Health Reform WK-EDGE Best practices to correct ‘systemic’ safety risks in group homes
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Wednesday, January 31, 2018

Best practices to correct ‘systemic’ safety risks in group homes

By Dietrich Knauth

Systemic failures found in group homes providing care for the disabled in Maine, Massachusetts, and Connecticut, indicate the problem is likely even more widespread, the Office of Inspector General (OIG) concluded in a report. In three of the four states it audited, the OIG found that group home beneficiaries are at risk of serious harm, because the states did not ensure that safety policies and procedures were followed (OIG Report, January 17, 2018).

The model practices recommended by OIG cover incident management and investigation, state-level incident management audits, state mortality reviews, and quality assurance for Medicaid-funded services. OIG undertook its initial review of group home safety in response to a 2012 congressional inquiry into deaths and abuse of individuals with developmental disabilities who lived in group homes.

Recommendations. The OIG recommended that CMS, which administers the Medicaid Home and Community-Based Services Waiver (HCBS) program that allows states to provide group home care for Medicaid beneficiaries, to take a more proactive role in overseeing state programs. The OIG also recommended that CMS provide guidance to improve states' compliance oversight programs, form a "SWAT" team to address systemic problems in state health and safety oversight, and take action to correct serious health and safety concerns, using its authority to issue and revoke waivers for the group home services under the HCBS program.

The new recommendations, developed in concert with the Department of Justice and HHS's Administration for Community Living and Office for Civil Rights, seek to provide the federal government and states with best practices for reporting, recording, and investigating incidents that result in serious injury to disabled people living in Medicaid-funded group homes.

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