Methods of Data Collection
The Minnesota Department of Human Services (DHS) initiated the Lead Agency Review of Home and Community Based Service (HCBS) programs in 2006 and has, to date, completed three full rounds of reviews for each lead agency that administers HCBS waiver programs. The six HCBS programs examined during the review are:
- Alternative Care (AC) program
- Brain Injury (BI) waiver
- Community Alternative Care (CAC) waiver
- Community Access for Disability Inclusion (CADI) waiver
- Developmental Disabilities (DD) waiver
- Elderly waiver (EW)
This evaluation process uses a comprehensive, mixed-method approach to review data, much of which is gathered during a multiday site visit. These methods are intended to provide a full picture of compliance, context and practices within each lead agency, and further explain how individuals benefit from the HCBS programs. Once the final analysis is complete, a customized report is prepared for each lead agency. The data collection methods are intended to glean supporting information, so that when strengths, recommendations or corrective actions are issued, they are supported by multiple sources.
The fourth round of reviews will take place from 2019 to 2023. Many aspects of this review process will remain the same, including: a review of participant case files, interviews and meetings with agency leadership, focus groups with lead agency case managers and assessors, and a survey taken by lead agency staff working with HCBS programs.
Enhancements to the review process for round four include an increased focus on each lead agency’s:
- Community access and inclusion for persons with disabilities, specifically in the area of housing, in accordance with Minnesota's Olmstead Plan;
- Access to integrated, competitive community employment;
- Addressing equity disparities that may exist in the community.
The overarching goal of the HCBS Lead Agency Review is to determine how HCBS programs are operating and meeting the needs of the people they serve. This evaluation process helps DHS assure compliance by counties and tribes in the administration of HCBS programs, share performance on key measures and outcomes, identify best practices to promote collaboration between lead agencies, and obtain feedback about DHS resources to prompt state improvements.
The HCBS Lead Agency Review supports the missions of the DHS administrations of Continuing Care for Older Adults (CCOA) and Community Supports (CSA). It also helps to ensure that long term care services and supports continue to improve the quality of life of Minnesotans and are sustainable over time.
Data Collection Sources and Methods
The Home and Community Based Services (HCBS) Lead Agency Review uses several methods and sources to conduct a comprehensive evaluation of Home and Community Based Service programs in each lead agency. This mixed method approach helps to provide a full picture of compliance, context and practices within each lead agency, and further explain how individuals benefit from the HCBS programs. Although each data source provides unique information, when fully complied, the data collection methods provide supporting information. When strengths, recommendations or corrective actions are issued, they are supported by multiple sources of data.
Data source and purpose:
- Lead agency performance summary data (MMIS/MAXIS) — Compares each lead agency to statewide averages and those of similarly sized agencies for select performance and operational indicators gathered from DHS systems.
- Individual case files — Identifies compliance with program requirements for AC, BI, CAC, CADI, DD, EW, the Jensen settlement agreement and Positive Support Transition Plans. Assesses the quality of case management services provided by the lead agency.
- Lead agency survey — Gathers feedback from the directors, managers, supervisors, case managers and assessors on the lead agency's strengths, areas for improvement, and relationships with HCBS providers."
- Case manager and assessor focus group — Discusses trends, barriers and opportunities within the community and explores practices that produce positive outcomes.
- Supervisor phone interview(s) — Discusses agency policies and procedures for HCBS Waiver program administration.
- Supervisor meeting — Shares results from Provider survey, Case manager and Assessor survey, and HCBS Assurance Plan, and also discusses service development and programmatic changes.