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Virginia QC - Best Practices: The Missing Puzzle Piece John Carpenter Quality Assurance Manager August 20, 2014.

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Presentation on theme: "Virginia QC - Best Practices: The Missing Puzzle Piece John Carpenter Quality Assurance Manager August 20, 2014."— Presentation transcript:

1 Virginia QC - Best Practices: The Missing Puzzle Piece John Carpenter Quality Assurance Manager August 20, 2014

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

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

4 Error Rate Statistics

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

6 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

7 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

8 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)

9 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

10 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

11 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

12 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

13 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

14 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

15 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), 3 rd party letters (bank, residence), 380 (all elements), comp sheet, and timeliness evaluation forms

16 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)

17 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

18 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


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