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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.
The following guides and definitions have been created to help you properly report critical incidents in the BUS.
Entering Critical Incidents into the BUS(Use Internet Explorer or Microsoft Edge Browsers to view)
The following training modules have been created to support your Agency's proper reporting of critical incidents in the BUS.
CIRS update in the BUS
DD Waiver Critical Incidents will be entered in the BUS
CIRS Issues in the BUS
Print function not working, Elderly Abuse reminder and future dates
Michael Pasillas - LTSS Critical Incident Policy Specialist
Andrea Behnke - IDD Critical Incident Policy Specialist