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

2. 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

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

4. 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?

5. 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 ( ) and Review the Entrance Packet
Letter stating a TCM Site Visit is scheduled
Agenda w/ schedule of events
Checklists
List on Encounters
The Call…

6. 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…

7. 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…

8. 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…

9. 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

10. 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)

11. 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…

12. 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…

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

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