Adult Medicaid Manual MA-2306 APPLICATION PROCESSING – CORRECTIVE ACTION PROCEDURES

II. REPORT CARD FAILURES

A. Adjusted Application Report Card

1. Non-compliance occurs when a county department of social services fails to meet the thresholds for Average Processing Time (APT) or Percent of Cases Processed Timely (PPT) for one month.

2. Report card performance may impact the county in two different ways:

a. Failure to meet the compliance thresholds in either Average Processing Time (APT) or Percent Processed Timely (PPT) for one month in either category may require that the county be monitored annually rather than every two years. See IV. below.

b. Non-compliance with processing thresholds in either APT or PPT on the Adjusted Application Report Card for three consecutive months, or, five months out of any twelve consecutive months, may be cause to convene a Local Compliance Team (See V. below for specific procedures).

3. Analysis of Non-Compliance

For any failure to meet the compliance thresholds on the report card, the county must complete an analysis to determine the reason cases pended beyond the due date. In addition to pulling the case records that may have caused the failure, use the DMA-5167, County Analysis – Non-Compliance, to assist in analysis of non-compliance and development of corrective action. The questions are a guide for help in completing analysis of the causes of the failure. Use the DMA-5167, County Analysis – Non-Compliance when the county does not meet monitoring compliance thresholds.

REVISED 11/01/11 – CHANGE NO. 17-11

(II.A.)

4. Documentation of Report Card Analysis

a. After completing the analysis, the county department must document findings, prepare a corrective action plan if necessary, and document when actions are taken. Complete the DMA-5169, Report Card Analysis.

b. Keep this information in a central file or notebook so the MPR can review it. This will also assist the county with any future concerns or disputes about corrective action taken or needed.

c. The MPR will review the county findings and assist in addressing any problem issues and in developing a corrective action plan.

d. State staff may also review the corrective action plan and documentation of action taken to assure that the plan is adequate to address the problems identified. The county retains full responsibility for development, implementation, and tracking of the corrective action plan.

B. Actual Time Report Card

Failure to meet the thresholds on the Actual Time Report Card may indicate a lack of understanding of exclusion of time. These cases should be reviewed to determine if the exclusion of time was correct. Follow procedures in II.4.a. above.