Under the definition of "serious incident", the statement "missing for any period of time" in #3 is too broad. There are numerous considerations here including the type of program, the individual's skills and abilties as they pertain to safety, the right to privacy, dignity of risk,etc., and other concerns. This regulation needs further clarification to balance the need to protect vulnerable persons with the rights of others to move freely in the community.

#4, a hospital admission is often planned as part of comprehensive medical care,e.g. sleep apnea study, observation duirng significant medication changes,etc. Scheudled or planned hospital admissions should not qualify as Level 2 Serious Incidents.

Please limit the requirement of root cause analysis to Level 2 and 3 Serious incidents. Suggest adding langauge that  Level 1 incidents be  reviewed and documented on a quarterly basis.

It is duplicative to require providers to report allegations of exploitation or theft to both Human Rights and Licensing. This is already covered and Licensure can access the CHRIS reports.

It is unreasonable to require providers to receive and review the resutls of criminal background checks prior to hire. This process currently takes weeks and even if expedited with the changes pending in the process,will not be quick enough. Prospective employees will just go elsewhere if expected to wait a month for hire.Additionally, the code of Virginia specifices that an offer of employment must be made and accepted prior to processing criminal background checks. Providers are able to discharge without legal consequence if the individual has a barrier crime based on language placed in the offer letter.Additionally, this requirment would place employers in legal jeopardy by requiring us to obtain information that legally we should not request until employment has been offered and accepted.

520C; include the "uniform risks,triggers and thresholds as defined by the Department' in the licensing regulaitons if providers are expected to comply with this. Providers will need more information and technical assistance or training from DBHDS on this.