The requirement to report level II and III serious incidents and human rights in CHRIS on weekends and holidays is unnecessary and an unfunded burden to all providers.  DBHDS does not review incidents on Saturdays, Sundays, or holidays, and therefore doesn’t have the same expectations on themselves nor the same budgetary burdens to pay staff on weekends /holidays and/or overtime. If it were urgent for DBHDS to review, then DBHDS should be reviewing within 24 hours also. The requirement to enter such reports should be changed from within 24 hours to “within 24 hours or as soon as possible the next business day.”

Sanctioning four late reports for a licensed service in a two-year period does not increase compliance, competency, or prevention.  In rural areas where we have large service areas, 30 facilities, and 750+ employees, this allows for no actual prevention efforts, only sanctions. For example, we can have an outpatient therapist in Galax report the ER visit of an individual late, then 15 months later, another outpatient therapist in Marion with a different supervisor in a building 70 minutes away, report learning of the expected death of an individual late, and be cited by this standard. In the past 18 months, any time we have had a late report, the staff person is provided documented supervision.  In 18 months, we have had zero repeat offenses of late reporting by the same staff person; so, we find this more effective, as opposed to sanctioning an entire service.  It is an unfair standard for large entities compared to small providers who have small numbers of staff and fewer opportunities for human error.  Staff are focused on the care of individuals.  We recommend that a percentage for compliance be established to take into account the variety of variables across our provider system.  We would also recommend that the "reset" be annually, not every two years.

It is concerning that these expectations went into effect prior to the opening of the public comment period, which implies that the public comments will not have a significant impact on the final requirement.