Reviews conducted by BQIS
For the original publication, please click here. The following is a text version of the original publication.
To: Division of Disability and Rehabilitative Services Waiver Providers
From: Shelly Thomas, Assistant Director, Bureau of Quality Improvement Services
Re: Reviews conducted by BQIS
Date: October 31, 2013
The Bureau of Quality Improvement Services (BQIS) has refocused our approach in conducting compliance reviews and complaint investigations. The primary focus of these activities is to assess consumer outcomes and safety as well as compliance with 460 IAC Article 6. All requirements outlined in 460 IAC Article 6, the DDRS’ Waiver Manual, DDRS’ approved Home and Community Based Services (HCBS) Waiver applications, as well as all state and federal regulations are still important and required. Below are detailed descriptions of the approach BQIS will utilize.
Revised Version of Compliance Evaluation Review Tool (CERT)
On November 1, 2013, BQIS will implement a revised version of the Compliance Evaluation and Review Tool (CERT) for provider compliance reviews. Independent of accreditation status, all new providers will be reviewed with this tool within 12 months of their initial approval as a Home and Community Based Services (HCBS) Waiver Provider. All existing providers approved to deliver services under the FSW and/or CIHW receive provider compliance reviews (with the CERT) that take into account their accreditation status and covered services. Providers with some accredited services, but not all, will have the non- accredited services reviewed using this tool. Providers that are fully accredited are exempt from a CERT review.
In addition to the streamlined tool, BQIS is amending its approach in conducting these reviews:
Complaints will have three categories of citations:
BQIS REVIEW APPEAL PROCESS
Appeal of Citations
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