of the performance improvement plan. 1. % of youth who reside within approved 1. 1. Semi DHMH/MHA Settings meet Based on the the home and findings, OHS living situations or who are disenrolled as a DHMH/MHA Annually and MHA will result of moving to a setting that is not sampling of with the CSAs setting create a authorized in this SPA. entire requirements performance enrolled as specified improvement roster in this SPA. plan within 30 working days of identification of deficiencies The SMA 1. % of quarterly progress reports submitted to 1. Quarterly 1&2. Annually DHMH/MHA& Based on the retains DHMH/Office of Health Services reports are DHMH/MHA DHMH/OHS findings, OHS authority and provided to and MHA will responsibility 2. % of enrollment census updates distributed to OHS by MHA 3. ASO/MHA create a for program OHS performance operations 2. Review of improvement and distribution plan within 30 oversight. list for census working days 3. Medical Eligibility/enrollment Oversight updates issued of by MHA identification 3. Review of CASII/CONS deficiencies. documentation The SMA 1. % of HCBS benefit service claims processed Defensible DHMH/ASO Annually DHMH/MHA If a maintains appropriately against fund source, authorization sampling performance financial history, service limitations, and coding. strategy; point improvement in time review plan is needed, through of services a program 2. % of participants with completed financial payment of received. director must eligibility reviews in accordance with policy at claims for submit a
of the performance improvement plan. Settings meet the home and setting requirements as specified in this SPA. 1. % of youth who reside within approved living situations or who are disenrolled as a result of moving to a setting that is not authorized in this SPA. 1. sampling of entire enrolled roster 1. DHMH/MHA with the CSAs Semi Annually DHMH/MHA Based on the findings, OHS and MHA will create a performance improvement plan within 30 working days of identification of deficiencies The SMA retains authority and responsibility for program operations and oversight. 1. % of quarterly progress reports submitted to DHMH/Office of Health Services 2. % of enrollment census updates distributed to OHS 3. Medical Eligibility/enrollment Oversight 1. Quarterly reports are provided to OHS by MHA 2. Review of distribution list for census updates issued by MHA 3. Review CASII/CONS documentation 1&2. DHMH/MHA 3. ASO/MHA Annually DHMH/MHA& DHMH/OHS Based on the findings, OHS and MHA will create a performance improvement plan within 30 working days of identification of deficiencies. The SMA maintains financial through payment of claims for 1. % of HCBS benefit service claims processed appropriately against fund source, authorization history, service limitations, and coding. 2. % of participants with completed financial eligibility reviews in accordance with policy at Defensible sampling strategy; point in time review of services received. DHMH/ASO Annually DHMH/MHA If a performance improvement plan is needed, a program director must submit a
1915_i_SPA_CMS_Submission.docx