HCBS Waiver Critical Incident Reporting

Health First Colorado (Colorado's Medicaid program) is a health care program for low income Coloradans. A waiver is an extra set of Health First Colorado benefits that you can qualify for in certain cases. Home and Community Based Services (HCBS) Waiver services complement and/or supplement the services that are available through the Medicaid State plan and other Federal, state and local public programs as well as the supports that families and communities provide to individuals. These benefits can help an individual remain in your home and community and, thereby, avoid institutionalization.

A critical incident is an actual or alleged event that creates the risk of serious harm to the health or welfare of a client receiving Health First Colorado benefits. A critical incident may endanger or negatively impact the mental and/or physical well-being of a client.

Critical Incidents include, but are not limited to: Death, Mistreatment/Abuse/Neglect/Exploitation, Injury/Illness to Client, Damage to Consumer's Property/Theft, Medication Management Issues, Criminal justice involvement/incarceration, Missing Person, Unsafe housing/displacement and others.

When a critical incident occurs involving an HCBS waiver participant, a report must be made to the case manager of the case management agency that is coordinating the care for the waiver participant. The case manager must report the critical incident within one business day of notification of the incident. The critical incident will be entered into the State Benefits Utilization System (BUS). Critical incidents can be reported to the case manager by home health agencies, caregivers, law enforcement, participants and their family.

 

CIRs Updates/Projects

 
Category Short Description Date Reported Status Additional Attachments
Critical Incident Training Series Memo HCPF IM 20-056 Informational Memo 12/02/2020   Critical Incident Training Series Memo
Critical Incident Fatal Five Details the top five disorders linked to preventable death 11/10/2020   CIR Fatal Five Module
Critical Incident Enter a CIR Critical Incident steps to enter a Critical Incident in the BUS 11/10/2020   Enter a CIR Module
Critical Incident Root Cause Critical Incident steps to determining the Root Cause of the Critical Incident 10/16/2020   CIR Root Cause Module
Critical Incident Follow-up Critical Incident Follow-up guidelines and examples 10/16/2020   CIR Follow-up Module
Critical Incident Reporting BUS Update HCPF OM 20-085 Operational Memo 08/26/2020  

Critical Incident Reporting BUS Update Memo

CIRS/BUS Update Training Tool

 

Critical Incident Forms and documents

 
Title Short Description Additional Attachments
Critical Incident Report Frequently Asked Questions Critical Incident Report FAQ's Critical Incident Report FAQ's
Service Provider Critical Incident Reporting form Used to notify waiver case manager of a Critical Incident Service Provider CIRS Form
Service Provider Critical Incident Follow-up Reporting form Used to notify waiver case manager of a Critical Incident Follow-up Service Provider CIRS Follow-up Form
 
 

CIRs Guides and Definitions

The following guides and definitions have been created to help you properly report critical incidents in the BUS.

Title Short Description Additional Attachments/Links
Critical Incident Reporting Technical Guide Guide for entering CIRS in the BUS updated Nov 2018 CIRS Technical Guide
CIRS Agency Administrator Reporting Technical Guide Guide for Agency Administrator BUS Reports CIRS Agency Administrator Reporting Technical Guide
CCB Critical Incident Reporting Requirements CCBCIRS reporting requirements CCB Critical Incident Reporting Requirements
DD Mistreatment Definitions DD Mistreatment terminology definitions DD Mistreatment Definitions
 

CIRs Webinars

The following webinars are available for your review to help you properly report critical incidents in the BUS.

Title Short Description Additional Attachments
Incident Management and Prevention Strategies Training Webinar This training is required for Case Managers at Community Centered Boards, Single-Entry Point agencies, and Children's HCBS Case Management Agencies, as well as all enrolled HCBS Provider Agencies that provide any HCBS waiver service Webinar Link
Incident Management and Prevention Strategies Training Webinar PowerPoint PowerPoint slide deck for the Incident Management and Prevention Strategies Training Webinar Webinar PPT
Fatal Five Overview Fatal Five disorders document referenced in Incident Management and Prevention Strategies Training Webinar Fatal Five Overview
Critical Incident and Mistreatment Participant Education Reporting Webinar Training for case managers and Case Management Agency staff on state prescribed tools for case managers to provide participant education about CIRs Webinar Link
 

CIRs Training Modules

The following training modules have been created to support your Agency's proper reporting of critical incidents in the BUS.

Title Short Description Additional Attachments/Links
Critical Incident Enter a CIR Critical Incident steps to enter a Critical Incident in the BUS Enter a CIR Module
Critical Incident Follow-up Critical Incident Follow-up guidelines and examples CIRS Follow-up Module
Critical Incident Definition Critical Incident Definition and examples CIRS Definition Module
Critical Incident Timeliness Critical Incident Notification and Follow-up Timeliness guidelines CIRS Timeliness Module
Critical Incident Fatal Five Details the top five disorders linked to preventable death CIR Fatal Five Module
Critical Incident Substantiated Definition Critical Incident Substantiated Definition and examples CIRS Substantiated Definition Module
Location of Critical Incident Location of Critical Incident details required for Critical Incident Reports and where this information is located in the BUS CIRS Location of Incident Module
Critical Incident Root Cause Critical Incident steps to determine the Root Cause of the Critical Incident CIR Root Cause Module
Critical Incident Details Incident details needed to complete a Critical Incident Report CIRS Incident Details Module
Editing and Deleting a Critical Incident Report How and when Critical Incidents Reports can be edited or deleted in the BUS CIRS Editing and Deleting a Critical Incident Report Module
Agency Administrator Reports Agency Administrator guide for pulling critical incident report data from the BUS

Agency Administrator Reports Module

 

CIRs Participant Information

 
Category Short Description Status Additional Attachments
Critical Incident and Mistreatment Participant Reporting QUICK Guide Guide for critical incident and mistreatment participant reporting 08/01/2019 Critical Incident and Mistreatment Participant Reporting QUICK Guide
Critical Incident and Mistreatment Participant Reporting QUICK Guide - Audio Audio Guide for critical incident and mistreatment participant reporting 09/04/2019 Critical Incident and Mistreatment Participant Reporting QUICK Guide - Audio
Critical Incident and Mistreatment Reporting Participant Education and Contacts Critical incident and mistreatment participant education and contacts 08/01/2019 Critical Incident and Mistreatment Reporting Participant Education and Contacts
       

 

CIRs Archived Memos

The following CIRs memos have been archived for your reference after issue resolution.
 
Category Short Description Date Archived Additional Attachments
Incident Management and Prevention Strategies Memo HCPF IM 20-030 Informational Memo 06/30/2020 Incident Management and Prevention Strategies Memo
Critical Incident Reporting for Covid-19 HCPF OM 20-022 Operational Memo 04/23/2020 Critical Incident Reporting Covid-19 Memo
Critical Incident Training Series HCPF IM 19-057 Informational Memo 03/18/2020 Critical Incident Training Series Memo
CIRS Mistreatment Participant Education HCPF OM 19-038 Operational Memo 03/18/2020 CIRS Mistreatment Participant Education Memo
Critical Incident Report BUS Email Notifications CIRS/BUS Email Notification Issue 03/18/2020 CIRS/BUS Notification Issue Memo
CIRS Children's Extensive Supports Waiver Timely Reporting HCPF OM 18-019 Operational Memo 07/30/2019 CIRS CES Timely Reporting Memo
CIRS email address HCPF IM 19-045Informational Memo 07/29/2019 CIRS General Email Address Memo
CIRS update in the BUS CIRS Roles and Responsibilities 07/08/2019 CIRS/BUS Memo
CIRS update in the BUS Several CIRS updates and changes to the BUS 10/15/2018 CIRS Update Release Memo
CIRS update in the BUS Secondary email address added to Critical Incident Follow-ups 10/09/2018 Secondary Email Address CIRS Memo

CIRS update in the BUS

DD Waiver Critical Incidents will be entered in the BUS

10/09/2018

CIRS/BUS Memo

CIRS Issues in the BUS

Print function not working, Elderly Abuse reminder and future dates

10/09/2018

CIRS/BUS Memo
CIRS Overdue Reports CIRS Overdue Report data is invalid 10/09/2018 CIRS Memo
CIRS emails CIRS Agency Quality person instructions 05/25/2018 CIRS Memo
CIRS update in the BUS APS/CPS question added to the BUS 06/29/2017 CIRS Memo
CIRS update in the BUS Edit/Delete functions added to the BUS 04/20/2016 CIRS/BUS Memo
CIRS update in the BUS Restrictive Intervention section added to the BUS 05/05/2015 CIRS Restrictive Intervention Memo

 

Contact Us

General CIRs email inquiries: HCPF_CIRs@state.co.us