HCBS Lead Agency Review

Minnesota Department of Human Services initiated the lead agency review of home and community-based service (HCBS) programs in 2006 and has, to date, completed four full rounds of reviews for each lead agency (county or tribal nation) that administers HCBS waiver programs. It examines all six HCBS programs in each lead agency:

• Alternative Card (AC) program
• Brain Injury (BI) waiver
• Community Alternative Care (CAC) waiver
• Community Access for Disability Inclusion (CADI) waiver
• Developmental Disabilities (DD) waiver
• Elderly waiver (EW)

Each review includes: 

• Surveys of all lead agency staff and leadership
• Focus groups with lead agency case managers and assessors
• Interviews and meetings with agency leadership
• Review of case files from each program
• Operational performance summaries

Minnesota Department of Human Services shares performance measures and operational indicators during the HCBS lead agency review. These data allow lead agencies to compare themselves to other cohort agencies (PDF) of a similar size on how they meet the needs of their community. DHS reports its findings to the Center for Medicare and Medicaid Services, Minnesota Olmsted Implementation Office, and state and community partners.

The Lead Agency Review is driven by federal and state policies and protocols, including: 

• The Centers for Medicare & Medicaid Services (CMS) Federal HCBS Rule Changes (PDF) and Factsheet on Home and Community Based Services Rule (PDF) - regulations governing HCBS for all states, explicitly for the following three Medicaid programs: waivers, state plan, and community first choice. These are requirements for the person-centered planning process and for the person-centered plan within HCBS. They reflect CMS's intent to ensure that individuals receiving services and supports through HCBS programs and add protections for individuals receiving services. 
• Minnesota Statute 245D - the licensing standards for all HCBS in Minnesota. 
• Minnesota's Olmsted Plan - a series of key activities our state must accomplish to ensure people with disabilities are living, learning, working , and enjoying life in the most integrated setting. 
• Person Centered, Informed Choice, and Transition Protocol - The protocol requires lead agencies to provide people with increased choices and opportunities for community inclusion and provides guidance for support planners as to what is a good practice and what is expected. 

Once DHS completes the final analysis, we will prepare a customized report for each lead agency. We will make both this report and the lead agency’s corrective action plan (if applicable) public. 

Reports and corrective action plans are available for the following reviews: 

Round 4 — April 2019 to August 2023 > | Round 5 Schedule >