Thank you for the opportunity to comment on the Emergency Regulations.  

Definitions: Group Home "in a community-based home having eight or fewer residents that provides 24-hour supervision by persons in direct care positions who do not live in the home."  Most Group Homes have moved away from live-in staff members, but there may be incidences in which live-in supports would be appropriate.  

Serious Incidents--The use of missing using the term "any "in the definition is problematic.  Many individuals are capable of time away and have the freedom to leave their homes to access the community.    The definition should reflect a serious elopement so as to avoid reporting every time a staff member does not know the exact location of an individual.

---“All hospital admissions” should be clearly defined as an unplanned admission to differentiate it from planned surgeries, procedures, and medical care as prescribed by a doctor.

----A root-cause analysis should be required for Level II and III, but the quarterly review of the Level 1 should be adequate.   Adding a requirement for a quarterly report and review of level 1 incidents would assist the provider is determining any patterns which need to be addressed.

Under 400—The section indicates that the criminal background check report needs to be available prior to hiring.  Under the Code of Virginia, the background checks are to be submitted after a job has been offered and accepted.  If the job has not been offered and accepted prior to completing the fingerprinting and submission form, employers are being told to ask for information they are not yet legally entitled to request.   In addition, it often takes as much as 6 weeks for the report to be returned to the employer.  With the severe shortage of applicants and DSPs this is a huge deterrent to hiring and will worsen the staff shortages across agencies.   People applying for DSP and other positions in the IDD world will not be able to deter employment for 6 weeks.  Even if the time for the report’s return is shortened, the gap from hire to work will cause great damage to the employee and the agency and may risk the quality of support to the individuals.   

Under 520C---“This process shall incorporate uniform risk triggers and thresholds as defined by the department.”  This language is unclear and the expectations of the DBHDS need to be clearly defined and providers trained in expectations if this language stands in the final regulations.