Home and Community Based Services Waiver
Guidance Document
Division of Children and Families

Policy

ICC Agency HCBS Monitoring and Evaluation Overview

Evaluation and monitoring of the HCBS Waiver Program is mandated by the federal government and the NYS Legislature to examine the efficacy and cost effectiveness of the program. ICC Agencies are required to routinely submit data to the OMH for monitoring and evaluating purposes.

Systematic evaluations focusing on child and family outcomes are completed within prescribed timeframes. Various instruments are utilized for this purpose including annual family and youth satisfaction surveys, the Admission Record, Six-Month Follow-Up and Child Discharge forms.

Another measurement utilized is the CANS MH Level of Care Rating Form from which data is compiled to evaluate treatment outcomes. Additionally, specific agency reports are monitored and data maybe summarized by OMH to assist in evaluating financial efficiency as well as service utilization and effectiveness.

The wide range of reports and instruments used to evaluate the HCBS Waiver Program look at multiple aspects of the program.  The following represents a sampling of areas evaluated:

Child and Family Outcomes:

• evidence of strength-based Individualized Care in each life domain;
• child level of recovery and changes in level of care per CANS MH Level of Care Rating Form; services supporting the family and sufficiency of supports;
• precipitating factors for admission into an RTF or inpatient care; and
• gaps in services.

Family Satisfaction:

• appropriateness;
• sensitivity;
• access;
• participation;
• effectiveness;
• and global satisfaction.

System Factors:

• the number of children and the geographic distribution of those participating in the HCBS Waiver;
• health and mental health profiles;
• utilization and costs of Waiver program services;
• savings achieved by avoiding placement in residential treatment facilities and inpatient facilities operated by OMH;
• the length of time children are enrolled in the HCBS Waiver;
• the utilization of waiting lists for the HCBS Waiver and for services  in RTF's, where appropriate;
• patterns of hospitalization and outcomes for children who have been  hospitalized;
• flex dollar expenditures;
• follow-up data on children who are disenrolled from the HCBS Waiver, including data on residential program placements; and
• discharge outcomes.

ICC Agency Site Visits

OMH ICC Agency Site Visits
In addition to demographic, clinical and fiscal reports, a site visit is conducted annually for each ICC Agency by a team of reviewers led and organized by the Regional Field Coordinator. The LGU, or designee, and OMH staff may also participate. As part of the site visit, the OMH Parent Advisor evaluates parent and youth satisfaction. The annual site visits follow specific guidelines set by the OMH to assure that the ICC Agency is adhering to the philosophy and all requirements of the HCBS Waiver Program. Site Visits include examination of all topics listed in the Site Visit Summary Form. If a program is deficient in any of these requirements, corrective actions are identified and the agency is formally notified within 30 days of the site visit.

Corrective Action Plans
The Field Coordinators forward copies of the  Site Visit Summary Form, with corrective actions noted to the agency and  to the OMH HCBS Waiver Program for review. The ICC Agencies must submit a plan of corrective actions to the Regional Field Coordinator within 30 days of receipt of the Site Visit Summary, using the OMH approved Corrective Actions Plan form. A copy of the agency's corrective action plan is forwarded by the Field Coordinator to OMH HCBS Waiver Program with a copy of the Field Coordinator's letter of approval of the plan. The Field Coordinator monitors implementation of the corrective action plan and provides technical assistance as needed.

NYS Department of Health (DOH) Audits
The NYS Department of Health is required to complete an annual audit of a sample consisting of 10% of the total HCBS Waiver caseload. The ICC Agencies provide copies of case records as requested by the DOH for this purpose. The DOH generates a summary with corrective actions noted. The ICC Agency completes the Corrective Action Plan using the OMH format and submits it to the OMH Field Coordinator within 30 days of receipt. The Field Coordinator forwards these to the HCBS Waiver Program. Technical assistance is provided as indicated.

Comments or questions about the information on this page can be directed to the Home and Community Based Waiver Program.