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What are the requirements of this waiver assurance, cont'd?

A state must provide training and/or information to participants or their informal caregivers concerning protections from abuse, neglect and exploitation. Training must include information on how to notify appropriate authorities. As part of its HCBS waiver application to CMS, a state must specify the entity responsible for providing training and/or information and the frequency of training.

A state must identify the entity responsible for reviewing:

  • How well the reporting system is working,

  • The type and frequency of methods used to determine if critical incidents are being properly reported and investigated, and

  • If data are being effectively used to prevent re-occurrence of incidents.

When this oversight function is not done by the state Medicaid Agency, the state must describe the process for communicating findings to the state Medicaid Agency and/or operating agency.

Most states have laws requiring that cases of alleged abuse, neglect and exploitation be reported to Child or Adult Protective Services. Nothing under the HCBS waiver changes this fundamental legal responsibility. However, in its HCBS waiver application, a state must identify processes for coordinating activities with Protective Services. Specifically, in cases involving HCBS waiver participants, the HCBS waiver must show how agencies work together to investigate and address incidents, and prevent their reoccurrence.

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