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

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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. - PowerPoint PPT Presentation

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Page 1: Virginia QC - Best Practices: The Missing Puzzle Piece

Virginia QC - Best Practices: The Missing Puzzle Piece

John CarpenterQuality Assurance Manager

August 20, 2014

Page 2: Virginia QC - Best Practices: The Missing Puzzle Piece

Agenda Virginia QC Trends and Structure Workload Data Multi-level Communication QC Monitoring and Evaluation Unit Systems and Automation Ongoing Challenges

Page 3: Virginia QC - Best Practices: The Missing Puzzle Piece

Virginia Quality Assurance Unit SNAP QC MEQC, PERM, Eligibility Pilots Management Evaluations SNAP Case Readers Nutrition Education

Page 4: Virginia QC - Best Practices: The Missing Puzzle Piece

Error Rate Statistics

Page 5: Virginia QC - Best Practices: The Missing Puzzle Piece

Multi-tier Approach Goal: avoid fiscal sanctions Administration SNAP Policy QC Local agency eligibility workers

Page 6: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 7: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 8: Virginia QC - Best Practices: The Missing Puzzle Piece

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)

Page 9: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 10: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 11: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 12: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 13: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 14: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 15: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 16: Virginia QC - Best Practices: The Missing Puzzle Piece

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)

Page 17: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 18: Virginia QC - Best Practices: The Missing Puzzle Piece

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

Page 19: Virginia QC - Best Practices: The Missing Puzzle Piece

END OF MY STORY

QUESTIONS?