1. Title IV-E

2. Quality Assurance and Accountability (QAA)
QAA Team:
Program Manager
2 Program Supervisors
5 Regional Teams
Central – 5 Program Consultants
Piedmont – 5 Program Consultants
Northern – 5 Program Consultants
Eastern – 4 Program Consultants
Western – 4 Program Consultants

3. QAA Reviews
The QAA team conducts two types of agency reviews to ensure proper use of IV-E funding
Child Welfare Case Reviews
Quarterly review of every agency
Reviews all new foster care funding cases to ensure proper IV-E eligibility determination
IV-E Ongoing Reviews
Once a year for every agency
Reviews all ongoing IV-E eligible youth for the agency
Verifies proper use of IV-E funds for services provided

4. 2nd Quarter FY IV-E CWCR Error Rates

5. 1st to 2nd Quarter Changes
Number of cases reviewed
Q1 = 648 Cases Reviewed
Q2 = 681 Case Reviewed
Federal Error Percentage decreased 3.06%
14.51 % to 11.45%
AFDC Eligibility decreased 3.59%
10.49% to 6.90%
Safety Requirements decreased 1.28%
2.16% to 0.88%
Total number of errors found
Q1 = 113 errors
Q2 = 82 errors

6. 2nd Quarter FY IV-E Ongoing Error Rates

7. Total Errors vs Cases with an Error
Total number of errors found
State level, regional level, and agency level
Number of cases with an error
Federal Case Error
Number of cases which had an error regardless of the amount of errors for that case
Example:
One case had three errors found: 2 ineligible payments and 1 safety requirement finding
3 total errors but only 1 Federal Case Error

8. 2019 Federal Review
On-side Review – September 23rd through the 27th, 2019
Period Under Review – October 1, 2018 through March 31, 2019.
80 cases randomly selected (20 oversample)
The cases that are determined for the review are selected from the Adoption and Foster Care Analysis and Reporting System (AFCARS).
Any case that had at least one IV-E foster care maintenance payment made during the PUR is eligible to be reviewed.

9. Substantial vs Non-Substantial Compliance
During the primary review, out of the 80 cases reviewed the State is allowed up to four federal case errors.
If five or more federal case errors are found during the primary review, the State will not be in substantial compliance
State must develop a Program Improvement Plan (PIP)
State will undergo a secondary review following the completion of the PIP.

10. Secondary Review 150 cases are pulled from a new Period Under Review
State must not exceed the compliance threshold of more than 10 percent in both the federal case error rate and the dollar error rate.
If not in compliance with a secondary review, a disallowance is assessed on the basis of the agency’s total foster care population for the 6 month PUR.

11. QAA Preparation for IV-E Review
AFCARS list of every IV-E youth during the PUR
Share information with each agency
Determine every CRF eligible to be reviewed
Safety matrices are up to date
Determine every out of state foster home eligible to be reviewed
Meetings with federal government begin in April

12. Agency Preparation for IV-E Review
PUR Ends 03/31/19
Complete an internal pull of all IV-E payments made during the federal PUR
Provides a list of all cases that are eligible to be pulled
Complete a thorough review of every case
Eligibility
Payment documentation
Safety checks for each placement during the PUR
Adjustments can be made up until the time we receive the list

13. Safety Requirements
3.34% of all cases were found to have a safety requirement error
Checklist for provider approval and re-approval dates
Inconsistent or inaccurate
Pulling two resource home files during the review
Verifying that the checks were completed and in the file
Verifying the dates match the dates on the checklist
Proper documentation for LCPA homes in eligibility file
LCPA license
Certificate of Approval of the home
State Form Letter – CRC and Registry Checks

14. Safety Requirements Best Practice
Good working relationship between resource home unit and eligibility unit
Tracking each resource home to know when background checks are due
Spreadsheets
Shared Calendar
Sharing these tracking tools with resource and eligibility staff creates another layer of internal quality control

15. Emergency Approvals Youth can be temporality placed for up to 60 days.
IV-E can begin the first day of the month in which all federal safety requirements are met:
Fingerprint background results
Central Registry verifications
All requirements have to be met within the 60 day and the license of approval issued.
Example: 60 day emergency approval 09/23/18 – 11/22/18
License of Approval begin date: 11/27/18 – 11/27/21
IV-E cannot pay from 11/23/18 – 11/26/18

16. Emergency Approvals Best Practice
Emergency Approval for title IV-E Reporting
Available on the Fusion IV-E website
Needs to be completed and put in eligibility file

17. ICPC Foster Homes Forms 100 A and B should be in eligibility file
These forms do not have information regarding background checks
Home Study is not required to be in the eligibility file
Should have the information regarding background checks
QAA consultant will ask to see Home Study to verify checks
If checks are not in the Home Study
Agency will need to work with ICPC and the other state to get documentation of background checks

18. OASIS Documentation and Agency Practice
Child Information
Eligibility Determination: IV-E vs CSA
Placement Information
Court Information
Maintenance Rates
Agency Practice
Eligibility File
All documentation is in file
All documentation is in the correct section of the file

19. Daily Supervision
IV-E can pay as long as no services are calculated into the rate
Case management
Therapy
Counseling
Assessments
Evaluations
IV-E does not distinguish between levels A, B, or C

20. Daily Supervision
Rate sheet defines what Daily Supervision entails and no services are being provided – IV-E can pay
Therapeutic Behavior Services are built into the rate – IV-E cannot pay.

21. Daily Supervision Working with Medicaid and CSA Uniform rate sheet
Daily Supervision and services are a “combined” rate – IV-E cannot pay.
Working with Medicaid and CSA
Uniform rate sheet
Organizing IV-E/DMAS allowable costs
Clear definitions of services

22. Family-Based Treatment Facility
Part of Families First
Allows claims for IV-E maintenance payments for a child placed with a parent in a licensed residential family-based treatment facility for substance abuse
Currently no such facilities in VA are licensed up to the standards as specified by Families First
Child must meet all IV-E foster eligibility requirements except the AFDC eligibility requirements
Evaluation on Fusion
Broadcast 09/24/18

23. January DYK – VEMAT Scores of 36
Common and costly
VEMAT scores 28 or above must be reassessed every 3 months
VEMAT score of 36 due solely to severe medical and physical needs can be assessed annually
Physicians statement
Detailing the child’s condition
Statement that the condition is unlikely to improve
Obtained within three months of the initial VEMAT Assessment score of 36
New statement must be obtained along with the next annual VEMAT Assessment

24. January DYK – VEMAT Scores of 36
If the agency does not receive the physician’s statement prior to the expiration date of the first VEMAT with the score of 36, then title IV-E funds should cease beginning the first day of the following month.
Example: VEMAT effective 02/01/18 – 04/30/18
Physicians statement not obtained prior to 04/30/18
IV-E funds cannot be used beginning 05/01/18
If the agency receives a physician’s statement after the expiration of the VEMAT, title IV-E funds can be used again beginning the first day of the month following receipt of the statement for the remainder of the year of approval

25. VEMAT Best Practice Excel spreadsheet of all VEMATs and due dates
Shared calendar with all VEMAT due dates
Eligibility workers can serve as a secondary level of internal quality assurance.
Any questions on the quality of the physician’s statement should be sent to regional permanency consultant

26. December DYK - Definitions and Details: Title IV-E Allowable Costs
Available on the Fusion IV-E website

27. Supplemental Clothing Allowance
Most common issue is the lack of documentation to support the purchase of clothing.
Receipts need to be in eligibility file to support payment
Shipping and handling is a non-reimbursable cost
Shall not exceed the designated rate
Regardless of IV-E, CSA, or combination of the two
It should be used by May 31st of each year
The date the bill is paid determines the fiscal year in which the payment is counted when it comes to fiscal year end

28. Supplemental Clothing Allowance Best Practice
IV-E Quick Reference Guide:
Internal Clothing Tracking Tool
Ensure the agency does not go over
Track which youth still has money available at the end of the fiscal year

29. Role of Finance Staff in IV-E
Knowing which youth are IV-E eligible
Access to OASIS
Easily accessible database of IV-E eligible youth
Knowing which payments can be paid from IV-E
Knowing IV-E rules surrounding eligible payments
Tracking of clothing allowances
Communication
Notice of Action

30. Updated IV-E Application/Evaluation
Updated IV-E Application has been posted to Fusion
An went out via our DYK distribution list with the application and description of changes
Currently working on a updated IV-E Evaluation
Once approved, will be posted to Fusion and sent to all agencies

31. Title IV-E Training New IV-E Training is offered every month
Each training should be posted to the Learning Center six months prior to training taking place
Online IV-E modules are available on Learning Center and are prerequisites for the in class training

32. Contact Information
Morgan Nelson – QAA Program Manager
Matthew Lafrinere – QAA Program Supervisor