During the TCM Site Visit a review of Agency s Administrative Processes is completed using a review tool which has been modified from an audit form created by AHCA. The following pages contain a set of questions related to TCM At Risk program compliance in the areas of: Agency Qualifications and Organization and Staff Credentials o Targeted Case Management Supervisors o Targeted Case Managers In the interest of simplifying the administrative review (and eliminating the need to bring personnel files to the debrief meetings), providers are asked to complete the questionnaire starting on page 2, attest to compliance and attach relevant documentation as appropriate. Instructions for Completing the Questionnaire Indicate your agency s name and program at the top of page 2. Review each Standard and Guidelines beginning with Standard 1.a on page 2 and indicate by selecting Y/N/NA in the column provided and include a staff signature and position of the person who completed that question and attests to compliance. For the 9 Standards that request attachments of process descriptions or other information (indicated by an * in the Guidelines column), please include the requested information with your submission of the completed questionnaire and be sure to select Y/N/NA as well. o o Attachments may be excerpts from existing policies and procedures, pdf copies of documents/reports/certifications or other existing information that can be complied and emailed back with the completed questionnaire. A new description/process does not need to be written up or updated to accompany this questionnaire. Please email your completed questionnaire and accompanying documents/files to michelle.prior@verizon.net and copy rbacon@childrensboard.org by Close of Business Thursday, March 27. Your program s information will be reviewed in advance of the provider training on Friday April 4, and specific follow up questions related to the questionnaire and accompanying documents will be shared with agency representatives prior to the conclusion of the April 4 th provider training. FINAL NOTE: This questionnaire eliminates the need for each provider to bring copies of training logs. 1
Criteria: To remain enrolled as a targeted case management provider agency for children at risk of abuse and neglect, the provider agency will maintain its contract with the Children s Service Council (CSC) and meet the certification criteria. PROVIDER NAME & TCM PROGRAM(S) (ex. ABC Agency Kinship) 1. PROVIDER AGENCY QUALIFICATIONS AND CERTIFICATION Standard a) Be under contract to receive funding from CSC for 100% of the cost of providing TCM to the target population. b) Be knowledgeable of and comply with state and federal statutes, rules and policies that pertain to this service and the target population. c) Have the ability to administer case management services to the target population as evidenced by sufficient numbers of managerial staff and targeted case management supervisors and case managers for children at risk of abuse and neglect. d) Be a community-based provider agency with a demonstrated capability to serve this target population. e) Have the financial management capacity and system to provide documentation of costs. Interpretive Guidelines Contract is current. Personnel files, credentialing, certification, etc. of case management supervisors and staff are current. Operating budget reviewed by Management Y N N/A Staff Signature/Position Verifying 2
Standard Interpretive Guidelines Y N N/A Staff Signature/Position Verifying f) Have established linkages with the local network of human services providers, schools and other resources in the service area. g) Have a Quality Improvement Program with written policies and procedures, which include an active case management peer review process and ongoing recipient and family satisfaction surveys. Program has documentation of signed interagency or cooperative agreements. Community resources brochures and information is available to staff and updated. * Attach description of how resource data is shared with staff * Attach description of QI monitoring tools, processes and reports. h) Have established pre-service and in-service training programs that promote the knowledge, skills, and competency of all case managers. *Attach description of training plans and documentation. i) Have an established credentialing process, which will assess and validate the qualifications of all case managers and supervisors of case managers. j) Maintain documentation and programmatic records that include clearly identified targeted case management for children at risk of abuse and neglect certifications for eligibility, assessments, service plans and service documentation. *Attach description of credentialing process. *Attach description of intake and screening process. 3
k) Have the capacity to provide supervision by a qualified practitioner l) Cooperate with and participate in monitoring conducted by AHCA and the CSC. Targeted Case Management 4
2. ORGANIZATIONAL CHART AND CREDENTIALING FILES The organizational chart and personnel files indicate capability to perform At-Risk TCM Services. Standard a) Management staff has sufficient experience and capability to administer the effective, ongoing operations of at-risk targeted case management. Interpretive Guidelines *Attach qualifications of current management staff Y N N/A Staff Signature/Position Verifying b) Targeted Case Management Supervisors 1. The organizational chart includes identification of a Targeted Case Management Supervisor who provides supervision for case management services and who has lead responsibility for overall coordination and provision of at-risk targeted case management. *Attach organizational chart and Job Description for TCM supervisor 2. TCM Supervisor is enrolled in Medicaid as a provider type 32. 3. TCM Supervisor has a bachelor s degree in a human services field and two years of professional case management experience or 3 years of other professional experience serving this target population or any combination thereof *Attach copy of TCM supervisors Medicaid PT32 enrollment. All TCM supervisors must meet criteria. 5
Additional Detail for Q. 3 In the latest draft TCM Provider Handbook, qualifications for TCM Supervisor now allow for staff with significant experience (five years of professional experience working with similar populations), but Bachelor degrees in nonhuman services fields to be certified for TCM. Please indicate if you have any workers or supervisor candidate who meet this criteria 4. TCM Supervisor must provide a minimum of four hours of monthly supervision to each individual targeted case manager. Each supervisor must keep an ongoing log documenting the supervision of each case manager. The log must contain at a minimum the amount of supervision, and start and end times of the supervision, the case manager s name, and the signature of the case management supervisor. Indicate how many staff may meet this criteria 5. To be eligible to enroll as a TCM supervisor for children At Risk of abuse and neglect, an individual must be employed by or under contract with a Medicaid-enrolled and certified TCM provider agency for children at risk of abuse and neglect and have completed the Case Manager Supervision Certification, found in the appendices of this handbook. The certification must be placed in the employee s personnel file All TCM Supervisors have a certification form in their personnel file. 6
Standard c) Targeted Case Managers 6. Targeted Case Manager: Ratio 1 counselor per 25 children receiving case management. Interpretive Guidelines Please indicate current ratio of counselor to children/ or families in the box to the right Y N N/A Staff Signature/Position Verifying 7. Each case manager is employed by or under contract with an agency that has been certified by the CSC as qualified to provide case management services to the target population. 8. Each case manager has a minimum of high school equivalent with a minimum of one year of experience working with children who have been abused, neglected or abandoned, or are at risk of abuse, neglect or abandonment. 9. Each case manager has successfully completed the required CSC-approved training and any other training including periodic retraining within required timeframes. 10. Each case manager has completed mandated reporter training that addresses abuse and neglect as outlined in Florida Statues, Chapter 39.201. 11. Specific to the identified service area, each case manager has knowledge of the resources that are available for children who are abused, neglected or abandoned or at risk for abuse, neglect or abandonment. All CM s are CSC qualified. All TCM CM s meet these educational and experience criteria All TCM CM complete training within required timeframes. All TCM CM have completed mandated reporter training. All TCM CM know or have access to resource available to the population being served. 7
12. Each case manager is knowledgeable of, and complies with, the state and federal statutes, rules, and policies that pertain to this service and target population. 13. Each case manager is certified as meeting these requirements. The certification must be placed in the employee s personnel file. 14. Each case manager must complete at least 24 hours of training within 45 days of hire 15. At least 20 hours of training is provided annually for each targeted case manager. All TCM CM know or have access to regulations, policy and procedures and other relevant materials pertinent to this service. All TCM CM have a certification form in their personnel file. Each TCM CM receives 24 hours of training as a new hire. Each TCM CM attends 20 hours or more of training annually. *Attach description of Training program for TCM CMs. 8