NQF Releases Final Report from the HCBS Committee

Lindsay Schwartz

The National Quality Forum (NQF) has released the final report from its Home and Community-Based Services (HCBS) Committee: Quality in Home and Community-Based Services to Support Community Living: Addressing Gaps in Performance Measures. Under a contract with the Department of Health and Human Services (HHS), NQF convened a committee to develop recommendations for prioritization of measurement opportunities. AHCA/NCAL has been following this work closely, keeping members informed, and submitting comments with each report.

During this two-year project, the committee:

• created a conceptual framework for measurement and an operational definition of HCBS; 
• conducted an environmental scan for measures, concepts, and instruments; 
• identified gaps in quality measures; and 
• drafted recommendations for prioritization in measurement. 

During the project, three interim reports were released, which can be found on the NQF website.

The final report includes global recommendations to improving quality measures in HCBS, the suggested measurement domains and subdomains, examples of measure concepts relevant to each subdomain, and recommendations for each domain. The committee has also identified characteristics of high-quality HCBS.

Global recommendations from the committee:

• Support quality measurement across all domains and subdomains.
• Build upon existing quality measurement efforts.
• Develop and implement a standardized approach to data collection, storage, analysis, and reporting.
• Ensure that emerging technology standards, development, and implementation are structured to facilitate quality measurement.
• Triangulate assessment of HCBS quality using an appropriate balance of measure types and units of analysis.
• Develop a core set of standard measures for use across the HCBS system, along with a menu of supplemental measures that are tailorable to the population, setting, and program.
• Convene a standing council of HCBS experts to evaluate and approve candidate measures.

Final suggested measurement domains for quality measurement:

• Service Delivery and Effectiveness
• Person-Centered Planning and Coordination
• Choice and Control
• Community Inclusion
• Caregiver Support
• Workforce
• Human and Legal Rights
• Equity
• Holistic Health and Functioning
• System Performance and Accountability
• Consumer Leadership in System Development 

NCAL will continue to monitor how HHS proceeds forward with the recommendations and keep members informed.