Quality Compliance

On June 5, 2018, Maryland Department of Health conducted an initial audit of our SPS Program.   The purpose of the audit was to determine SCI’s compliance with the 2017 Provider Solicitation for Comprehensive Case Management and Supports Planning Services for Medicaid Long-Term Services and Supports. The audit period was March 17, 2017 to December 31, 2017.  The outcome of the audit showed that SCI was 72% compliant with the Solicitation Requirements.  For the purposes of this audit, 86% and above is considered a compliant score, therefore SCI was found to be out of compliance.

Thirteen deficiencies were found:

1. Submit of Quarterly Conflict Report
2. Completion of Monthly Monitoring Forms
3. Completion of Initial Visit within 14 days
4. Contact LHD for Late InterRAI Assessment
5. Contact MDH for Late InterRAI Assessment
6. Completion of Community Setting Questionnaire
7. Obtain Plan of Service Signatures
8. Submit Plan of Service within 20 days of InterRAI Completion
9. Make Direct Contact with Participants Monthly
10. Meet In-person with Participants Every 90 Days
11. Completion of Monthly Monitoring Forms
12. Ensure Approval of Annual Plans of Service
13. Submit Weekly Billing Audits

As a result of the audit, the following actions were taken:

1. Review and revision of SPS Procedures.
2. Re-education of Supports Planners.
3. Development and implementation of SP Tracking Tool, which tracked Solicitation due dates.
4. Development and implementation of the Quality Improvement Plan which required monthly
   audits of the 13 deficiencies.
5. Routine monitoring and modification of processes.

An improvement in the average monthly Quality Compliance percentage was seen through the year as indicated below in the graph. It reflects the monthly results of the Quality Improvement Plan audit.

Person-Centered Activity

Supports Planners are responsible for providing quality person-centered case management services to the people they serve and should be spending the majority of their work time doing so.   Performance Utilization measures the amount of a Supports Planner’s work time that is spent providing person-centered activities.

To increase Performance Utilization, the following actions were taken:

1. Review and revision of associated SPS Procedures.
2. Re-education of Supports Planners and Supervisor led coaching.
3. Development and implementation of SP Activity Logs and Performance Utilization Reports.
4. Development and implementation of Incentive and Bonus Programs.
5. Routine monitoring and modification of processes.

This process includes steps for both Supervisors and Support Planners that supported consistency and progress across the program with a significant steady increase in average Performance Utilization percentage throughout the year as indicated below in the graph.