Responsible Party for Frequency of data Sampling Approach data collection/generation: (check each that collection/generation (check each that applies) (check each that applies) applies) State Medicaid Agency Weekly 100% Review Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Annually Specify: Administrative Service Continuously and Stratified: Describe Organization Ongoing Group: Other Specify: Other Specify: Add another Data Source for this performance measure Data Aggregation and Analysis Responsible Party for Frequency of data data aggregation and aggregation and analysis analysis: (check each that (check each that applies applies State Medicaid Agency Weekly Operating Agency Monthly Sub-State Entity Quarterly Other Annually Specify: Continuously and Ongoing Other Specify: Add another Performance measure (button to prompt another performance measure) Performance % of providers licensed by DDS that continue to meet applicable licensure Measure: or certification standards. (Number of providers that continue to meet applicable licensure or certification standards/ Number of providers subject to licensure/certification) Data Source (Select one) (Several options are listed in the on-line application): Provider performance monitoring If is selected, specify: ‘Other’
Responsible Party for data collection/generation (check each that applies) Frequency of data collection/generation: (check each that applies) Sampling Approach (check each that applies) State Medicaid Agency Weekly 100% Review Operating Agency Monthly Less than 100% Review Sub-State Entity Quarterly Representative Sample; Confidence Interval = Other Specify: Annually Administrative Service Organization Continuously and Ongoing Stratified: Describe Group: Other Specify: Other Specify: Add another Data Source for this performance measure Data Aggregation and Analysis Responsible Party for data aggregation and analysis (check each that applies Frequency of data aggregation and analysis: (check each that applies State Medicaid Agency Weekly Operating Agency Monthly Sub-State Entity Quarterly Other Specify: Annually Continuously and Ongoing Other Specify: Add another Performance measure (button to prompt another performance measure) Performance Measure: % of providers licensed by DDS that continue to meet applicable licensure or certification standards. (Number of providers that continue to meet applicable licensure or certification standards/ Number of providers subject to licensure/certification) Data Source (Select one) (Several options are listed in the on-line application): Provider performance monitoring If ‘Other’ is selected, specify:
ABI-RH%20Renewal%20Application-Redlined%20draft-October%202017.docx