Hello,

As a citizen of Virginia and a Licensed Professional Counselor, I would like to submit these comments in regards to the Draft DBHDS Licensure Regulations.:

Definitions:  Missing; Current proposed definition:  “ a circumstance in which an individual is at any time not physically present where and where his is expected or supposed to be.  Requirement- Level II serous incident_ An individual who is missing for any period of time

The definition of "Missing" is too broad and extremely problematic.  It is not in line with an individual’s rights.  An adult with decision making capacity has the right to be where he or she chooses without a report to the being made to the State, even if he or she changes his mind about his schedule.  If an individual knows that, if he or she agrees to the provision of services for their substance use, mental illness or developmental disorder that a report will be made to the state if he is not physically at a location where he is expected to be, this may create a barrier to agreeing to services. Adults that have decision making capacity (unless another determination has been made)  and are not required to inform their provider if they change their mind about where they intend to be.  This would be an infringement on individual’s rights as it is written.  In addition, this requirement would be unreasonable to carry out in regards to outpatient services.  The definition proposed does not outline that this is only in relation to residential or inpatient services.  Therefore, anytime and adult misses an appointment or is even late, a notification would be required to the State.  This is not reasonalbe. It is recommended that this be amended to  "Missing means a circumstance of an individual in residential or inpatient programming who has been assessed to lack decision making capacity, has a guardian or authorized representative or who has been assessed to be a danger to himself/herself is not physically present when or where he is expected or supposed to be." (or other similar language)

Article 3 105-400 E: Criminal Background Checks:There is already difficulty throughout the State in hiring qualified applicants. While adding in wording to require that the criminal history and registry checks be reviewed before hiring seems reasonable at first glance, it will have a detrimental impact on services.  After interviewing for a position, applicants who have been selected for a position cannot be asked to complete the background check and then wait lengthy periods of time before  “being hired”   Qualified applicants will surely take another job while waiting.  This will further erode the ability of programs throughlut the State to hire skilled and credentialed staff.  The requirement of a review of the background check and registry search prior to hiring will delay an already long hiring process. It will result in unfilled positions and the loss of potential employees. Change to say review the criminal history and background check regulations before being released to provide direct services to individuals.  Staff may be hired and remain in a training capacity while awaiting results..

Definitions: Serious injury- The new definition takes out that an injury is defined as an occurrence while the individual is supervised or involved in services.  Individuals who agree to services for their disability are NOT agreeing to all aspects of their life being reportable to a State agency.  It could easily be seen as a violation of their rights as an individual that their medical information is required to be reported (even against their will) .  Just because someone signs up for services at the a program , that should not give the program the right (requirement)  to make reports to a State entity if he is in a car accident or accidently sprains his ankle if that has no association at all with a program or service. This is an over step regarding reporting that can easily be a barrier to an individual agreeing to services.

Definition Recovery- The section on substance use can be seen as discriminatory.  While recovery for individuals with mental illness is described as a "Journey of healing and transformation enabling an individual with a mental illness to live a meaningful life in the community or his choice", "Substance abuse recovery is “Incremental” leading to positive “social change” … As we continue to fight stigma in light of the opioid epidemic and want individuals to seek help and recovery, it is especially important that state documents and regulations  includes wording that is positive and cannot be seen as discriminatory. Recommend combining to say something similar to

“Recovery is a journey of healing and transformation enabling an individual to live a meaningful life in the community reflective of healthy functioning in accordance with his/her goals”

Thank you for your consideration of these important issues.