HCBS Training

Assessing Progress Across Tiers

triange few, some, all people

The evaluation plan can be organized using the tiered model of person-centered and positive support practices that was described in Module 1. Organizations using a tiered approach for person-centered practices create an evaluation plan that tracks progress at all three tiers. The evaluation plan addresses effort, fidelity, and outcomes at each tier since how people are supported depends on the intensity of support needed. The tiered model includes:

  • Tier One: Practices implemented for all people,
  • Tier Two: Strategies for monitoring and acting early when some people need a little more support to improve their lives and address minor problems, and
  • Tier Three: A more individualized and intensive plan for a few people who are experiencing more significant challenges.

The triangle on this page shows a tiered model for HCBS services. The Module Resource section includes more information about this tiered approach for person-centered practices. The team is focused on Tier 1 in these modules. These are the universal practices for all people.  The long-term plan,  action plan, and  Year 1 SMARTIE goals the team has created will be the part of the evaluation plan.

Examples of Evaluation at Each Tier

  • Assess efforts related to the action plan
  • Gather team fidelity of implementation data at Tier 1 using the Minnesota Team Checklist
  • Gather and use outcome data (e.g., incident reports, injuries, staff attrition/retention summaries, quality-of-life surveys, satisfaction and cultural responsiveness surveys, policies changes, documents) to make decisions
  • Assess efforts related to providing Tier 2 supports (e.g., quality-of-life strategies, group interventions, simple plans to support people by improving social or emotional skills)
  • Fidelity of implementation at Tier 2 for team action planning and for group or individual interventions
  • Changes in quality of life measures, social skills, home settings, or job opportunities
  • Overall summary of progress among the people who receive Tier 2 supports
  • Assess efforts to establish training expertise for person-centered plan facilitation, positive behavior support plan development, or related positive support improvements
  • Fidelity of implementation at Tier 3 for teams monitoring individual plans for people
  • Outcome data gathered to assess the impact of individual plans (e.g., changes in quality of life, decreases in challenges encountered).
  • Overall summary of progress among the people who receive Tier 3 supports