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Assurance 4 - Health and Welfare

Participants are protected from abuse, neglect and exploitation and get help when things go wrong or bad things happen.

This assurance emphasizes the role of HCBS waivers in reporting, investigating, and resolving serious incidents which include, at a minimum, cases of abuse, neglect and exploitation.  (click here for more information about abuse, neglect and exploitation)

What are the requirements of this HCBS waiver assurance?

A state must have a system for reporting and investigating critical events including, at a minimum, cases of abuse, neglect, and exploitation. The system must describe:

  • The definition of critical events that must be reported.

  • The identification of individuals/entities that must report critical incidents.

  • The timeframes within which the critical event must be reported.

  • The method of reporting (e.g., phone, written form, web-based reporting system).

  • The entity (or entities) that receives reports of each type of critical event or incident.

  • The entity that is responsible for evaluating reports and how reports are evaluated.

  • The entity that is responsible for conducting investigations and how investigations are conducted.

  • The timeframes for conducting an investigation and completing an investigation.

  • The process and timeframes for informing the participant (or the participant’s family or legal representative as appropriate) and other relevant parties (e.g., the HCBS waiver providers, licensing and regulatory authorities, the HCBS waiver operating agency) of investigation results.
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