Document Type


Publication Date



Disability and Aging, Cutler Institute, USM Aging Initiative, Policy


Early in the development of this first working paper on QM roles and responsibilities, QA/QI grantees contributed to a preliminary outline of the issues to be addressed. A subset of grantee states agreed to more fully discuss their perceptions of the issues and to guide the exploratory efforts of Muskie School staff. While the initial list of issues was quite lengthy, it was subsequently reduced to four essential questions:

  1. How is quality defined for HCBS?
  2. What is meant by quality management?
  3. How do states develop quality management expertise?
  4. How do states organize their quality management strategies?

This paper attempts to answer these questions from the perspectives of the grantees and available federal guidance. The topic is limited to quality management strategies focused on the quality of services and supports for HCBS consumers and is not intended to represent the quality management field as a whole.


These contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal government. Please include this disclaimer whenever copying or using all or any part of this document in dissemination activities.

Funding Organization or Grant

This document was developed under Grant No. 11-P-92015/2-01 from the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services.