional abuse and neglect? | No |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the State prohibit mail censorship? | Yes |
| Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? | No Information |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? | No |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | Yes |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | No Information |
| Is a grievance procedure required for youth and families? | No |
| Is youth consent required for all treatment received? | No Information |
| Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? | Yes |
| Is there regulation on physical restraint? | No |
| Is there regulation on chemical restraint? | No Information |
| Is there regulation on mechanical restraint? | Allowed |
| Is there regulation on seclusion? | Allowed |
| General Oversight and Transparency | None |
| Oversight Agency | None |
| Which state agency oversees investigations? | None |
| Are investigations and outcomes visible to the public online? | No |
| Is this type of program required to be licensed by the state? | No |
| Is a list of licensed facilities available to the public? | Not Applicable |
| Can complaints be filed online? Is the reporting portal easy to find? | No |
| Does the state conduct unannounced site visits? How many per year? | No |
| Are background checks required, including volunteers? | No |
| Is a full-time licensed clinician required to be on staff? | No |
| Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? | No |
| Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? | No |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | No |
| Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? | No |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No |
| Does the state require medical response training for all staff working with children in residential settings? | No |
| Does the state require 1:4 staffing ratio or higher? | No |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | No |
| Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? | No |
| Does the State define institutional abuse and neglect? | No |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the State prohibit mail censorship? | No |
| Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? | No |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? | No |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | No |
| Is a grievance procedure required for youth and families? | No |
| Is youth consent required for all treatment received? | No |
| Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? | No |
| Is there regulation on physical restraint? | No |
| Is there regulation on chemical restraint? | No |
| Is there regulation on mechanical restraint? | No |
| Is there regulation on seclusion? | No |
| General Oversight and Transparency | Department of Behavioral Health and Developmental Services |
| Oversight Agency | Department of Behavioral Health and Developmental Services |
| Which state agency oversees investigations? | Department of Behavioral Health and Developmental Services |
| Are investigations and outcomes visible to the public online? | Yes |
| Is this type of program required to be licensed by the state? | Yes |
| Is a list of licensed facilities available to the public? | Yes |
| Can complaints be filed online? Is the reporting portal easy to find? | Yes |
| Does the state conduct unannounced site visits? How many per year? | Yes. Annually |
| Are background checks required, including volunteers? | Yes |
| Is a full-time licensed clinician required to be on staff? | Yes |
| Is parental consent required to make any changes to a child's medical or mental health treatment plan, unless an emergency? | No Information |
| Does the state require that parents be notified of an emergency involving their child within 24-hours of the incident occurring? | No Information |
| Does the state require notification within 24-hours of a program admitting, discharging or major treatment change for children under its care? | Yes |
| Does the state require that a licensed psychiatrist provide an initial mental health evaluation and to maintain detailed records of the child's care and treatment plan? | Yes |
| Does the state require mandatory child abuse response training for all staff working with children in residential settings? | No |
| Does the state require medical response training for all staff working with children in residential settings? | Yes |
| Does the state require 1:4 staffing ratio or higher? | No. 1:10 |
| Ban on Conversion Therapy for LGBTQA+ youth? | Yes |
| Are there admissions requirements? | Yes |
| Are the parents and the admitted child required to be informed of their rights, the process to report violations of those rights, and the program's role in protecting those rights before admission? | No Information |
| Does the State define institutional abuse and neglect? | No |
| Are there civil penalties for violations of institutional child abuse and neglect? | No Information |
| Does the State prohibit mail censorship? | Yes |
| Does the state require that youth have access to guardians, legal counsel, welfare advocates, religious clergy and family/friends via telephone as frequently as can be facilitated? | Yes |
| Does the state require that children be allowed visitors in private during normal visiting hours? | No |
| Is it required that youth receive individualized and appropriate mental health treatment that is evidence-based? | Yes |
| Is medical and psychological experimentation on youth prohibited without the express consent of all involved parties? | No Information |
| Is it required that youth receive education that is of the same quality and outcomes as their assigned public school? | No Information |
| Is it required that youth receive age-appropriate sexual education, access to sexual healthcare, and menstruation supplies? | No |
| Are youth provided with access to advocacy services and representation? | Yes |
| Does the state require parental consent to all treatment received? | Yes |
| Is a grievance procedure required for youth and families? | Yes |
| Is youth consent required for all treatment received? | Yes |
| Does the State have zoning and occupancy requirements for structures being used to house youth in residential settings? | Yes |
| Is there regulation on physical restraint? | Yes |
| Is there regulation on chemical restraint? | Allowed |
| Is there regulation on mechanical restraint? | Allowed |
| Is there regulation on seclusion? | Allowed |
Additional Information
Unsilenced Program Database: Virginia Programs
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