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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

CategoryShort DescriptionDate ReportedStatusAdditional Attachments
Substance Abuse Signs and SymptomsSubstance abuse, signs and symptoms training07/28/2022 Substance Abuse Signs and Symptoms Module
Critical Incident Reporting COVID-19 MemoHCPF OM 22-03707/06/2022 Critical Incident Reporting COVID-19 Memo
Suicidal Ideation and PreventionSuicidal Ideation warning signs and Prevention strategies02/17/2022 Suicidal Ideation and Prevention Module

Critical Incident Forms and Documents

TitleShort DescriptionAdditional Attachments
Critical Incident Report Frequently Asked QuestionsCritical Incident Report FAQ'sCritical Incident Report FAQ's
Service Provider Critical Incident Reporting formUsed to notify waiver case manager of a Critical IncidentService Provider CIRS Form
Service Provider Critical Incident Follow-up Reporting formUsed to notify waiver case manager of a Critical Incident Follow-upService 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.

TitleShort DescriptionAdditional Attachments/Links
Critical Incident Reporting Technical GuideGuide for entering CIRS in the BUS CIRS Technical Guide
CIRS Agency Administrator Reporting Technical GuideGuide for Agency Administrator BUS ReportsCIRS Agency Administrator Reporting Technical Guide
CCB Critical Incident Reporting RequirementsCCBCIRS reporting requirementsCCB Critical Incident Reporting Requirements
DD Mistreatment DefinitionsDD Mistreatment terminology definitionsDD Mistreatment Definitions

CIRs Webinars

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

TitleShort DescriptionAdditional Attachments
Incident Management and Prevention Strategies Training WebinarThis 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 serviceWebinar Link
Incident Management and Prevention Strategies Training Webinar PowerPointPowerPoint slide deck for the Incident Management and Prevention Strategies Training WebinarWebinar PPT
Fatal Five OverviewFatal Five disorders document referenced in Incident Management and Prevention Strategies Training WebinarFatal Five Overview
Critical Incident and Mistreatment Participant Education Reporting WebinarTraining for case managers and Case Management Agency staff on state prescribed tools for case managers to provide participant education about CIRsWebinar Link

CIRs Training Modules

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

TitleShort DescriptionAdditional Attachments/Links
Substance Abuse Signs and SymptomsSubstance abuse, signs and symptoms trainingSubstance Abuse Signs and Symptoms Module
Critical Incident Enter a CIRCritical Incident steps to enter a Critical Incident in the BUSEnter a CIR Module
Critical Incident Follow-upCritical Incident Follow-up guidelines and examplesCIRS Follow-up Module
Critical Incident DefinitionCritical Incident Definition and examplesCIRS Definition Module
Critical Incident TimelinessCritical Incident Notification and Follow-up Timeliness guidelinesCIRS Timeliness Module
Critical Incident Fatal FiveDetails the top five disorders linked to preventable deathCIR Fatal Five Module
Critical Incident Substantiated DefinitionCritical Incident Substantiated Definition and examplesCIRS Substantiated Definition Module
Location of Critical IncidentLocation of Critical Incident details required for Critical Incident Reports and where this information is located in the BUSCIRS Location of Incident Module
Suicidal Ideation and PreventionSuicidal Ideation warning signs and Prevention strategiesSuicidal Ideation and Prevention Module
Critical Incident Root CauseCritical Incident steps to determine the Root Cause of the Critical IncidentCIR Root Cause Module
Critical Incident DetailsIncident details needed to complete a Critical Incident ReportCIRS Incident Details Module
Editing and Deleting a Critical Incident ReportHow and when Critical Incidents Reports can be edited or deleted in the BUSCIRS Editing and Deleting a Critical Incident Report Module
Agency Administrator ReportsAgency Administrator guide for pulling critical incident report data from the BUSAgency Administrator Reports Module

CIRs Participant Information

CategoryShort DescriptionStatusAdditional Attachments
Critical Incident and Mistreatment Participant Reporting QUICK GuideGuide for critical incident and mistreatment participant reporting08/01/2019Critical Incident and Mistreatment Participant Reporting QUICK Guide
Critical Incident and Mistreatment Participant Reporting QUICK Guide - AudioAudio Guide for critical incident and mistreatment participant reporting09/04/2019Critical Incident and Mistreatment Participant Reporting QUICK Guide - Audio
Critical Incident and Mistreatment Reporting Participant Education and ContactsCritical incident and mistreatment participant education and contacts08/01/2019Critical Incident and Mistreatment Reporting Participant Education and Contacts

CIRs Archived Memos

The following CIRs memos have been archived for your reference after issue resolution.
 
CategoryShort DescriptionDate ArchivedAdditional Attachments
Critical Incident Reporting MemoHCPF IM 21-043 Informational Memo07/07/2022Critical Incident Webpage Update Memo
Critical Incident Training Series MemoHCPF IM 20-056 Informational Memo07/07/2022Critical Incident Training Series Memo
Incident Management and Prevention Strategies MemoHCPF IM 20-030 Informational Memo06/30/2020Incident Management and Prevention Strategies Memo
Critical Incident Reporting for Covid-19HCPF OM 20-022 Operational Memo04/23/2020Critical Incident Reporting Covid-19 Memo
Critical Incident Training SeriesHCPF IM 19-057 Informational Memo03/18/2020Critical Incident Training Series Memo
CIRS Mistreatment Participant EducationHCPF OM 19-038 Operational Memo03/18/2020CIRS Mistreatment Participant Education Memo

Contact Us

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