The Health Risk Screening Tool (HRST) is a web-based, HIPAA compliant rating instrument developed to detect health destabilization in vulnerable populations. The HRST screens for health risks associated with a wide variety of disabilities, including developmental disabilities, physical disabilities, disabilities associated with aging and other conditions, which specifically affect systems of the body and the person’s ability to engage in functional activities. Part of the instrument examines the health risks associated with psychiatric or behavioral disorders, particularly those that result from medications, self-injurious behavior or restriction of movement.
The Heath Risk Screening Tool is a simple 22 item scale designed to find out who is at the greatest risk of illness and health destabilization. It then responds by producing action steps that empower support staff in the form of special attention and prevention.
The HRST was developed for use by non-licensed staff such as case managers, independent support coordinators, program staff, direct care professionals and others who directly impact services and supports for those in specialized health care settings.
Outcomes and Uses
There are several potential outcomes and uses for the HRST results. The instrument assigns point scores to twenty-two (22) distinct rating items related to functional status, behavior, physiological condition and safety of the person being screened. Scores for twenty-two rating items are assigned by the user answering a series of objective Yes/No questions related to each item. The resulting numerical totals of the twenty-two rating items are assigned Health Care Levels associated with degrees of health risk.
The most important outcome of the HRST screening is to guide in the provision of health care support and surveillance. The instrument is used to determine the types of further assessment and evaluation required by the person to be safe and healthy in the least restrictive setting.
Features & Functions:
- Detects health destabilization early in vulnerable populations.
- Field-tested, validated, reliable and user-friendly.
- Helps meet CMS health and safety requirements.
- Quantifies level of health risk based on objective criteria.
- Establishes a health baseline and allows the health status to be monitored.
- Assists with transition planning and continuity of care.
- Defines acuity.
- Identifies health related support needs specific to the person.
- Determines types of further assessment, evaluation and staff training.
- Enhances Individual Service Plan development.
- Enables personalized and less restrictive settings.
- Assists with budgeting and equitable resource allocation.
- Provides web-based, real-time data accessibility.
- Reports can display numerous parameters:
- And more
The HRST can be used for objective, reliable rate setting, exceptional rate determination, criteria for clinical services and decisions of Level of Care eligibility. Whether at the state or the provider level, the need exists for effective allocation of resources. The HRST directly aligns the level of service to the person’s legitimate need.
Equitable Resource Allocation
The HRST gives the ability to accurately look at the health status of people served in a region or served by a provider or case managers, among others. The HRST Health Care Levels are based on quantifiable and objective criteria. Cost can be allocated for persons who truly need a higher rate, rather than assuming that high rates are needed for persons simply because they are in wheelchairs or look like they are medically complex. Conversely, the HRST identifies people, such as those with behavioral challenges, who are often not identified as requiring the level of support they do need.
State resources are valuable and limited. Some regions require educational support for community providers and families; other regions require intensive medical/nursing/therapy supports for the people themselves. The HRST allows the state and provider administrative staff to view the state as a whole with appropriate allocation of resources based on an objective, comprehensive screening of individual needs.
Proactive Approach = Lower Morbidity = Reduced Cost
The HRST screens for health risks on a regular, routine and acute-event basis. The screenings detect health issues early before they develop into a health crisis. This, in many instances, avoids the extreme cost of additional medications, staffing, professional services, ER visits and hospital admissions.
Allowing someone to destabilize for a period of time before treatment often results in the person requiring a higher level of health care at significantly increased cost. An example is a person who goes from eating by mouth to having a gastrostomy or jejunostomy tube. This increases the cost of eating to double or quadruple the costs of eating orally. In addition, the person's risk for GI bleeding increases substantially, which increases the likelihood of requiring 24-hour nursing care.
Early identification of health risks + early intervention = improved outcomes for the person + lower health care costs.
The Centers for Medicare & Medicaid Services (CMS) will reimburse 50% of the cost for the services that the HRST provides through Medicaid Administration Match. CMS requires that systems be in place for monitoring the health and safety of someone receiving services and the Health Risk Screening Tool (HRST) assists in fulfilling this requirement.
As an example, the State of Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) is the operating agency for the Home and Community Based Waiver Programs for those with developmental disabilities. Georgia DBHDD uses Medicaid Administration Match for its operational functions of the waiver. The HRST is part of the annual assessment of people with developmental disabilities, and it is part of the level of care determination and Individual Service Plan development for approximately 15,000 people.
Two independent studies have been completed using the HRST. Both studies were conducted on people with intellectual and developmental disabilities who were screened using the HRST.
The first study came from The Center for Outcome Analysis which focused on the use of the HRST Health Care Level as a prognostic indicator of longevity over a 9-year span of time.
The second was from Georgia's Department of Behavioral Health and Developmental Disabilities (DBHDD). Georgia has used the HRST in their annual mortality review since 2013. Both studies independently support a strong correlation between the HRST Health Care Level and mortality dynamics.▶ GET REPORT