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This report focuses on the current system for critical incident reporting and tracking within long-term care waiver programs. It also includes recommendations from stakeholders on a definition of critical incident and emergency backup, policy recommendations for new mechanisms that would more appropriately address the needs of consumers, and outlines an implementation plan for new critical incident management mechanisms and statewide emergency backup infrastructure.

The Colorado Department of Health Care Policy & Financing contracted with an independent consultant to organize and facilitate six focus groups with consumers of Medicaid waiver services, family members or representatives, and consumer-directed program participants. The focus groups discussed consumer experiences with existing emergency backup and critical incident management systems and identified strengths and potential weaknesses. This report provides results from the focus groups.

Recommendations for a Research Agenda on Asset Development for People with Disabilities-Previous work indicates that people with disabilities have significantly fewer assets than people without disabilities. Research suggests that individuals in lower income tiers are able to save and that holding assets has a positive relationship with personal well being, economic security and community involvement. This paper recommends four significant areas in developing a research agenda.

This paper outlines some of the factors program managers may need to consider in identifying strategies for integrating information to support their quality improvement activities. The focus of this paper primarily is on synthesizing information from different data sources and integrating two or more files. For the more technically minded, the Appendix provides examples of states system integration efforts.

This paper walks through different types of HCBS waiver reports and includes steps for thinking through the purpose, content and format, while tailoring report presentation to meet the needs of specific audiences. Wherever possible, state examples are provided and supplemented by sample reports that combine promising features. Seven types of reports are highlighted that guide program management, inform policy development, measure program outcomes and identify areas for quality improvement.

Presenting numbers and patterns is a critical component of data analysis. Once analyses have been completed, the next step involves sharing key findings with staff and stakeholders and using findings as a basis for decision-making. There are a number of ways to present data and the challenge is in constructing an effective visual. This paper provides an overview of the most frequently used formats and includes tips on how to select among the different types.

What do program managers need informed about with data quality management? Many rely on technical staff to actually conduct the technical aspects of data import, cleaning and analysis. Nevertheless, it is important for a program manager to understand the process and to provide the time and resources necessary to produce reliable and accurate data. This paper focuses on ways to assure the accuracy, discusses tools for analyzing trends and patterns and provides tips on interpreting results.

What applications can states use to measure home and community based services? The purpose of this report is to outline the key components of performance measurement and to discuss their relevance and potential use in HCBS.The paper also offers practical approaches for states to gradually build a HCBS performance measurement set to serve as the foundation for their quality management activities and CMS required reporting.

With this funding for Systems Transformation, CMS will be awarding several states and non-profit agencies with small supplemental grants. States and other eligible organizations, in partnership with their disability and aging communities, may submit proposals to design and construct systems infrastructure that will result in effective and enduring improvements in community long-term support systems.

Gathering information from waiver participants can be costly and time intensive, and is not always necessary. Depending upon the size and scope of the state’s waiver program, it is often sufficient and more cost effective to draw representative samples. This guide is designed to provide states with practical information about sampling techniques, what to consider when deciding whether to sample and the strategies to employ in quality management work.