113-4          CORRECTIVE ACTION PLANNING SPREADSHEET (CAPS Corrective Action Planning Spreadsheets)

The CAPS Quality Assessment Review CommitteeQuality Assessment Review Committeeis a monthly report to DPA staff identifying errors discovered during QA Quality Assessment reviews of Alaska Supplemental Nutrition Assistance, Alaska Temporary Assistance, Adult Public Assistance, and Medicaid Programs.  The CAPS Corrective Action Planning Spreadsheets process isQuality Assessment Review CommitteeQuality Assessment Review Committee:

1. Designated caseworkers will be notified by the Public Assistance Program Officer (PAPO) by email announcing that this month’s case errors have been uploaded to the QA Quality Assessment SharePoint site for their review. Within the same email, caseworkers will receive the CAPS Corrective Action Planning Spreadsheets identifying all errors by office, review number, program, sample month, error amount (if active), and the root cause of the error. Errors are assigned to the office the case is CARC’D to when the sample is pulled. All cases will remain with the original office for reporting purposes. If a region feels another office should respond to the CAPS then this must be worked out between the regions. Due to statewide caseload processing it can be difficult for QA Quality Assessment to determine the office responsible and must rely on the random sample.
   
   

2. Caseworkers will have seven days to review the QA Quality Assessment error documents. Caseworkers must provide a summary of how the case will be corrected and how the office will prevent future errors by the requested due date. All corrective action questions must go to the policy team not the QA Quality Assessment team.
   
   

a. SNAP Supplemental Nutrition Assistance Program errors:

From time to time caseworkers may determine that the error cited by QA Quality Assessment may be incorrect. QA Quality Assessment may have missed something or used incorrect verification, etc., if this happens it is extremely important that staff follow a request for additional review process. This process allows the QA Quality Assessment team to remain unbiased as required by federal regulation.

Request for additional review process:

When requesting an additional review, staff must have policy review the case before the request is sent to the QA Quality Assessment Program Officer (PAPO) for review. Once policy has reviewed and if the case still needs further review, an email is sent to the QA Quality Assessment Program Officer for review. The request for additional review must be received by the program officer no later than the current due date given for the errors. We are still under strict deadlines for all errors. The email must consist of all supporting documentation and verification that is needed for the review and a summary of why the case needs to be re-reviewed. The Program Officer will make a decision about the case within 5 days; once a decision is made there is no further recourse. As a reminder, staff is not to contact the household or any other collaterals during this review.

b. For all other programs (ATAP Alaska Temporary Assistance Program, APA Adult Public Assistance, Medicaid):

Caseworkers may contact the QA Quality Assessment supervisor for errors that are related to ATAP Alaska Temporary Assistance Program, APA Adult Public Assistance, and Medicaid only. The QA Quality Assessment supervisor will determine if the error will stand or be overturned.

3. For the QA Quality Assessment sample month and prior months no corrections will be made to a QA Quality Assessment review until an email with the final CAPS Corrective Action Planning Spreadsheets spreadsheet is received from the PAPO Public Assistance Program Officer releasing the errors for correction. This will be done immediately after the corrective action due date. Staff must not process overpayments or issue underpayments until after the CAPS Corrective Action Planning Spreadsheets is finalized. 
   
   

4. For future benefit months the Supervisor will have the worker take corrective action within three (3) days from the date of notification of the Q-form being posted to the QA Quality Assessment SharePoint site.  Correcting the case immediately will help avoid additional errors if the case is sampled for review again in a later month.
   
   

5. After the CAPS Corrective Action Planning Spreadsheets spreadsheet with corrective action planning is received by all offices with errors, the PAPO Public Assistance Program Officer will send the CAPS Corrective Action Planning Spreadsheets to the QA Quality Assessment supervisors for approval of office case action. The QA Quality Assessment supervisors have 24 hours to approve the CAPS Corrective Action Planning Spreadsheets.
   
   

6. Once the CAPS Corrective Action Planning Spreadsheets spreadsheet is approved by the QA Quality Assessment supervisors the PAPO Public Assistance Program Officer with send an email to the designated CAPS Corrective Action Planning Spreadsheets staff releasing all errors for corrective action.
   
   After the errors are released:
   
   

7. Supervisors addressing the case finding on the CAPS Corrective Action Planning Spreadsheets will notify the worker that the error has been finalized and corrective action should be taken. 
   
   

8. CAPS Corrective Action Planning Spreadsheets cases with errors will be corrected within two (2) days following the release of the error.  Staff will follow Administrative Procedure Manual Section 109-9H for documentation criteria and case note title.
   
   

9. Completed GEN 95 Report of Claim Determination forms must be emailed directly to yvonne.algabre@alaska.gov. Please make sure that the subject line states “GEN 95 Report of Claim Determination -CAPS Corrective Action Planning Spreadsheets”.   
   
   

10. Supervisors of the staff member responsible for the case correction will monitor to ensure corrections happen timely.
    
    

11. Supervisors will report to their Regional Case Reviewers (RCR Regional Case Reviewers) once corrective action has been taken.
    
    

12. RCR Regional Case Reviewer will monitor all CAPS Corrective Action Planning Spreadsheets errors for their Region and if the corrective action has not been reported back within seven (7) days, an email will be sent to the Supervisor asking for immediate action. 
    
    

13. Upon receiving notification the corrective action has been completed, the RCR Regional Case Reviewer will check EIS Eligibility Information System to ensure all actions (overpayment-GEN 95 Report of Claim Determination completed, underpayment – benefits issued, CANO Case Notes, notices) have been taken.
    
    

14. RCR Regional Case Reviewers will submit a report to the DOST Division Operations Support Team Case Reviewer no later than the 1st day of the following month identifying the error number and the case corrections.