Virginia Regulatory Town Hall View Comments

Department of Behavioral Health and Developmental Services

State Board of Behavioral Health and Developmental Services

Guidance Document Change: This guidance is intended to clarify the reporting requirements to the Office of Human Rights (OHR) for peer-on-peer aggressions that occur in licensed or DBHDS-funded community provider settings. It is intended to supersede guidance dated June 15, 2017, entitled “Office of Human Rights Peer-to-Peer Reportable Incidents.” The impetus for clarification was a comprehensive review of neglect data entered by providers in the DBHDS Computerized Human Rights Information System (CHRIS), and collaborative conversations with key stakeholders.

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5/22/23 4:45 pm

Commenter: Anonymous

Peer

The letter notes the 24 hour time frame for reporting. This is an undue burden on providers and creates needless citations. The reporting requirement at 48 or 72 hours provides the following benefits:
1. Allows for a full discussion/narrative without having to go back into CHRIS or have someone from IMU call to gain clarification
2. Allows providers to focus on youth, program, staff, and ensuring safety without having to worry about getting a report in on time
3. IMU division is a monitoring division only. It does not provide support or services to aid providers. The need for 24 hour reporting to such a division provides not benefit to youth or anyone in a program setting.
4. IMU staff are not present on weekends or holidays—what is the reason for using such reporting when the IMU staff are not even reviewing any documentation until they return to office
5. Providers, for the most part, are aware of their reporting requirements and are trying to balance staffing, safety, and reporting. Allow providers the opportunity to prioritize safety before paperwork

The letter notes staff names need to be entered into the CHRIS system. On its face, this seems like a punitive measure that could be utilized by any agency against staff. Various staff at IMU have noted the staff names are not used anywhere—so why do they need to be entered into the system? I am aware of the departments memo outlining the reasons the department has given for their authority to require a staff name. An alternative view is that this policy is a violation of staff’s basic rights.
1. Increasingly law enforcement and CPS are asking for the results of investigations done by providers when these entities are involved in a case. What stops these entities from requesting information from the CHRIS system regarding other “founded’ human rights issues? Is this not an issue that could impact a staff person’s rights?
2. The staff at IMU consistently note that staff names are not used in any way. Then why are providers required to enter this? Again this seems unfair to the staff person who now has their name in a statewide system.

This phrase “Three or more incidents of peer-on-peer aggression involving the same peers within seven-day timeframe.”
1. Does this mean all the same peers? What if one of the peers involved in one incident was involved in another but not anyone else? How is this measured? All the same peers?

This phrase, “Incidents of peer-on-peer aggression that are determined to be reportable after a review by the provider shall be entered in CHRIS within 24 hours of this determination.”
1. What happens when IMU obtains a SIR from DBHDS and disagrees with the providers assessment of the situation? Is the provided then penalized for not reporting? Given citation for late reporting?
2. How are providers ensured that their decision will be honored by the IMU and that citations will not be given for late reporting?

“Emotional harm may be evidenced by documented changes in the individual’s behavior (i.e., becoming more withdrawn, avoidance of peer(s), or clinical documentation from a qualified professional)”
1. How are providers supposed to measure “emotional harm”? We work with youth who have trauma and other issues. How are we to measure this in any demonstrable way?
2. All of the things listed are things seen daily among youth in the program. General mental health shows these behaviors.
3. This element should be removed. Not because it is not important but because there is no demonstrable way to prove this occurred based on staff or program shortcomings.

CommentID: 217021