access & intake community services...

ACCESS & INTAKE COMMUNITY SERVICES CONTRACTS

Contract Billing & Payment 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 Community Services Contracts work measurement study of Billing & Payment 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 Misti Ackerman, Manager, Willie Mae Jones, Supervisor, and Stephanie Santos-Vela, Program Specialist, of Billing & Payment guided the design and implementation of the study. Lena Brown Owens and Shelley Swisher of Contract Oversight & Support 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 Contracts Billing & Payment 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 Contracts 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 TABLE OF CONTENTS EXECUTIVE SUMMARY Executive Summary ...................................................................................................................................... iii Key Findings ................................................................................................................................................ iv INTRODUCTION Background ................................................................................................................................................... 1 Study Design ................................................................................................................................................. 1 STANDARD TIMES Standard Time Definition ............................................................................................................................... 6 Standard Time Results .................................................................................................................................. 6 PERCENTAGE OF TIME Action Summary ............................................................................................................................................ 7 Program Summary ........................................................................................................................................ 8 Activity Summary .......................................................................................................................................... 9 PERCENTAGE OF TIME BY ACTION Onsite Review: Program Summary ............................................................................................................. 10 Onsite Review: Activity Summary ............................................................................................................... 11 Onsite Review: HCS ................................................................................................................................... 12 Onsite Review: TxHmL ............................................................................................................................... 13 Onsite Review: CDS ................................................................................................................................... 14 Complaint: Activity Summary ...................................................................................................................... 15 Special Onsite Review: Activity Summary .................................................................................................. 16 Remaining Actions ...................................................................................................................................... 17 General Program Related ........................................................................................................................... 18 PERCENTAGE OF TIME BY PROGRAM HCS: Action Summary ................................................................................................................................ 19 HCS: Activity Summary ............................................................................................................................... 20 TxHmL: Action Summary ............................................................................................................................ 21 TxHmL: Activity Summary ........................................................................................................................... 22 CDS: Action Summary ................................................................................................................................ 23 CDS: Activity Summary ............................................................................................................................... 24 CONCLUSION Limitations ................................................................................................................................................... 25 APPENDIX A: Basic Study Statistics APPENDIX B: PDA PowerPoint Demo APPENDIX C: Study Codes & Definitions APPENDIX D: Study Instruction Booklet

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ILLUSTRATIONS

Figures

Figure 1: Study Instrument Decision Tree ................................................................................................ 2 Figure 2: Action Summary ........................................................................................................................ 7 Figure 3: Program Summary .................................................................................................................... 8 Figure 4: Activity Summary....................................................................................................................... 9 Figure 5: Onsite Review: Program Summary ......................................................................................... 10 Figure 6: Onsite Review: Activity Summary ........................................................................................... 11 Figure 7: Onsite Review: HCS Activities ................................................................................................ 12 Figure 8: Onsite Review: TxHmL Activities ............................................................................................ 13 Figure 9: Onsite Review: CDS Activities ................................................................................................. 14 Figure 10: Complaint: CDS Activities ........................................................................................................ 15 Figure 11: Special Onsite Review: HCS Activities .................................................................................... 16 Figure 12: General Program Related Activities ........................................................................................ 18 Figure 13: HCS: Action Summary ............................................................................................................. 19 Figure 14: HCS: Activity Summary ........................................................................................................... 20 Figure 15: TxHmL: Action Summary ......................................................................................................... 21 Figure 16: TxHmL: Activity Summary ....................................................................................................... 22 Figure 17: CDS: Action Summary ............................................................................................................. 23 Figure 18: CDS: Activity Summary ........................................................................................................... 24

Tables

Table 1: Study Selection Guide ............................................................................................................... 3 Table 2: Onsite Review: Program Summary ......................................................................................... 10 Table 3: Onsite Review: Activity Summary ........................................................................................... 11 Table 4: Onsite Review: HCS Activities ................................................................................................ 12 Table 5: Onsite Review: TxHmL Activities ............................................................................................ 13 Table 6: Onsite Review: CDS Activities ................................................................................................ 14 Table 7: Complaint: CDS Activities ....................................................................................................... 15 Table 8: Special Onsite Review: HCS Activities ................................................................................... 16 Table 10: HCS: Action Summary ............................................................................................................ 19 Table 11: TxHmL: Action Summary ........................................................................................................ 21 Table 12: CDS: Action Summary ............................................................................................................ 23

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 Billing & Payment section over the three (3) month period from September through November 2011. Ten (10) Contract Specialists were assigned random study start dates over the study period and spent an average of twelve and a half workdays collecting a minimum of 220 random time samples per participant. Participants collected random moment study data regarding the following: • Action: one of ten (10) primary functions, i.e. Onsite Review, Complaint, etc. • Program: one of three (3) associated with the selected Action, HCS, TxHmL, and CDS. • Activity: one of thirty-four (34) specific activities to complete the selected Action/Program

combination, i.e. Prepare Packet, Record Review, Entrance Conference, 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 spent, 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 ±2.0 percent. Key Findings Summary: • Contract Billing and Payment related Activities comprised forty-six percent (45.9%) of Contract

Specialist time resulting in a completed Action.

• General Program Related Activities accounted for fifty-two percent (51.6%) of Contract Specialist time.

• Of the program-related Actions, Specialists spent the largest percentage of time in Onsite Review, at thirty-nine percent (39.1%). The other program-related Actions combined accounted for nine percent (9.0%) of time.

• The largest percentage of time spent in a Program was HCS, at thirty-two percent (32.1%). CDS and TxHmL were less than fourteen percent (14.0%) combined.

• Contract Specialists spent the greatest amount of time in the following four Activities: Meetings/Trainings/Conference (13.1%), Travel (10.6%), Administrative Duties (10.6%), and Prepare Packet (10.4%).

• Standard times will not be reported for this study due to the low number of completed Actions for Action/Program combinations during the study period.

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Key Findings Action: Percentage of Time General Program Related 51.6% Onsite Review 39.1% Complaint 3.2% Non Work Related 2.4% Special Onsite Review 1.8% Desk Review 0.7% Recoupment 0.7% Administrative Review 0.3% SARC 0.2% Special Desk Review* 0.0%

*Not selected during study period. Program: Percentage of Time General Program Related* 51.6% HCS 32.1% CDS 13.1% Non Work Related* 2.4% TxHmL 0.7%

*General Program Related and Non Work Related were collected as Actions and the percentages are included to account for this time. Activity: Percentage of Time Meetings/Training/Conference 13.1% Post Complaint 1.0% Travel 10.6% Workbook 0.9% Administrative Duties 10.6% Exit Conference 0.7% Prepare Packet 10.4% TPR Request 0.6% Record Review 7.7% Pre Refute Process 0.5% Technical Assistance 6.9% Entrance Conference 0.5% Select Sample 6.0% Screening Criteria 0.3% Provider Correspondence 5.0% Refute Process 0.2% PNA 4.6% Post Review 0.2% Data Entry 3.7% Merging Workbooks 0.1% Individual Work Pages 3.7% Advance Notice 0.1% Non Work Related* 2.4% Entrance Conference (Onsite) 0.1% Hearings 2.0% Payment Plans 0.1% Cost Reports 1.9% Request Documents (Desk)** 0.0% Other 1.9% Present Packet** 0.0% Hotline Calls 1.7% Committee** 0.0% Spreadsheet 1.3% Timesheet Review** 0.0% Receipt Preparation 1.3%

*Non Work Related activities were collected as an Action and the percentage are 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 Community Services Contracts Billing & Payment unit 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 percentage of time calculations for the completion of Billing & Payment Program Specialist duties within specific Actions, Programs, and 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. The study period was extended into December 2011 for one participant due to scheduling issues. All Billing & Payment full time equivalent (FTE) positions were selected for participation in the study. The study population consisted of eleven (11) FTEs. Ten (10) participants completed the study for a participation rate of ninety one percent (90.9%). One (1) FTE position was vacant during the study period. 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 validity of results. The average time for completion of the study was 99.9 hours, or 12.5 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 2.5 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

PDA Emits Sample Alert ACTION

Input Selection

Input Selection

Input Selection

End Selection Process

Input Selection

LunchLeaveTravel PROGRAM

ACTIVITY

Correction

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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

Onsite Review

Home & Community-based Services (HCS) Texas Home Living Waiver (TxHmL)

Advance Notice Select Sample Prepare Packet Entrance Conference Record Review Pre Refute Process Refute Process Exit Conference Post Review Spreadsheet Technical Assistance Other Travel

Consumer Directed Services (CDS)

Advance Notice Screening Criteria Prepare Packet Entrance Conference Timesheet Review Workbook Individual Work Pages Merging Workbooks Exit Conference Post Review Other Travel

Desk Review HCS TxHmL

Advance Notice Select Sample Prepare Packet Record Review Pre Refute Process Refute Process Post Review Spreadsheet Technical Assistance Other

Recoupment HCS TxHmL

Payment Plans TPR Request

Special Onsite Review HCS TxHmL


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Selection 1 Selection 2 Selection 3 ACTION PROGRAM ACTIVITY

Special Desk Review HCS TxHmL


Complaint CDS

Receipt & Preparation Request Documents (Desk) Entrance Conference (Onsite) Record Review Workbook Individual Work Pages Merging Workbooks Exit Conference Post Complaint Other Travel

Sanction Action Review Committee (SARC) HCS TxHmL CDS

Prepare Packet Present Packet Committee Other

Administrative Review CDS


General Program Related Continue

Hotline Calls Cost Reports Data Entry Hearings PNA Provider Correspondence Meeting/Training/Conference Administrative Duties Technical Assistance Other Travel

Non Work Related

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Confidence Interval The study maintained a ninety-five (95.0%) percent confidence interval with a margin of error of ±2.0%. 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. Billing & Payment Specialists collected 2,417 time samples during the three-month study period. The percentages of time spent in given activities are both precise and statistically reliable due to the number of samples collected. 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 Work measurement study results 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 Results 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 Action/Program combinations. Completed Actions during the study period did not rise to the minimum threshold of thirty (30) for any measured Action/Program combination. Consequently, standard times will not be reported for this study. The lack of completed Actions does not have a bearing upon the validity of the following derived percentages of time spent by participants.

PERCENTAGE OF TIME

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Action Summary The first level of data collected by Program Specialists identified one of ten (10) Actions in which they were engaged at the time the PDA signaled. Program Specialists spend forty-six percent (46.0%) of time in Program-related Actions and fifty-four percent (54.0%) of time in General Program or Non Work Related activities. Figure 2: Action Summary

General Program Related51.6%

Onsite Review39.1%

Complaint3.2%

Non Work Related2.4%

Special Onsite Review1.8%

Desk Review0.7%

Recoupment0.7% Administrative Review

0.3%

SARC0.2%

Special Desk Review*0.0%

*Not selected during the study period.

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Program Summary The second level of data collected by Program Specialists identified one of three (3) possible Programs predicated by the previous Action.1 Regardless of specific Action selections, Program Specialists spent the following percentage of time within each Program:* Figure 3: Program Summary

General Program Related51.6%

HCS32.1%

CDS13.1%

Non Work Related2.4%

TxHmL0.7%

*Total may not equal 100.0% due to rounding.

1 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 Summary The third level of data collected by Program Specialists identified one of thirty-four (34) possible Activities predicated by the previous Action and Program selection.2 Regardless of specific Action or Program selections, Program Specialists spent the greatest percentage of time in the following activities: Figure 4: Activity Summary

13.1%

10.6% 10.6% 10.4%

7.7%

6.9%

6.0%

5.0%4.6%

3.7% 3.7%

2.4%2.0% 1.9% 1.9% 1.7%

1.3% 1.3%1.0%

0%

5%

10%

15%

Activities with percentages less than one-percent (1.0%) are shown below:

• Workbook 0.9% • Merging Workbooks 0.1% • Exit Conference 0.7% • Advance Notice 0.1% • TPR Request 0.6% • Entrance Conference (Onsite) 0.1% • Pre Refute Process 0.5% • Payment Plans 0.1% • Entrance Conference 0.5% • Request Documents (Desk)* 0.0% • Screening Criteria 0.3% • Present Packet* 0.0% • Refute Process 0.2% • Committee* 0.0% • Post Review 0.2% • Timesheet Review* 0.0%


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

PERCENTAGE OF TIME BY ACTION

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Onsite Review: Program Summary Thirty-nine percent (39.1%) of time samples collected were in Onsite Review (Figure 2, page 7). There were three (3) possible Program selections for Onsite Review. Calculated within each Program, and in selection guide order, specialists spent their time as follows: Table 2: Onsite Review: Program Summary

Program Percent Total HCS 74.2%

100.0% TxHmL 1.8% CDS 24.0%

Figure 5: Onsite Review: Program Summary

HCS74.2%

CDS24.0%

TxHmL1.8%

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Onsite Review: Activity Summary There were eighteen (18) possible Activity selections for Onsite Review. The percentages of time specialists spent in these Activities are as follows:* Table 3: Onsite Review: Activity Summary

Functional Group Activity Percent Total

Preparation

Advance Notice 0.3%

38.3% Select Sample (HCS/TxHmL only) 12.4% Screening Criteria (CDS only) 0.2% Prepare Packet 25.4%

Onsite Review

Entrance Conference 1.2%

33.6%

Record Review (HCS/TxHmL only) 19.0% Pre Refute Process (HCS/TxHmL only) 1.2% Refute Process (HCS/TxHmL only) 0.5% Timesheet Review** (CDS only) 0.0% Workbook (CDS only) 0.5% Individual Work Pages (CDS only) 9.4% Merging Workbooks (CDS only) 0.2% Exit Conference 1.6%

Post/Other

Post Review 0.2%

2.6% Spreadsheet (HCS/TxHmL only) 1.7% Technical Assistance (HCS/TxHmL only) 0.4% Other 0.3%

Travel Travel 25.4% 25.4% Figure 6: Onsite Review: Activity Summary

0.3%

12.4%

0.2%

25.4%

1.2%

19.0%

1.2% 0.5% 0.0% 0.5%

9.4%

0.2%1.6%

0.2%1.7%

0.4% 0.3%

25.4%

0%

5%

10%

15%

20%

25%

30%

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

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Onsite Review: HCS HCS accounted for seventy-four percent (74.2%) of specialists time within Onsite Review (Fig. 5, pg. 10). There were thirteen (13) possible Activity selections. Within HCS, specialists spent their time as follows:* Table 4: Onsite Review: HCS Activities


Preparation Advance Notice 0.4%

50.2% Select Sample 16.4% Prepare Packet 33.4%

Onsite Review


28.8% Record Review 24.4% Pre Refute Process 1.6% Refute Process 0.7% Exit Conference 1.0%

Post/Other

Post Review 0.3%

3.3% Spreadsheet 2.3% Technical Assistance 0.6% Other 0.1%

Travel Travel 17.6% 17.6% Figure 7: Onsite Review: HCS Activities

0.4%

16.4%

33.4%

1.1%

24.4%

1.6%0.7% 1.0% 0.3%

2.3%0.6% 0.1%

17.6%

0%

5%

10%

15%

20%

25%

30%

35%

40%


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Onsite Review: TxHmL TxHmL accounted for almost two percent (1.8%) of specialists time within Onsite Review (Fig. 5, pg. 10). There were thirteen (13) possible Activity selections. Within TxHmL, specialists spent their time as follows:* Table 5: Onsite Review: TxHmL Activities

Program Activity Percent Total

Preparation Advance Notice** 0.0%


Onsite Review

Entrance Conference** 0.0%

47.1% Record Review 47.1% Pre Refute Process** 0.0% Refute Process** 0.0% Exit Conference** 0.0%

Post/Other

Post Review** 0.0%

0.0% Spreadsheet** 0.0% Technical Assistance** 0.0% Other** 0.0%

Travel Travel 11.8% 11.8% Figure 8: Onsite Review: TxHmL Activities

0.0%

11.8%

29.4%

0.0%

47.1%

0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

11.8%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


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Onsite Review: CDS CDS accounted for twenty-four percent (24.0%) of specialists time within Onsite Review (Fig. 5, pg. 10). There were twelve (12) possible Activity selections. Within CDS, specialists spent their time as follows: Table 6: Onsite Review: CDS Activities


Preparation Advance Notice* 0.0%

1.3% Screening Criteria 0.9% Prepare Packet 0.4%

Onsite Review


47.1%

Timesheet Review* 0.0% Workbook 2.2% Individual Work Pages 39.2% Merging Workbooks 0.9% Exit Conference 3.5%

Post/Other Post Review* 0.0% 0.9% Other 0.9% Travel Travel 50.7% 50.7%

Figure 9: Onsite Review: CDS Activities

0.0%0.9% 0.4% 1.3%

0.0%2.2%

39.2%

0.9%

3.5%

0.0% 0.9%

50.7%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

55%


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Complaint: Activity Summary Complaint accounted for three percent (3.2%) of time samples collected (Figure 2, page 7). The only Program selection for Complaint was CDS. There were eleven (11) possible Activity selections. Within CDS, specialists spent their time as follows:* Table 7: Complaint: CDS Activities


Preparation Receipt & Preparation 41.0%

41.0% Request Documents (Desk)** 0.0%

Onsite Review

Entrance Conference (Onsite) 2.6%

28.3%

Record Review** 0.0% Workbook 21.8% Individual Work Pages** 0.0% Merging Workbooks 1.3% Exit Conference 2.6%

Post/Other Post Complaint 30.8%

30.8% Other** 0.0%

Travel Travel** 0.0% 0.0% Figure 10: Complaint: CDS Activities

41.0%

0.0%

2.6%

0.0%

21.8%

0.0%1.3%

2.6%

30.8%

0.0% 0.0%0%

5%

10%

15%

20%

25%

30%

35%

40%

45%


16

Special Onsite Review: Activity Summary Special Onsite Review accounted for almost two percent (1.8%) of samples collected (Figure 2, page 7). Program selections were HCS and TxHmL, with one hundred percent (100.0%) of time spent within HCS. There were thirteen (13) possible Activity selections. Within HCS, specialists spent their time as follows: Table 8: Special Onsite Review: HCS Activities


Preparation Advance Notice* 0.0%


Onsite Review

Entrance Conference* 0.0%

2.3% Record Review* 0.0% Pre Refute Process* 0.0% Refute Process 2.3% Exit Conference* 0.0%

Post/Other

Post Review 2.3%

39.5% Spreadsheet 37.2% Technical Assistance* 0.0% Other* 0.0%

Travel Travel* 0.0% 0.0% Figure 11: Special Onsite Review: HCS Activities

0.0%

44.2%

14.0%

0.0% 0.0% 0.0%

2.3%

0.0%

2.3%

37.2%

0.0% 0.0% 0.0%0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%


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Remaining Actions Less than two percent (1.9%) of the total time samples collected were within the remaining Actions: Desk Review (0.7%), Recoupment (0.7%), Administrative Review (0.3%), and SARC (0.2%). Special Desk Review was not selected during the study period. Desk Review Program selections for Desk Review were HCS and TxHmL. HCS accounted for ninety-four percent (94.4%) and TxHmL nearly six percent (5.6%) of time sample selections within Desk Review. Recoupment Program selections for Recoupment were HCS and TxHmL. HCS accounted for one hundred percent (100.0%) of time sample selections within Recoupment. TxHmL was not selected during the study period. Administrative Review The only Program selection for Administrative Review was CDS. SARC The Program selections for SARC were HCS, TxHmL and CDS. HCS accounted for eighty percent (80.0%) and CDS twenty percent (20.0%) of time sample selections within SARC. TxHmL was not selected during the study period. The low number of time samples collected within the remaining Actions (Desk Review, Recoupment, Administrative Review, and SARC) precludes the calculation of significant percentages of time Specialists may spend in associated Activities. Therefore, breakdown of these Action/Activities will not be displayed.

18

General Program Related General Program Related accounted for almost fifty-two percent (51.6%) of time samples collected (Figure 2, page 7). There were eleven (11) possible Activity selections. The percentage of time spent by specialists within General Program Related Activities are presented below, in descending order:* Figure 12: General Program Related Activities

25.4%

20.4%

12.8%

9.6%9.0%

7.1%

3.9% 3.7% 3.4% 3.2%

1.4%

0%

5%

10%

15%

20%

25%

30%


PERCENTAGE OF TIME BY PROGRAM

19

HCS: Action Summary Figure 3, page 8 showed that HCS Actions and Activities comprise thirty-two percent (32.1%) of time spent by specialists. There were six (6) possible Action selections for HCS. Calculated within HCS, specialists spent their time as follows: Table 9: HCS: Action Summary

Action Percent Total Onsite Review 90.1%

100%

Special Onsite Review 5.5% Desk Review 2.2% Recoupment 2.1% SARC 0.1% Special Desk Review* 0.0%

Figure 13: HCS: Action Summary

Onsite Review90.1%

Special Onsite Review5.5%

Desk Review2.2%

Recoupment2.1%

SARC0.1%

Special Desk Review*0.0%


20

HCS: Activity Summary HCS Actions and Activities comprise thirty-two percent (32.1%) of time spent by specialists, (Figure 3, page 8). There were seventeen (17) possible Activity selections for HCS. Calculated within HCS, specialists spent their time in the following activities: Figure 14: HCS: Activity Summary

31.1%

22.8%

18.1%

15.8%

4.1%

1.8% 1.4% 1.0% 0.9% 0.8% 0.8% 0.4% 0.4% 0.3% 0.3% 0.0% 0.0%0%

5%

10%

15%

20%

25%

30%

35%

*Not selected during study period.

21

TxHmL: Action Summary Figure 3, page 8 showed that TxHmL Actions and Activities comprised less than one-percent (0.7%) of time spent by specialists. There were six (6) possible Action selections for TxHmL, and specialists spent their time as follows: Table 10: TxHmL: Action Summary


100%

Desk Review 5.6% Recoupment* 0.0% Special Onsite Review* 0.0% Special Desk Review* 0.0% SARC* 0.0%

Figure 15: TxHmL: Action Summary

Onsite Review94.4%

Desk Review5.6%

Recoupment*0.0%

Special Onsite Review*0.0% Special Desk Review*

0.0%

SARC*0.0%


22

TxHmL: Activity Summary TxHmL Actions and Activities comprised less than one-percent (0.7%) of time spent by specialists, (Figure 3, page 8). There were seventeen (17) possible Activity selections for TxHmL, and specialists spent their time in the following activities: Figure 16: TxHmL: Activity Summary

44.4%

27.8%

16.7%

11.1%

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

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

*Not selected during study period.

23

CDS: Action Summary Figure 3, page 8 showed that CDS Actions and Activities comprised thirteen percent (13.1%) of time spent by specialists. There were four (4) possible Action selections for CDS. Calculated within CDS specialists spent their time as follows: Table 11: CDS: Action Summary


100% Complaint 24.7% Administrative Review 2.2% SARC 1.3%

Figure 17: CDS: Action Summary

Onsite Review71.8%

Complaint24.7%

Administrative Review2.2%

SARC1.3%

24

CDS: Activity Summary CDS Actions and Activities comprised thirteen percent (13.1%) of time spent by specialists, (Figure 3, page 8). There were nineteen (19) possible Activity selections for CDS. Calculated within CDS, specialists spent their time in the following activities: Figure 18: CDS: Activity Summary

36.4%

28.2%

10.1%

7.6% 7.0%

3.2%2.2% 1.6% 0.9% 0.9% 0.9% 0.6% 0.3% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0%

0%

5%

10%

15%

20%

25%

30%

35%

40%

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

CONCLUSION

25

Limitations Standard times will not be reported for this study due to the low number of completed Actions for Action/Program combinations during the study period. 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 Action/Program combinations. Completed Actions during the study period did not rise to this threshold for any measured Action/Program combination. The impact of seasonality during a full year is unknown due to the three-month study of period September through November 2011.

APPENDIX A: Basic Study Statistics

A-1

A-1. Basic Statistics

Average Number of Hours on Study 99.9

Average Number of Time Samples Per Hour 2.5

Average Length of Study in Days 12.5

Population 11

Number of Participants 10

Participation rate 90.9%

APPENDIX B: PDA PowerPoint Demo

B-1

Community Services ContractsBilling & Payment

Work Measurement Study 2011Program Specialists PDA Orientation

Work Measurement UnitOffice of Budget & Data Management Services

Chief Financial Officer DivisionGO

WMS results are used by program management & budget staff to:

WMS Purpose

• assess the amount of time spent in job duties

• evaluate the impact of program & policy changes

GO

The Work Measurement Study (WMS) determines the amount of time spent on various billing & payment activities.

• develop the Legislative Appropriations Request (LAR)

• distribute agency resources

PDA Orientation

You should complete this orientation prior to your WMS telephone training session.

GO

The PDA is the device used to collect all of your WMS study data. The following presentation provides a basic understanding of the WMS data collection process.

• Personal Digital Assistant (PDA)

You will be receiving the following:

• Study Instruction Booklet

• PDA Cradle Charger

B-2

PDA Orientation

The following demo provides a simulated “real-time” example of how to make entries for the WMS.

The demo has pre-set selections; clicking on choices other than what the example requests will not alter the following screens.

Use your mouse cursor to make the selections.

GO

Click the “Power Button” to turn on the PDA.

NOTE: The demo has pre-set selection entries & will only produce responses matching the examples.

Turning on the PDA

Click the “SamplePro” icon to initiate the study software.

Starting the Study

B-3

Click the “abc” to bring up the PDA keyboard.

Entering Your User ID

Entering Your User ID

In this example, the User ID is “abcd”

Your “User ID” is on your study instruction booklet.

After entering User ID Tap “Done”

Click “Continue” to complete sign on.

Signing on to the Study

B-4

Click “Start Study” to begin the study.

Starting the Study

“Sound” is the default setting that emits a beep for

sample alerts.

This is the default setting.

“Buzz” causes the PDA to silently vibrate. Recommended

for training & meetings.

Sound and/or BuzzThere are three options on how you want the PDA to signal.

You may choose a combination of these options.

“LED” is not recommended since it is silent & you may miss sample alerts.

GO

The “Sampling in Progress” screen is the primary screen where you wait for sample

alerts.

Once you see this screen you are on the study.

Resume your work duties & wait for a sample alert.

To simulate a “Sample Alert”

click anywhere on the screen.

Sampling in Progress

B-5

Click “OK” to respond to the sample alert.

Sample Alert

Click “Onsite Review” for the Action.

NOTE: The demo has pre-set selection entries & will only produce responses matching the examples.

Level 1

Menu Choices

Your training instruction booklet provides the level menu definitions.

Click “HCS” for the Program.

Level 2

Menu Choices

The “Exit” & “Note” buttons are not used in the study.

B-6

Click “Prepare Packet” for the Activity.

Level 3

Menu Choices

If you do not see your activity, click the down arrow on the scroll bar to

reveal more menu choices.

Click “OK” to enter your selections.

Review your entries before clicking “OK.”

Corrections are made by clicking the first entry to re-

display the selections.

Selection Summary

Clicking “OK” returns you to the “Sampling in Progress” screen to wait for your next sample alert.

You have 6 minutes to respond to an alert.

If you do not respond to the alert within 5 minutes, you get a “one-

minute warning” signal.

Click “OK” to continue.

One Minute Warning

If you fail to respond after the “one minute

warning” you will receive one final

series of beeps to let you know you missed

a sample alert.

B-7

Once you’ve entered your selections, you will return to the “Sampling in Progress” screen to wait for the next

sample alert.

Repeat these steps with each sample alert.

GO


Lunch/Leave/Travel

There are three instances where you will ignore the sample alerts you receive:

• when you are on your lunch • when you are on leave during the day (but will return)• when you are traveling in a car or plane

You will enter Lunch/Leave/Travel time through the entry screens discussed in the following pages.

GO

Lunch/Leave/Travel

The following screens provide examples of how you will make your lunch, leave, & travel entries for the work measurement study.

The demo has pre-set selections; clicking on selection choices other than what the example requests will not alter the following screens.

GO

B-8

Click on the “Lunch/Leave/Travel” button to

make these entries.

Lunch/Leave/Travel

If this is the first entry of the day, the “Activity Log” will be blank.

Click on the “New” button to access the selection menu.

Activity Log

Click on the “Lunch” selection to make a lunch entry.

Lunch/Leave/Travel Menu

B-9

For this example, click on the “12P” to enter the “hour” portion of the lunch “Start Time” entry.

Lunch Entry

12:30 PM until 1:30 PM

The highlighted sections indicates where the cursor

selection will make the entry.

Use the scroll bar to show more times to

choose.

For this example, click on the “30” to enter the “minutes”

portion of lunch “Start Time.”

Lunch Entry


Lunch Entry


Click on the “End Time” box to make the entries for the end

of lunch.

B-10

Lunch Entry


For this example, click on the “1” to enter the “hour” portion

of lunch “End Time.”

The highlighted sections indicates where the cursor

selection will make the entry.

Lunch Entry


Click on the “30” to enter the “minutes” portion of lunch

“End Time.”

Lunch Entry


After checking that selections are correct, click the “OK”

button to submit the entries.

B-11

Lunch Entry


The “Activity Log” is now updated to include the entry.

Click the “Save” button to conclude the “Lunch” entry.


GO

Once you’ve entered your selections, you will return to the

“Sampling in Progress” screen to await the next sample alert.

Additional Lunch, Leave or Travel entries are made by repeating the

preceding steps.

For accuracy, it is recommended that Lunch/Leave/Travel entries be made as soon as the activity ends.

That is all there is to it.

With a little practice, making study entries is

quick & easy.

Signing Off of the Study

Click the “Exit Study” button to initiate the end of the study day.

You should be signed on to the study as long

as you are on “paid state time”.

End your study at the end of your work day.

B-12

Return to the Home Screen

Click the “End Study” button to exit the study.

This is a critical step.

Signing Off of the Study

Click the “Power” button to turn off the PDA.

B-13

Be Sure to Recharge

Be sure to recharge the PDA each night using the charger cradle or the sync

cable.

GO

You will get “hands on” practice during your scheduled training session.

The training takes about one (1) hour to complete.

Click your analyst’s email address below to send an email that you have completed the PowerPoint orientation.

Thanks!

[email protected]

[email protected]

[email protected]

[email protected]

APPENDIX C: Study Codes & Definitions

C-1

BILLING & PAYMENT SELECTION GUIDE ACTION PROGRAM ACTIVITY

Onsite Review

HCS TxHmL


CDS










Complaint CDS


C-2

BILLING & PAYMENT SELECTION GUIDE (cont.) ACTION PROGRAM ACTIVITY

SARC HCS TxHmL CDS





Hotline Calls Cost Reports Data Entry Hearings PNA Provider Correspondence Meetings/Training/Conference Administrative Duties Technical Assistance Other Travel

Non Work Related

C-3

BILLING & PAYMENT “ACTION” DEFINITIONS ACTION DESCRIPTION

Onsite Review

A fiscal review conducted at program provider’s place of business for one or more HCS provider agreements to determine compliance with HCS Program Billing Guidelines & verify service claims. Includes all steps, duties, technical assistance & travel for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. entrance conference, workbook, IWP, exit, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Desk Review

A fiscal review conducted by telephone & certified mail for one or more HCS provider agreements to determine compliance with HCS Program Billing Guidelines, & verify service claims. Includes all steps, duties, technical assistance for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. prepare packet, record review, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Recoupment A process in which DADS recovers an overpayment to a provider agency. Includes all steps, duties, technical assistance for: • Payment plan preparation • Third Party Recovery (TPR) requests

Special Onsite Review

A fiscal review conducted at a program provider’s place of business for one or more HCS provider agreements as a result of a billing anomaly identified by DADS staff or as a result of information related to billing issues received from a source other than DADS staff. Includes all steps, duties, technical assistance & travel for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. entrance conference, workbook, IWP, merging, exit, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Special Desk Review

A fiscal review conducted at a DADS office by telephone & certified mail for one or more HCS provider agreements as a result of a billing anomaly identified by DADS staff or as a result of information related to billing issues received from a source other than DADS staff. Includes all steps, duties, technical assistance for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. prepare packet, record review, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Complaint

An allegation against a provider or employee of a provider regulated by DADS that involves a violation of a statute in the Texas Administrative Code (TAC). Includes all steps, duties, technical assistance & travel associated with conducting a complaint investigation from complaint notification to the conclusion & issuance of the report of findings, such as: • Investigation preparation (e.g. requesting documents, preparing questions, completing forms, etc.) • Conducting investigation (e.g. entrance conference, record review, interviews, exit, etc.)

SARC

DADS process for determining & imposing actions & sanctions against a provider for contract non-compliance through a Sanction Action Review Committee (SARC). Includes all duties associated with SARC such as: • SARC preparation (e.g. packet preparation, legal & management consultation, etc.) • SARC presentation (by phone or in person) • SARC committee duties

Administrative Review

A written request from a provider for a review when the provider believes a formal monitoring was not conducted with current DADS policies & procedures. Includes all steps, duties, technical assistance, & travel associated with conducting an administrative review from the issuance of advance notice to the conclusion of the exit conference, such as: • Review preparation (e.g. notification, preparing packet, etc.) • Conducting review (e.g. entrance conference, workbook, IWP, merging, exit, etc.) • Post review (e.g. report findings, create review file, etc.)

General Program Related

Performance of Billing & Payment associated activities that cannot be identified with specific action listed above. Examples of General Program Related activities include: • Monitoring office communication

(e.g. Hotline calls) • Office meetings/training/conferences • Cost reports • Technical assistance

• Correspondence with a provider • Administrative duties • Other duties as assigned in support of unit • Human Resource activities (e.g. leave) • Preparing travel vouchers

Non Work Related Performance of Non Work related activities during the workday. Non Work examples include: • Breaks • Personal phone calls

• Working on this study (e.g. speaking to a WMS analyst)

BILLING & PAYMENT “PROGRAM” DEFINITIONS PROGRAM DESCRIPTION

HCS A Medicaid waiver program serving persons with intellectual/developmental disabilities. Services delivered by contracted providers evaluated for certification shortly after first individual is enrolled & annually thereafter. License not required.

TxHmL A Medicaid waiver program providing limited services to persons with intellectual/developmental disabilities in their own or family home. Services delivered by contracted providers are evaluated for certification after first individual is enrolled & annually thereafter. License not required.

CDS

A voucher payment option that empowers consumers to make personal decisions related to the delivery of personal assistance & respite services within their 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.

C-4

BILLING & PAYMENT “ACTIVITY” DEFINITIONS ACTION/ACTIVITY DESCRIPTION

Ons

ite/D

esk

Rev

iew

Advance Notice

Activities related to notifying contract provider staff of monitoring review by mail, telephone or fax. Includes, but not limited to: • Completing Notice of Review Form 2152 • Establishing review location • Identifying contracts under review • Identifying needed documents & records

• Requesting agency overview • Request contract info/receipt of sample list • For Desk Review only, also include Entrance

Conference activities listed below Select Sample (HCS/TxHmL only)

Activities related to selection of population of individuals served by provider for analysis in a monitoring review using CARE data system or COGNOS.

Screening Criteria (CDS only)

Activities related to verifying provider’s business information & status; such as: • Access federal/state websites & DADS reference

reports • Completing Screening Form 5196 • Using Secretary of State (SOS) Direct System

Prepare Packet

Activities related to preparation for review. Includes, but not limited to: • Preparing components of the monitoring tools • Gathering work papers, forms, supplies • Making copies of related review materials

• Checking review packet content checklist • Providing sample list to provider

Entrance Conference (Onsite only)

Activities conducted at the beginning of a review. Includes, but not limited to: • Discuss the purpose of the review & agenda • Introduce attendees & establish contact person(s) • Obtain records to be reviewed • Request information identified on the review form • Signing review forms

• Distribute coming letter & sign in sheet • Advise refute findings options • Discuss protocol/answer questions • Distribute consumer list • Negotiate times

Record Review (HCS/TxHmL only)

Reviewing all relevant documents needed to complete a review, determine compliance scores & calculate recoupment amount, if any. Includes, but not limited to: • Working with provider to obtain documentation • Providing/making copies • Preparing/providing requested documents list • Requiring immediate corrective action • Pull initial sample list/expand sample • Determining missing documentation

• Determining Initial Plan of Care (IPC) • MR/RC Assessments • Progress notes • Service delivery logs/staff files • Requesting items requiring action • Revision of monitoring results

Pre Refute Process (HCS/TxHmL only)

All activities related to preparing for the Refute Process. Includes, but not limited to: • Numbering error sheet pages • Checking Level of Need (LON) reimbursement

rates • Verify dollar errors • Review error code & comments

• Alphabetizing/copying error sheets • Explaining refute process • Answering questions • Negotiating time

Refute Process (HCS/TxHmL only)

Activities related to process where provider has opportunity to present documentation that errors presented by DADS staff in review are corrected. Includes, but not limited to: • Presentation of provider’s refuting documentation • Explain accepted/unaccepted documentation • Marking/signing error sheets

• Calculating dollars in error • Recoupment list/error sheet documentation • Revision of review results

Timesheet Review (CDS only)

Activities related to preparing, reviewing timesheet records for conducting review. Activities include, but not limited to: • Verifying rate charge matches hours worked

Workbook (CDS only)

All duties associated with completing Monitoring Workbook tab of program monitoring tool. Includes, but not limited to: • Reviewing standards • Completing compliance summary

• Troubleshooting Workbook

Individual Work Pages (CDS only)

All duties associated with completing Individual Work Page tabs of program monitoring tool for each consumer identified in selected sample. Includes, but not limited to: • Completing program specific checklists & tables • Troubleshooting Individual Work Pages

Merging Workbooks (CDS only)

All duties associated with merging team member Workbook assignments (electronically or manually) into a single monitoring tool. Includes troubleshooting the merge.

Exit Conference (Onsite only)

Any activity related to conducting the conclusion of the review & to complete the following activities: • Present findings & compliance level • Advise/discuss demand for payment &

recoupment • Request corrective action plan (CAP) • Request items requiring action /missing

• Advise recourse options • Receive necessary signatures • Form 5990, Contract Monitoring Exit Conference • Answering questions

Post Review

Activities related to the review, occurring after review concludes. Includes, but not limited to: • Providing copies of review documents • Report review results/fraud • Confirm/review items requested at exit • Process request to place/release vendor hold

• Develop & maintain review file • Communication w/provider by phone/other • Send demand for payment letter

Spreadsheet (HCS/TxHmL only)

Activities related to creating, building & reviewing demand for payment spreadsheets for errors & other documentation.

Technical Assistance (HCS/TxHmL only) Providing instruction, information, &/or answering questions in person, by telephone or by email to provider/staff.

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

Travel All travel related to completing duties (e.g. onsite visit, travel plans, airport wait time, etc.).

C-5

BILLING & PAYMENT “ACTIVITY” DEFINITIONS (cont.) ACTION/ACTIVITY DESCRIPTION

Rec

oupm

ent Payment Plans

All activities concerned with determining provider’s payment plan. Includes, but not limited to: • Communications with provider • Completing all forms/documents

• Provide documentation

TPR Request

Activities related to processing Recoupment amount involving a Third Party Recovery. Includes, but not limited to: • Prepare email • Send copies of payment plans

• Working on spreadsheets • Preparing/sending letter

ACTION/ACTIVITY DESCRIPTION

Spec

ial O

nsite

/Spe

cial

Des

k R

evie

w (H

CS,

TxH

mL

Onl

y)

Advance Notice

Activities related to notifying contract provider staff of monitoring review by mail, telephone or fax. Includes, but not limited to: • Completing Notice of Review Form 2152 • Establishing review location • Identifying contracts under review • Identify needed documents & records

• Request agency overview • Request contract info/receipt of sample list • For Desk Review only, also include Entrance

Conference activities listed below

Select Sample Activities related to selection of a population of individuals served by a provider for analysis in a monitoring review using CARE data system or COGNOS.

Prepare Packet

Activities related to preparation of review. Includes, but not limited to: • Preparing components of the monitoring tools • Gathering work papers, forms, supplies • Making copies of related review materials



Activities conducted at beginning of review. Includes, but not limited to: • Discuss purpose of review & agenda • Introduce attendees & establish contact person(s) • Obtain records to be reviewed • Request information identified on review form • Signing review forms


Record Review



Pre Refute Process

All activities related to preparing for Refute Process. Includes, but not limited to: • Numbering error sheet pages • Checking LON reimbursement rates • Verify dollar errors • Review error code & comments


Refute Process

Activities related to process where provider has opportunity to present documentation that errors presented by DADS staff in the review are corrected. Includes, but not limited to: • Presentation of provider’s refuting documentation • Explain accepted/unaccepted documentation • Marking/signing error sheets



Any activity related to conducting conclusion of review. Includes, but not limited to: • Present findings & compliance level • Advise/discuss demand for payment &

recoupment • Request corrective action plan (CAP) • Request items requiring action/missing

documents • Provide hardcopies of documents


Post Review

Activities related to the review, occurring after the review concludes. Includes, but not limited to: • Providing copies of review documents • Report review results/fraud • Confirm/review items requested at exit • Process request to place/release vendor hold


Spreadsheet Activities related to creating, building/reviewing demand for payment spreadsheets for errors & other documentation.

Technical Assistance Providing instruction, information, &/or answering questions in person, by telephone or by email to provider/staff.



C-6


Com

plai

nt (C

DS

Onl

y)

Receipt & Preparation

Activities relating to preparing to initiate a complaint investigation. Includes, but not limited to: • Sending complaint notice Form 2164 • Determining onsite or desk review period • Selecting sample

• Completing forms/documents • Preparing interview statements

Request Documents (Desk)

Activities associated with communicating with complainant, by phone, email, fax, or letter, to request documentation to conduct a desk investigation.

Entrance Conference

Activities conducted at beginning of a complaint. Includes, but not limited to: • Discuss purpose of visit/agenda • Introduce attendees & establish contact person(s) • Obtain records to be reviewed • Request information identified on the review form • Signing review forms


Record Review

Reviewing all relevant documents needed to complete a complaint, determine compliance scores & calculate recoupment amount, if any. Includes, but not limited to: • Working with provider to obtain documentation • Providing/making copies • Preparing/providing requested documents list • Requiring immediate corrective action • Pull initial sample list/expand sample • Determining missing documentation


Workbook All duties associated with completing the Monitoring Workbook tab of monitoring tool. Includes, but not limited to: • Reviewing standards • Completing the compliance summary


Individual Work Pages All duties associated with completing Individual Work Page tabs of monitoring tool for each consumer identified in selected sample. Includes, but not limited to: • Completing program specific checklists & tables • Troubleshooting Individual Work Pages

Merging Workbooks All duties associated with merging team member workbook assignments (electronically/manually) into a single monitoring tool. Includes troubleshooting the merge.

Exit Conference





Post Complaint Activities related to complaint investigation occurring after investigation concludes. Includes, but not limited to: • Making appropriate referrals • Submitting SARC referral

• Developing & maintaining investigation file

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

Travel All travel related to completing duties (e.g. onsite visit, travel plans, airport wait time, etc.). ACTION/ACTIVITY DESCRIPTION

SAR

C

Prepare Packet All duties associated with preparation of packet for submittal to SARC. Includes completing Form 2160, SARC Memorandum & appropriate signatures.

Present Packet Activity related to presenting SARC findings/recommendations to SARC committee.

Committee All duties associated with being a sitting member of SARC. Includes preparation, notifications, attending pre & post meetings, etc.

Other Other duties not specifically addressed above (e.g. technical assistance, filing, copying, listening to meeting, etc.)

C-7


Adm

inis

trat

ive

Rev

iew

(CD

S O

nly)

Advance Notice

Activities related to notifying contract provider staff of monitoring review by mail, telephone or fax. Includes, but not limited to: • Completing Notice of Review Form 2152 • Establishing review location • Identifying contracts under review

• Identify needed documents & records • Request agency overview • Request contract info/receipt of sample list

Screening Criteria

Activities related to verifying provider’s business information & status. Includes, but not limited to: • Access federal/state websites/DADS reference

reports • Completing Screening Form 5196

• Using Secretary of State (SOS) Direct System

Prepare Packet



Entrance Conference

Activities conducted at beginning of a review. Includes, but not limited to: • Discuss the purpose of the review & agenda • Introduce attendees & establish contact person(s) • Obtain records to be reviewed • Request information identified on the review form • Signing review forms


Timesheet Review Activities related to preparing, reviewing timesheet records for conducting review. Activities include, but not limited to: • Verifying rate charge matches hours worked

Workbook All duties associated with completing Monitoring Workbook tab of monitoring tool. Includes, but not limited to: • Reviewing standards • Completing the compliance summary


Individual Work Pages All duties associated with completing Individual Work Page tabs of monitoring tool for each consumer identified in selected sample. Includes, but not limited to: • Completing program specific checklists & tables • Troubleshooting Individual Work Pages

Merging Workbooks All duties associated with merging team member workbook assignments (electronically or manually) into a single monitoring tool. Includes troubleshooting merge.

Exit Conference

Any activity related to conducting conclusion of review & to complete following activities: • Present findings & compliance level • Advise/discuss demand for payment &




Post Review

Activities related to review, occurring after the review concludes. Including the following: • Providing copies of review documents • Report review results/fraud • Confirm/review items requested at exit • Process request to place/release vendor hold




Gen

eral

Pro

gram

Rel

ated

Hotline Calls Listening to & documenting voice mail box messages from Hotline.

Cost Reports Activities associated with completing Cost Report for HCS only.

Data Entry All data entry into systems, databases, spreadsheets, or logs used to populate the contract with data, monitor receipt, completion status or productivity (e.g. HCATS, Provider Online (POL), etc.).

Hearings All duties related to preparing for, attending, presenting or otherwise assisting in a hearing.

PNA Activities associated with making corrections to Personal Needs Allowance.

Provider Correspondence

Any general program, (not review or complaint related) communication with a provider, (e.g. phone calls, email, letters, letter preparation).

Meeting/Training/ Conference

All duties associated with preparing for, attending, presenting or otherwise assisting in any meeting, training, or conference. Includes time providing training/mentoring to other employees, work groups & special projects.

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 otherwise providing contract related information & assistance outside of the monitoring review, complaint, or other formal processes.

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

Travel All travel related to completing duties (e.g. training, meetings, conferences, travel plans, airport wait-time, etc.).

APPENDIX D: Study Instruction Booklet

COMMUNITY SERVICES CONTRACTS

Billing & Payment Program 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 PROGRAM SPECIALIST SELECTION GUIDE....................................................... 8 PROGRAM SPECIALIST “ACTION” DEFINITIONS ............................................ 10 PROGRAM SPECIALIST “PROGRAM” DEFINITIONS ....................................... 10 PROGRAM SPECIALIST “ACTIVITY” DEFINITIONS .......................................... 11 SIGN-ON PROCEDURES ..................................................................................... 15 STARTING THE STUDY ....................................................................................... 18 SAMPLE ALERT SCREEN ................................................................................... 19 DATA ENTRY ........................................................................................................ 20 LUNCH/LEAVE/TRAVEL ...................................................................................... 23 ENDING THE STUDY DAY ................................................................................... 27 SOFTWARE INSTALLATION ............................................................................... 28 PDA HOTSYNC PROCEDURES ........................................................................... 29

Work Measurement 1 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 Program Specialists spend performing various contract activities in the Billing & Payment 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 Billing & Payment 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 Fiscal Reviews 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: Onsite Reviews, Recoupment, Complaints, etc. Program: Home & Community-Based Services Waiver (HCS), etc. Activity: preparing packets, conducting entrance or exit conferences, traveling, 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 synchronization cradle into the USB port on your laptop 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 laptop (Figure 5). Palm Cradle Installation

Cradle Connections to charge PDA

Connect the USB plug using the port

on your laptop

Cradle Plug

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

Figure 5

Figure 3

Connect

Figure 1 Figure 2 USB port

Connects to PDA

USB port

Figure 4

Connects to cigarette lighter


PDA MAINTENANCE Charge the PDA in the synchronization 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.


PROGRAM SPECIALIST SELECTION GUIDE

ACTION PROGRAM ACTIVITY

Onsite Review

HCS TxHmL


CDS










Complaint CDS



PROGRAM SPECIALIST SELECTION GUIDE (cont.) ACTION PROGRAM ACTIVITY

SARC HCS TxHmL CDS





Hotline Calls Cost Reports Data Entry Hearings PNA Provider Correspondence Meetings/Training/Conference Administrative Duties Technical Assistance Other Travel

Non Work Related


PROGRAM SPECIALIST “ACTION” DEFINITIONS ACTION DESCRIPTION

Onsite Review

Fiscal review conducted at program provider’s place of business for one or more HCS provider agreements to determine compliance with HCS Program Billing Guidelines & verify service claims. Includes all steps, duties, technical assistance & travel for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. entrance conference, workbook, IWP, exit, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Desk Review

Fiscal review conducted by telephone & certified mail for one or more HCS provider agreements to determine compliance with HCS Program Billing Guidelines & verify service claims. Includes steps, duties, technical assistance for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. prepare packet, record review, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Recoupment A process in which DADS recovers overpayment to provider agency. Includes steps, duties, technical assistance for: • Payment plan preparation • Third Party Recovery (TPR) requests

Special Onsite Review

Fiscal review conducted at a program provider’s place of business for one or more HCS provider agreements as a result of a billing anomaly identified by DADS staff or as a result of information related to billing issues received from a source other than DADS staff. Includes all steps, duties, technical assistance & travel for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. entrance conference, workbook, IWP, merging, exit, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Special Desk Review

Fiscal review conducted at a DADS office by telephone & certified mail for one or more HCS provider agreements as a result of a billing anomaly identified by DADS staff or as a result of information related to billing issues received from a source other than DADS staff. Includes all steps, duties, technical assistance for: • Review preparation (e.g. notification, screening criteria, preparing packet, etc.) • Conducting review (e.g. prepare packet, record review, refute process, etc.) • Post review (e.g. report findings, create review file, etc.)

Complaint

An allegation against a provider or employee of a provider regulated by DADS involving violation of statute in the Texas Administrative Code (TAC). Includes steps, duties, technical assistance & travel associated with conducting investigation from notification to the conclusion & issuance of report of findings, such as: • Investigation preparation (e.g. requesting documents, preparing questions, completing forms, etc.) • Conducting investigation (e.g. entrance conference, record review, interviews, exit, etc.)

SARC

DADS process for determining & imposing actions & sanctions against a provider for contract non-compliance through a Sanction Action Review Committee (SARC). Includes all duties associated with SARC such as: • SARC preparation (e.g. packet preparation, legal & management consultation, etc.) • SARC presentation (by phone or in person) • SARC committee duties

Administrative Review

A written request from provider for review when provider believes formal monitoring was not conducted with current DADS policies & procedures. Includes steps, duties, technical assistance, & travel associated with conducting an administrative review from issuance of advance notice to conclusion of exit conference, such as: • Review preparation (e.g. notification, preparing packet, etc.) • Conducting review (e.g. entrance conference, workbook, IWP, merging, exit, etc.) • Post review (e.g. report findings, create review file, etc.)

General Program Related

Performance of Billing & Payment associated activities that cannot be identified with specific action listed above. Examples of General Program Related activities include: • Monitoring office communication

(e.g. Hotline calls) • Office meetings/training/conferences • Cost reports • Technical assistance

• Correspondence with a provider • Administrative duties • Other duties as assigned in support of unit • Human Resource activities (e.g. leave) • Preparing travel vouchers

Non Work Related Performance of Non Work related activities during the workday. Non Work examples include: • Breaks • Personal phone calls

• Working on this study (e.g. speaking to a WMS analyst)

PROGRAM SPECIALIST “PROGRAM” DEFINITIONS PROGRAM DESCRIPTION

HCS Medicaid waiver program serving persons with intellectual/developmental disabilities. Services delivered by contracted providers evaluated for certification shortly after individual enrolled & annually. License not required.

TxHmL Medicaid waiver program providing limited services to persons with intellectual/developmental disabilities in their own or family home. Services delivered by contracted providers are evaluated for certification after first individual is enrolled & annually. License not required.

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 & selecting Consumer Directed Services Agency (CDSA) to conduct financial management services such as payroll & employer taxes.


PROGRAM SPECIALIST “ACTIVITY” DEFINITIONS ACTION/ACTIVITY DESCRIPTION

Ons

ite/D

esk

Rev

iew

Advance Notice

Activities related to notifying contract provider staff of monitoring review by mail, telephone or fax. Includes, but not limited to: • Completing Notice of Review Form 2152 • Establishing review location • Identifying contracts under review • Identifying needed documents & records

• Requesting agency overview • Request contract info/receipt of sample list • For Desk Review only, also include Entrance

Conference activities listed below Select Sample (HCS/TxHmL only)

Activities related to selection of population of individuals served by provider for analysis in a monitoring review using CARE data system or COGNOS.

Screening Criteria (CDS only)

Activities related to verifying provider’s business information & status; such as: • Access federal/state websites & DADS reference

reports • Completing Screening Form 5196 • Using Secretary of State (SOS) Direct System

Prepare Packet

Activities related to preparation for review. Includes, but not limited to: • Preparing components of the monitoring tools • Gathering work papers, forms, supplies • Making copies of related review materials



Activities conducted at the beginning of a review. Includes, but not limited to: • Discuss the purpose of the review & agenda • Introduce attendees & establish contact(s) • Obtain records to be reviewed • Request information identified on review form • Signing review forms


Record Review (HCS/TxHmL only)



Pre Refute Process (HCS/TxHmL only)

All activities related to preparing for the Refute Process. Includes, but not limited to: • Numbering error sheet pages • Checking Level of Need (LON) reimbursement

rates • Verify dollar errors • Review error code & comments


Refute Process (HCS/TxHmL only)

Activities related to process where provider has opportunity to present documentation that errors presented by DADS staff in review are corrected. Includes, but not limited to: • Present provider’s refuting documentation • Explain accepted/unaccepted documentation • Marking/signing error sheets


Timesheet Review (CDS only)

Activities related to preparing & reviewing timesheet records for review. Activities include, but not limited to: • Verifying rate charge matches hours worked

Workbook (CDS only)

All duties associated with completing Monitoring Workbook tab of monitoring tool. Includes, but not limited to: • Reviewing standards • Completing compliance summary


Individual Work Pages (CDS only)

All duties associated with completing Individual Work Page tabs of program monitoring tool for each consumer identified in selected sample. Includes, but not limited to: • Completing program specific checklists & tables • Troubleshooting Individual Work Pages

Merging Workbooks (CDS only)

All duties associated with merging team member Workbook assignments (electronically or manually) into a single monitoring tool. Includes troubleshooting the merge.


Any activity related to conducting the conclusion of the review & to complete the following activities: • Present findings & compliance level • Advise/discuss demand payment & recoupment • Request corrective action plan (CAP) • Request items for action/missing documents • Provide hardcopies of documents


Post Review

Activities related to the review, occurring after review concludes. Includes, but not limited to: • Providing copies of review documents • Report review results/fraud • Confirm/review items requested at exit • Process request to place/release vendor hold


Spreadsheet (HCS/TxHmL only)

Activities related to creating, building & reviewing demand for payment spreadsheets for errors & other documentation.

Technical Assistance (HCS/TxHmL only)

Providing instruction, information, &/or answering questions in person, by telephone or by email to provider/staff.




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

Rec

oupm

ent

Payment Plans

All activities concerned with determining provider’s payment plan. Includes, but not limited to: • Communications with provider • Completing all forms/documents

• Provide documentation

TPR Request

Activities related to processing Recoupment amount involving a Third Party Recovery. Includes, but not limited to: • Prepare email • Send copies of payment plans

• Working on spreadsheets • Preparing/sending letter

ACTION/ACTIVITY DESCRIPTION

Spec

ial O

nsite

/Spe

cial

Des

k R

evie

w (H

CS,

TxH

mL

Onl

y)

Advance Notice

Activities related to notifying contract provider staff of monitoring review by mail, telephone or fax. Includes, but not limited to: • Completing Notice of Review Form 2152 • Establishing review location • Identifying contracts under review • Identify needed documents & records

• Request agency overview • Request contract info/receipt of sample list • For Desk Review only, also include Entrance

Conference activities listed below

Select Sample Activities related to selection of a population of individuals served by a provider for analysis in a monitoring review using CARE data system or COGNOS.

Prepare Packet




Activities conducted at beginning of review. Includes, but not limited to: • Discuss purpose of review & agenda • Introduce attendees & establish contact

person(s) • Obtain records to be reviewed • Request information identified on review form • Signing review forms


Record Review



Pre Refute Process

All activities related to preparing for Refute Process. Includes, but not limited to: • Numbering error sheet pages • Checking LON reimbursement rates • Verify dollar errors • Review error code & comments


Refute Process

Activities related to process where provider has opportunity to present documentation that errors presented by DADS staff in the review are corrected. Includes, but not limited to: • Presentation of provider’s refuting

documentation • Explain accepted/unaccepted documentation • Marking/signing error sheets







Post Review

Activities related to the review, occurring after the review concludes. Includes, but not limited to: • Providing copies of review documents • Report review results/fraud • Confirm/review items requested at exit • Process request to place/release vendor hold


Spreadsheet Activities related to creating, building/reviewing demand for payment spreadsheets for errors & documentation.

Technical Assistance Providing instruction, information &/or answering questions in person, telephone or email to provider/staff.





Com

plai

nt (C

DS

Onl

y)

Receipt & Preparation

Activities relating to preparing to initiate a complaint investigation. Includes, but not limited to: • Sending complaint notice Form 2164 • Determining onsite or desk review period • Selecting sample

• Completing forms/documents • Preparing interview statements

Request Documents (Desk)

Activities associated with communicating with complainant, by phone, email, fax, or letter, to request documentation to conduct a desk investigation.

Entrance Conference

Activities conducted at beginning of a complaint. Includes, but not limited to: • Discuss purpose of visit/agenda • Introduce attendees & establish contact

person(s) • Obtain records to be reviewed • Request information identified on the review

form • Signing review forms


Record Review

Reviewing all relevant documents needed to complete a complaint, determine compliance scores & calculate recoupment amount, if any. Includes, but not limited to: • Working with provider to obtain documentation • Providing/making copies • Preparing/providing requested documents list • Requiring immediate corrective action • Pull initial sample list/expand sample • Determining missing documentation


Workbook

All duties associated with completing the Monitoring Workbook tab of monitoring tool. Includes, but not limited to: • Reviewing standards • Completing the compliance summary


Individual Work Pages

All duties associated with completing Individual Work Page tabs of monitoring tool for each consumer identified in selected sample. Includes, but not limited to: • Completing program specific checklists & tables • Troubleshooting Individual Work Pages

Merging Workbooks All duties associated with merging team member workbook assignments (electronically/manually) into a single monitoring tool. Includes troubleshooting the merge.

Exit Conference





Post Complaint Activities related to complaint investigation occurring after investigation concludes. Includes, but not limited to: • Making appropriate referrals • Submitting SARC referral

• Developing & maintaining investigation file



SAR

C

Prepare Packet All duties associated with preparation of packet for submittal to SARC. Includes completing Form 2160, SARC Memorandum & appropriate signatures.

Present Packet Activity related to presenting SARC findings/recommendations to SARC committee.

Committee All duties associated with being a sitting member of SARC. Includes preparation, notifications, attending pre & post meetings, etc.

Other Other duties not specifically addressed above (e.g. technical assistance, filing, copying, listening to meeting, etc.)



Adm

inis

trat

ive

Rev

iew

(CD

S O

nly)

Advance Notice

Activities related to notifying contract provider staff of monitoring review by mail, telephone or fax. Includes, but not limited to: • Completing Notice of Review Form 2152 • Establishing review location • Identifying contracts under review

• Identify needed documents & records • Request agency overview • Request contract info/receipt of sample list

Screening Criteria

Activities related to verifying provider’s business information & status. Includes, but not limited to: • Access federal/state websites/DADS reference

reports • Completing Screening Form 5196

• Using Secretary of State (SOS) Direct System

Prepare Packet



Entrance Conference

Activities conducted at beginning of a review. Includes, but not limited to: • Discuss the purpose of the review & agenda • Introduce attendees & establish contact(s) • Obtain records to be reviewed • Request information identified on review form • Signing review forms


Timesheet Review Activities related to preparing, reviewing timesheet records for conducting review. Activities include, but not limited to: • Verifying rate charge matches hours worked

Workbook All duties associated with completing Monitoring Workbook tab of monitoring tool. Includes, but not limited to: • Reviewing standards • Completing the compliance summary


Individual Work Pages

All duties associated with completing Individual Work Page tabs of monitoring tool for each consumer identified in selected sample. Includes, but not limited to: • Completing program specific checklists & tables • Troubleshooting Individual Work Pages

Merging Workbooks All duties associated with merging team member workbook assignments (electronically or manually) into a single monitoring tool. Includes troubleshooting merge.

Exit Conference

Any activity related to conducting conclusion of review & to complete following activities: • Present findings & compliance level • Advise/discuss demand for payment &


documents

• Provide hardcopies of documents • Advise recourse options • Receive necessary signatures • Form 5990, Contract Monitoring Exit Conference • Answering questions

Post Review

Activities related to review, occurring after the review concludes. Including the following: • Providing copies of review documents • Report review results/fraud • Confirm/review items requested at exit • Process request to place/release vendor hold




Gen

eral

Pro

gram

Rel

ated

Hotline Calls Listening to & documenting voice mail box messages from Hotline.

Cost Reports Activities associated with completing Cost Report for HCS only.

Data Entry All data entry into systems, databases, spreadsheets, or logs used to populate the contract with data, monitor receipt, completion status or productivity (e.g. HCATS, Provider Online (POL), etc.).

Hearings All duties related to preparing for, attending, presenting or otherwise assisting in a hearing.

PNA Activities associated with making corrections to Personal Needs Allowance. Provider Correspondence

Any general program, (not review or complaint related) communication with a provider, (e.g. phone calls, email, letters, letter preparation).

Meeting/Training/ Conference

All duties associated with preparing for, attending, presenting or otherwise assisting in any meeting, training, or conference. Includes time providing training/mentoring to other employees, work groups & special projects.

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 otherwise providing contract related information & assistance outside of the monitoring review, complaint, or other formal processes.

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

Travel All travel related to completing duties (e.g. 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 CSBP 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. 23).

• The “Exit Study” button is discussed later (p. 27).

• 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:

• Onsite Review 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 a displayed. Based upon your Action, you must now choose the “Program” best describing your current activity. In this example:

• HCS


DATA ENTRY (cont.)

This is the third level selection menu.

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

• Prepare Packet 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: Onsite Review 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 or plane

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 “Travel” 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 “End Time” box.

• Tap the hour 09 & the minute 15. 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.

An example of multiple listings.



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. 23).


ENDING THE STUDY DAY

It is important to sign 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 sign 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 logged 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. 10).

After the HotSync, tap the “Home” button to return to the three-icon sign on screen (p. 15).

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, you must 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 29).

3. If your PDA stops signaling for over two hours, re-start the study (page 15).

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