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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 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
Virginia Quality Assurance Unit • SNAP QC • MEQC, PERM, Eligibility Pilots • Management Evaluations • SNAP Case Readers • Nutrition Education
Multi-tier Approach • Goal: avoid fiscal sanctions • Administration • SNAP Policy • QC • Local agency eligibility workers
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 • 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 • 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.) • 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 • 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) • 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 • 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 • 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 • 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 • 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 • 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 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 • 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 QUESTIONS?