Resource Center

FSQAP Discovery Review Tools

July 1, 2014 ~ Update


Provider Tool Revisions Effective July 1, 2014

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Discovery tools used by Delmarva reviewers to evaluate provider compliance, currently named “Delmarva Provider Discovery” are being renamed “Florida Statewide Quality Assurance Program (FSQAP) Discovery” to more accurately reflect their function.

The tools used by Delmarva to evaluate specific provider services or the Service Specific Record Review (SSRR) tools have now removed ‘billing discrepancies’ from non-critical tool components.

Provider scores will continue to be based on standards applicable under the Florida Medicaid Developmental Disabilities (DD) Waiver Services Coverage and Limitations Handbook dated effective November 2010.

General Information:

  • Here, on the Delmarva website, you will find all FSQAP Discovery review tools.
  • The FSQAP Discovery review tools will reflect the date of the most current version in the footer. For example, the Provider Discovery Review Administrative tool footer reads: DFMC_FLDD_Discovery_Administrative_2014_0701. The 2014_0701 indicates it is the July 2014 version.
  • Delmarva’s Customer Service Representative Elizabeth Stratigeas is available to assist if you have any questions.  She can be reached at stratigease@delmarvafoundation.org or 1-866-254-2075.

February 1, 2014 ~ Update



Review Tools Update Details for February 2014

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New Discovery tools were implemented statewide on February 1st, 2013.  Tools were posted on the Delmarva website and opportunities for feedback have been ongoing. 

New tools were based on the iBudget Draft Handbook and technical assistance has been provided by Delmarva reviewers for a full year (2/1/2013 – 1/31/2014) allowing providers and other stakeholders one year to become familiar with new standards and with iBudget requirements.

The Developmental Disabilities iBudget Medicaid Coverage and Limitations Handbook remains in the process of promulgation and edits have been ongoing. While we await promulgation of iBudget Medicaid Coverage and Limitations Handbook, iBudget specific standards will continue to receive technical assistance and not be counted in numeric scoring.

Standards which were new to the tools beginning 2/1/13, but were not iBudget specific will no longer be considered Technical Assistance (T/A) standards. These standards will be reviewed and included in numeric scoring.

Updated tools are slated for implementation on February 1st, 2014.  Implementation of updated tools will be as follows:

  • Provider scores will continue to only be based on standards applicable under the Developmental Disabilities (DD) Waiver Services and Limitations handbook dated November 2010 and other requirements such as Florida statutes and Florida Administrative Code until the iBudget Handbook is promulgated.
  •  All service standards will be reviewed; however there will NOT be any numeric scoring of iBudget specific standards
  • Reviewers will note ‘“Met” or “Not Met” with T/A provided. Provider scores will not be impacted with a finding of “Not Met” with T/A provided.
  • Delmarva reviewers will continue to provide informal technical assistance as needed on iBudget requirements.
  • The iBudget training requirement titled “Core Competencies “will remain inactive until the standardized state approved curriculum has been developed and implemented. 
  • In the interim, the following trainings are still required per the Developmental Disabilities November 2010 Handbook and are identified as standards 3a – 3e on the Administrative Tool:
    • Direct Care Core Competency – includes two modules “Intro to Developmental Disabilities” and “Health and Safety”.
    • Person Centered Approach/Personal Outcome Measures
    • Choice and Rights
  • Technical Assistance will no longer be applicable for training and service standards that were “new” to the tools beginning 2/1/13 but were not specific to iBudget.  These standards will be reviewed and scored accordingly.
  • The corresponding document entitled Status of T/A Standards and Not Met Reasons Effective 2/1/14 [pdf] spells out what standards are iBudget specific and will remain T/A and what standards are not specific to iBudget and will no longer be T/A beginning 2/1/2014.

General Information:

  • Posted to the website you will find all the iBudget Service Specific tools including the Administrative tool, the Observation Review Checklist, and the revised Health Summary. 
  • To ensure you have the most current version, the footer of each iBudget Discovery tool will reflect the date. For example, the Provider Discovery Review Administrative tool footer reflects: DFMC_FLDD_iBudget_Administrative_2014_0201. The 2014_0201 indicates it is the February 2014 version. Please discard earlier versions of the tools.
  • Delmarva’s Customer Service Representative Elizabeth Stratigeas is available to assist if you have any questions.  She can be reached at stratigease@delmarvafoundation.org or 1-866-254-2075.

September 1, 2013 ~ Update


Review Tools Update Details for September 2013

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New Discovery tools were implemented Statewide on February 1st, 2013.  The Developmental Disabilities iBudget Medicaid Coverage and Limitations Handbook remains in the process of promulgation and edits have been ongoing. For this reason, revisions have continued to occur for the Discovery Tools as revisions are made in the draft iBudget Handbook and feedback is received from AHCA, APD and other stakeholders.

Updated service tools have been posted on the Delmarva website. To ensure you have the most current version, the footer of each iBudget Discovery tool will reflect the date. For example, the Provider Discovery Review Administrative tool footer reflects: DFMC_FLDD_iBudget_Administrative_2013_0901. The 2013_0901 indicates it is the September 2013 version. Please discard earlier versions of the tools.

 New and/or temporary processes being implemented include the following:

  • Administrative Tool: Regarding Respite (Under 21) the following standard has been removed - Agency Respite provider is registered with AHCA as a Companion & Homemaker Services provider.
  • Administrative Tool: The requirement to have a high school diploma or equivalent has been removed as a minimum education requirement.
  • Edits to protocols have been made throughout for further clarification.
  • All service standards will be reviewed; however there will NOT be any numeric scoring of Standards or not met reasons described as NEW.   Reviewers will note ‘Met’ or ‘Met – T/A Provided’ on the NEW Standards, but the Provider’s score will not be impacted. Provider scores will only be based on Standards applicable under the DD Waiver Services and Limitations Handbook dated November 2010 and other requirements including Florida statutes. 
  • Delmarva reviewers will continue to provide informal technical assistance as needed on iBudget requirements. This will apply for one year (2/1/2013-1/31/2014), giving providers ample opportunity to adjust to new iBudget requirements and feedback received, and still allow APD and AHCA the opportunity to collect information on the new waiver.

To be informed of updates to the tools, please sign up for electronic notification on the home page at www.dfmc-florida.org.
Delmarva’s Customer Service Representative Elizabeth Stratigeas is available to assist if you have any questions.  She can be reached at stratigease@delmarvafoundation.org or 1-866-254-2075.


March 15, 2013 ~ Update


Review Tools & Quick Reference Guides Update Details for March 15, 2013 & Prior

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New Discovery tools were implemented Statewide on February 1st, 2013.  The Developmental Disabilities iBudget Medicaid Coverage and Limitations Handbook remains in the process of promulgation and edits have been ongoing. For this reason, revisions have continued to occur for the Service Specific Discovery tools as revisions are made in the draft iBudget Handbook.

Updated service tools have been posted on the Delmarva website. The Quick Reference Guides have also been updated to reflect changes. To ensure you have the most current version, the footer of each Quick Reference Guide and iBudget Discovery tool will reflect the date. For example, the Provider Discovery Review Administrative tool footer reflects: DFMC_FLDD_iBudget_Administrative_2013_0301. The 2013_0301 indicates it is the March 2013 version. Please discard earlier versions of the tools.

 New and/or temporary processes being implemented include the following:

  • All service standards will be reviewed; however there will NOT be any numeric scoring of Standards or not met reasons described as NEW.   Reviewers will note ‘Met’ or ‘Not Met’ on the NEW Standards, but the Provider’s score will not be impacted. Provider scores will only be based on Standards applicable under the DD Waiver Services and Limitations Handbook dated November 2010 and other requirements including Florida statutes.

  • Delmarva reviewers will provide informal technical assistance as needed on iBudget requirements. This will apply for one year (2/1/2013-1/31/2014), giving providers ample opportunity to adjust to new iBudget requirements and feedback received, and still allow APD and AHCA the opportunity to collect information on the new waiver.

  • New training requirements will stay inactive and not be reviewed until an effective date for new training is determined. 

  • For Regions of the State not yet on iBudget, iBudget Discovery Review tools will be applied to DD Waiver Services where the service name has changed as follows:

    • Adult Day Training – Life Skills 3
    • Companion – Life Skills 1
    • Supported Employment – Life Skills 2
    • In Home Support Services – Personal Supports
    • Personal Care Assistance – Personal Supports
    • In Home Support Services – Personal Supports
    • Respite (over 21) – Personal Supports

In addition, to aid in this transition process, a Quick Reference Guide (not to be confused with the actual review tool) has been developed for each service to highlight changes from the old HCBS review tool to the new iBudget tool.

To be informed of updates to the tools, please sign up for electronic notifications - Individuals or Providers.

Delmarva’s Customer Service Representative Elizabeth Stratigeas is available to assist if you have any questions.  She can be reached at stratigease@delmarvafoundation.org or 1-866-254-2075.


February 2013 ~ Update

While iBudget tools are slated for implementation on February 1, 2013,  there will be a grace period where new standards will be scored ‘Met’ or ‘TA’ (Technical Assistance) as opposed to ‘Met’ or ‘Not Met’.  The grace period will be in effect from February 1, 2013 through January 31, 2014. Providers who received ‘deemed status’ on their Provider Discovery Review (PDR) during the period from January 2012 through December 2012 are invited to take advantage of the  grace period and technical assistance offered by contacting Delmarva at Stratigease@delmarvafoundation.org,  and requesting a PDR this year. 


February 1, 2013 ~ Notice

 

General Information About the iBudget Discovery Tool Implementation

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Tools were posted on the Delmarva website and feedback was solicited from all stakeholders.  Additionally, a workgroup composed of APD, AHCA, and Delmarva invited a variety of providers to offer face-to-face recommendations. The revised tools reflect responsiveness to feedback provided and the resultant tools demonstrate:

  • Shortened tools for most services
  • Removal of ‘perfect compliance’ with an opportunity for demonstrating partial compliance
  • Removal of potential billing discrepancy for non-critical components
  • Simplified layout to make easier to follow
  • Protocols and potential not met reasons clarify requirements
  • Clear linkage to source documents

New tools are slated for implementation on February 1st, 2013. Opportunities for feedback will be ongoing. Implementation of new tools will be as follows:

  • All service standards will be reviewed; however there will NOT be any numeric scoring of new or iBudget specific standards.
  • Reviewers will note ‘Met’ or ‘Not Met’ but the Provider’s score will not be impacted. Provider scores will only be based on standards applicable under the DD Waiver Services and Limitations handbook dated November 2010 and other requirements such as Florida statutes.
  • Delmarva reviewers will provide informal technical assistance as needed on iBudget requirements. This will apply for up to one year, giving providers ample opportunity to adjust to new iBudget requirements and feedback received, and still allow APD and AHCA the opportunity to collect information on the new waiver.
  • Any new training requirements will stay inactive and not be reviewed until an effective date for new training is determined.
  • Tools will be implemented statewide. For those regions of the state not yet on iBudget, iBudget review tools will be applied to DD Waiver Services where the service name has changed as follows:

    • Adult Day Training – Life Skills 3
    • Companion – Life Skills 1
    • Supported Employment – Life Skills 2
    • In Home Support Services – Personal Supports
    • Personal Care Assistance – Personal Supports
    • In Home Support Services – Personal Supports

  • A Quick Reference Guide (not to be confused with the actual review tool) has been developed for each service to highlight changes from the old HCBS review tool to the new iBudget tool. 
  • Posted to the website you will find all the iBudget Service Specific tools, the revised Observation Review Checklist, the revised Health Summary (previously known as the Health and Behavioral Assessment) and the Quick Reference Guides mentioned above.
  • Delmarva’s Customer Service Representative Elizabeth Stratigeas is available to assist if you have any questions.  She can be reached at stratigease@delmarvafoundation.org or 1-866-254-2075.
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Review Manual & Resources ~ PDFs

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Review Tools ~ July 1, 2014 (PDFs)

Title
Record Review Tool

Person Centered Review (PCR)

Individual Interview Instrument (February 2010)
Health Summary

Title
Record Review Tool

Provider Discovery Review (PDR)

Administrative
Observation Review Checklist

Service Specific Individual Record Review (SSRR)

Title
Record Review Tool
Behavior Analysis
Behavior Assistant
CDC+ Consultant
CDC+ Representative
Life Skills Development 1 (Companion)
Life Skills Development 2 (Supported Employment)
Life Skills Development 3 (Adult Day Training)
Personal Supports
Residential Habilitation (Standard)
Residential Habilitation (Behavior Focus)
Residential Habilitation (Intensive Behavior)
Respite (under 21)
Special Medical Home Care
Supported Living Coaching
Waiver Support Coordination

Provider Discovery Review (PDR) Survey

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Request for Reconsideration (updated February 1, 2014)
If you disagree with the findings related to noted billing discrepancies in your Provider Discovery Review (PDR) report, you may request a Reconsideration Review.  The Reconsideration Request must be made in writing (using the Reconsideration Request form located below) and received within 30 days of your receipt of the annual PDR report.

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The National Core Indicators is a collaboration among participating National Association of State Directors of Developmental Disability Services (NASDDDS) member state agencies and the Human Services Research Institute (HSRI), with the goal of developing a systematic approach to performance and outcome measurement.
http://www2.hsri.org/nci/

 

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