Shiba Sumeshwar, MAA/TCM Coordinator; Monterey County TCM Site Visit Shiba Sumeshwar, MAA/TCM Coordinator; Monterey County

DHCS is not validating nor approving [this] TCM Site Visit Presentation in whole or partially. Changes made to the site visit entrance packet and/or DHCS site visit procedures are at DHCS’ discretion. Disclaimer

Objectives Prepare staff Prepare material Understand the site visit Make the visit a positive experience Objectives

What is a Site Visit? Programmatic review of the TCM program Are you following the rules and policies correctly? Performed by DHCS TCM Unit Staff As required by Federal Guidelines This is not an Audit This review is not punitive in nature What is a Site Visit?

The Call… Your TCM Analyst will contact you Your LGA has been chosen for a TCM Site Visit Coordinate when the Site Visit will happen Coordinate individuals to be interviewed Receive (E-mail) and Review the Entrance Packet Letter stating a TCM Site Visit is scheduled Agenda w/ schedule of events Checklists List on Encounters The Call…

The Prep… The Letter… The Agenda… Review the whole packet Review the letter with the unit Keep in touch with your Analyst Ask Questions, It’s Okay The Agenda… Reserve a room for the State staff to review documents The Prep…

The Prep… The Checklists… List of Case Managers w/ IDs in TCM System Encounter log(s) – Required items on Encounter Logs: The client’s name. The client’s date of birth and include the mother’s date of birth in the case of newborns. The client’s Medi-Cal number, Beneficiary Identification Number, or Social Security number. The date of the TCM service (encounter). The name of the provider agency. The name or ID number of the case manager. Time Surveys Time Cards Duty Statements Contracts, MOU’s, PMP’s Freedom of Choice, Fee Mechanism Training Materials (TCM and CM) The Prep…

The Prep… The Encounters… Client’s name DOB Date of Service Medi-Cal or SS# or Client I.D.# Case Manager Name and NPI# Type of Contact (Home, Office, Phone…) Type of Service Provided Encounter Number Encounter notes (explanation of service provided) The Prep…

Electronic or Hard Copy “All documents that are stated in the entrance packet have to be made available in a hard copy.” However, the State also understands that electronic systems are used for various applications including, but not limited to EHR (Electronic Health Records), Time Surveys, and Time Cards. Contact your analyst to discuss your electronic systems and what accommodations can be made and training the State to use your system. Electronic or Hard Copy

Electronic or Hard Copy (Recommendation) EHR Time Cards MOUs/ PPA/ Contracts Cost Report Training Material Time Surveys (Blue ink signature) Electronic or Hard Copy (Recommendation)

The Visit… State Staff will arrive Staff Interviews Entrance Interview Staff Interviews Documentation Review: Encounter logs, Case Records, Time Surveys, Time Cards, Etc. Exit Interview Overview of preliminary findings During the Visit The TCM Coordinator and/or TCM Unit Supervisor should be available at all times Answer questions or requests from the State The Visit…

After the Site Visit… Summary of Findings Review findings w/ TCM Unit Respond to findings within 60 days Corrective action plan List of all findings, disallowances, concerns in detail Review findings w/ TCM Unit Opportunity to make system changes as deemed necessary Use this as a learning experience and a measurement for the unit After the Site Visit…

The Experience… For LGA Coordinator TCM Unit Program Supervisor Case Manager Supervisor Case Manager The Experience…

Your Questions and Concerns… Review questions and concerns submitted via Survey Monkey Any other questions or concerns Your Questions and Concerns…