Deaths of developmentally disabled in home-care settings should get closer reviews: GAO

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States should more thoroughly investigate deaths of people with developmental disabilities who were receiving home- and community-based services for care, according to a new government report. The Centers for Medicare & Medicaid Services should pressure states to review such deaths more closely, the Government Accountability Office says.

"Concerns about deaths resulting from poor quality of care and inadequate oversight of individuals with developmental disabilities receiving community-based care," compelled Sen. Charles Grassley (R-IA) to request the report (GAO-08-529).

The GAO interviewed officials in 14 states and found they varied widely in how they reviewed the deaths of individuals with developmental disabilities who received care under Medicaid waivers. Some reviewed only unexpected deaths, for example. Four of the states added extra steps to their reviews, which produced "greater accountability and transparency," GAO report authors wrote. They call for more in-depth reporting, which Health and Human Services officials countered would not be in line with other groups' reporting requirements.

The report can be found at