DHS developed the Lead Agency Reviews (LARs) for Home and Community Based Services (HCBS) to assure compliance with state and federal requirements, identify promising practices that improve the quality of services, and gather feedback about DHS technical assistance. The reviews aim to be constructive in nature, while gathering and sharing information with lead agencies to encourage the use of performance based management. This session will focus on the process of a Lead Agency Review including understanding the protocols of a typical site visit comprising of pre-visit, on-site and follow up activities including waiver case file review. After a brief summary of round three findings, the Lead Agency Review team will share the performance measures and themes including community integration, equity and program sustainability that will be examined throughout round four of lead agency reviews beginning in April, 2019.