Health and Welfare in Self-Directed Home- and Community-Based Services (HCBS): Environmental Scan

MACPAC conducted an environmental scan of three states to better understand the strategies states employ to ensure beneficiary health and welfare in self-direction and how those strategies compare to or align with existing federal policy. Staff found that all states have policies and procedures in place to protect beneficiary health and welfare in self-direction, often employing safeguards beyond what is required in federal statute and regulation. These safeguards include policies on incident management and reporting, monitoring service delivery and expenditures for risk detection, representatives, mandatory disenrollment and continuity of care, HCBS provider standards, and program integrity and quality oversight. Staff presented these findings from the environmental scan for the Commission's input.