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 Development, including information on becoming a provider, information about Virginia’s Person-Centered ISP, who to contact for technical assistance, and training resources.
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 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”
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
Commencement of Round 7 – April 21, 2025
Round 7 of the Quality Service Reviews (QSRs) commenced on April 21, 2025. Provider samples will be posted to the HSAG VA QSR SharePoint site in the Round 7 Sample Folder by April 21, 2025. Please note the instructions for providers are located at the top of the sample file. CSBs/BHAs may have two samples – one for their provider sample and one for their full support coordinator sample.
HSAG utilizes the HSAG Secure Access File Exchange (SAFE) site: safe.hsag.com for all review documentation uploads. Files uploaded into SAFE must not be password protected. An invitation will be emailed to the listed primary contact/CEO for your organization. If you would like to request additional users, please email a completed “HSAG SAFE Provider Access Request” form found in Provider Resources to VAQSR@hsag.com.
Documents cannot be uploaded into SharePoint.
Providers must review their sample and notify their reviewer of any alternate requests before May 2, 2025.
HSAG also asks that providers submit their review documentation no later than May 22, 2025. As a reminder, providers/CBSs can utilize SAFE or provide access to EHRs. Providers/CSBs are encouraged to reference the Round 7 Documentation Submission Checklist on the VA QSR SharePoint site for further information. Please be aware there are different timelines associated with EHR access for submission of the documentation checklist.
If you have any questions regarding the Round 7 process, please do not hesitate to contact HSAG at VAQSR@hsag.com, or contact your assigned reviewer directly.
Expanded Consultation and Technical Assistance (ECTA)
Beginning at the conclusion of Round 6, 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.
OCQI 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. 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 ECTA for QSR-PQR: QI/RM Data Elements.”
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
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