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 member receiving Health First Colorado benefits. A critical incident may endanger or negatively impact the mental and/or physical well-being of a member.
Critical Incidents include, but are not limited to: Death, Mistreatment/Abuse/Neglect/Exploitation, Injury/Illness to Member, 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 |
|---|---|---|---|---|
| Substance Abuse Signs and Symptoms | Substance abuse, signs and symptoms training | 07/28/2022 | Substance Abuse Signs and Symptoms Module | |
| Suicidal Ideation and Prevention | Suicidal Ideation warning signs and Prevention strategies | 02/17/2022 | Suicidal Ideation and Prevention Module |
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 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 |
|---|---|---|
| Substance Abuse Signs and Symptoms | Substance abuse, signs and symptoms training | Substance Abuse Signs and Symptoms Module |
| Critical Incident Definition | Critical Incident Definition and examples | CIRS Definition 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 |
| Suicidal Ideation and Prevention | Suicidal Ideation warning signs and Prevention strategies | Suicidal Ideation and Prevention Module |
| Critical Incident Details | Incident details needed to complete a Critical Incident Report | CIRS Incident Details 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
| Category | Short Description | Date Archived | Additional Attachments |
|---|---|---|---|
| Critical Incident Reporting Memo | HCPF IM 21-043 Informational Memo | 07/07/2022 | Critical Incident Webpage Update Memo |
| Critical Incident Training Series Memo | HCPF IM 20-056 Informational Memo | 07/07/2022 | Critical Incident Training Series Memo |
| Incident Management and Prevention Strategies Memo | HCPF IM 20-030 Informational Memo | 06/30/2020 | Incident Management and Prevention Strategies Memo |
Contact Us
General CIRs email inquiries: HCPF_CIRs@state.co.us