113-1          PURPOSE OF QUALITY ASSESSMENT

The Quality Assessment ( QA Quality Assurance ) review provides valuable statistics and information on the agency's performance in delivering benefits.   QA Quality Assurance reviews measure:

• Payment accuracy,
   

• Case management techniques,
   

• Effectiveness of policy and procedures, and
   

• How well we perform in our mission to promote self-sufficiency and provide basic living expenses to Alaskans in need.

The QA Quality Assurance review is the primary tool used by staff to develop training initiatives, policies, and techniques that will enhance the delivery of services and benefits to DPA Division of Public Assistance ’s recipients.  For Alaska's Medicaid, Food Stamp, and Child Care programs, the QA Quality Assurance review is a federal requirement.  For other DPA Division of Public Assistance programs, QA Quality Assurance reviews ensure that policies and procedures meet state laws and achieve the agency’s mission.

113-1 A.     MEDICAID PROGRAM

Two types of reviews are conducted for the Medicaid program; Medicaid Eligibility Quality Control ( MEQC Medicaid Eligibility Quality Control ) and PERM Payment Error Rate Measurement .   MEQC Medicaid Eligibility Quality Control is a targeted review of specific services.  Through targeted reviews, DPA Division of Public Assistance is able to extract information needed to design effective and efficient Medicaid policies.  Payment Error Rate Measurement ( PERM Payment Error Rate Measurement ) reviews are assigned on a cycle, requiring completion of one year out of every three.

113-1 B.     ADULT PUBLIC ASSISTANCE PROGRAM

The QA Quality Assurance review provides information about quality of work, clarity of the program's policies, and effectiveness of the procedures in delivering the benefits.

113-1 c.     ALASKA TEMPORARY ASSISTANCE PROGRAM

The QA Quality Assurance Reviewers evaluate the effectiveness of the Alaska Temporary Assistance Program's policies and procedures.   QA Quality Assurance Reviewers conduct complete case reviews, including home visits when possible, and contact with clients by telephone.  the type of information gathered changes depending on the program's performance measures and the focus or desired results of new policies.  Yearly, Legislative Audit randomly selects cases from the completed reviews to validate the QA Quality Assurance Reviewer's findings.

113-1 D.     FOOD STAMP PROGRAM

The Food Stamp Quality Assessment review includes specific review elements, required documents and verifications, and strict time frames for completing the review process.  The federal agency, Food and Nutrition Service ( FNS Food and Nutrition Service ), closely regulates and monitors the process,verifying that case samples are statistically random and that the transmission of the review findings is completed according to policy.  FNS randomly selects cases from those transmitted to monitor Alaska's Food Stamp Program  compliance with federal regulations, and to ensure QA Quality Assurance follows the required FNS review process.  Alaska's final Food Stamp Program payment error rate is finalized when the process has been completed for all cases reviewed during the federal fiscal year.

113-1 E     CHILD CARE ASSISTANCE PROGRAM

The Child Care review process is a statistically random sampling of authorized cases, by regional office, in accordance with the federal government's Child Care Development Fund requirements.  Results from this review process provide confirmation of proper authorizations, and assist Alaska's child Care Assistance Program with continued improvement of process and procedures.

113-1 F.     OTHER PROJECTS

Often the QA Quality Assurance Unit performs ad-hoc review projects for the Division.  These include Site Assessments, Management Evaluations, and case readings that may target an office, unit, worker, or type of client. (An example of this might be reading all Food Stamp cases with members who are commercial fishermen.)  The QA Quality Assurance Program Officer works directly with the appropriate leadership or team staff members to define and organize these projects.