113-4          CORRECTIVE ACTION PLANNING SPREADSHEET (CAPS)

The CAPSCorrective Action Planning Spreadsheets is a monthly report to DPADivision of Public Assistance staff identifying errors discovered during QAQuality Assessment reviews of Alaska Supplemental Nutrition Assistance, Alaska Temporary Assistance, Adult Public Assistance, and Medicaid programs. The CAPSCorrective Action Planning Spreadsheets process is:

1. Designated caseworkers will be notified by the Public Assistance Program Officer (PAPOPublic Assistance Program Officer) by email announcing that this month's case errors have been uploaded to the QAQuality Assessment SharePoint site for their review. Within the same email, caseworkers will receive the CAPSCorrective 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 CARCCase Record Control'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 CAPSCorrective Action Planning Spreadsheets then this must be worked out between the regions. Due to statewide caseload processing, it can be difficult for QAQuality Assessment to determine the office responsible and must rely on the random sample.
2. Caseworkers will have seven days to review the QAQuality 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 QAQuality Assessment team.

a. SNAPSupplemental Nutrition Assistance Program errors:

From time to time, caseworkers may determine that the error cited by QAQuality Assessment may be incorrect. QAQuality 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 QAQuality 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 QAQuality Assessment Program Officer (PAPOPublic Assistance Program Officer) for review. Once Policy has reviewed and if the case still needs further review, an email is sent to the QAQuality 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 (ATAPAlaska Temporary Assistance Program, APAAdult Public Assistance, Medicaid):

Caseworkers may contact the QAQuality Assessment supervisor for errors that are related to ATAPAlaska Temporary Assistance Program, APAAdult Public Assistance, and Medicaid only. The QAQuality Assessment Supervisor will determine if the error will stand or be overturned.

3. For the QAQuality Assessment sample month and prior months, no corrections will be made to a QAQuality Assessment review until an email with the final CAPSCorrective Action Planning Spreadsheets spreadsheet is received from the PAPOPublic 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 CAPSCorrective 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 QAQuality 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 CAPSCorrective Action Planning Spreadsheets spreadsheet with corrective action planning is received by all offices with errors, the PAPOPublic Assistance Program Officer will send the CAPSCorrective Action Planning Spreadsheets to the QAQuality Assessment supervisors for approval of office case action. The QAQuality Assessment supervisors have 24 hours to approve the CAPSCorrective Action Planning Spreadsheets.
6. Once the CAPSCorrective Action Planning Spreadsheets spreadsheet is approved by the QAQuality Assessment supervisors, the PAPOPublic Assistance Program Officer will send an email to the designated CAPSCorrective Action Planning Spreadsheets staff releasing all errors for corrective action.

After the errors are released:

7. Supervisors addressing the case finding on the CAPSCorrective Action Planning Spreadsheets will notify the worker that the error has been finalized and corrective action should be taken.
8. CAPSCorrective 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 95Report of Claim Determination forms must be emailed directly to yvonne.algabre@alaska.gov. Please make sure that the subject line states "GEN 95 - CAPS."
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 (RCRRegional Case Reviewers) once corrective action has been taken.
12. RCRRegional Case Reviewer will monitor all CAPSCorrective 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 RCRRegional Case Reviewer will check EISEligibility Information System to ensure all actions (overpayment - GEN 95Report of Claim Determination completed, underpayment - benefits issued, CANOCase Notes, notices) have been taken.
14. RCRRegional Case Reviewers will submit a report to the DOSTDivision Operations Support Team Case Reviewer no later than the 1st day of the following month identifying the error number and the case corrections.