access & intake community services...

ACCESS & INTAKE COMMUNITY SERVICES CONTRACTS

Contract Enrollment Work Measurement Study

Program Specialists September – November 2011

FINAL REPORT 2012

Prepared by:

Work Measurement Unit Budget & Data Management Services

Chief Financial Officer Division Texas Department of Aging & Disability Services

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ACKNOWLEDGMENTS The Work Measurement Unit of the Texas Department of Aging & Disability Services (DADS) conducted this work measurement study of Community Services Contract Enrollment Program Specialists. The following Work Measurement staff coordinated the collection and conducted the analysis of all data used in the preparation of this report: • Jan Amazeen, Unit Manager • Rick Ash, Senior Analyst • Hope Hargrove, Senior Analyst • Brad Wood, Senior Analyst Paul Straka, Manager, Judy Sauls and Cecile Hay, Program Specialists, of the Community Services Contract Enrollment program guided the design and implementation of the study. Lena Brown-Owens, Shelley Swisher and Cecile Hay provided program product counts of completed actions. Leanor Johnson, Human Resources Specialist for the Department of Health and Human Services Commission, provided time and leave data. A special “thank you” to all of the Community Services Contract Enrollment Program Specialists who participated in the study for their professionalism, patience and persistence in completing the study. Each participant is a credit to the Community Services program.

Please send requests for information or reports to:

Work Measurement Unit (W-421) Texas Department of Aging & Disability Services

P.O. Box 149030 Austin, Texas 78714-9030

(512) 438-3785

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TABLE OF CONTENTS

ACKNOWLEDGMENTS ................................................................................................................................ i

TABLE OF CONTENTS ............................................................................................................................... ii

EXECUTIVE SUMMARY

Executive Summary ...................................................................................................................................... x

Key Findings ................................................................................................................................................ xi

INTRODUCTION

Background ................................................................................................................................................... 1

Study Design ................................................................................................................................................. 1

STANDARD TIMES

Standard Time Definition ............................................................................................................................... 7

Standard Time Results ................................................................................................................................ 10

PERCENTAGE OF TIME

Action .......................................................................................................................................................... 11

Program....................................................................................................................................................... 12

Activity ......................................................................................................................................................... 13

PERCENTAGE OF TIME - ACTION BY PROGRAM BY ACTIVITY

Contract Enrollment: Program Summary .................................................................................................... 14

Contract Enrollment: Activity Summary ...................................................................................................... 15

Contract Enrollment: PHC/FC/CAS Summary ............................................................................................ 16

Contract Enrollment: MDCP Summary ....................................................................................................... 17

Contract Enrollment: CDS Summary .......................................................................................................... 18

Contract Enrollment: Hospice Summary ..................................................................................................... 19

Contract Enrollment: CBA Summary .......................................................................................................... 20

Contract Enrollment: DAHS Summary ........................................................................................................ 21

Contract Enrollment: CLASS/CMA Summary ............................................................................................. 22

Contract Enrollment: CLASS/DSA Summary .............................................................................................. 23

Contract Enrollment: DBMD Summary ....................................................................................................... 24

Contract Enrollment: Remaining Programs ................................................................................................ 25

Termination/Cancellation: Program Summary ............................................................................................ 26

Termination/Cancellation: Activity Summary .............................................................................................. 27

Termination/Cancellation: PHC/FC/CAS Summary .................................................................................... 28

Termination/Cancellation: CWP Summary ................................................................................................. 29

Termination/Cancellation: CBA Summary .................................................................................................. 30

Termination/Cancellation: Remaining Programs ........................................................................................ 31

Change/Update: Program Summary ........................................................................................................... 32

Change/Update: Activity Summary ............................................................................................................. 33

Change/Update: PHC/FC/CAS Summary ................................................................................................... 34

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Change/Update: CDS Summary ................................................................................................................. 35

Change/Update: Remaining Programs ....................................................................................................... 36

Contract Assignment: Program Summary .................................................................................................. 37

Contract Assignment: Activity Summary ..................................................................................................... 38

Contract Assignment: Hospice Summary ................................................................................................... 39

Contract Assignment: DAHS Summary ...................................................................................................... 40

Contract Assignment: PHC/FC/CAS Summary .......................................................................................... 41

Contract Assignment: Remaining Programs ............................................................................................... 42

Contract Extension: Program Summary ..................................................................................................... 43

Contract Extension: Activity Summary ........................................................................................................ 44

Contract Extension: PHC/FC/CAS Summary ............................................................................................. 45

Contract Extension: CBA Summary ............................................................................................................ 46

Other Amendment: Program Summary ...................................................................................................... 47

Other Amendment: Activity Summary ......................................................................................................... 48

Other Amendment: Hospice Summary ....................................................................................................... 49

Other Amendment: PHC/FC/CAS Summary .............................................................................................. 50

Other Amendment: Remaining Programs ................................................................................................... 51

SARC: Program Summary .......................................................................................................................... 52

SARC: Activity Summary ............................................................................................................................ 53

SARC: DAHS Summary .............................................................................................................................. 54

SARC: Remaining Programs ...................................................................................................................... 55

Regional Amendment: Program Summary ................................................................................................. 56

Regional Amendment: Activity Summary .................................................................................................... 57

Regional Amendment: CBA Summary ........................................................................................................ 58

Regional Amendment: Remaining Programs .............................................................................................. 59

Expiration: Program Summary .................................................................................................................... 59

General Program Related: Activity Summary ............................................................................................. 60

CONCLUSION

Limitations ................................................................................................................................................... 61

APPENDIX A: Basic Study Statistics ................................................................................................ A-1

APPENDIX B: PDA PowerPoint Demo ............................................................................................. B-1

APPENDIX C: Study Codes & Definitions ........................................................................................ C-1

APPENDIX D: Study Instruction Booklet .......................................................................................... D-1

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ILLUSTRATIONS

Figures

Figure 1: Study Instrument Decision Tree ........................................................................................... 2 Figure 2: Action .................................................................................................................................. 11 Figure 3: Program .............................................................................................................................. 12 Figure 4: Activity ................................................................................................................................ 13 Figure 5: Contract Enrollment: Program Summary............................................................................ 14 Figure 6: Contract Enrollment: Activity Summary .............................................................................. 15 Figure 7: Contract Enrollment: PHC/FC/CAS Activities ..................................................................... 16 Figure 8: Contract Enrollment: MDCP Activities ................................................................................ 17 Figure 9: Contract Enrollment: CDS Activities ................................................................................... 18 Figure 10: Contract Enrollment: Hospice Activities .............................................................................. 19 Figure 11: Contract Enrollment: CBA Activities .................................................................................... 20 Figure 12: Contract Enrollment: DAHS Activities ................................................................................. 21 Figure 13: Contract Enrollment: CLASS/CMA Activities ...................................................................... 22 Figure 14: Contract Enrollment: CLASS/DSA Activities ....................................................................... 23 Figure 15: Contract Enrollment: DBMD Activities................................................................................. 24 Figure 16: Termination/Cancellation: Program Summary .................................................................... 26 Figure 17: Termination/Cancellation: Activity Summary ...................................................................... 27 Figure 18: Termination/Cancellation: PHC/FC/CAS Activities ............................................................. 28 Figure 19: Termination/Cancellation: CWP Activities ........................................................................... 29 Figure 20: Termination/Cancellation: CBA Activities ............................................................................ 30 Figure 21: Change/Update: Program Summary ................................................................................... 32 Figure 22: Change/Update: Activity Summary ..................................................................................... 33 Figure 23: Change/Update: PHC/FC/CAS Activities ............................................................................ 34 Figure 24: Change/Update: CDS Activities .......................................................................................... 35 Figure 25: Contract Assignment: Program Summary .......................................................................... 37 Figure 26: Contract Assignment: Activity Summary ............................................................................. 38 Figure 27: Contract Assignment: Hospice Activities............................................................................. 39 Figure 28: Contract Assignment: DAHS Activities .............................................................................. 40 Figure 29: Contract Assignment: PHC/FC/CAS Activities .................................................................... 41 Figure 30: Contract Extension: Program Summary ............................................................................. 43 Figure 31: Contract Extension: Activity Summary ................................................................................ 44 Figure 32: Contract Extension: PHC/FC/CAS Activities ....................................................................... 45 Figure 33: Contract Extension: CBA Activities ..................................................................................... 46 Figure 34: Other Amendment: Program Summary............................................................................... 47 Figure 35: Other Amendment: Activities ............................................................................................... 48

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Figure 36: Other Amendment: Hospice Activities................................................................................. 49 Figure 37: Other Amendment: PHC/FC/CAS Activities ........................................................................ 50 Figure 38: SARC: Program Summary .................................................................................................. 52 Figure 39: SARC: Activity Summary .................................................................................................... 53 Figure 40: SARC: DAHS Activities ....................................................................................................... 54 Figure 41: Regional Amendment: Program Summary ......................................................................... 56 Figure 42: Regional Amendment: Activity Summary ............................................................................ 57 Figure 43: Regional Amendment: CBA Activities ................................................................................. 58 Figure 44: General Program Related: Activity Summary ..................................................................... 60

Tables

Table 1: Study Selection Guide ............................................................................................................... 3 Table 2: Standard Times in Hours and Minutes (hh:mm) ..................................................................... 10 Table 3: Contract Enrollment: Program Summary ................................................................................ 14 Table 4: Contract Enrollment: Activity Summary................................................................................... 15 Table 5: Contract Enrollment: PHC/FC/CAS Activities ......................................................................... 16 Table 6: Contract Enrollment: MDCP Activities .................................................................................... 17 Table 7: Contract Enrollment: CDS Activities........................................................................................ 18 Table 8: Contract Enrollment: Hospice Activities .................................................................................. 19 Table 9: Contract Enrollment: CBA Activities ........................................................................................ 20 Table 10: Contract Enrollment: DAHS Activities ..................................................................................... 21 Table 11: Contract Enrollment: CLASS/CMA Activities .......................................................................... 22 Table 12: Contract Enrollment: CLASS/DSA Activities ........................................................................... 23 Table 13: Contract Enrollment: DMBD Activities..................................................................................... 24 Table 14: Termination/Cancellation: Program Summary ........................................................................ 26 Table 15: Termination/Cancellation: Activity Summary .......................................................................... 27 Table 16: Termination/Cancellation: PHC/FC/CAS Activities ................................................................. 28 Table 17: Termination/Cancellation: CWP Activities ............................................................................... 29 Table 18: Termination/Cancellation: CBA Activities ................................................................................ 30 Table 19: Change/Update: Program Summary ....................................................................................... 32 Table 20: Change/Update: Activity Summary ......................................................................................... 33 Table 21: Change/Update: PHC/FC/CAS Activities ................................................................................ 34 Table 22: Change Update: CDS Activities .............................................................................................. 35 Table 23: Contract Assignment: Program Summary .............................................................................. 37 Table 24: Contract Assignment: Activity Summary ................................................................................. 38 Table 25: Contract Assignment: Hospice Activities................................................................................. 39 Table 26: Contract Assignment: DAHS Activities ................................................................................... 40 Table 27: Contract Assignment: PHC/FC/CAS Activities ........................................................................ 41

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Table 28: Contract Extension: Program Summary ................................................................................. 43 Table 29: Contract Extension: Activity Summary .................................................................................... 44 Table 30: Contract Extension: PHC/FC/CAS Activities ........................................................................... 45 Table 31: Contract Extension: CBA Activities ......................................................................................... 46 Table 32: Other Amendment: Program Summary................................................................................... 47 Table 33: Other Amendment: Activities ................................................................................................... 48 Table 34: Other Amendment: Hospice Activities..................................................................................... 49 Table 35: Other Amendment: PHC/FC/CAS Activities ............................................................................ 50 Table 36: SARC: Program Summary ...................................................................................................... 52 Table 37: SARC: Activity Summary ........................................................................................................ 53 Table 38: SARC: DAHS Activities ........................................................................................................... 54 Table 39: Regional Amendment: Program Summary ............................................................................. 56 Table 40: Regional Amendment: Activity Summary ................................................................................ 57 Table 41: Regional Amendment: CBA Activities ..................................................................................... 58

EXECUTIVE SUMMARY

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Executive Summary At the request of Community Services Contract management staff, Work Measurement Unit staff conducted a work measurement study of the Contract Enrollment section over the three (3) month period from September through November 2011. Nine (9) Contract Enrollment Specialists were assigned random study start dates over the study period and spent an average of thirteen (12.7) work days collecting at least 220 random time samples per participant. Participants collected random moment study data regarding the following: • Action: one of eleven (11) primary functions, i.e. Contract Enrollment, Expiration, etc. • Program: one of twelve (12) associated with the selected Action, i.e. CBA, PHC/FC/CAS, etc. • Activity: one of forty-six (46) specific activities to complete the selected Action/Program combination,

i.e. Review Application, Suspense Letter, Data Entry, etc. Time samples collected, Actions completed, and hours worked by participants provide the basis for the calculation of the primary results of the work measurement study: • Standard Times: the average amount of time, in hours and minutes, for the completion of a given

Action/Program combination. • Percentages of Time: the percent of time spent in a given Action/Program combination and/or

Activity. The study maintained a ninety-five percent (95.0%) confidence interval with a margin of error of ±2.5 percent. Key Findings Summary: • Five (5) Action/Program combinations produced reliable standard time calculations.

• Fifty-nine percent (58.9%) of Specialist time was spent in contract related activities resulting in

completed Actions.

• General Program Related activities accounted for thirty-three percent (33.0%) of Contract Specialists time.

• Of the program-related Actions the largest percent of time was spent in Contract Enrollment at twenty-eight percent (28.4%). The other program-related Actions combined account for thirty percent (30.3%) of time.

• Six Programs, PHC/FC/CAS (22.4%), CDS (6.4%), MDCP (6.3%), and CBA (6.1%), Hospice (5.7%), and DAHS (4.8%), accounted for almost fifty-two percent (51.7%) of Specialist time.

• Enrollment Specialists spent the highest percentage of time in the following three activities: Phone/Mail/Email (15.4%), Data Entry (8.7%), and Suspense Letter (7.1%).

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Key Findings Standard Times

Action CBA CDS MDCP PHC/FC/CAS Contract Enrollment 3:01 2:09 4:39 5:19 Contract Extension NS 3.07

Results are presented in hours and minutes (hh:mm) format. Actions completed and/or time samples collected for Action/Program combinations that did not rise to the minimum threshold count of 30 or above for a reliable calculation are denoted by NS (not sufficient) or are not presented. Shaded area denotes Action/Program combination was not applicable. Action: Percentage of Time General Program Related 33.0% Contract Enrollment 28.4% Termination/Cancellation 9.2% Non Work Related 8.0% Change/Update 6.1% Contract Assignment 5.2% Contract Extension 4.9% Other Amendment 1.8% SARC 1.5% Regional Amendment 1.4% Expiration 0.4%

Program: Percentage of Time General Program Related* 33.0% PHC/FC/CAS 22.4% Non Work Related* 8.0% CDS 6.4% MDCP 6.3% CBA 6.1% Hospice 5.7% DAHS 4.8% CWP 2.5% CLASS/CMA 2.0% CLASS/DSA 1.6% DBMD 0.6% TAS 0.5% PACE** 0.0%

*General Program Related and Non Work Related were collected as Actions and the percentages are included to account for this time. **Not selected during study period.

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Activity: Percentage of Time Phone/Mail/Email 15.4% Data Entry 8.7% Non Work Related* 8.0% Other 7.1% Suspense Letter 7.1% Review Returned Documents 5.5% Review Application 4.3% Meeting/Training/Conference 3.8% Research 3.6% Assignment Log 3.5% Screening Criteria 3.3% Administrative Duties 3.1% Finalize Contract 3.0% Address/Relocation 2.4% Termination/VH Letter 2.2% Add/Delete Codes 2.2% Review Final Contract 2.1% Distribute Contract 1.9% Technical Assistance 1.1% Review Final Assignment 1.1% Cancellation Letter 1.0% Finalize Extension 1.0% Review Termination 0.9% Review Final Termination 0.9% Policy Review/Forms 0.7% Review Amendment 0.7% Distribute Client Hold Letter 0.7% Review Final Amendment 0.6% Review Extension 0.5% Review Final Extension 0.4% Process Client Hold Letter 0.4% Ownership/Structure 0.3% Distribute Assignment 0.3% Distribute Extension 0.3% Assignment Request 0.2% Finalize Assignment 0.2% Review Assignment 0.2% Process Other Letter 0.2% Transfer Communication 0.2% Expiration/VH Letter 0.1% Finalize Amendment 0.1% Review Expiration 0.1% VH Placement/Release 0.1% Distribute Amendment 0.1% Review Final Expiration** 0.0% Distribute Other Letter** 0.0% Travel** 0.0%

*Non Work Related activities were collected as an Action and the percentage is included to account for this time. **Not selected during study period.

INTRODUCTION

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Background This Department of Aging and Disability Services (DADS) work measurement study of the Contract Enrollment program was conducted by the Work Measurement (WM) unit and completed at the request of Community Services Contracts Director, Bill Campbell and approval of Chief Financial Officer, Gordon Taylor. The study provides statistically valid standard time calculations for the completion of contract enrollment duties in addition to reliable percentages of time spent by Contract Enrollment Program Specialists on specific enrollment activities. Additionally, study results provide managers information and data for evaluating the impact of program and policy changes and analytical tools for use by budget staff in the development of the Legislative Appropriations Request (LAR) and the distribution of agency resources.

Study Design

Methodology To develop standard times and percentages of time with a high degree of statistical reliability, Work Measurement employed a simple random sampling methodology to conduct a Random Moment Time Study (RMTS) using Personal Digital Assistants (PDAs) for data collection. A RMTS is a federally recognized statistical sampling technique where participants record work activities from pre-defined selections at random moments during the study period. Sampling occurred in two stages:

1) random start dates were assigned to each participant to begin collecting data, and, 2) random time samples emitted by PDAs were collected by each participant.

Participation The three-month study period began September 1, 2011 and ended November 30, 2011. All Contract Enrollment full time equivalent (FTE) positions were selected for participation in the study. The study population consisted of nine (9) FTEs. Nine (9) participants completed the study for a participation rate of one hundred percent (100%). Based on the size of the program and the study population, study participants were required to collect a minimum of 220 time samples to achieve statistically valid results. The average time for completion of the study was 101.6 hours, or 12.7 workdays (Appendix A).

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Data Collection Participants were provided a PowerPoint Training Demo (Appendix B), a study instruction booklet (Appendix C), and a PDA pre-loaded with study software to serve as a self-contained data collection instrument for study information. WM analysts conducted face-to-face training with participants explaining the purpose of the study, and the use of the PDA for collecting, entering, and submitting collected study data. Basic identification and work information for each participant was confirmed during the training session. WM analysts assisted participants in loading and installing study software on their workstations. The PDA study instrument used a menu-driven decision tree, with each selection determining the next level of choices. When the device signaled, participants recorded the corresponding activity they were performing at that moment. The PDA emitted random signals (time samples) at an average of 2.4 times per hour. Lunch, leave, and travel times were entered using special manual procedures. Participants collected time samples whenever working, including work occurring outside normal assigned hours. At least twice per week participants were required to submit collected data via the PDA “hot-sync” process to electronically transmit data to the WM server. Selections were entered into the PDA via a three-step entry process based upon the level definitions. Completing a routine entry took approximately 10 seconds (Figure 1). Figure 1: Study Instrument Decision Tree

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With each random time sample received, participants made their three-step data entry from a pre-defined selection menu shown in Table 1. Table 1: Study Selection Guide

Selection 1 Selection 2 Selection 3 ACTION PROGRAM ACTIVITY

Contract Enrollment

Community Based Alternatives Waiver (CBA) Consumer Directed Services (CDS) Community Living Assistance and Support Services Waiver Program/Consumer Managed Agency (CLASS/CMA) Community Living Assistance and Support Services Waiver Program/Direct Services Agency (CLASS/DSA) Consolidated Waiver Program (CWP) Day Activity & Health Services (DAHS) Deaf Blind with Multiple Disabilities Waiver (DBMD) Hospice Medically Dependent Children Program (MDCP) Program of All-inclusive Care for the Elderly (PACE) Primary Home Care/Family Care/ Community Attendant Services (PHC/FC/CAS) Transition Assistance Services (TAS)

Review Application Suspense Letter Review Returned Documents Screening Criteria Finalize Contract Review Final Contract Data Entry Distribute Contract Other

Contract Assignment

CBA CDS CLASS/CMA CLASS/DSA CWP DAHS DBMD Hospice MDCP PACE PHC/FC/CAS TAS

Assignment Request Review assignment Suspense Letter Review Returned Documents Screening Criteria Finalize Assignment Review Final Assignment Data Entry Distribute Assignment Other

Contract Extension

CBA CWP PACE PHC/FC/CAS

Review Extension Suspense Letter Review Returned Documents Screening Criteria Finalize Extension Review Final Extension Data Entry Distribute Extension Other

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Termination/Cancellation


Review Termination Termination/VH Letter Cancellation Letter Review Final Termination Transfer Communication VH Placement/Release Data Entry Other

Expiration CBA PACE PHC/FC/CAS

Review Expiration Expiration/VH Letter Review Final Expiration Transfer Communication VH Placement/Release Other

Change/Update


Ownership/Structure Address/Relocation Add/Delete Codes Other

Regional Amendment

CBA DAHS MDCP PHC/FC/CAS TAS

Review Amendment Suspense Letter Review Returned Documents Screening Criteria Finalize Amendment Review Final Amendment Data Entry Distribute Amendment Other

Other Amendment



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Sanction Action Review Committee (SARC)

CBA CLASS/CMA CLASS/DSA CWP DAHS DBMD MDCP PHC/FC/CAS TAS

Process Client Hold Letter Process Other Letter Distribute Client Hold Letter Distribute Other Letter Other

General Program Related Continue

Assignment Log Research Meeting/Training/Conference Phone/Mail/Email Policy Review/Forms Administrative Duties Technical Assistance Other Travel

Non Work Related

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Confidence Interval The study maintained a ninety-five percent (95.0%) confidence interval with a margin of error of ±2.5%. The confidence interval is a mathematical description of the estimated range of values in which collected results are expected to fall. The degree of confidence, or confidence level, is an index of certainty that the probability of that expected range is true. Contract Enrollment Specialists collected 2,013 time samples during the three-month study period. Because of the large number of samples collected during the study the calculated standard times and derived percentages of time spent in given activities are both precise and statistically reliable. Data Integrity To ensure data integrity, Work Measurement staff employed the following quality assurance steps and techniques: • participants completed a PowerPoint presentation on using the PDA data collection instrument; • participants received face-to-face training, with written instructions; • the PDA data collection structure only allowed logical activity entry combinations; • Work Measurement analysts reviewed submitted data with the participant throughout their study

period; • Work Measurement analysts used data-cleaning procedures to identify and correct data entry

errors prior to analysis of the data.

STANDARD TIMES

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Standard Time Definition Results of a work measurement study are normally expressed in the output of a “standard time.” A “standard time” is the average time to perform or complete an Action, from start to finish, within a given Action/Program combination. The time samples collected, actions completed, and hours worked by participants serve as the basis for developing standard times and for determining percentages of time devoted to work activities. Standard time calculations include all time spent by Program Specialists, individually and as part of a team.

Standard times are presented only where sufficient data is available to ensure statistical reliability. Where time samples or Actions completed for an Action/Program combination were too low for reliable calculation, NS (not sufficient) is listed. Standard times are stated in hours and minutes (e.g. 1 hour and fifteen minutes = 1:15).

A standard time is calculated as follows:

Percent of Time Spent in Action/Program Combinations1

Multiplied By Net Hours Worked by Participants in the Study Period2

Divided By Actions Completed in Action/Program Combinations3

Action Definitions Contract Enrollment: Process establishing whether applicant meets qualifications or criteria to obtain contract to provide goods &/or services in accordance with terms & conditions specified by DADS. All duties associated with processing an open enrollment or competitive contract application from receipt of request until finalized application is approved & distributed. Includes all steps, duties, technical assistance, processing, executing & distributing a finalized enrollment contract. Contract Assignment: Transfer of the obligations, rights & interests in a contract form one provider to different provider. All duties associated with processing contract assignment from receipt of request until finalized assignment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract assignment. Contract Extension: Contract amendment in which DADS extends contract end date of provisional & term contracts. All activities associated with processing a contract extension from receipt of request until finalized contract extension is approved & distributed. Includes all steps, duties, technical assistance, processing executing, & distributing a finalized contract extension.

1 Percent of time is calculated from time samples collected during the study period by participants. 2 Net hours are calculated from time/leave data provided by Human Resources: work hours available in each month, plus overtime

earned, minus leave taken. 3 Completed Actions are provided by Contract & Oversight Services Staff from the Health & Human Services Contract Administration & Tracking System (HCATS) and by Program staff.

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Termination/Cancellation: Ending a contract in accordance with terms & conditions, voluntarily or involuntarily, by one or both parties, including cancellation of contract due to availability of appropriated funds or until federal &/or state governments cease to participate in the program. All duties associated with termination/cancellation (voluntary or involuntary) of a contract from receipt & review to close out. Includes all steps, duties, & technical assistance in preparing for termination/cancellation (e.g. termination letter, vendor hold placement/release, etc.). Expiration: Contract is allowed to expire due to contract non-compliance, such as not passing a monitoring review. Includes all steps, duties, technical assistance in preparing for expiration (e.g. expiration letter, vendor hold placement/release, etc.). Change/Update: Processing changes or updates, to an existing contract, that do not require an amendment to contract. Includes all steps, duties, technical assistance, & database updates (e.g. ownership structure, address/relocation, add/delete codes). Regional Amendment: Revision, change or addition to terms & conditions of state enrolled contract to add or delete a county. All activities associated with processing a regional amendment; from receipt of request until finalized amendment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized regional amendment to a state enrolled contract. Other Amendment: Material revision, change or addition to terms & conditions of contract, other than regional amendments, assignments or extensions. All activities associated with processing a contract amendment; from receipt of request until finalized amendment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract amendment (e.g. doing business as (DBA) & legal name changes, etc.). SARC: Sanction Action Review Committee (SARC) considers what type of sanction is imposed by DADS on provider. All activities related to processing notice of SARC decisions to provider (e.g. preparing the written notification of decision & routing to the appropriate recipients for review & approval & mailing the notice). General Program-Related: Performance of any activity not related to a specific action listed above (e.g. attending training, meetings, or conferences, reviewing email & policy, completing travel vouchers, providing technical assistance, etc.). Non-Work Related: Performance of Non Work related activities during the workday. Non Work examples include breaks, personal phone calls & working on the study (e.g. speaking with a WMS analyst). Program Definitions Community Based Alternatives (CBA): Community Based Alternatives/Home & Community Support Services provides service & support to aged & disabled persons as alternatives to residing in a nursing facility. Consumer Directed Services (CDS): Voucher payment option empowering consumers to make personal decisions related to delivery of personal assistance & respite services within current home & community-based program. Consumers serve as employer & are responsible for screening, hiring, training & dismissing providers & must select a Consumer Directed Services Agency (CDSA) to conduct financial management services such as payroll & employer taxes. Community Living Assistance & Support Services/Consumer Managed Agency (CLASS/CMA): Community Living Assistance & Support Services Waiver Program - Consumer Managed Agency is a Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people with developmental disabilities other than MR as a consumer managed alternative to ICF/MR institutional care.

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Community Living Assistance & Support Services/Direct Services Agency (CLASS/DSA): Community Living Assistance & Support Services Waiver Program - Direct Services Agency is a Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people with developmental disabilities other than MR as a direct services alternative to ICF/MR institutional care. Consolidated Waiver Program (CWP): Consolidated Waiver Program provides home & community-based services to children & adults who are eligible for services in a nursing facility or in an intermediate care facility for persons with mental retardation or a related condition. Day Activity & Health Services (DAHS): Day Activity & Health Services provide daytime services five days a week (M-F). Services are designed to address the physical, mental, medical & social needs of individuals & must be provided or supervised by a licensed nurse. Deaf Blind with Multiple Disabilities Waiver (DBMD): Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people who are deaf & blind & have a third disability, as an alternative to ICF/MR institution care. Hospice: Array of special services provided to terminally ill persons of all ages & their families in home or other residential setting during final stages of life to help them cope with but not cure illness. A team of doctors, nurses, home health aides, social workers, counselors, & trained volunteers provide physical care & guidance. Medically Dependent Children Program (MDCP): Medically Dependent Children Program is a Medicaid waiver program providing respite, adjunct support services, minor home modifications, adaptive aids, financial management services, & transition assistance services to children as an alternative to nursing facility care. Program of All-inclusive Care for the Elderly (PACE): Program of All-inclusive Care for the Elderly is a Medicaid program allowing comprehensive community & medical services under a capitated, risk-based system to frail elderly people fifty-five & older, as a cost-effective alternative. Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS): Primary Home Care/Family Care /Community Attendant Services are programs providing in-home services. PHC provides non-technical, personal care services for individuals whose chronic health problems impair ability to perform activities of daily living. FC assists individuals who are functionally limited in performing daily living activities with personal care activities, housekeeping, meals & transportation. CAS provides non-technical personal care services for individuals whose chronic health problems impair ability to perform activities of daily living & with income ineligible for PHC. Transition Assistance Services (TAS): Transition Assistance Services provides Medicaid-eligible people residing in nursing facilities assistance to set up a household in the community if the person will be enrolling in CBA, DBMD, CLASS, or MDCP.

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Standard Time Results Of the one-hundred and eight (108) possible standard time calculations for an Action/Program combination, five (5) combinations produced a valid calculation. Table 2: Standard Times in Hours and Minutes (hh:mm)

Action CBA CDS MDCP PHC/FC/CAS Contract Enrollment 3:01 2:09 4:39 5:19 Contract Extension NS 3:07

Actions completed and/or time samples collected for Action/Program combinations that did not rise to the minimum threshold count of 30 or above for a reliable calculation are denoted by NS (not sufficient). Based on statistical principles, standard times are presented only when sufficient data is available to ensure statistical reliability. Work Measurement employs a threshold of thirty (30) time samples collected and/or Actions completed for an Action/Program combination for reporting a standard time. Completed Actions and/or time samples collected during the study period did not rise to this threshold for the other one-hundred and three (103) Action/Program combinations.

PERCENTAGE OF TIME

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Action The first level of data collected by Program Specialists identified one of eleven (11) Actions in which they were engaged at the time the PDA signaled.* Figure 2: Action

General Program Related33.0%

Contract Enrollment28.4%

Termination/ Cancellation

9.2%

Non Work Related8.0%

Change/Update6.1%

Contract Assignment5.2%

Contract Extension4.9%

Other Amendment1.8%

SARC1.5%

Regional Amendment1.4%

Expiration0.4%

*Total may not equal 100.0% due to rounding.

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Program The second level of data collected by Specialists identified one of twelve (12) possible Programs4 predicated by the previous Action.* Figure 3: Program

General Program Related33.0%

PHC/FC/CAS22.4%

Non Work Related8.0%

CDS6.4%

MDCP6.3%

CBA6.1%

Hospice5.7%

DAHS4.8%

CWP2.5%

CLASS/CMA2.0%

CLASS/DSA1.6%

DBMD0.6%

TAS0.5%

PACE**0.0%

*Total may not equal 100.0% due to rounding. **Not selected during the study period.

4 General Program Related and Non Work Related were collected as Actions with no subsequent Program and the percentages are included to account for this time.

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Activity The third level of data collected by Program Specialists identified one of forty-six (46) possible Activities5 predicated by the previous Action and Program selection. Figure 4: Activity

15.4%

8.7%8.0%

7.1% 7.1%

5.5%

4.3%3.8% 3.6% 3.5% 3.3% 3.1% 3.0%

2.4% 2.2% 2.2% 2.1% 1.9%1.1% 1.1% 1.0% 1.0%

0%

5%

10%

15%

20%

Activity percentages of less than one percent (1.0%) not shown in Figure 4:

• Review Termination 0.9% • Finalize Assignment 0.2%

• Review Final Termination 0.9% • Review Assignment 0.2%

• Policy Review/Forms 0.7% • Process Other Letter 0.2%

• Review Amendment 0.7% • Transfer Communication 0.2%

• Distribute Client Hold Letter 0.7% • Expiration/VH Letter 0.1%

• Review Final Amendment 0.6% • Finalize Amendment 0.1%

• Review Extension 0.5% • Review Expiration 0.1%

• Review Final Extension 0.4% • VH Placement/Release 0.1%

• Process Client Hold Letter 0.4% • Distribute Amendment 0.1%

• Ownership/Structure 0.3% • Review Final Expiration* 0.0%

• Distribute Assignment 0.3% • Distribute Other Letter* 0.0%

• Distribute Extension 0.3% • Travel* 0.0%

• Assignment Request 0.2%

*Not selected during the study period.

5 Non Work Related activities were collected as an Action and the percentage is included to account for this time.

PERCENTAGE OF TIME - ACTION BY PROGRAM BY ACTIVITY

14

Contract Enrollment: Program Summary Contract Enrollment comprised twenty-eight percent (28.4%) of time spent by specialists, (Fig. 2, pg. 11). There were twelve (12) possible Program choices for Contract Enrollment, and ten (ten) were selected. The table and figure below show the time spent by specialists calculated within each Program.* Table 3: Contract Enrollment: Program Summary

Program Percent Total PHC/FC/CAS 39.3%

100.0%

MDCP 16.6% CDS 12.9% Hospice 8.9% CBA 8.6% DAHS 5.4% CLASS/CMA 4.0% CLASS/DSA 2.4% DBMD 1.2% TAS 0.5% CWP** 0.0% PACE** 0.0%

Figure 5: Contract Enrollment: Program Summary

PHC/FC/CAS39.3%

MDCP16.6%

CDS12.9%

Hospice8.9%

CBA8.6%

DAHS5.4%

CLASS/CMA4.0%

CLASS/DSA2.4%

DBMD1.2%

TAS0.5%

CWP**0.0%

PACE**0.0%


15

Contract Enrollment: Activity Summary There were nine (9) possible Activity selections for Contract Enrollment. Calculated by Activity, regardless of Program and in study selection guide order, specialists spent their time as follows:* Table 4: Contract Enrollment: Activity Summary

Functional Group Activity Percent Total

Preparation/Review

Review Application 14.3%

52.5% Suspense Letter 15.7% Review Returned Documents 14.3% Screening Criteria 8.2%

Finalize Finalize Contract 10.7% 18.0% Review Final Contract 7.3%

Post/Other Data Entry 17.5%

29.4% Distribute Contract 6.8% Other 5.1%

Figure 6: Contract Enrollment: Activity Summary

14.3%

15.7%

14.3%

8.2%

10.7%

7.3%

17.5%

6.8%

5.1%

0%

5%

10%

15%

20%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract

Data Entry DistributeContract

Other


16

Contract Enrollment: PHC/FC/CAS Summary PHC/FC/CAS accounted for thirty-nine percent (39.3%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). There were nine (9) possible Activity selections. Calculated within PHC/FC/CAS and in study selection guide order, specialists spent their time as follows:* Table 5: Contract Enrollment: PHC/FC/CAS Activities


Preparation/Review






Figure 7: Contract Enrollment: PHC/FC/CAS Activities

12.4% 12.4% 12.9%

10.2%

17.8%

7.6%

16.4%

4.9% 5.3%

0%

5%

10%

15%

20%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract


Other


17

Contract Enrollment: MDCP Summary MDCP accounted for nearly seventeen percent (16.6%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). There were nine (9) possible Activity selections. Calculated within MDCP, and in study selection guide order, specialists spent their time as follows:* Table 6: Contract Enrollment: MDCP Activities


Preparation/Review






Figure 8: Contract Enrollment: MDCP Activities

12.6%

28.4%

13.7%

3.2%4.2% 4.2%

17.9%

13.7%

2.1%

0%

5%

10%

15%

20%

25%

30%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract


Other


18

Contract Enrollment: CDS Summary CDS accounted for almost thirteen percent (12.9%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). There were nine (9) possible Activity selections. Calculated within CDS, and in study selection guide order, specialists spent their time as follows:* Table 7: Contract Enrollment: CDS Activities


Preparation/Review






Figure 9: Contract Enrollment: CDS Activities

9.5%10.8% 10.8%

1.4%2.7%

8.1%

44.6%

8.1%

4.1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract


Other


19

Contract Enrollment: Hospice Summary Hospice accounted for almost nine percent (8.9%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). Of the nine (9) possible Activity choices, eight (8) were selected. Calculated within Hospice, and in study selection guide order, specialists spent their time as follows: Table 8: Contract Enrollment: Hospice Activities


Preparation/Review





11.7% Distribute Contract* 0.0% Other 3.9%

Figure 10: Contract Enrollment: Hospice Activities

3.9%

11.8%

23.5%

21.6%

15.7%

11.8%

7.8%

0.0%

3.9%

0%

5%

10%

15%

20%

25%

30%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract

Data Entry DistributeContract*

Other


20

Contract Enrollment: CBA Summary CBA accounted for nearly nine percent (8.6%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). There were nine (9) possible Activity selections. Calculated within CBA, and in selection guide order, specialists spent their time as follows:* Table 9: Contract Enrollment: CBA Activities


Preparation/Review






Figure 11: Contract Enrollment: CBA Activities

34.7%

10.2%12.2%

4.1%2.0%

12.2%

8.2%6.1%

10.2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract


Other


21

Contract Enrollment: DAHS Summary DAHS accounted for over five percent (5.4%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). There were nine (9) possible Activity selections. Calculated within DAHS, and in study selection guide order, specialists spent their time as follows:* Table 10: Contract Enrollment: DAHS Activities


Preparation/Review






Figure 12: Contract Enrollment: DAHS Activities

9.7%

12.9%

22.6%

19.4%

12.9%

3.2%

6.5% 6.5% 6.5%

0%

5%

10%

15%

20%

25%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract


Other


22

Contract Enrollment: CLASS/CMA Summary CLASS/CMA accounted for four percent (4.0%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). There were nine (9) possible Activity selections. Calculated within CLASS/CMA, and in study selection guide order, specialists spent their time as follows:* Table 11: Contract Enrollment: CLASS/CMA Activities


Preparation/Review






Figure 13: Contract Enrollment: CLASS/CMA Activities

17.4% 17.4%

21.7%

4.3% 4.3% 4.3% 4.3%

17.4%

8.7%

0%

5%

10%

15%

20%

25%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeContract

ReviewFinal

Contract


Other


23

Contract Enrollment: CLASS/DSA Summary CLASS/DSA accounted for over two percent (2.4%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). Of the nine (9) possible Activity choices, three (3) were selected. Calculated within CLASS/DSA, and in study selection guide order, specialists spent their time as follows:* Table 12: Contract Enrollment: CLASS/DSA Activities


Preparation/Review


100.0% Suspense Letter 57.1% Review Returned Documents 7.1% Screening Criteria** 0.0%

Finalize Finalize Contract** 0.0% 0.0% Review Final Contract** 0.0%

Post/Other Data Entry** 0.0%

0.0% Distribute Contract** 0.0% Other** 0.0%

Figure 14: Contract Enrollment: CLASS/DSA Activities

35.7%

57.1%

7.1%

0.0% 0.0% 0.0% 0.0% 0.0% 0.0%0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%

60%

ReviewApplication

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria**

FinalizeContract**

ReviewFinal

Contract**

DataEntry**

DistributeContract**

Other**


24

Contract Enrollment: DBMD Summary DBMD accounted for over one percent (1.2%) of specialists time within Contract Enrollment, (Fig. 5, pg. 14). Of the nine (9) possible Activity choices, six (6) were selected. Calculated within DBMD, and in study selection guide order, specialists spent their time as follows:* Table 13: Contract Enrollment: DMBD Activities


Preparation/Review


28.6% Suspense Letter** 0.0% Review Returned Documents 14.3% Screening Criteria** 0.0%



42.9% Distribute Contract** 0.0% Other 14.3%

Figure 15: Contract Enrollment: DBMD Activities

14.3%

0.0%

14.3%

0.0%

14.3% 14.3%

28.6%

0.0%

14.3%

0%

5%

10%

15%

20%

25%

30%

ReviewApplication

SuspenseLetter**

ReviewReturned

Documents

ScreeningCriteria**

FinalizeContract

ReviewFinal

Contract

Data Entry DistributeContract**

Other


25

Contract Enrollment: Remaining Programs Less than one percent (0.5%) of time was spent within TAS; CWP and PACE were not selected during the study period, (Fig. 5, pg. 14). Contract Enrollment Activities for TAS will not be displayed due to the low percentage of time spent in this Action/Program combination during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

26

Termination/Cancellation: Program Summary Termination/Cancellation comprised nine percent (9.2%) of time spent by specialists, (Fig. 2, pg. 11). There were twelve (12) possible Program selections, and eleven (11) were selected. The table and figure below show the time spent by specialists calculated within each Program.* Table 14: Termination/Cancellation: Program Summary


100.0%

CWP 25.8% CBA 14.0% CLASS/CMA 7.5% CLASS/DSA 5.9% DAHS 5.4% DBMD 3.2% MDCP 3.2% CDS 2.7% TAS 1.6% Hospice 0.5% PACE** 0.0%

Figure 16: Termination/Cancellation: Program Summary

PHC/FC/CAS30.1%

CWP25.8%

CBA14.0%

CLASS/CMA7.5%

CLASS/DSA5.9%

DAHS5.4%

DBMD3.2%

MDCP3.2%

CDS2.7%

TAS1.6%

Hospice0.5%

PACE**0.0%


27

Termination/Cancellation: Activity Summary There were eight (8) possible Activity selections for Termination/Cancellation. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows:* Table 15: Termination/Cancellation: Activity Summary


Prep/Review/Send Review Termination 10.2%

45.7% Termination/VH Letter 24.2% Cancellation Letter 11.3%

Finalize/Process Review Final Termination 9.7%

11.9% Transfer Communication 1.1% VH Placement/Release 1.1%

Post/Other Data Entry 24.2% 42.5% Other 18.3% Figure 17: Termination/Cancellation: Activity Summary

10.2%

24.2%

11.3%

9.7%

1.1% 1.1%

24.2%

18.3%

0%

5%

10%

15%

20%

25%

30%


28

Termination/Cancellation: PHC/FC/CAS Summary PHC/FC/CAS accounted for thirty percent (30.1%) of specialists time within Termination/Cancellation, (Fig. 16, pg. 26). Of the eight (8) possible Activity choices, seven (7) were selected. Calculated within PHC/FC/CAS, and in study selection guide order, specialists spent their time as follows:* Table 16: Termination/Cancellation: PHC/FC/CAS Activities





22.2% Transfer Communication 1.8% VH Placement/Release** 0.0%

Post/Other Data Entry 23.2% 41.1% Other 17.9% Figure 18: Termination/Cancellation: PHC/FC/CAS Activities

12.5%

16.1%

7.1%

21.4%

1.8%

0.0%

23.2%

17.9%

0%

5%

10%

15%

20%

25%

30%

*Total may not equal 100.0% due to rounding. **Not selected during the study period

29

Termination/Cancellation: CWP Summary CWP accounted for nearly twenty-six percent (25.8%) of specialists time within Termination/Cancellation, (Fig. 16, pg. 26). Of the eight (8) possible Activity choices, five (5) were selected. Calculated within CWP, and in study selection guide order, specialists spent their time as follows:* Table 17: Termination/Cancellation: CWP Activities




Finalize/Process Review Final Termination** 0.0%

0.0% Transfer Communication** 0.0% VH Placement/Release** 0.0%

Post/Other Data Entry 27.1% 47.9% Other 20.8% Figure 19: Termination/Cancellation: CWP Activities

6.3%

27.1%

18.8%

0.0% 0.0% 0.0%

27.1%

20.8%

0%

5%

10%

15%

20%

25%

30%


30

Termination/Cancellation: CBA Summary CBA accounted for fourteen percent (14.0%) of specialists time within Termination/Cancellation, (Fig. 16, pg. 26). There were eight (8) possible Activity selections. Calculated within CBA, and in study selection guide order, specialists spent their time as follows:* Table 18: Termination/Cancellation: CBA Activities





19.1% Transfer Communication 3.8% VH Placement/Release 3.8%

Post/Other Data Entry 15.4% 30.8% Other 15.4% Figure 20: Termination/Cancellation: CBA Activities

19.2%

23.1%

7.7%

11.5%

3.8% 3.8%

15.4% 15.4%

0%

5%

10%

15%

20%

25%

30%


31

Termination/Cancellation: Remaining Programs The remaining combined percentages of time spent by Specialists within Termination/Cancellation Programs totaled thirty percent (30.0%): CLASS/CMA (7.5%), CLASS/DSA (5.9%), DAHS (5.4%), DBMD (3.2%), MDCP (3.2%), CDS (2.7%), TAS (1.6%), Hospice (0.5%), and PACE was not selected during the study period, (Fig. 16, pg. 26). Termination/Cancellation Activities within CLASS/CMA, CLASS/DSA, DAHS, DBMD, MDCP, CDS, TAS, and Hospice will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

32

Change/Update: Program Summary Change/Update comprised six percent (6.1%) of time spent by specialists, (Fig. 2, pg. 11). There were twelve (12) possible Program selections, and nine (9) were selected. The table and figure below show the time spent by specialists calculated within each Program. Table 19: Change/Update: Program Summary


100.0%

CDS 33.6% Hospice 7.4% CBA 6.6% MDCP 5.7% DAHS 4.9% CWP 2.5% CLASS/CMA 1.6% TAS 1.6% CLASS/DSA* 0.0% DBMD* 0.0% PACE* 0.0%

Figure 21: Change/Update: Program Summary

PHC/FC/CAS36.1%

CDS33.6%

Hospice7.4%

CBA6.6%

MDCP5.7%

DAHS4.9%

CWP2.5%

CLASS/CMA1.6%

TAS1.6%

CLASS/DSA*0.0%

DBMD*0.0%

PACE*0.0%


33

Change/Update: Activity Summary There were four (4) possible Activity selections for Change/Update. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows: Table 20: Change/Update: Activity Summary

Activity Percent Total Ownership/Structure 4.9%

100.0% Address/Relocation 39.3% Add/Delete Codes 36.1% Other 19.7%

Figure 22: Change/Update: Activity Summary

4.9%

39.3%

36.1%

19.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%


34

Change/Update: PHC/FC/CAS Summary PHC/FC/CAS accounted for thirty-six percent (36.1%) of specialists time within Change/Update, (Fig. 21, pg. 32). There were four (4) possible Activity selections. Calculated within PHC/FC/CAS, and in study selection guide order, specialists spent their time as follows: Table 21: Change/Update: PHC/FC/CAS Activities

Program Activity Percent Total

PHC/FC/CAS

Ownership Structure 4.5%


Figure 23: Change/Update: PHC/FC/CAS Activities

4.5%

75.0%

2.3%

18.2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%

60%

65%

70%

75%

80%


35

Change/Update: CDS Summary CDS accounted for almost thirty-four percent (33.6%) of specialists time within Change/Update, (Fig. 21, pg. 32). Of the four (4) possible Activity choices, three (3) were selected. Calculated within CDS, and in study selection guide order, specialists spent their time as follows:* Table 22: Change Update: CDS Activities


CDS

Ownership Structure** 0.0%


Figure 24: Change/Update: CDS Activities

0.0%2.4%

82.9%

14.6%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%

60%

65%

70%

75%

80%

85%

Ownership/Structure** Address/Relocation Add/Delete Codes Other


36

Change/Update: Remaining Programs The remaining combined percentages of time spent by Specialists within Change/Update Programs totaled thirty percent (30.3%): Hospice (7.4%) CBA (6.6%), MDCP (5.7%), DAHS (4.9%), CWP (2.5%), CLASS/CMA (1.6%), and TAS (1.6%); CLASS/DSA, DBMD, and PACE were not selected during the study period, (Fig. 21, pg. 32). Change/Update Activities within Hospice, CBA, MDCP, DAHS, CWP, CLASS/CMA, and TAS will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

37

Contract Assignment: Program Summary Contract Assignment comprised five percent (5.2%) of time spent by specialists, (Fig. 2, pg. 11). There were twelve (12) possible Program selections, and nine (9) were selected. The table and figure below show the time spent by specialists calculated within each Program.* Table 23: Contract Assignment: Program Summary

Program Percent Total Hospice 38.1%

100.0%

DAHS 17.1% PHC/FC/CAS 17.1% MDCP 10.5% CDS 8.6% CLASS/DSA 3.8% CBA 2.9% CLASS/CMA 1.0% TAS 1.0% CWP** 0.0% DBMD** 0.0% PACE** 0.0%

Figure 25: Contract Assignment: Program Summary

Hospice38.1%

DAHS17.1%

PHC/FC/CAS17.1%

MDCP10.5%

CDS8.6%

CLASS/DSA3.8%

CBA2.9%

CLASS/CMA1.0%

TAS1.0%

CWP**0.0%

DBMD**0.0%

PACE**0.0%


38

Contract Assignment: Activity Summary There were ten (10) possible Activity selections for Contract Assignment. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows:* Table 24: Contract Assignment: Activity Summary


Prep/Review/Send

Assignment Request 8.6%

44.8% Review Assignment 3.8% Suspense Letter 10.5% Review Returned Documents 14.3% Screening Criteria 7.6%

Finalize/Process Finalize Assignment 4.8% 25.8% Review Final Assignment 21.0%


29.5% Distribute Assignment 5.7% Other 5.7%

Figure 26: Contract Assignment: Activity Summary

8.6%

3.8%

10.5%

14.3%

7.6%

4.8%

21.0%

18.1%

5.7% 5.7%

0%

5%

10%

15%

20%

25%


39

Contract Assignment: Hospice Summary Hospice accounted for thirty-eight percent (38.1%) of specialists time within Contract Assignment, (Fig. 25, pg. 37). Of the ten (10) possible Activity choices, eight (8) were selected. Calculated within Hospice, and in study selection guide order, specialists spent their time as follows: Table 25: Contract Assignment: Hospice Activities


Prep/Review/Send

Assignment Request* 0.0%

40.0% Review Assignment 2.5% Suspense Letter 7.5% Review Returned Documents 15.0% Screening Criteria 15.0%



30.0% Distribute Assignment* 0.0% Other 5.0%

Figure 27: Contract Assignment: Hospice Activities

0.0%

2.5%

7.5%

15.0% 15.0%

2.5%

27.5%

25.0%

0.0%

5.0%

0%

5%

10%

15%

20%

25%

30%


40

Contract Assignment: DAHS Summary DAHS accounted for seventeen percent (17.1%) of specialists time within Contract Assignment, (Fig. 25, pg. 37). Of the ten (10) possible Activity choices, eight were selected. Calculated within DAHS, and in study selection guide order, specialists spent their time as follows:* Table 26: Contract Assignment: DAHS Activities


Prep/Review/Send

Assignment Request** 0.0%

22.3% Review Assignment** 0.0% Suspense Letter 5.6% Review Returned Documents 11.1% Screening Criteria 5.6%



66.7% Distribute Assignment 27.8% Other 11.1%

Figure 28: Contract Assignment: DAHS Activities

0.0% 0.0%

5.6%

11.1%

5.6% 5.6% 5.6%

27.8% 27.8%

11.1%

0%

5%

10%

15%

20%

25%

30%


41

Contract Assignment: PHC/FC/CAS Summary PHC/FC/CAS accounted for seventeen percent (17.1%) of specialists time within Contract Assignment, (Fig. 25, pg. 37). Of the ten (10) possible Activity choices, eight (8) were selected. Calculated within PHC/FC/CAS, and in study selection guide order, specialists spent their time as follows:* Table 27: Contract Assignment: PHC/FC/CAS Activities


Prep/Review/Send

Assignment Request 5.6%

44.5% Review Assignment 11.1% Suspense Letter 11.1% Review Returned Documents 16.7% Screening Criteria** 0.0%



11.2% Distribute Assignment 5.6% Other** 0.0%

Figure 29: Contract Assignment: PHC/FC/CAS Activities

5.6%

11.1% 11.1%

16.7%

0.0%

5.6%

38.9%

5.6% 5.6%

0.0%0%

5%

10%

15%

20%

25%

30%

35%

40%


42

Contract Assignment: Remaining Programs The remaining combined percentages of time spent by Specialists within Contract Assignment Programs was nearly twenty-eight percent (27.8%): MDCP (10.5%), CDS (8.6%), CLASS/DSA (3.8%), CBA (2.9%), CLASS/CMA (1.0%), TAS (1.0%); CWP, DBMD, and PACE were not selected during the study period, (Fig. 25, pg. 37). Contract Assignment Activities within MDCP, CDS, CLASS/DSA, CBA, CLASS/CMA, and TAS will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

43

Contract Extension: Program Summary Contract Extension comprised almost five percent (4.9%) of time spent by specialists, (Fig. 2, pg. 11). Of the four (4) possible Program choices for Contract Extension, two (2) were selected. The table and figure below show the time spent by specialists calculated within each Program. Table 28: Contract Extension: Program Summary


100.0% CBA 15.3% CWP* 0.0% PACE* 0.0%

Figure 30: Contract Extension: Program Summary

PHC/FC/CAS84.7%

CBA15.3%

CWP*0.0%

PACE*0.0%


44

Contract Extension: Activity Summary There were nine (9) possible Activity selections for Contract Extension. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows:* Table 29: Contract Extension: Activity Summary


Prep/Review/Send

Review Extension 11.2%


Finalize/Process Finalize Extension 20.4% 29.6% Review Final Extension 9.2%


15.2% Distribute Extension 6.1% Other 2.0%

Figure 31: Contract Extension: Activity Summary

11.2%

28.6%

8.2%7.1%

20.4%

9.2%

7.1%6.1%

2.0%

0%

5%

10%

15%

20%

25%

30%

ReviewExtension

SuspenseLetter

ReviewReturned

Documents

ScreeningCriteria

FinalizeExtension

ReviewFinal

Extension

Data Entry DistributeExtension

Other


45

Contract Extension: PHC/FC/CAS Summary PHC/FC/CAS accounted for almost eighty-five percent (84.7%) of specialists time within Contract Extension, (Fig. 30, pg. 43). There were nine (9) possible Activity selections. Calculated within PHC/FC/CAS, and in study selection guide order, specialists spent their time as follows:* Table 30: Contract Extension: PHC/FC/CAS Activities


Prep/Review/Send






Figure 32: Contract Extension: PHC/FC/CAS Activities

10.8%

33.7%

7.2% 8.4%

16.9%

9.6%

6.0% 6.0%

1.2%

0%

5%

10%

15%

20%

25%

30%

35%


46

Contract Extension: CBA Summary CBA accounted for fifteen percent (15.3%) of specialists time within Contract Extension, (Fig. 30, pg. 43). There were nine (9) possible Activity choices and seven (7) of these were selected. Calculated within CBA, and in study selection guide order, specialists spent their time as follows: Table 31: Contract Extension: CBA Activities


Prep/Review/Send


26.6% Suspense Letter* 0.0% Review Returned Documents 13.3% Screening Criteria* 0.0%




Figure 33: Contract Extension: CBA Activities

13.3%

0.0%

13.3%

0.0%

40.0%

6.7%

13.3%

6.7% 6.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


47

Other Amendment: Program Summary Other Amendment comprised almost two percent (1.8%) of time spent by specialists, (Fig. 2, pg. 11). There were twelve (12) possible Program selections for Other Amendment. Six (6) were selected. The table and figure below show the time spent by specialists calculated within each Program. Table 32: Other Amendment: Program Summary

Program Percent Total Hospice 38.9%

100.0%

PHC/FC/CAS 33.3% MDCP 11.1% CBA 8.3% DAHS 5.6% TAS 2.8% CDS* 0.0% CLASS/CMA* 0.0% CLASS/DSA* 0.0% CWP* 0.0% DBMD* 0.0% PACE* 0.0%

Figure 34: Other Amendment: Program Summary

Hospice38.9%

PHC/FC/CAS33.3%

MDCP11.1%

CBA8.3%

DAHS5.6%

TAS2.8%

CDS*0.0%

CLASS/CMA*0.0%

CLASS/DSA*0.0%

CWP*0.0% DBMD*

0.0%

PACE*0.0%


48

Other Amendment: Activity Summary There were nine (9) possible Activity selections for Other Amendment. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows:* Table 33: Other Amendment: Activities


Prep/Review/Send

Review Amendment 5.6%


Finalize/Process Finalize Amendment 2.8% 30.6% Review Final Amendment 27.8%


19.5% Distribute Amendment 5.6% Other 11.1%

Figure 35: Other Amendment: Activities

5.6%

27.8%

11.1%

5.6%

2.8%

27.8%

2.8%

5.6%

11.1%

0%

5%

10%

15%

20%

25%

30%


49

Other Amendment: Hospice Summary Hospice accounted for nearly thirty-nine percent (38.9%) of specialists time within Other Amendment, (Fig. 34, pg. 47). Of the nine (9) possible Activity choices, seven (7) were selected. Calculated within Hospice, and in study selection guide order, specialists spent their time as follows:* Table 34: Other Amendment: Hospice Activities


Prep/Review/Send



Finalize/Process Finalize Amendment** 0.0% 7.1% Review Final Amendment 7.1%


35.7% Distribute Amendment 7.1% Other 28.6%

Figure 36: Other Amendment: Hospice Activities

7.1%

28.6%

7.1%

14.3%

0.0%

7.1%

0.0%

7.1%

28.6%

0%

5%

10%

15%

20%

25%

30%


50

Other Amendment: PHC/FC/CAS Summary PHC/FC/CAS accounted for thirty-three percent (33.3%) of specialists time within Other Amendment, (Fig. 34, pg. 47). Of the nine (9) possible Activity choices, four (4) were selected. Calculated within PHC/FC/CAS, and in study selection guide order, specialists spent their time as follows:* Table 35: Other Amendment: PHC/FC/CAS Activities


Prep/Review/Send

Review Amendment** 0.0%

41.6% Suspense Letter 33.3% Review Returned Documents 8.3% Screening Criteria** 0.0%



8.3% Distribute Amendment 8.3% Other** 0.0%

Figure 37: Other Amendment: PHC/FC/CAS Activities

0.0%

33.3%

8.3%

0.0% 0.0%

50.0%

0.0%

8.3%

0.0%0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%


51

Other Amendment: Remaining Programs The remaining combined percentages of time spent by Specialists within Other Amendment Programs totaled nearly twenty-eight percent (27.8%): MDCP (11.1%), CBA (8.3%), DAHS (5.6%), TAS (2.8%); CDS, CLASS/CMA, CLASS/DSA, CWP, DBMD, and PACE were not selected during the study period, (Fig. 34, pg. 47). Other Amendment Activities within MDCP, CBA, DAHS, and TAS will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

52

SARC: Program Summary SARC comprised almost two percent (1.5%) of time spent by specialists, (Fig. 2, pg. 11). Of the nine (9) possible Program choices for SARC, three (3) were selected. The table and figure below show the time spent by specialists calculated within each Program. Table 36: SARC: Program Summary

Program Percent Total DAHS 80.6%

100.0%

CLASS/DSA 9.7% MDCP 9.7% CBA* 0.0% CLASS/CMA* 0.0% CWP* 0.0% DBMD* 0.0% PHC/FC/CAS* 0.0% TAS* 0.0%

Figure 38: SARC: Program Summary

DAHS80.6%

CLASS/DSA9.7%

MDCP9.7%

CBA*0.0%

CLASS/CMA*0.0%

CWP*0.0%

DBMD*0.0% PHC/FC/CAS*

0.0%TAS*0.0%


53

SARC: Activity Summary There were five (5) possible Activity selections for SARC. Four were selected during the study period. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows: Table 37: SARC: Activity Summary

Activity Percent Total Process Client Hold Letter 25.8%

100.0% Process Other Letter 12.9% Distribute Client Hold Letter 45.2% Distribute Other Letter* 0.0% Other 16.1%

Figure 39: SARC: Activity Summary

25.8%

12.9%

45.2%

0.0%

16.1%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

Process ClientHold Letter

Process Other Letter Distribute ClientHold Letter

Distribute OtherLetter*

Other


54

SARC: DAHS Summary DAHS accounted for nearly eighty-one percent (80.6%) of specialists time within SARC, (Fig. 38, pg. 52). Out of five (5) Activity choices, three (3) were selected. Calculated within DAHS, and in study selection guide order, specialists spent their time as follows: Table 38: SARC: DAHS Activities


DAHS

Process Client Hold Letter 32.0%

100.0% Process Other Letter* 0.0% Distribute Client Hold Letter 52.0% Distribute Other Letter* 0.0% Other 16.0%

Figure 40: SARC: DAHS Activities

32.0%

0.0%

52.0%

0.0%

16.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%

Process Client HoldLetter

Process OtherLetter*

Distribute Client HoldLetter

Distribute OtherLetter*

Other


55

SARC: Remaining Programs The remaining combined percentages of time spent by Specialists within SARC Programs was a total of nineteen percent (19.4%): CLASS/DSA (9.7%), MDCP (9.7%); CBA, CLASS/CMA, CWP, DBMD, PHC/FC/CAS, and TAS were not selected during the study period, (Fig. 30, pg. 43). SARC Activities within CLASS/DSA and MDCP will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

56

Regional Amendment: Program Summary Regional Amendment comprised one percent (1.4%) of time spent by specialists, (Fig. 2, pg. 11). There were five (5) possible Program choices for Regional Amendment, and four (4) were selected. The table and figure below show the time spent by specialists calculated within each Program.* Table 39: Regional Amendment: Program Summary

Program Percent Total CBA 55.2%

100.0% PHC/FC/CAS 24.1% DAHS 17.2% MDCP 3.4% TAS** 0.0%

Figure 41: Regional Amendment: Program Summary

CBA55.2%

PHC/FC/CAS24.1%

DAHS17.2%

MDCP3.4%

TAS**0.0%


57

Regional Amendment: Activity Summary Of the nine (9) possible Activity choices for Regional Amendment, eight (8) were selected. Calculated by Activity regardless of Program, and in study selection guide order, specialists spent their time as follows:* Table 40: Regional Amendment: Activity Summary


Prep/Review/Send



Finalize/Process Finalize Amendment 3.4% 10.3% Review Final Amendment 6.9%


20.6% Distribute Amendment** 0.0% Other 10.3%

Figure 42: Regional Amendment: Activity Summary

44.8%

10.3%

6.9%6.9%

3.4%

6.9%

10.3%

0.0%

10.3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


58

Regional Amendment: CBA Summary CBA accounted for fifty-five percent (55.2%) of specialists time within Regional Amendment, (Fig. 41, pg. 56). Of the nine (9) Activity choices, seven (7) were selected. Calculated within CBA, and in study selection guide order, specialists spent their time as follows:* Table 41: Regional Amendment: CBA Activities


Prep/Review/Send





18.8% Distribute Amendment** 0.0% Other 6.3%

Figure 43: Regional Amendment: CBA Activities

50.0%

12.5%

6.3%6.3%

0.0%

6.3%

12.5%

0.0%

6.3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%


59

Regional Amendment: Remaining Programs The remaining combined percentages of time spent by Specialists within Regional Amendment Programs was a total of nearly forty-five percent (44.7%): PHC/FC/CAS (24.1%), DAHS (17.2%), MDCP (3.4%); TAS was not selected during the study period, (Fig. 41, pg. 56). Regional Amendment Activities within PHC/FC/CAS, DAHS, and MDCP will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities. Expiration: Program Summary The combined percentages of time spent by Specialists within Expiration comprised less than one percent (0.4%), Figure 2, page 11. Program selections for Expiration were CBA, PACE and PHC/FC/CAS. PHC/FC/CAS accounted for seventy-five percent (75.0%) and CBA twenty-five percent (25.0%) of time sample selections within Expiration. PACE was not selected during the study period. Expiration Activities within PHC/FC/CAS and CBA will not be displayed due to the low percentage of time spent in these Action/Program combinations during the study period. The low number of time samples collected precludes the calculation of significant percentages of time Specialists may actually spend in associated Activities.

60

General Program Related: Activity Summary General Program Related accounts for thirty-three percent (33.0%) of time samples collected, (Fig. 2, pg. 11). Of the nine (9) possible Activity choices for General Program Related, eight were selected. The figure below shows the time spent by specialists calculated within each Activity in descending order.* Figure 44: General Program Related: Activity Summary

46.6%

11.4% 11.0% 10.7%9.5%

5.3%3.3%

2.3%0.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


CONCLUSION

61

Limitations Standard times were reported for Action/Program combinations only with sufficient data to support a calculation with statistical reliability. Where time samples or Actions completed within an Action/Program combination were insufficient for a reliable calculation a standard time was not listed. Work Measurement calculates a standard time on Action/Program combinations with time samples and completed Actions of 30 or more.6 Where time samples and Actions completed permit, standard times can be calculated for unreported combinations, but without the level of statistical reliability as contained within the report. As used in this report, standard times indicate the average amount of time Contract Enrollment Program Specialists spend to complete a particular action, not how much time the specialist should have taken to complete the action. The impact of seasonality during a full year is unknown due to the three-month study of period September through November 2011.

6 Statistical research has demonstrated that as the sample size approaches or exceeds 30 the distribution of the means moves closer to the norm. Work Measurement has established a minimum threshold of 30 time samples and 30 completed Actions for publishing the calculation.

APPENDIX A: Basic Study Statistics

A-1

A-1. Basic Statistics

Average Number of Hours on Study 101.6

Average Number of Time Samples Per Hour 2.4

Average Length of Study in Days 12.7

Population 9

Number of Participants 9

Participation rate 100.0%

APPENDIX B: PDA PowerPoint Demo

APPENDIX C: Study Codes & Definitions

C-1

CONTRACT ENROLLMENT SELECTION GUIDE ACTION PROGRAM ACTIVITY

Contract Enrollment



Contract Assignment


Assignment Request Review Assignment Suspense Letter Review Returned Documents Screening Criteria Finalize Assignment Review Final Assignment Data Entry Distribute Assignment Other

Contract Extension








Change/Update



C-2

CONTRACT ENROLLMENT SELECTION GUIDE (cont.) ACTION PROGRAM ACTIVITY

Regional Amendment



Other Amendment



SARC





Non Work Related

C-3

CONTRACT ENROLLMENT “ACTION” DEFINITIONS ACTION DESCRIPTION

Contract Enrollment

Process establishing whether applicant meets qualifications or criteria to obtain contract to provide goods &/or services in accordance with terms & conditions specified by DADS. All duties associated with processing an open enrollment or competitive contract application from receipt of request until finalized application is approved & distributed. Includes all steps, duties, technical assistance, processing, executing & distributing a finalized enrollment contract.

Contract Assignment Transfer of the obligations, rights & interests in a contract from one provider to different provider. All duties associated with processing contract assignment from receipt of request until finalized assignment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract assignment.

Contract Extension Contract amendment in which DADS extends contract end date of provisional & term contracts. All activities associated with processing a contract extension from receipt of request until finalized contract extension is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract extension.


Ending a contract in accordance with terms & conditions, voluntarily or involuntarily, by one or both parties, including cancellation of contract due to availability of appropriated funds or until federal &/or state governments cease to participate in the program. All duties associated with termination/cancellation (voluntary or involuntary) of a contract from receipt & review to close out. Includes all steps, duties, & technical assistance in preparing for termination/cancellation (e.g. termination letter, vendor hold placement/release, etc.).

Expiration Contract is allowed to expire due to contract non-compliance, such as not passing a monitoring review. Includes all steps, duties, technical assistance in preparing for expiration (e.g. expiration letter, vendor hold placement/release, etc.).

Change/Update Processing changes or updates, to an existing contract, that do not require an amendment to contract. Includes all steps, duties, technical assistance, & database updates (e.g. ownership structure, address/relocation, add/delete codes).

Regional Amendment

Revision, change or addition to terms & conditions of state enrolled contract to add or delete a county. All activities associated with processing a regional amendment; from receipt of request until finalized amendment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized regional amendment to a state enrolled contract.

Other Amendment

Material revision, change or addition to terms & conditions of contract, other than regional amendments, assignments or extensions. All activities associated with processing a contract amendment; from receipt of request until finalized amendment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract amendment (e.g. doing business as (DBA) & legal name changes, etc.).

SARC Sanction Action Review Committee (SARC) considers what type of sanction is imposed by DADS on provider. All activities related to processing notice of SARC decisions to provider (e.g. preparing the written notification of decision & routing to the appropriate recipients for review & approval & mailing the notice).

General Program Related Performance of any activity not related to a specific action listed above (e.g. attending training, meetings, or conferences, reviewing email & policy, completing travel vouchers, providing technical assistance, etc.).

Non Work Related Performance of Non Work related activities during the workday. Non Work examples include breaks, personal phone calls & working on the study (e.g. speaking with a WMS analyst).

CONTRACT ENROLLMENT “PROGRAM” DEFINITIONS

PROGRAM DESCRIPTION

CBA Community Based Alternatives/Home & Community Support Services provides service & support to aged & disabled persons as alternatives to residing in a nursing facility.

CDS

Voucher payment option empowering consumers to make personal decisions related to delivery of personal assistance & respite services within current home & community-based program. Consumers serve as employer & are responsible for screening, hiring, training & dismissing providers & must select a Consumer Directed Services Agency (CDSA) to conduct financial management services such as payroll & employer taxes.

CLASS/CMA Community Living Assistance & Support Services Waiver Program - Consumer Managed Agency is a Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people with developmental disabilities other than MR as a consumer managed alternative to ICF/MR institutional care.

CLASS/DSA Community Living Assistance & Support Services Waiver Program - Direct Services Agency is a Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people with developmental disabilities other than MR as a direct services alternative to ICF/MR institutional care.

CWP Consolidated Waiver Program provides home & community-based services to children & adults who are eligible for services in a nursing facility or in an intermediate care facility for persons with mental retardation or a related condition.

DAHS Day Activity & Health Services provide daytime services five days a week (M-F). Services are designed to address the physical, mental, medical & social needs of individuals & must be provided or supervised by a licensed nurse.

DBMD Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people who are deaf & blind & have a third disability, as an alternative to ICF/MR institution care.

Hospice Array of special services provided to terminally ill persons of all ages & their families in home or other residential setting during final stages of life to help them cope with but not cure illness. A team of doctors, nurses, home health aides, social workers, counselors, & trained volunteers provide physical care & guidance.

MDCP Medically Dependent Children Program is a Medicaid waiver program providing respite, adjunct support services, minor home modifications, adaptive aids, financial management services, & transition assistance services to children as an alternative to nursing facility care.

PACE Program of All-inclusive Care for the Elderly is a Medicaid program allowing comprehensive community & medical services under a capitated, risk-based system to frail elderly people fifty-five & older, as a cost-effective alternative.

PHC/FC/CAS

Primary Home Care/Family Care /Community Attendant Services are programs providing in-home services. PHC provides non-technical, personal care services for individuals whose chronic health problems impair ability to perform activities of daily living. FC assists individuals who are functionally limited in performing daily living activities with personal care activities, housekeeping, meals & transportation. CAS provides non-technical personal care services for individuals whose chronic health problems impair ability to perform activities of daily living & with income ineligible for PHC.

TAS Transition Assistance Services provides Medicaid-eligible people residing in nursing facilities assistance to set up a household in the community if the person will be enrolling in CBA, DBMD, CLASS, or MDCP.

C-4

CONTRACT ENROLLMENT “ACTIVITY” DEFINITIONS

ACTION/ACTIVITY DESCRIPTION

Enro

llmen

t

Review Application Any activity associated with the review & processing of a completed contract enrollment packet from a provider. Duties include, but are not limited to: • Verify forms & documents are submitted & complete • Verify signatures & notarization

Suspense Letter All activities related to preparing, processing, & sending by mail/fax suspense letter to prospective provider advising of suspension, requesting missing/additional information, documentation &/or correction of errors from enrollment packet.

Review Returned Documents

Any activities related to review of documents received after review application process & suspense letter to determine if prospective provider has all documents required.

Screening Criteria All activity associated with screening prospective providers to verify legal entity’s business information & status. Includes: • Form 5916, DADS Screening Criteria • Research federal/state websites & DADS reports

Finalize Contract

All activities associated with processing approved contract enrollment packet & finalizing/executing contract. Includes: • Form 4109, Texas Identification Number (TIN) • Form 3254, Provider Agreement pg., (boilerplate) • Signature Request letter • Contract Approval Letter

• Establish contract/provider number/effective dates • Assigning begin/end dates • Routing enrollment packet for manager approvals • Peer review corrections

Review Final Contract All activities associated with reviewing completed contract from contract specialist for accuracy & signatures, & if necessary, returning packet for corrections.

Data Entry All data entry into systems, databases, spreadsheets, or logs used to populate contract with data, monitor receipt, completion status or productivity.

Distribute Contract Any activity associated with distributing hard or electronic copies of contract documents according to internal mailing procedures to applicable recipients, & setting up contract file (e.g. notification sent to regions).

Other Other duties not specifically addressed above (e.g. filing, copying, etc.). ACTION/ACTIVITY DESCRIPTION

Ass

ignm

ent

Assignment Request

All duties associated with receipt of request for contract assignment by a contractor (e.g. change of ownership, legal entity EIN, etc.). Duties include, but are not limited to: • Review request & assess action • Request evidence & documents • Form 5881, Contract Assignment & Agreement

• Request Forms 2192, 3681, 3254, 3691, etc. • Consult legal/management • Prepare packet & file folder

Review Assignment

Activities pertaining to reviewing a Change of Ownership (CHOW) or Contract Assignment (CA) request. Duties include: • Determining criteria met by provider/assignee • Deciding appropriate course of action for request • Verifying all forms/documents are submitted/complete

• Verifying signatures & legal entity names • Verifying contract numbers & associated programs • Request for assignment evidence of documentation

Suspense Letter All activities related to preparing, processing, & sending (mailing, faxing) suspense letter to prospective provider advising of suspension & requesting missing information, documentation &/or correction of errors.


Any activities related to review of documents received after review assignment process & suspense letter to determine if the prospective provider has all documents required.


Finalize Assignment

All activities related to processing the approved Contract Assignment or Change of Ownership for finalization. Includes: • Form 3254, Provider Agreement • Signature Request Letter • Obtain contract number & legal entity record in POL • Preparing CHOW/CA approval letter

• Sending forms for approval • Routing documents for signature authority • Peer review corrections

Review Final Assignment

All activities associated with reviewing the completed assignment from contract specialist for accuracy & signatures, & if necessary, returning packet for corrections.

Data Entry All data entry into systems, databases, spreadsheets, or logs used to populate the contract with data, monitor receipt, completion status or productivity.

Distribute Assignment

All activity associated with distribution of the CHOW/CA documents to the contract assignee, contract file, & if applicable regional contract staff, Regulatory Services or HHSC Rate Analysis. Duties include: • Preparation of the packet • Preparations for certified mailing

• Sending emails

Other Other duties not specifically addressed above (e.g. filing, copying, etc.).

C-5

CONTRACT ENROLLMENT “ACTIVITY” DEFINITIONS (cont.) ACTION/ACTIVITY DESCRIPTION

Exte

nsio

n

Review Extension

Any activity related to reviewing an amendment to extend the end date a provisional or term contract. Duties include: • Creating amendment numbers • Determining effective dates • Preparing/routing amendment documents

• Completing/sending contract forms • Receiving & reviewing forms for accuracy/signatures



Any activities related to review of documents received after review extension process & suspense letter to determine if prospective provider has all documents required.

Screening Criteria All activity associated with screening prospective providers to verify legal entity’s business information & status. Includes: • Comptroller website • License information (HCCSA)

Finalize Extension Any activity related to finalizing an amendment to extend end date of a provisional or term contract. Duties include preparing/routing contract approval letters/forms for signatures & making peer review corrections.

Review Final Extension

All activities associated with reviewing completed extension from contract specialist for accuracy & signatures, if necessary, returning packet for corrections.


Distribute Extension Any activity related to distributing an amendment to extend the end date of a provisional or term contract. Duties include: • Scanning documents • Notification emails

• Compiling forms/documents • Distributing approval letter/amendment


Term

inat

ion/

Can

cella

tion

Review Termination

Duties associated w/review of contract termination to provisional or term contract. Duties include verifying notice of intent to terminate form is complete & accurate. Other examples include: • Verifying lack of service delivery • Determining type of termination • Identifying contract staff responsible for processing

• Verifying rate enhancement participation status • Verifying number of consumers • Email to contract manager

Termination/VH Letter

Activities related to preparing/sending Termination/Vendor Hold Letters to advise provider of pending action(s). Includes: • Completing all forms/documents • Obtaining approvals • Routing letters

• Faxing, sending, forwarding documents • Peer review corrections

Cancellation Letter

Activities related to preparing/sending Cancellation Letters to advise a provider of pending action(s). Includes: • Completing all forms/documents • Obtaining approvals • Routing letters


Review Final Termination

All activities associated with reviewing completed termination documents from contract specialist for accuracy & signatures, if necessary, returning packet for corrections.

Transfer Communication

Any activity related to preparing & communicating with DADS case management staff to ensure each individual affected by termination is provided an opportunity to transfer services. Includes: • Completing all forms • Obtaining approvals • Preparing, sending, forwarding email

VH Placement/Release

Activities related to placing a suspension of payment to a provider, due to provider’s failure to comply with contract terms & activities occurring after contract expiration date has been identified & close out-steps are completed. Includes • Completing all forms • Obtaining approvals

• Preparing, sending, forwarding email



Expi

ratio

n

Review Expiration

Activities associated with review & screening of documents pertaining to an expiring provisional or term contract. Includes insuring notification form(s) is complete & accurate also reviewing email from the regions & all activities related to: • Verifying provisional or term contract • Identifying contract staff responsible for processing • Verifying rate enhancement participation status

• Verifying number of consumers • Email to contract manager

Expiration/VH Letter

Activities related to preparing/sending Expiration/Vendor Hold Letters advising provider of pending action(s). Includes: • Completing all forms/documents • Obtaining approvals • Routing/distributing letters

• Preparing/sending/forwarding mail & email • Peer review corrections

Review Final Expiration

All activities associated with reviewing completed expiration documents from contract specialists for accuracy & signatures, if necessary, returning packet for corrections.


Any activity related to preparing & communicating with DADS case management staff to ensure each individual affected by the expiration is provided an opportunity to transfer services. Includes: • Completing all forms • Obtaining approvals

• Preparing/sending/forwarding email


Activities related to placing a suspension of payment to provider due to failure to comply with contract terms & activities occurring after the contract expiration date has been identified & close out-steps are completed. Includes: • Completing all forms • Obtaining approvals

• Submitting form(s) to Claims Management Systems • Preparing/sending/forwarding email


C-6

CONTRACT ENROLLMENT “ACTIVITY” DEFINITIONS (cont.) ACTION/ACTIVITY DESCRIPTION

Cha

nge/

Upd

ate Ownership/Structure

Any activity related to a non-amendment ownership structure change of less than 50%. Includes: • Ensuring changes are processed by appropriate staff • Request error corrections • Verifying forms for completeness & accuracy

• Completing/sending DADS Screening Criteria • Form 5839, Notification of Change to Contractor

Information • Documenting contract file

Address/Relocation

Any activity related to a non-amendment address or relocation change. Includes: • Verifying forms for completeness & accuracy • Updates to Provider Online • Form 4110, Payee Change Request

• Email staff for choice list update • Documenting file • Verifying licenses

Add/Delete Codes Any activity involved with adding or deleting service codes related to a contracted provider.

Other Other duties not addressed above (e.g. signature authority change, phone/fax number change, filing, copying, etc.). ACTION/ACTIVITY DESCRIPTION

Reg

iona

l & O

ther

Am

endm

ent

Review Amendment

Any activity related to reviewing a request for an amendment to a contract: Includes: • Verifying completeness/accuracy/signatures • Verifying license/certification • Requesting additional information

• Creating amendment number(s)/boilerplate • Verifying preliminary requirements for approval/denial • Verifying legal name change/DBA

Suspense Letter All activities related to preparing, processing, & sending (mailing, faxing) suspense letter to the prospective provider advising of suspension & requesting missing information, documentation &/or correction of errors.


Any activities related to the review of documents that were received after the review amendment process & the suspense letter to determine if the prospective provider has all documents required.


Finalize Amendment Any activity related to finalizing an amendment. Includes: • Preparing/sending denial letter • Determining effective date

• Routing documents for approval • Peer review corrections

Review Final Amendment

All activities associated with reviewing completed amendment from contract specialists for accuracy & signatures, if necessary, returning packet for corrections.


Distribute Amendment Any activity related to distributing an amendment of a provisional or term contract. Duties include but are not limited to: • Scanning documents • Notification emails

• Compiling forms/documents • Preparing & distributing approval letter


SAR

C

Process Client Hold Letter

All activities related to preparing & processing a client hold letter to a provider sanctioned by the Sanction Action Review Committee (SARC), (e.g. completing & copying forms/letters).

Process Other Letter All activities related to preparing & processing a sanction letter to a provider (Not a client hold), such as SARC vendor hold, termination, or debarment.

Distribute Client Hold Letter

All activities related to distribution of a client hold letter to a provider sanctioned by the Sanction Action Review Committee (SARC), (e.g. routing, copying, faxing, emailing, & mailing documents).

Distribute Other Letter All activities related to distribution of a sanction letter to a provider (Not a client hold), such as SARC vendor hold, termination, or debarment.

Other Other duties not specifically addressed above (e.g. listening to SARC meeting, filing, copying, etc.). ACTION/ACTIVITY DESCRIPTION

Gen

eral

Pro

gram

Rel

ated

Assignment Log Activities related to distributing assignments, reporting information in log, updating log as needed, etc.

Research Any general program related research that is not related to specific contract or provider action listed above. Meeting/Training/ Conference

All duties related to preparing for, attending, presenting or otherwise assisting in any meeting, training, or conference. Includes time providing training/mentoring to other employees.

Phone/Mail/Email All general non-Action related phone calls & emails. If a phone call or email is related to a specific monitoring review, follow up, complaint, CAP, etc. the call should be related to that ongoing action.

Policy Review/Forms Any activity related to research on contract policy, procedures & practice. Includes reviewing emails, DADS Information Updates, legislative updates, reviewing updated forms, & reviewing handbook policy & procedure.

Administrative Duties Any general program related activity not specifically listed, (e. g. maintaining office equipment, completing administrative forms, human resource & personnel activities, file management, travel vouchers, etc.).

Technical Assistance Providing instruction, information, answering questions, or providing contract related information & assistance to an existing provider or applicant outside of formal processes.


Travel All travel related to completing duties: training, meetings, conferences, travel plans, airport wait-time, etc.

APPENDIX D: Study Instruction Booklet

COMMUNITY SERVICES CONTRACTS

Contract Enrollment Contract Specialists

WORK MEASUREMENT STUDY INSTRUCTION BOOKLET

2011

Work Measurement Unit Office of Budget & Data Management

701 W. 51st Street, W-421 Austin, TX 78751

Fax: (512) 438-4370

TABLE OF CONTENTS PURPOSE AND OVERVIEW .......................................................................................... 1

CONTACTS AND TROUBLESHOOTING ASSISTANCE .............................................. 2

WORK MEASUREMENT EQUIPMENT .......................................................................... 3

PDA HARDWARE SETUP ............................................................................................. 4

PDA MAINTENANCE ..................................................................................................... 5

FAQ ................................................................................................................................. 6

STUDY INSTRUCTIONS OVERVIEW ............................................................................ 7

CONTRACT SPECIALIST SELECTION GUIDE ............................................................ 8

CONTRACT SPECIALIST “ACTION” DEFINITIONS .................................................. 10

CONTRACT SPECIALIST “PROGRAM” DEFINITIONS ............................................. 11

CONTRACT SPECIALIST “ACTIVITY” DEFINITIONS ................................................ 12

SIGN-ON PROCEDURES ............................................................................................. 16

STARTING THE STUDY ............................................................................................... 19

SAMPLE ALERT SCREEN .......................................................................................... 20

DATA ENTRY ............................................................................................................... 21

LUNCH/LEAVE/TRAVEL ............................................................................................. 24

ENDING THE STUDY DAY .......................................................................................... 28

SOFTWARE INSTALLATION ...................................................................................... 29

PDA HOTSYNC PROCEDURES .................................................................................. 30

Work Measurement 1 Eff. October 8, 2012

PURPOSE AND OVERVIEW The Work Measurement unit of the Office of Budget and Data Management is conducting this Community Services Contracts work measurement study (WMS) at the request of the Director of Community Services Contracts and with the approval of the Chief Financial Officer. The purpose of the WMS is to provide statistically valid and reliable information about the amount of time Contract Specialists spend performing various contract activities in the Contract Enrollment section. WMS results are used by managers as a tool to assess and analyze the impact of program and policy changes on the Contracts program. Agency budget analysts use the results in the development of the Legislative Appropriations Request (LAR) and the distribution of agency resources. What is a work measurement study?

A WMS is a systematic, statistically valid method of gathering information about the amount of time spent by staff on key functions and activities within the Contract Enrollment section. The WMS documents the time spent in key functions and activities by collecting random work moments each day over a three-month study period. During the study, study participants are assigned randomly selected start dates and collect data over a two-week study period.

What results are produced by work measurement studies?

The primary output of a WMS is the calculation of a Standard Time. A standard time is the average time it takes to complete a specific process resulting in a product or unit of work. For example, the product may be the number of Contract Enrollments completed during the study period. In addition to standard times, the WMS produces information on the percentage of time spent in three key areas: Action: Contract Enrollments, Assignments, Terminations, etc. Program: Community Based Alternatives Waiver (CBA), Hospice, etc. Activity: reviewing applications, finalizing & distributing contracts, etc.


CONTACTS AND TROUBLESHOOTING ASSISTANCE Work Measurement Unit Office of Budget & Data Management Department of Aging & Disability Services 701 W. 51st Street, W-421 Austin, TX 78751 Fax: (512) 438-4370 Contacts for:

• General Study Questions • PDA Equipment • PDA Use

Jan Amazeen, Manager (512) 438-3785 [email protected] Rick Ash, Senior Analyst (512) 438-5743 [email protected] Hope Hargrove, Senior Analyst (512) 438-3909 [email protected] Brad Wood, Senior Analyst (512) 438-4608 [email protected]

Please contact a Work Measurement analyst for all hardware or software problems and questions.


WORK MEASUREMENT EQUIPMENT PALM m500 PDA

You will be using a Palm M500 for the study, your study package should include the following items:

Palm PDA Palm Power Cord (AC Charger)

Palm Cradle

• The power cord for the Palm should be attached to the cradle’s USB cord.

• You also receive a sync/charger cable for charging the PDA while in your car.

Palm Sync/Charger Cable


PDA HARDWARE SETUP Plug the AC adapter into an AC current outlet. Be sure the AC adapter cord and the cradle cable cord are connected (Figure 1). You are now ready to charge your PDA. Plug the PDA cradle into any USB port on your PC as shown below (Figures 2, 3, & 4). The sync charger cable connects the same way (Figure 5). You are now ready to send data. Note: When charging the PDA, the PDA Cradle does not have to be connected to your computer. The stand-alone Sync/Charger Cable can be used in your car with the Car Adapter or, minus the Car Adaptor, plugged into the USB port of your PC (Figure 5). Palm Cradle Installation

Cradle Connections to charge PDA

Connect the USB plug using the port on your

PC

Cradle Plug

Connect to cigarette lighter of car or to USB port on PC.

Figure 5

Figure 3

Connect

Figure 1 Figure 2 USB port

Connects to PDA

USB ports

Figure 4

Connects to cigarette lighter


PDA MAINTENANCE Charge the PDA in the cradle or using the sync/charger cable as shown below:

Insert the PDA into the PDA Cradle as shown (Figure 1). Note: If you have inserted the PDA

correctly, you will hear a short beep and see the On/Off button light up.

The Sync/Charger cable connects to the PDA and cigarette lighter adapter as shown (Figure 2).

Remove the PDA from the PDA Cradle as shown (Figure 3). The PDA removes from the Sync/Charger by squeezing the plug.

General Maintenance: • Never use a pen, pencil, or other sharp object on the surface of the PDA screen. • The PDA is not waterproof. Do not expose it to rain or other moisture. • Do not drop the PDA or expose it to strong bumps or impacts. • Keep the PDA away from heaters and other heat sources.

Figure 1

Figure 3

Figure 2

On/Off


FAQ The following graphic shows important features of your PDA:

Power Button

Stylus

Display Screen

“Home” Button

“Keyboard” Icon

Where is the stylus?

The stylus is located on the right side of the PDA in a designated slot. What if I lose my stylus?

Contact the Work Measurement unit (p. 2) for replacement. Why won’t my stylus tap where I am pointing?

Your stylus and PDA needs to be calibrated, contact the Work Measurement unit. Why does my PDA keep turning itself off?

The PDA has an automatic “sleep” feature to conserve battery power after two minutes of inactivity. Press the power button to “wake” the PDA. Sample alerts continue while in “sleep” mode.

Why won’t my PDA turn on?

The PDA’s battery may be low. Please make sure you charge your PDA each day (p. 5). Why won’t my PDA charge?

Ensure all connections are secure (p. 4). If you still have problems contact the Work Measurement unit for instructions (p. 2).

For additional problems or questions, contact the Work Measurement unit. See Contacts and Troubleshooting Assistance (p. 2).


STUDY INSTRUCTIONS OVERVIEW General Instructions When you begin each work day, you will turn on the PDA, sign on to the work measurement study, and remain logged on until your work day ends. You will receive and respond to random “sample alerts” or signals throughout your work day. It is critical that you sign on to the study properly and remain logged on until your work day ends. Stopping and starting the PDA can alter the reliability of your collected data. NOTE: Your “work day” is not just when you are working your normal office hours, but is

defined as any time you are “on the clock” for state pay. If your day begins from home with work-related travel, sign on to the study before traveling, or if you work after hours, do not sign off the study until your work day ends. Your normal commute to and from the office does not count as work-related travel.

When driving, remain signed on to the study. You will continue receiving sample alerts, but DO NOT respond to the PDA signals (too dangerous). You will enter the time separately to account for travel. During lunch, remain signed on to the study. You will continue receiving sample alerts, but DO NOT respond; just ignore the signals. You will enter the time separately to account for lunch. Similarly, if you are temporarily off duty during the middle of the work day for sick or annual leave, ignore the sample alerts until you return to work. You will enter the time separately to account for leave. Your 15-minute break is paid state time, respond using the Non Work Related entry. Your participation in the study continues until you have successfully responded to at least two hundred twenty (220) “good” sample alerts (approximately 11 days). The more diligently you respond to sample alerts, the sooner the study ends. You should receive about twenty (20) sample alerts during the course of an average eight (8) hour work day (approximately 2.5 sample alerts per hour). For each sample alert you receive, you have a total of six (6) minutes to respond. If you do not make an entry, the PDA provides a reminder beep when you have one (1) minute left. If you fail to make an entry you receive a final “missed sample alert” beep. If you miss responding to a sample alert, make a note of the time and activity and provide this information to your Work Measurement Analyst. If you do not see the “Sampling in Progress” screen on your PDA, or your PDA fails to send a sample alert for over two (2) hours, you may need to re-sign on to the study. PLEASE REMEMBER TO CHARGE YOUR PDA EACH DAY. NOTE: You are responsible for maintaining the proper functioning of your PDA by keeping it fully charged

using the cradle or charger cable. At least once per week you are required to transmit or “HotSync” your collected data to the Work Measurement server (See PDA HotSync Procedures on p. 29). Your Work Measurement analyst will coordinate a date and time with you. When you “HotSync” your data, please call your analyst to verify that the data was received, to confirm the accuracy of the data, and/or provide information on any missed sample alerts you noted. Your analyst will provide an update on your study progress and let you know when you have met the required number of time samples. When you have completed the study, your analyst provides you with equipment return instructions.


CONTRACT SPECIALIST SELECTION GUIDE ACTION PROGRAM ACTIVITY

Contract Enrollment



Contract Assignment


Assignment Request Review Assignment Suspense Letter Review Returned Documents Screening Criteria Finalize Assignment Review Final Assignment Data Entry Distribute Assignment Other

Contract Extension








Change/Update




CONTRACT SPECIALIST SELECTION GUIDE (cont.) ACTION PROGRAM ACTIVITY

Regional Amendment



Other Amendment



SARC





Non Work Related


CONTRACT SPECIALIST “ACTION” DEFINITIONS ACTION DESCRIPTION

Contract Enrollment

Process establishing whether applicant meets qualifications or criteria to obtain contract to provide goods &/or services in accordance with terms & conditions specified by DADS. All duties associated with processing an open enrollment or competitive contract application from receipt of request until finalized application is approved & distributed. Includes all steps, duties, technical assistance, processing, executing & distributing a finalized enrollment contract.

Contract Assignment

Transfer of the obligations, rights & interests in a contract from one provider to different provider. All duties associated with processing contract assignment from receipt of request until finalized assignment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract assignment.

Contract Extension

Contract amendment in which DADS extends contract end date of provisional & term contracts. All activities associated with processing a contract extension from receipt of request until finalized contract extension is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract extension.


Ending a contract in accordance with terms & conditions, voluntarily or involuntarily, by one or both parties, including cancellation of contract due to availability of appropriated funds or until federal &/or state governments cease to participate in the program. All duties associated with termination/cancellation (voluntary or involuntary) of a contract from receipt & review to close out. Includes all steps, duties, & technical assistance in preparing for termination/cancellation (e.g. termination letter, vendor hold placement/release, etc.).

Expiration Contract is allowed to expire due to contract non-compliance, such as not passing a monitoring review. Includes all steps, duties, technical assistance in preparing for expiration (e.g. expiration letter, vendor hold placement/release, etc.).

Change/Update Processing changes or updates, to an existing contract, that do not require an amendment to contract. Includes all steps, duties, technical assistance, & database updates (e.g. ownership structure, address/relocation, add/delete codes).

Regional Amendment

Revision, change or addition to terms & conditions of state enrolled contract to add or delete a county. All activities associated with processing a regional amendment; from receipt of request until finalized amendment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized regional amendment to a state enrolled contract.

Other Amendment

Material revision, change or addition to terms & conditions of contract, other than regional amendments, assignments or extensions. All activities associated with processing a contract amendment; from receipt of request until finalized amendment is approved & distributed. Includes all steps, duties, technical assistance, processing, executing, & distributing a finalized contract amendment (e.g. doing business as (DBA) & legal name changes, etc.).

SARC

Sanction Action Review Committee (SARC) considers what type of sanction is imposed by DADS on provider. All activities related to processing notice of SARC decisions to provider (e.g. preparing the written notification of decision & routing to the appropriate recipients for review & approval & mailing the notice).

General Program Related Performance of any activity not related to a specific action listed above (e.g. attending training, meetings, or conferences, reviewing email & policy, completing travel vouchers, providing technical assistance, etc.).

Non Work Related Performance of Non Work related activities during the workday. Non Work examples include breaks, personal phone calls & working on the study (e.g. speaking with a WMS analyst).


CONTRACT SPECIALIST “PROGRAM” DEFINITIONS PROGRAM DESCRIPTION

CBA Community Based Alternatives/Home & Community Support Services provides service & support to aged & disabled persons as alternatives to residing in a nursing facility.

CDS

Voucher payment option empowering consumers to make personal decisions related to delivery of personal assistance & respite services within current home & community-based program. Consumers serve as employer & are responsible for screening, hiring, training & dismissing providers & must select a Consumer Directed Services Agency (CDSA) to conduct financial management services such as payroll & employer taxes.

CLASS/CMA

Community Living Assistance & Support Services Waiver Program - Consumer Managed Agency is a Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people with developmental disabilities other than MR as a consumer managed alternative to ICF/MR institutional care.

CLASS/DSA

Community Living Assistance & Support Services Waiver Program - Direct Services Agency is a Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people with developmental disabilities other than MR as a direct services alternative to ICF/MR institutional care.

CWP Consolidated Waiver Program provides home & community-based services to children & adults who are eligible for services in a nursing facility or in an intermediate care facility for persons with mental retardation or a related condition.

DAHS Day Activity & Health Services provide daytime services five days a week (M-F). Services are designed to address the physical, mental, medical & social needs of individuals & must be provided or supervised by a licensed nurse.

DBMD Medicaid waiver of Social Security Act allowing Texas to provide community-based services to people who are deaf & blind & have a third disability, as an alternative to ICF/MR institution care.

Hospice

Array of special services provided to terminally ill persons of all ages & their families in home or other residential setting during final stages of life to help them cope with but not cure illness. A team of doctors, nurses, home health aides, social workers, counselors, & trained volunteers provide physical care & guidance.

MDCP Medically Dependent Children Program is a Medicaid waiver program providing respite, adjunct support services, minor home modifications, adaptive aids, financial management services, & transition assistance services to children as an alternative to nursing facility care.

PACE Program of All-inclusive Care for the Elderly is a Medicaid program allowing comprehensive community & medical services under a capitated, risk-based system to frail elderly people fifty-five & older, as a cost-effective alternative.

PHC/FC/CAS

Primary Home Care/Family Care /Community Attendant Services are programs providing in-home services. PHC provides non-technical, personal care services for individuals whose chronic health problems impair ability to perform activities of daily living. FC assists individuals who are functionally limited in performing daily living activities with personal care activities, housekeeping, meals & transportation; CAS provides non-technical personal care services for individuals whose chronic health problems impair ability to perform activities of daily living & with income ineligible for PHC.

TAS Transition Assistance Services provides Medicaid-eligible people residing in nursing facilities assistance to set up a household in the community if the person will be enrolling in CBA, DBMD, CLASS, or MDCP.


CONTRACT SPECIALIST “ACTIVITY” DEFINITIONS ACTION/ACTIVITY DESCRIPTION

Enro

llmen

t Review Application

Any activity associated with the review & processing of a completed contract enrollment packet from a provider. Duties include, but are not limited to: • Verify forms & documents are submitted &

complete • Verify signatures & notarization

Suspense Letter All activities related to preparing, processing, & sending by mail/fax suspense letter to prospective provider advising of suspension, requesting missing/additional information, documentation &/or correction of errors from enrollment packet.


Any activities related to review of documents received after review application process & suspense letter to determine if prospective provider has all documents required.

Screening Criteria

All activity associated with screening prospective providers to verify legal entity’s business information & status. Includes: • Form 5916, DADS Screening Criteria • Research federal/state websites & DADS

reports

Finalize Contract

All activities associated with processing approved contract enrollment packet & finalizing/executing contract. Includes: • Form 4109, Texas Identification Number

(TIN) • Form 3254, Provider Agreement pg.,

(boilerplate) • Signature Request letter • Contract Approval Letter

• Establish contract/provider number/effective dates

• Assigning begin/end dates • Routing enrollment packet for manager

approvals • Peer review corrections

Review Final Contract

All activities associated with reviewing completed contract from contract specialist for accuracy & signatures, & if necessary, returning packet for corrections.

Data Entry All data entry into systems, databases, spreadsheets, or logs used to populate contract with data, monitor receipt, completion status or productivity.

Distribute Contract Any activity associated with distributing hard or electronic copies of contract documents according to internal mailing procedures to applicable recipients, & setting up contract file (e.g. notification sent to regions).


Ass

ignm

ent

Assignment Request

All duties associated with receipt of request for contract assignment by a contractor (e.g. change of ownership, legal entity EIN, etc.). Duties include, but are not limited to: • Review request & assess action • Request evidence & documents • Form 5881, Contract Assignment &

Agreement

• Request Forms 2192, 3681, 3254, 3691, etc. • Consult legal/management • Prepare packet & file folder

Review Assignment

Activities pertaining to reviewing a Change of Ownership (CHOW) or Contract Assignment (CA) request. Duties include: • Determining criteria met by provider/assignee • Deciding appropriate course of action for

request • Verifying all forms/documents are

submitted/complete

• Verifying signatures & legal entity names • Verifying contract numbers & associated

programs • Request for assignment evidence of

documentation



Any activities related to review of documents received after review assignment process & suspense letter to determine if the prospective provider has all documents required.

Screening Criteria


reports

Finalize Assignment

All activities related to processing the approved Contract Assignment or Change of Ownership for finalization. Includes: • Form 3254, Provider Agreement • Signature Request Letter • Obtain contract number & legal entity record

in POL • Preparing CHOW/CA approval letter

• Sending forms for approval • Routing documents for signature authority • Peer review corrections

Review Final Assignment

All activities associated with reviewing the completed assignment from contract specialist for accuracy & signatures, & if necessary, returning packet for corrections.


Distribute Assignment

All activity associated with distribution of the CHOW/CA documents to the contract assignee, contract file, & if applicable regional contract staff, Regulatory Services or HHSC Rate Analysis. Duties include: • Preparation of the packet • Preparations for certified mailing

• Sending emails



CONTRACT SPECIALIST “ACTIVITY” DEFINITIONS (cont.) ACTION/ACTIVITY DESCRIPTION

Exte

nsio

n Review Extension

Any activity related to reviewing an amendment to extend the end date a provisional or term contract. Duties include: • Creating amendment numbers • Determining effective dates • Preparing/routing amendment documents

• Completing/sending contract forms • Receiving & reviewing forms for

accuracy/signatures

Suspense Letter All activities related to preparing, processing, & sending (mail/fax) suspense letter to prospective provider advising of suspension & request missing information, documentation &/or correction of errors.


Any activities related to review of documents received after review extension process & suspense letter to determine if prospective provider has all documents required.

Screening Criteria All activity associated with screening prospective providers to verify legal entity’s business information & status. Includes: • Comptroller website • License information (HCCSA)

Finalize Extension Any activity related to finalizing an amendment to extend end date of provisional/term contract. Duties include preparing/routing approval letters/forms for signatures & making peer review corrections.

Review Final Extension

All activities associated with reviewing completed extension from contract specialist for accuracy & signatures, if necessary, returning packet for corrections.


Distribute Extension

Any activity related to distributing an amendment to extend the end date of a provisional or term contract. Duties include: • Scanning documents • Notification emails

• Compiling forms/documents • Distributing approval letter/amendment


Term

inat

ion/

Can

cella

tion

Review Termination

Duties associated w/review of contract termination to provisional or term contract. Duties include verifying notice of intent to terminate form is complete & accurate. Other examples include: • Verifying lack of service delivery • Determining type of termination • Identifying contract staff responsible for

processing

• Verifying rate enhancement participation status


Termination/VH Letter

Activities related to preparing/sending Termination/Vendor Hold Letters to advise provider of pending action(s). Includes: • Completing all forms/documents • Obtaining approvals • Routing letters


Cancellation Letter

Activities related to preparing/sending Cancellation Letters to advise a provider of pending action(s). Includes: • Completing all forms/documents • Obtaining approvals • Routing letters


Review Final Termination

All activities associated with reviewing completed termination documents from contract specialist for accuracy & signatures, if necessary, returning packet for corrections.


Any activity related to preparing & communicating with DADS case management staff to ensure each individual affected by termination is provided an opportunity to transfer services. Includes: • Completing all forms • Obtaining approvals • Preparing, sending, forwarding email


Activities related to placing a suspension of payment to a provider, due to provider’s failure to comply with contract terms & activities occurring after contract expiration date has been identified & close out-steps are completed. Includes • Completing all forms • Obtaining approvals

• Preparing, sending, forwarding email





Expi

ratio

n

Review Expiration

Activities associated with review & screening of documents pertaining to an expiring provisional or term contract. Includes insuring notification form(s) is complete & accurate also reviewing email from the regions & all activities related to: • Verifying provisional or term contract • Identifying contract staff responsible for

processing • Verifying rate enhancement participation

status


Expiration/VH Letter

Activities related to preparing/sending Expiration/Vendor Hold Letters advising provider of pending action(s). Includes: • Completing all forms/documents • Obtaining approvals • Routing/distributing letters

• Preparing/sending/forwarding mail & email • Peer review corrections

Review Final Expiration

All activities associated with reviewing completed expiration documents from contract specialists for accuracy & signatures, if necessary, returning packet for corrections.


Any activity related to preparing & communicating with DADS case management staff to ensure each individual affected by the expiration is provided an opportunity to transfer services. Includes: • Completing all forms • Obtaining approvals

• Preparing/sending/forwarding email


Activities related to placing a suspension of payment to provider due to failure to comply with contract terms & activities occurring after the contract expiration date has been identified & close out-steps are completed. Includes: • Completing all forms • Obtaining approvals

• Submitting form(s) to Claims Management Systems

• Preparing/sending/forwarding email Other Other duties not specifically addressed above (e.g. filing, copying, etc.).


Cha

nge/

Upd

ate

Ownership/ Structure

Any activity related to a non-amendment ownership structure change of less than 50%. Includes: • Ensuring changes are processed by

appropriate staff • Request error corrections • Verifying forms for completeness & accuracy

• Completing/sending DADS Screening Criteria • Form 5839, Notification of Change to

Contractor Information • Documenting contract file

Address/Relocation

Any activity related to a non-amendment address or relocation change. Includes: • Verifying forms for completeness & accuracy • Updates to Provider Online • Form 4110, Payee Change Request

• Email staff for choice list update • Documenting file • Verifying licenses

Add/Delete Codes Any activity involved with adding or deleting service codes related to a contracted provider.

Other Other duties not addressed above (e.g. signature authority change, phone/fax number change, filing, copying, etc.).


Reg

iona

l & O

ther

Am

endm

ent

Review Amendment

Any activity related to reviewing a request for an amendment to a contract: Includes: • Verifying completeness/accuracy/signatures • Verifying license/certification • Requesting additional information

• Creating amendment number(s)/boilerplate • Verifying preliminary requirements for

approval/denial • Verifying legal name change/DBA

Suspense Letter All activities related to preparing, processing, & sending (mailing, faxing) suspense letter to the prospective provider advising of suspension & requesting missing information, documentation &/or correction of errors.


Any activities related to the review of documents that were received after the review amendment process & the suspense letter to determine if the prospective provider has all documents required.

Screening Criteria


reports

Finalize Amendment

Any activity related to finalizing an amendment. Includes: • Preparing/sending denial letter • Determining effective date

• Routing documents for approval • Peer review corrections

Review Final Amendment

All activities associated with reviewing completed amendment from contract specialists for accuracy & signatures, if necessary, returning packet for corrections.


Distribute Amendment

Any activity related to distributing an amendment of a provisional or term contract. Duties include but are not limited to: • Scanning documents • Notification emails

• Compiling forms/documents • Preparing & distributing approval letter




SAR

C

Process Client Hold Letter

All activities related to preparing & processing a client hold letter to a provider sanctioned by the Sanction Action Review Committee (SARC), (e.g. completing & copying forms/letters).

Process Other Letter

All activities related to preparing & processing a sanction letter to a provider (Not a client hold), such as SARC vendor hold, termination, or debarment.

Distribute Client Hold Letter

All activities related to distribution of a client hold letter to a provider sanctioned by the Sanction Action Review Committee (SARC), (e.g. routing, copying, faxing, emailing, & mailing documents).

Distribute Other Letter

All activities related to distribution of a sanction letter to a provider (Not a client hold), such as SARC vendor hold, termination, or debarment.

Other Other duties not specifically addressed above (e.g. listening to SARC meeting, filing, copying, etc.). ACTION/ACTIVITY DESCRIPTION

Gen

eral

Pro

gram

Rel

ated

Assignment Log Activities related to distributing assignments, reporting information in log, updating log as needed, etc.

Research Any general program related research that is not related to specific contract or provider action listed above.

Meeting/Training/ Conference

All duties related to preparing for, attending, presenting or otherwise assisting in any meeting, training, or conference. Includes time providing training/mentoring to other employees.

Phone/Mail/Email All general non-Action related phone calls & emails. If a phone call or email is related to a specific monitoring review, follow up, complaint, CAP, etc. the call should be related to that ongoing action.

Policy Review/Forms

Any activity related to research on contract policy, procedures & practice. Includes reviewing emails, DADS Information Updates, legislative updates, reviewing updated forms, & reviewing handbook policy & procedure.

Administrative Duties

Any general program related activity not specifically listed, (e. g. maintaining office equipment, completing administrative forms, human resource & personnel activities, file management, travel vouchers, etc.).

Technical Assistance

Providing instruction, information, answering questions, or providing contract related information & assistance to an existing provider or applicant outside of formal processes.


Travel All travel related to completing duties: training, meetings, conferences, travel plans, airport wait-time, etc.


SIGN-ON PROCEDURES

This screen is your “home” screen.

• Turn on the PDA by pressing the “On/Off” button at the top right corner of the device.

Note: If you do not see this screen when you turn

on your PDA, use your stylus to tap the “Home” button until this screen appears.

The sign-on procedures must be used each time you sign on to the study.

• Tap the “SamplePro” icon.


SIGN-ON PROCEDURES (cont.)

This is the “User Ref” screen for entering your User ID.

• Tap the “Keyboard” Icon ( ).

Note: Your “User ID” is on the label on the front of

your study instruction booklet. You enter your “User ID” each day to sign on to the study.

Alert your Work Measurement analyst if the study name reads anything other than CSCE 2011.

This is the keyboard screen for entering your User ID.

• Tap in your four-letter “User ID”

• Tap the “Done” Button. Note: The “User ID” is NOT case sensitive.

If you make an error, the backspace key is located in the right hand corner.


SIGN-ON PROCEDURES (cont.)

Entering your “User ID” correctly is important to avoid the loss of your data.

• Tap the “Continue” Button. Note: Make sure your User ID is correctly listed in

the User Ref box.

Tapping “Start Study” begins the study and starts the PDA’s sampling alerts.

• Tap the “Start Study” button. Note: This is a critical entry screen from which you

begin and end the study each day.


STARTING THE STUDY

This is the “Sampling in Progress” screen.

The study is now in progress and this screen is where you wait for all sample alerts. Once you see this screen, you can return to work until the PDA signals you to respond. • The “Lunch/Leave/Travel” button is

discussed later (p. 24).

• The “Exit Study” button is discussed later (p. 28).

• The “Sound,” “LED” and/or “Buzz”

checkboxes allow you to change how the PDA signals.

Put your PDA away for now and refer to the following pages while your analyst explains the selection instructions for when you receive a sample alert. If you receive a sample alert during the training let your analyst know. Reminder: If your screen goes blank, press the power button to exit the automatic “sleep” feature.


SAMPLE ALERT SCREEN

This is the “Sampling Alert’ screen.

When you receive a sample alert signal, the PDA prompts you for an entry. Tapping the “OK” button takes you to the data collection screen. Note: You have six (6) minutes in which to respond

to a sample alert.

If you do not tap “OK” within five (5) minutes, you receive a one-minute warning.

This is the “Sampling Alert Warning” screen.

Tapping the “OK” button takes you to the data collection screen. Note: If you have not entered a selection after one-

minute you receive a series of beeps indicating you have missed an alert.


DATA ENTRY

This is the first level selection menu.

The “Action” selection menu is shown. You must choose an “Action” best describing your current activity. Use your stylus to tap on your selection. In this example:

• Contract Enrollment Note: The “Exit” and “Note” buttons are not used in

this study.

This is the second level selection menu.

Your Action selection is shown and the “Program” selection menu is displayed. Based upon your Action, you must now choose the “Program” best describing your current activity. In this example:

• CBA

Scroll Bar

Scroll Bar


DATA ENTRY (cont.)

This is the third level selection menu.

Your Action & Program selections are shown and the “Activity” selection menu is displayed. Based upon your Action & Program selections, you must now choose a specific “Activity” best describing your current activity. In this example:

• Review Application Note: Use the scroll bar to reveal additional Activity

selections.

This is the selection summary & entry screen.

Your Action, Program, & Activity selections are summarized. Review the entries for accuracy. Tapping the “OK” button saves your selections and returns you to the “Sampling in Progress” screen to wait for your next sample alert. Note: If corrections are required, tap the first

selection (Action) to re-display the menus.

In this example: Contract Enrollment. Once you tap “OK” you cannot correct errors. Make a note to advise your analyst of the error for manual correction.

Scroll Bar


DATA ENTRY (cont.)

The entry process leads you back to the “Sampling in Progress” screen.

From the “Sampling in Progress” screen you wait for your next sample alert. From this screen you initiate the next lesson in your training:

• Lunch/Leave/Travel

Note: As discussed in the General Instructions (p. 7), there are three (3) instances where you ignore the sample alerts you receive:

• when you have lunch • when you take leave during the day (but will return) • when you travel in a car

Any time you are engaged in one of these activities you will not respond to PDA sample alerts.

<< S T O P >>

Please retrieve your PDA to continue the rest of your training session.

Press the power button to wake the device from

“sleep” mode.


LUNCH/LEAVE/TRAVEL

The “Lunch/Leave/Travel” button allows you to account for time during the day in which you will not respond to sample alerts.

• Tap the “Lunch/Leave/Travel” button. Note: The “Lunch/Leave/Travel” entries require you

to enter a start and end time.

For accuracy, it is recommended that you make these entries immediately after your lunch, taking leave, or after travel.

This is the “Activity Log” screen.

• Tap the “New” button. Note: “Lunch/Leave/Travel” entries for each day are

summarized on the Activity Log. If this is your first “Lunch/Leave/Travel” entry, your screen is blank.


LUNCH/LEAVE/TRAVEL (cont.)

The menu displays a list for lunch, leave, & travel.

• Tap on the “Lunch” entry.

The “Activity Log” screen & entries are the same for Lunch, Leave, or Travel.

The “Start Time” box is highlighted and defaults to 8:00 am. • Tap the hour 12P to enter start time. • Tap the “End Time” box.



A start time requires an end time.

• Tap the hour 01 for the end time. The system calculates the total elapsed time and presents it for confirmation. • Tap the “OK” button. Note: You must enter a “Start Time” AND an “End

Time” to complete your entry. Use the scroll bars to reveal times not shown.

The “Activity Log” lists each entry you make.

• Tap the “Save” button. Note: If you have additional entries, tap “New” and repeat the entry process. Tapping the “Save” button returns you to the “Sampling in Progress” screen.



You can correct Lunch/Leave/Travel entries.

To correct an entry, tap it with the stylus to bring up the Edit/Delete screen. Tapping “edit” returns you to the time entry screen for corrections. Tapping “delete” erases the entry.

Note: If you receive a sample alert prior to saving your “Lunch/Leave/Travel” entry, the “Sampling Alert” screen appears and requires a response. Sample alert signals take priority and exit you from the “Lunch/Leave/Travel” function. Your selection from the review screen is always “Non Work Related” since you were working on the study at the time of the signal. After entering “Non Work Related,” you must tap the “Lunch/Leave/Travel” button and re-start the entry process (p. 24).


ENDING THE STUDY DAY

It is important to log off the study each day.

• Tap the “Exit Study” button. Note: If you do not exit the study, your device

continues signaling.

Don’t forget to “End Study” to complete the log off process.

• Tap the “End Study” button.


ENDING THE STUDY DAY (cont.) Ending the study returns you to the three-icon start

screen where you turn off the device.

• Press the “On/Off” button to turn off the device.

<< S T O P >>

SOFTWARE INSTALLATION Before proceeding, we need to download your study software and install it to your PC.

• Ensure you are logged in to the DADS network and/or using VPN.

Your Work Measurement Analyst will walk you through the installation.

The site for downloading the software is listed below:

ftp://147.80.233.224


PDA HOTSYNC PROCEDURES The synchronization process, called the “HotSync Operation” or “Sync,” is the transferring of information between a computer and a PDA. The PDA transfers data to your computer, which then transfers the data to a Work Measurement server.

Note: For the “HotSync” process to work, you must be signed in to the DADS network. Palm PDA HotSync Procedures 1. Place the PDA in the cradle 2. Press the “HotSync” button on the cradle as shown below (Figure 1). If you are using a sync/charger

cable, tap the “HotSync” icon (Figure 2) and the “HotSync” button (Figure 3):

Note: To successfully “sync” the

cradle must be plugged in to the USB port of your computer.

HotSync Icon HotSync Button 3. The first time you sync the PDA, the following message appears:

The above message disappears when the following message comes up:

Figure 1

Figure 2

Figure 3


PDA HOTSYNC PROCEDURES (cont.)

When you tap on the “OK” button, the following message may appear:

Tap on the “OK” button. 4. When the HotSync begins, the following screen appears:

5. While the HotSync is in progress, a screen similar to the following displays:

Note: The status will rapidly scroll through numerous headings.

Note: The status will rapidly scroll through numerous headings.


PDA HOTSYNC PROCEDURES (cont.)

When HotSync is complete, the message below appears:

Leave the message on the screen. 6. When the PDA has finished the HotSync, repeat step 2.

This is a critical step: YOU MUST HOTSYNC TWICE.

7. You should receive the same successful message as shown above after the second HotSync. 8. Tap “OK” on the two messages to clear them from your screen. 9. Remove the PDA from the cradle. 10. If the HotSync is unsuccessful, contact your analyst (p. 2). 11. You return to the “HotSync Screen” upon completion. Tap the “Home” button to return to the three-

icon sign on screen (p. 16).

After the HotSync, tap the “Home” button to return to the three-icon sign on screen (p. 16).

PDA HotSync Screen


PDA HOTSYNC PROCEDURES (cont.) 12. Once you have completed the HotSync and returned to the three-icon sign on screen, you can restart

the study, or turn off the PDA as necessary.

• Press the “On/Off” button to turn off the device.

Note: The HotSync exits you from the study, if your work day continues after syncing, restart the study.


Notes: 1. Sign and fax a copy of your property agreement (page 2).

2. HotSync your data at least once a week (page 30).

3. If your PDA stops signaling for over two hours, re-start the study (page 16).

4. If you have any questions or problems, call us immediately (page 2).