Virginia QC - Best Practices: The Missing Puzzle Piece

1. Virginia QC - Best Practices: The Missing Puzzle Piece John Carpenter Quality Assurance Manager August 20, 2014

2. Agenda • Virginia QC Trends and Structure • Workload Data • Multi-level Communication • QC Monitoring and Evaluation Unit • Systems and Automation • Ongoing Challenges

3. Virginia Quality Assurance Unit • SNAP QC • MEQC, PERM, Eligibility Pilots • Management Evaluations • SNAP Case Readers • Nutrition Education

4. Error Rate Statistics

5. Multi-tier Approach • Goal: avoid fiscal sanctions • Administration • SNAP Policy • QC • Local agency eligibility workers

6. 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

7. 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

8. 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)

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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), 3rd party letters (bank, residence), 380 (all elements), comp sheet, and timeliness evaluation forms

16. 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)

17. 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

18. 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

19. END OF MY STORY QUESTIONS?