Virginia QC - Best Practices: The Missing Puzzle Piece
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Virginia QC - Best Practices: The Missing Puzzle Piece. John Carpenter Quality Assurance Manager August 20, 2014. Agenda. Virginia QC Trends and Structure Workload Data Multi-level Communication QC Monitoring and Evaluation Unit Systems and Automation Ongoing Challenges.

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Virginia QC - Best Practices: The Missing Puzzle Piece

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Virginia qc best practices the missing puzzle piece

Virginia QC - Best Practices: The Missing Puzzle Piece

John Carpenter

Quality Assurance Manager

August 20, 2014


Agenda

Agenda

  • Virginia QC Trends and Structure

  • Workload Data

  • Multi-level Communication

  • QC Monitoring and Evaluation Unit

  • Systems and Automation

  • Ongoing Challenges


Virginia quality assurance unit

Virginia Quality Assurance Unit

  • SNAP QC

  • MEQC, PERM, Eligibility Pilots

  • Management Evaluations

  • SNAP Case Readers

  • Nutrition Education


Error rate statistics

Error Rate Statistics


Multi tier approach

Multi-tier Approach

  • Goal: avoid fiscal sanctions

  • Administration

  • SNAP Policy

  • QC

  • Local agency eligibility workers


Virginia s structure

Virginia’s Structure

  • State supervised; locally administered

  • 120 local agencies; 136 multiple sites where benefits are issued

  • Eligibility determined by local agency employees not state personnel

  • State agency provides guidance, consultation, and oversight


Case and workload data

Case and Workload Data

  • Active cases statewide: 431,704

    • Based on FNS248 submitted August 1, 2014

  • Each local agency worker may average a caseload of 1000, contingent on location and programs assigned

  • QC reviews for FFY2013

    • Active: 1099

    • Negative: 783


Communication

Communication

  • Enhance working dialogue between SNAP and QC

  • Corrective action process – review error elements and deploy training accordingly

  • Policy training – in person and on line, regional SNAP consultants and training unit

  • Payment Accuracy Conference and yearly BPRO (Benefit Programs Organization)


Communication cont

Communication (cont.)

  • More involvement in the error review process

  • Consultation on policy interpretation

  • Different from many other states, VA does not have an error review committee

    • Reviewer – Supervisor – QC Specialist – QC Manager

  • Send error to local agencies immediately


Monitoring and evaluation unit

Monitoring and Evaluation Unit

  • SNAP Case Readers - #1 Best Practice

    • 30+ years experience

    • Review cases from a QC perspective not an eligibility worker supervisor role

    • Strategically placed in local agencies across the Commonwealth

    • Targeted reviews: intake, prior to authorization, cases with income, timeliness, denials, etc.

    • Reporting mechanism


Monitoring and evaluation unit cont

Monitoring and Evaluation Unit (cont)

  • Management Evaluations - #2 Best Practice

  • The 10 agencies with the largest caseloads are reviewed every year

    • Formerly Big 20; all have >10,000 SNAP HH

  • 12 medium size agencies every other year

    • Caseloads with >5,000 SNAP HH

  • 98 small agencies once every three years

    • Caseloads with <5,000 SNAP HH


Me review components

ME Review Components

  • Expedited Services

  • Non-Expedited Services

  • Thirty Day Client Delay

  • Renewal Timeliness

  • Terminations, Denials, and Withdrawals

  • Recipient Claims Management and Reporting

  • Customer Service/Program Access

  • Civil Rights

  • National Voter Registration Act (NRVA) of 1993

  • Recipient Integrity


Me expectations

ME Expectations

  • Compliance = at least 75% of cases reviewed per target area are correct

  • Failure to meet the requirements – Quality Improvement Plan, a.k.a. Corrective Action Plan

  • Agencies found out of compliance are placed in a “continual re-review” status to ensure they adequately address deficiencies


System development

System Development

  • Virginia is an upload state for SNAP-QCS - #3 Best Practice

  • QA Reviewers requested continued use of Q5i

    • Edits, custom reports, tools, and strengthens internal controls

    • QA Supervisors ensure that all data is comprehensive and entered correctly – forced review

  • Performance Indicator Reports published monthly –assists with corrective action


Custom automation

Custom Automation

  • Entire QA workbook is automated in Excel - #4 Best Practice

  • Data is entered into a “Home Page” and automatically populates all tabs within the Excel workbook (VA’s version of the 380)

    • HH correspondence (interview, consent), 3rd party letters (bank, residence), 380 (all elements), comp sheet, and timeliness evaluation forms


Sub recipient monitoring

Sub-recipient Monitoring

  • Regional SNAP policy consultants; local agency case review schedule - #5 Best Practice

  • Each consultant is assigned 20-25 local agencies

  • Must conduct a yearly comprehensive case review to evaluate SNAP performance

  • Data and reports evaluated and shared (APA)


Local agency requirements

Local Agency Requirements

  • Local agency eligibility supervisors are required to review cases completed by all their assigned workers - #6 Best Practice

  • Random selection (may be targeted for error prone elements), results entered into database, and tracked by SNAP Policy Unit

  • Follow-up conducted on review results at both state and local level


Challenges

Challenges

  • Prospective budget vs. actual circumstances

  • Waiver of the certification face-to-face interview

    • Successful for timeliness and customer service

  • Shelter

    • Client statement vs. QC verification

  • Electronic Application

  • Affordable Care Act


End of my story

END OF MY STORY

QUESTIONS?


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