R510-400-18. Contract Compliance

  (1) The Division is responsible for monitoring Home and Community Based Alternatives Services and Older Americans Act Title IIIB Programs. Each Agency shall be monitored annually.

  (2) PROCEDURE-Scheduling:

  (a) The Agency shall be notified at least 10 working days prior to an annual monitoring review. The Division will notify the Agency of the procedures, scheduling, monitoring standards and any other relevant information concerning the monitoring visit.

  (3) PROCEDURE- Division Monitoring Procedures:

  (a) In preparation for the monitoring visit, the Division shall review any corrective action reports, correspondence identifying technical assistance needs, and other pertinent information.

  (b) The Division will monitor service program activities, case records, service expenditures, caseloads and contractual provisions.

  (c) The Division will review randomly selected case records and interview the clients and Agency Case Managers as necessary to complete the monitoring process.

  (d) A minimum of 10% or ten case records (whichever is the largest of the case load) will be reviewed. At times more records, up to 100% of program records, may be reviewed if the Division finds significant program inconsistencies, errors in documentation, inadequate provision of service, or any other aspect that the Division deems necessary.

  (e) An exit interview will be conducted with the Agency Director or designee. The purpose of this interview is to present findings of the monitoring visit. The findings shall include:

  (i) Overall evaluation of the performance of the Home and Community Based Alternatives Services Program.

  (ii) Contractual, Policy and Procedure deficiencies.

  (iii) Situations where additional review of case files of other documentation is necessary.

  (iv) Areas where a plan of correction will be needed.

  (v) Identify and recognize positive or innovative aspects of the Agency's service program.

  (vi) Client comments.

  (g) The Division may request a Department fiscal/contract audit of the Agency. This audit may be requested when the Division documents problems concerning:

  (i) Budget balance

  (ii) Agency Service Provider sub-contract monitoring.

  (iii) Case Management supervision.

  (iv) Provider/Client complaints.

  (v) Timely payment for service.

  (vi) Intake and referral.

  (vii) Access problems.

  (viii) Eligibility problems.

  (h) PROCEDURE-Division Monitoring Report:

  (a) The Division shall provide the Agency with a written report of its formal findings within 10 working days of the monitoring visit.

  (b) The report will include contractual, policy and procedural compliance status and areas of special concern.

  (c) The Division will require a corrective action plan that addresses noncompliance issues as needed.

  (4) PROCEDURE-Responding to Reports:

  (a) The Agency may appeal issues of disagreement to the Division within 10 working days from receipt of the report. If the Division, upon appeal, concludes that a corrective action must take place, the Agency will implement the action.

  (b) A correction action plan will be implemented in accordance with an agreed upon time schedule, but will not exceed 90 days from the time the Division approves the plan.

  (c) The Division will provide technical assistance to the Agency, as requested, to complete the correction action plan. The Agency will notify the Division upon implementation of the corrective action plan. The Division may make additionally monitoring visits to the Agency to review records and assure that the corrective action plan requirements were met.

  (d) The Division may enact the termination clause of the DHS contract if a corrective action plan is not implemented by the Agency.