This report explores the topic of effective individual risk management in community-based services among States engaged in risk planning for Medicaid home- and community-based services (HCBS) waiver participants. Administrators from 11 State operating agencies, representing a range of waiver types and geographic areas, were interviewed for this report. These agencies served at least one of four waiver populations (the elderly, people with physical disabilities, people with mental retardation, and/or people with developmental disabilities or brain injuries).

This tool addresses the following topics:

• Purpose and methodology
• The relationship between risk management and quality management
• Identifying and planning to mitigate risk at the individual level
• Monitoring and remediating risk at the individual level
• Training and resources for staff to support individuals
• Addressing risk system-wide
• Conclusions