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
Error Rate Statistics
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), 3 rd 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 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?