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Virginia QC - Best Practices: The Missing Puzzle Piece John Carpenter Quality Assurance Manager August 20, 2014
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Agenda Virginia QC Trends and Structure Workload Data Multi-level Communication QC Monitoring and Evaluation Unit Systems and Automation Ongoing Challenges
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Virginia Quality Assurance Unit SNAP QC MEQC, PERM, Eligibility Pilots Management Evaluations SNAP Case Readers Nutrition Education
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Error Rate Statistics
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Multi-tier Approach Goal: avoid fiscal sanctions Administration SNAP Policy QC Local agency eligibility workers
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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
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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
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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)
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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
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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
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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
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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
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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
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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
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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
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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)
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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
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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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END OF MY STORY QUESTIONS?
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