Family and Children's Medicaid MA-3217 EVALUATING COUNTY/DDS PERFORMANCE

II. POLICY PRINCIPLES

A. Counties and DDS must meet monthly average processing time (APT) standards and percent processed timely (PPT) standards. Monthly report cards are generated by EIS and used to measure County and DDS performance on APT and PPT.

1. The monthly APT standard for counties is 45 or 90 days depending on the aid/program category. Refer to IV.A. In addition, counties must also timely process 85% or 90% (depending on county size) of the applications processed in that report month. Refer to IV.B.

2. On a statewide basis, DDS must also meet APT and PPT standards. The monthly APT for DDS is 70 days for MAD applications. In addition, DDS must also render a disability decision on 85% or 90% (depending on county size) of the MAD applications processed in that report month. Refer to IV.B.

B. The county DSS and DDS are monitored annually or biannually via record review by DMA monitoring staff to ensure compliance with, acceptance of, and disposition of applications without delay. Frequency of this monitoring is determined by the agency’s performance on the monthly report cards.

(II.B.)

1. An Actual Time Report Card showing the exact APT/PPT and an Adjusted Application Report card showing the APT/PPT after an allowance for excluded processing days, is produced each month for both the county and DDS. Refer to V.A.

2. Report cards for the prior month are produced on the night of the 5th working day of the next month. For example, the October report card is run on the 5th work night in November.

C. The county DSS must correct cases that are identified by DMA monitoring staff, Medicaid Program Representatives, QC staff, county DSS staff, or local/state hearing officials as being dispositioned improperly. See MA-3215, Processing the Application, for procedures.

D. The Medicaid Program Representatives monitor the reopening of applications cited by DMA monitoring staff as being improper dispositions.