That's All Folks!

Presently sitting at the airport awaiting my flight.  It was a great conference and I hope that by following this blog, you gained something from it as well.  I would love some feedback!!

Closing - W.H.I.S.T.L.E. While You Work - Wednesday - 9:45

Closing Speaker - W.H.I.S.T.L.E. While You Work

Wednesday - 9/12/12  9:45

LaWayne Salter - Florida 

Whistle while you work song

7 key strategies to improve performance and release your potential

3 types of individuals in the world -make things happen, watch things happen, wonder what happened

#1 - win big - celebrate your success - go to person - make things happen but sometimes forget to make things happen for yourself

changes your mood

if we don't celebrate ourselves, who will?

challenges your personal expectations

inspires others

#2 Harness the greatness within you

acknowledge and embrace it

find your niche

open your own "me market"  - be the resource everyone else requires - being marketable - be the problem solver

#3 Inventory and invest 

Look at the knowledge, skills and abilities we have and invest in what we need

#4 strengthen your weaknesses

A.C.T. - acknowledge, confront, train

everyone has weakness - acknowledge don't hide - confront the fear/ situation - train your weakness 

#5 trust your failures

opportunity to begin again more intelligently

it's an event and NOT a person

not failing - Not growing

learn from mistakes

#6 lose the excuses and leverage opportunities

tools of incompetence

devised to camouflage the real issues

un-ending possibilities

wants the day to say "he's up"

#7 evaluate and adjust your F.O.C.U.S.

Fear

Opportunities

Commitments

Understanding

Strategies

Fear motivates you to make a change - where are your opportunities? - are you overcommitments (first word for child is typically "no") people have a way to make us feel guilty for saying "No" - do we really understand what we are involved in  - have to have goals and roadmap for getting there

Maintain the momentum

stay in the stream of things (nemo and turles in the gulf stream) we should never be surprised by new things coming out

change lanes as needed - don't want people in front of you putting on the brakes unnecessarily - habital breakers - you have to be able to change lanes as needed

monitor your cruise control - don't get comfortable with what you are doing - life always has a way to throw things in front of us

 

Cee Candy Winners!!

Q5i Chocolate Winners!!

Congratulations to the winners of the Cee Candies which were awarded by the great folks at Q5i!!  Larry Goolsby of APHSA, Bertha Levin of APHSA, Jean Ryan from Kentucky and Terri Wilkerson from Florida will be bringing home a one pound box of chocolates!!!  Congrats!!

Nevada utilizes Q5i for SNAP QC reviews, TANF Data Reporting and Administrative Hearings.  Please contact me if you would like details on this robust application!!

QC Integrity - Completion Rates and Likely Conclusion - Tuesday 1:30

SNAP Program and QC Integrity - Completion Rates and Likely Conclusion

Tuesday 9/11/12  1:30

Fran Heil and Dave Young (FNS)

Completion rates should be at 98% or above.  

FNS has been monitoring this rate for some time and is concerned about the increases with the drops.  They are trying to figure it out.  And they have discovered multiple reasons.  Staff turnover contributes.  They have instructed regions to complete reviews to determine what the problems with completion rate are.  These QC ME reviews are often welcomed because information is shared about improving the completion rate.  FNS is always willing to provide technical assistance.

The FNS Office of Research and Analysis will be examining the issue of completion rates.  They will be conducting a study as to the who, what, when, where, how and why of the existing completion rate issue.

Dave -( PowerPoint will be added to the PartnerWeb soon)

Required at 98% minimum - if 95% or below, requires data analysis and corrective action plan.  In FY11, the national average was 92.84%. 

There is an adjustment to the regression rate if completion rate below 95%

In last 5 years there has been an improvement in the national average.

For States with a large sample size (1080 annual reviews), 2 cases per month will place you at 98% and 5 cases per month will place you below 95%.

NSTR versus Incomplete - difference is in attempts to locate the client.  For NSTR you must make 2 attempts to locate.  These attempts must be made with contacts who are likely to know the location of a client.  In order to qualify, there must be feedback from the source.  Therefore, documentation of the reviewer is critical.  Automation can assist in these location attempts.

Likely conclusion can be a great source to complete a case missing minimum information.  But you must follow the rules to get there.  

Regulations for NSTR are located at 310 Section 330-338 & 7 CFR 275.12(g)(2) -  If clients have moved out of state, the case is NSTR.  If client is hospitalized, the case is NSTR.

Unable to Locate NSTR - HB 310, 442.1 - rarely seen anymore because of electronic case records.  Usely a falsified case in today's world.  

UTL - you must be abel to document 2 elements of eligibility and have 2 attempts to loccate for NSTR to apply.  

What is difference between UTL for NSTR and Incomplete?  creating confusion, FNS is looking at 310 modification to clarify.

There can be no direct client contact in a NSTR disposition.  

If case is NSTR, cannot be completed.

If incomplete, contact with the state eligibility staff is allowed in efforts to locate the client and to advise them on the client's non-cooperation.  In all cases where the client has refused to cooperate or failed to cooperate, the SAQC MUST attempt to complete the case.  Example case where client had completed a recert and 15 days later was pulled for QC.  Client refused to cooperate but all asects of eligibiilty was verified at recent recert.  Case can be completed with likely conclusion.

Verifications must be reviewed to determine if it meets the verification requirement and it does not conflict with any other evidence.  

Example:  Case was incomplete due to missing rent verification.  However, the rent in and of itself doe not change the outcome of the allotment when a budget is completed.  Therefore, likely conclusion could be utilized to complete the case.

Judging the reliability of the evidence - Recently a case was re-reviewed where a homeless client was being dropped as incomplete.  One of the contacts was a priest in charge of a local homeless shelter.  QC asked him to let the client know that QC was looking for him.  Priest got back to QC that he had passed on the message and QC had documented this.  Changed the outcome from UTL to refusal to cooperate.  QC staff must use prudent judgment and clearly document.

Waivers have been creating problems for the QC review process.  State waivers are for the benefit of eligibility processing usually.  QC has their own verification standards which must be adhered to.

The worksheet is required for dropped cases.  It is part of the review process.  The 380 worksheet documents the work SAQC did to attempt to complete the review for both internal state staff and FNSQC.  Document the worksheet clearly.

Likely conclusion - must attempt to verify all elements - document all efforts to verify elements - cannot use likely conclusion for non-citizen status, IEVS bank accounts and employment, vehicles, SSNs and work requirements.

Always use what information is available to you. 

Questions:

Q:  Gary from Minnesota - Homeless ABAWDS what would you suggest be used as a second contact if they have general address as a postal address.  A: Dave - NY has a homeless department.  Use a local homeless shelter contact, soup kitchen, use relative contact identified in the case record.  Last resort, use the local certification office to determine if they have had any recent contact with the client.  

Q:  NSTR - did not access benefits in review month in 2 following months, what about $16 households who stockpile their benefits.  Are they still NSTR?  A:  Dave - Yes

Q:  Coment about EBT benefits and access - if clients don't access EBT within 90 days, the account goes off line and the EBT card had to be reactivated.  

Q:  Mentioned about the rent and could not verify but did not make a difference in the allotment, what about income.  We have been told that if the income could not be verified, the case could not be completed.  seems like a double standard. A:  You must be able to complete a comparison 1.  Bottom line.

Q:  Gary from Minnesota - follow up with likely conclusion - they were told by their regional re-reviewer that likely conclusion could not be used for comp I.  A:  Fran - comp I must be completed.  Not trying to get into dispute about what they were told by regional staff.   

Fran is trying to determine what prevents state staff from being able to complete a case.  He needs to know what is preventing cases from being completed so they can adjust policy is needed.

Completion of comp I is critical for ability to complete a review.  You must be able to complete comp I for case to be completed.  

Q:  Bob from Alaska - states are in a catch 22 situation.  If they don't complete, the FNSQC could complete with likely conclusion and regress the finding.  A:  Dave - yes.  That is why you should arbitrate the FNSQC finding if necessary.  (Side note - in these types of disagrees, you can only arbitrate the disposition on the case.  You cannot arbitrate the error finding amount.) 

Q:  Collins from Arkansas - States would love to have a committment that something will be send to the regions to ensure that everyone is on the same page.  Arbitration is a labor intensive process.  A:  Fran will commit to having a conference call with regional FNS staff.  

SNAP Technical Advisory Group (TAG) - Tuesday 3:30

QC Technical Advisory Group (TAG) Meeting

Tuesday, 9/11/12   3:30

FNS Headquarters staff

Timeliness of Recertifications, Error Coding, Open forum for raising issues and asking questions

Liz Weber - Recertification Timeliness Coding -  Update - FNS will measure effective 10/11.  Had 14 states participate in pilots.  They conducted surveys and made adjustments along the way.  Feedback was that it wasn't that bad.  Training was less than a day.  Saw room for improvement due to completion of the pilot.  Handout is new page for the recert timeliness codes.  Limit review to the previous 12 months prior to the sample date.  Will be released on PartnerWeb.  

Fran Heil - Training materials will be released before the end of September.  5 tools and one of them is the 310 update page.  Will be posted to PartnerWeb.

Clarification - Code 30 on the 310 update draft indicates a case was issued benefits outside of the approved certification cycle.

Q:  Will this information be part of the June notification letters to the Governors?  A:  No, the letters to the Governors announce the error rates which this has nothing to do with.  Until it becomes a issue, it will not be updated with the Governors.

Q:  Is code 68 and 70 required for all reviews.  A:  Yes.  Both deal with the timeliness measure.  Be sure to follow the directions carefully.  It is possible that both measures will be coded for the same action.

A webinar will be scheduled for training on this in October.

Nancy Baca-Stepan - Arbitrations 

Fran Heil- Nancy has the right to talk to any FNS staff for clarification on policy based issued.  They are not making decisions.  They are trying to ensure that she has the support from FNS she needs.  And Nancy added that if a State feels they need to talk to her about an arbitrated issue, they need to contact her to schedule a time to do so.  But everyone needs to understand that she will not make a decision on the fly or over the phone.

She wants us to know that she does not know your State.  When you submit a arbitration packet, you must explain your acronyms, codes, etc.  When you submit a packet, explain a little bit about your State.  For example, if the issue involves income, explain what your conversion calculation is.

Also, explain what your policy references indicate.  

Chapter 14 is your friend when submitting an arbitration packet.  The format for QC cases clarification memo should be followed also.  Even when cases are electronic.  

If there is something confusing to you, please contact her.

Q:  Fran from FNS - Is there anything additionally which needs to submitted with the negative review packets?  A:  She has seen two things - is the notice clear and understandable? and is there a procedural issue?  

 Dave Young - FNS is coming up with a new option for completing the clint interview.  Effective FY13, by waiver, States will be allowed to conduct video interviews in leu of face-to-face interviews.  There will be no restriction on the case allotment value.  Fran does not intend to make States submit anything to apply for this.  Rather codes will be added to the schedule to capture this as an interview type in field 69 and the 310 will be updated.

Oregon has had a waiver since 2007 and recently Pennsylvania was approved for this waiver.   However, the following parameters must be adhered to: (1) state agency must have a secure link for the video conference.  (2) if clients prefer a face-to-face interview that must be made available and a client's failure to agree to a video conference cannot be perceived as a refusal to cooperate.

Draft policy will be provided to states for comment and feedback soon.  But Fran suggests that States carefully consider this practice and roll it out over time.   

Congress wants to know the difference in error rates under the tolerance levels and between the $25 and $50 tolerance levels.  That's why there was a recent rush to provide the data to FNS.   They are trying to gather information so they can fight to keep the $50 threshold.  

Fran has been shifted into a new position at FNS and will no longer be the National Headquarters QC Chief.  He will be responsible for moving QC projects along rather than supervising the QC staff.  However, he will continue to work with the new QC Chief daily.  The position is presently announced on USAJobs.  Anyone who is interested should apply.

APHSA President's Message - 9/12/12

APHSA president - Tracy Wareing

Tuesday General Session 9/11/12 - 8:30

Pathways to the Future

What is the next generation of human services?  What will future look like?  

Pathways involves presenting the opportunities ahead for human service agencies.  It involves using capital wisely. And is built on members input.  Focus is on promoting sound efficient, workable and sustainable solutions to the needs of low income populations and those served by social service programs. 

Today's reality present challenges - growing needs and less resources - rigid oversight - volatile political environment - unsustainable path presently - what should we look at changing in national policies?

Pathways is an action agenda of policy and practice reforms designed to help secure the next generation of health and human services delivery.

It is an ongoing effort & movement, not just documents or corrective action plans. 

It is about the integration and alignment of programs and services within and across government and private sectors.  It is about shared government moving beyond traditional lines and advancing a shared agenda with other public sector partners, the private non-profit sector and businesses.  It is about deliberate experimentation allowing for research and development that fosters innovation.  It is about elevating existing practices.  

Accomplishments which are noteworthy which involve SNAP, TANF and other programs, clear impacts on federal policies record achievements in program integration.  SNAP is presently experiencing historically low Active error rates.   Budget outlook remains stagnant - caseloads could keep raising, narrow focus on accountability for process rather than results may continue.   

Outcomes sought - gainful employment and independence, stronger families and communities, healthier families and communities, sustained families and communities

key elements which are preventative, collaborative and strategic - prevention, early intervention, bridge supports, capacity building and sustainability.

foundational tools - flexible financing, technology infrastructure, a prepared workforce, client engagement, accountability - think through projects 

pathways - what are we doing?  published documents- policy briefs setting policy priorities for four outcomes; specific policy recommendations - raise the locals voice initiative - launch innovation center 

national workgroup on integration - APHSA led collaboration with federal and vendor partners to identify opportunities and practical solutions for integrating human services and health programs - exemplifies the type of partnerships desired to transform the health and human services system -focused on providing practical, real-time guidance for states/localities - website

innovation center - launching pad for emerging issues and breakthrough innovations - supports transformation to an integrated outcome-focused model - four initial focus areas - alternative financing of human services, adaptable leadership, government's role in the 21st century, social return on investment.

What lies ahead?  dissemination of Pathways statements on core vision, principles, and recommendations - specific policy recommendations - website

where are key opportunities for change?  where can policies be aligned?  Let APHSA know if you feel something is missing in their policy briefs/ recommendations

Tuesday Opening Session - 8:30

Perspectives on the Roadmap from Today to 2015:  Federal Panel

Tuesday, 9/11/12  8:30

Kay Brown (GAO), Andrew Feldman (OMB), Jessica Shahin (FNS) and Michelle Dilks (ACF)

 Kay is Director ...  Andrew is .... (on phone)  Jessica is ... Michelle is ....

Kay - thanks for good work you do - GAO legislative branch agency reports to congress and reviews federal funds - 2 challenges presently are increasing needs and increase in aging populations which in turn create need for additional services. In '11, 7,600 individuals per day turn 65.  There are significant fiscal constrains with present practices being unsustainable over long term.  There was a total of 493 billion awarded  in grants last year.  The focus over the  next few years: effectiveness, efficiencies, integrity.  The SNAP program is gaining attention in the areas of fraud, waste and abuse.   Also,  duplication of services and program overlap study will be their upcoming 3 yr project.  Programs are too complex to clients, the program administrators and agencies who monitor.  Programs must gain administrative efficiencies through application process, alignment of policies, and other fragmentation issues.  Key factors for success in collaboration - strong leadership and agreement on goals along with results oriented decision making. Does data measure what we want measured?  For example, the TANF WPR is flawed.  There are better measures for performance.  What should be monitored and measured and still keep the focus on work?    Support policy alignment, innovative practices.

Andrew (via phone connection) Has tracked historical initiatives and elements.  How do we balance the need to put money into things which work while at the same time investing in innovations?  Suggests tiered investment opportunities:  what works?   what could work?  Proof of concept tier using the least amount of money available.  How do we harness private investment?  Suggests modeling from the social impact bonds from England which is used in current grant innovations.  How do we work across agencies for better outcomes and provide opportunities for cross funding?   Recently the director of OIB issued memorandum m-12-14 (which is available on the OIB website) Challenges agencies to prepare new ways to do things in next budget through waivers and partnerships. Develop technological investments.  And use grants to do what works for agencies during tough budget times. 

Michelle - ACF vision for Child Care is that more children in low-income families are able to access high quality child care.  Their goals include strengthening program integrity, building a child care subsidy system that can support child development, ensure the health and safety of children, build quality rating and improvement system and  build strong professional development and workforce initiatives.  CCDF funds require an application for funds, application approval and fund allocation, states are required to submit  data reports and required amendments, conduct quality activities, submit fiscal reports, participate in audits, and complete error rate reporting.  Recent developments in technical assistance launched the National Center on Child Care Subsity Innovation and Accountability.  This will integrate program integrity and provide enhanced technical assistance. Recently there has been a national conference call series on Fraud Prevention (200+ participants).  There are also requirements to conduct internal controls through self-assessment tools.  Changes to the error rate methodology  is presently in clearance process (first year impacted will be 2014) There will also be an error definition workgroup established.  This group will also issue informational memos and data reports will include information on the quality of childcare.  The goal is to create balance between access to services and quality of care. 

Jessica -Thanks!  The work we do  makes a difference every day.  Presently, SNAP is under a lot of scrunity but thanks to the QC process, we have data to support the integrity of the program.   We have  proven that the program can have both access and integrity.  Customer service, integrity and access is a three legged stool. FNS tries to provide the tools States need.  Take advantage of PartnerWeb.  Share good practices.  She tries to talk to commissioners, administrators and program leaders.  Encourages us to talk all the way through our organizations.  Participate in state exchange program sharing.  She believe there probably needs to be more clearity  with communications. Iimproper payments, fraud and abuse are firmly established. Presently the administration of program involves a focus on integrity. For example, they are presently working on rules for receiptants EBT card replacement guidance.  And they actively fight fraud on their website and fight fraud on social media sites. FNS has built a tool to manage searches of social media websites which will search via a e-mail notification process. This was developed with  partnership funds.   There are also plans for a national clearinghouse project which will check for dual participation across states.  A pilot of this revealed a "hit" response of  less than 1% in the 10 state pilot. Success creates new challenges. How can you get the rate lower?   Upcoming focus will be to examine the  complexity and possible integration with other federal programs.  This will involve using administrative process improvements.   Idaho is already strong in this - using technology in process improvements.  There are  $5 million in grants available each year and business process re-engineering awards are available for states which are having difficulties.  We also need to improve access to healthy foods. The farm bill may continue for another year.  Congress is looking to save money on the program not spend more money.  Recognized states who have achieved good program delivery through high completion rates (law requires 95%) - Virgin Islands 99.3%, Wyoming 99.29%, North Dakota 98.87%, North Carolina 98.75%, Mississippi 98.6%, Kentucky 98.28%, Idaho 98.125%, Rhode Island 98.07%