Developmental Services Information for Providers

Provider Network Supports

Provider Network Supports focuses on developing and sustaining a qualified community of providers in Virginia so that people who have developmental disabilities and their families have choice and access to options that meet their needs. You can find resources from Provider Network Supports, including information on becoming a provider, information about Virginia’s Person-Centered ISP, who to contact for technical assistance, and training opportunities via the following link. 

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Home and Community-Based Settings Rule

The “Home and Community Based Services (HCBS) Settings Regulations” (often called the HCBS Rule) intends to ensure individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting. 

More information can be found in the following PowerPoint presentations: 

HCBS for Providers 

HCBS for Support Coordinators 

HCBS Modification Training (Dec. 2024) 

“Back to the Basics” for Support Coordinators Regarding the HCBS Settings Rule PART 1 (March 2025) 

“Back to the Basics” for Support Coordinators Regarding the HCBS Settings Rule PART 2 (March 2025) 

“Back to the Basics” for Support Coordinators Regarding the HCBS Settings Rule PART 3 (March 2025) 

HCBS Bimonthly Newsletters: “The Download” 

Issue #1 – June 2025 

In addition, DMAS has the HCBS Toolkit for providers seeking clarification and resources on elements of compliance with the rule. 

Quality Service Reviews

What is a quality service review (QSR)?

A quality service review evaluates the quality of services at the individual, provider, and system-wide level. QSRs include: 

  • Person-centered reviews 
  • Individual and family interviews and/or surveys 
  • Provider quality reviews 

Who is involved in the QSR?

DBHDS contracts with Health Services Advisory Group (HSAG) to conduct the QSRs. Licensed providers, community service boards, which include behavioral health authorities and are known collectively as CSBs, are required to participate in QSRs. Individuals, authorized representatives, supported decision makers, and legal guardians are also involved. 

How does DBHDS use QSR results? 

DBHDS uses QSRs to evaluate: 

  • The quality of services at an individual, licensed provider, region, and system-wide level 
  • The extent services are provided in the most integrated setting suitable to the individuals’ needs and choices 
  • Whether individuals’ needs are being identified and met through person-centered planning and thinking (including building on the individuals’ strengths, preferences, and goals) 
  • Whether services are being provided in the most integrated setting suitable to the individuals’ needs and are consistent with their informed choices 
  • Whether individuals are having opportunities for integration in all aspects of their lives (living arrangements, work, and other day activities, access to community services and activities, and opportunities for relationships with non-paid individuals) 

DBHDS uses QSRs to assess the adequacy of licensed providers and CSBs quality improvement strategies. 

DBHDS also uses QSR data for: 

  • Reporting purposes 
  • Improving the service experience 
  • Determining how to improve the array of services provided 
  • Identifying and implementing quality improvement initiatives. 

How should licensed providers and CSBs use QSR results? 

Licensed providers and CSBs use QSR results to: 

  • Identify improvement strategies and plan improvement efforts 
  • Improve the service experience 
  • Determine how to improve the array of services provided 
  • Identify and implement quality improvement initiatives  

  

QSR Round Information

Conclusion of Round 7:

DBHDS and HSAG thanks all those participating in the Round 7 Quality Service Review (QSR), which occurred April 2025 through September 2025. While HSAG’s technical assistance to CSBs and licensed providers regarding their QSR quality enhancement plan (QEP) has ended, DBHDS’ Office of Community Quality Improvement Expanded Consultation and Technical Assistance (ECTA) team now offers ECTA to CSBs and licensed providers who received a ‘QEP indicated’ in the Round 7 QSR Report for the Provider Quality Improvement (PQR) Quality Improvement/Risk Management elements number 5 to 31, and a HSAG approved QEP response.

A general announcement for the upcoming QSR-PQR ECTA will come via DD Constant Contact. Direct invitations will then be emailed to identified CSBs and licensed providers meeting ECTA criteria to participate in ECTA. The email comes from ecta@dbhds.virginia.gov. Participation is not mandatory. Support from the ECTA Team will be provided on a first-come first-served basis, as available.  If the response date is missed, CSBs/licensed providers will need to monitor the Constant Contact notices sent out by Developmental Services so they will be aware of the next round of ECTA and be prepared to respond to the direct invitations. Receiving ECTA does not guarantee that ECTA participants will be found to have met this element at their next QSR, as compliance is dependent on the CSB’s/ licensed provider’s implementation of consultation and adherence to the regulations.

QSR Documents 

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QSR Reports 

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Expanded Consultation and Technical Assistance (ECTA) 

At the conclusion of Round 6 of the QSRs, DBHDS began offering ECTA to CSBs and licensed providers who received a ‘QIP Indicated’ in the Round 6 QSR Report for the QSR element “Does the provider collect and track performance data, including serious incidents and other risk information?” Identified providers meeting ECTA criteria received a direct invitation to participate in ECTA.

DBHDS continues to offer ECTA to CSBs and licensed providers meeting ECTA criteria. At the end of Round 7, HSAG will send the ECTA Management Team the list of providers who have a quality enhancement plan (QEP) indicated for specified QI and/or RM data elements as shown on the Provider Quality Review (PQR) portion of the QSR Reports. The ECTA Management Team will email direct invitations to those providers offering ECTA specific to the QI/RM data elements. That email will come from ECTA@dbhds.virginia.gov, with the subject line: “Invitation to participate in Expanded Consultation and Technical Assistance for QSR.”

Please note:  For providers seeking ECTA, there is no guarantee that a provider will be found to have met the QI/RM data elements at their next QSR, as achieving a status of “Met” for these elements depends on the degree to which providers adopt and consistently implement QI/RM principles, concepts, and tools presented during OCQI ECTA as part of a cycle of continuous quality improvement. 

If you have any questions about the QSR process overall, please contact 

dbhds_QSR@dbhds.virgina.gov 

or

vaqsr@hsag.com.