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Module 1

Module 1. AAA Monitoring Training Day 1. Welcome. Introductions Schedule: Break – mid-morning 12:15 – networking lunch 1:45 pm afternoon session 5:00 pm adjourn. Objectives. Understand how to use the DAAS Monitoring Tool Kit Increase knowledge of utilization of ARMS Reports

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Module 1

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  1. Module 1 AAA Monitoring Training Day 1

  2. Welcome • Introductions • Schedule: • Break – mid-morning • 12:15 – networking lunch • 1:45 pm afternoon session • 5:00 pm adjourn

  3. Objectives • Understand how to use the DAAS Monitoring Tool Kit • Increase knowledge of utilization of ARMS Reports • Be able to assess risk at various levels of providers • Understand fiscal reviews including unit verification as well as fiscal monitoring requirements • Conduct subcontract monitoring and ensure accountability at the provider level • Have improved monitoring technique including writing reports, scheduling visits, reviewing corrective action plans and conducting follow-up visits

  4. History and Philosophy of Monitoring in the Aging Network • Steve Freedman, Chief, Service Operations

  5. Monitoring Website Orientation • http://www.ncdhhs.gov/aging/monitor/monitor.htm

  6. Phyllis Bridgeman, Service Operations, DAAS Purpose – guidance for programmatic monitoring Provision of context and the “big picture” Description of the process as well as the onsite monitoring event Grounding in DAAS’s risk-based monitoring approach Toolkitfor New Monitors

  7. Purpose – guidance for programmatic monitoring A smattering of kitchen-table wisdom “If it ain’t broke, don’t fix it.” “An ounce of prevention is worth a pound of cure.” “It’s both an art and a science.” Building capacity for confident, competent, fair monitors Introduction to the tools of the trade New monitors: questions welcomed Old monitors: share your experience Toolkitfor New Monitors

  8. Uses of the toolkit Orientation and self-study for new monitors Introduction to online monitoring resources Identification of DAAS program consultants for specific services Topics of discussion with mentors from within the AAA and other regions Primer and introduction to information that will be provided in more detail during the service-specific training modules Toolkitfor New Monitors

  9. How the toolkit is organized Basic information presented like FAQs Glossary Links to online resources Provides links to the real tools (Sec. 308 policies, service standards, monitoring tools, sample risk assessment forms, etc.) Introduces, summarizes, and/or discusses the content of various resources but does not duplicate the content (with the exception of documents in the Appendices). Appendices with resources Most up-to-date versions are posted on the monitoring website Toolkitfor New Monitors

  10. Table of Contents The monitoring cycle Getting started Risk assessments The monitoring schedule Site visits Reports, follow-up, and close-out Documentation (Note the similarities to Sec. 308 of the AAA Policies & Procedures Manual.) and … Toolkitfor New Monitors

  11. How the toolkit is organized Glossary of terms Appendices Current versions are found on the monitoring website, but are included in the toolkit for the convenience of monitors Includes updated required/recommended documentation in AAA’s monitoring files Includes updated indexes to administrative letters by number and by category Toolkitfor New Monitors

  12. Toolkit assembly instructions The guidance The website The monitoring policy The service standards The monitoring instruments The risk assessment tools The monitoring plan The monitoring files Toolkitfor New Monitors

  13. The toolkit is no substitute for experience. Learn the service provider’s history Review prior monitoring reports Seek a mentor Ask questions when in doubt – even experienced monitors learn from each other Toolkitfor New Monitors

  14. Remember that this toolkit is just an introduction and primer. Stay tuned for the details of service-specific monitoring in Module 2 of this training (next year). The details of how to conduct programmatic monitoring, unit verifications, client record reviews, etc., will be fully explained. The tools in the toolkit will be put to use! Toolkitfor New Monitors

  15. Break time... Come back in 15 minutes……

  16. Desk Reviews Don’t underestimate the value of this step. Begin your documentation file … at the beginning. Assemble what’s on hand about the provider’s services and monitoring history from ARMS reports and the AAA’s files. Preparation for Onsite Monitoring

  17. Desk Reviews A good place to start – AAA’s Exhibit 14 Monitoring Plan and Exhibit 14a List of Subcontractors The who, what, when of preparing to monitor Focus on the providers who need to be monitored this year. Identify all the services that will be monitored. Determine the extent of monitoring – programmatic monitoring, unit verifications, both, fiscal reviews? Preparation for Onsite Monitoring

  18. Desk Reviews What’s in the AAA files? Risk assessments Monitoring files with notations about previous site visits Prior non-compliance findings Corrective actions plans Complaint logs Agency audits Soon – subcontractor performance evaluations from each provider in every county Preparation for Onsite Monitoring

  19. Desk Reviews What’s in the AAA files? Materials sent to AAA for review or information (e.g., contracts, RFPs, event materials, fund-raising campaigns, meeting minutes, program accomplishments, progress reports, newspaper articles, etc.) Expenditure documentation sent to AAA (e.g., receipts related to reimbursement requests for non-unit services) Preparation for Onsite Monitoring

  20. Desk Reviews What can you learn from the provider’s funding plan documents? Review of 732, 732A, 732A1 forms for allowable costs Inclusion of budget for a subcontract Scope of agency’s services and potentially other funding sources that support the programs Preparation for Onsite Monitoring

  21. 732A

  22. 732A-1

  23. Desk Reviews Examples of useful ARMS reports: ZGA 370 reports = services, allocated amounts, units, unit rates, consumer contributions, monthly or YTD expenditures, funds utilization rate ZGA 301 = site/route/worker code chart. Useful when selecting a client sample across codes so the sample will be representative. ZGA 517 – good to spot-check the utilization rates throughout year Next two presentations will highlight how two regions are using ARMS data Preparation for Onsite Monitoring

  24. ZGA370-YTD

  25. Desk Reviews What did your review indicate needs to be done onsite? Review past non-compliance deficiencies and determine if the situation has improved? Revisit audit issues of the programs you will monitor to assure that problems have not recurred? Observe service delivery, recordkeeping system, eligibility determination process? Programmatic review, unit verification, fiscal review, or all three? Special circumstances, e.g., new provider or provider close-out? Preparation for Onsite Monitoring

  26. Getting Ready Gathering materials to take on-site Previous reports or audits for follow-up? Service-specific monitoring tools Programmatic tools, unit verification tools, both? Fiscal review tools? Multiple copies of certain pages, such as client record reviews Service standards ARMS reports for sample selection, funding utilization review, etc. Consumer contributions tool Audit compliance supplement tools (14 criteria) Exhibit 14a and the subcontractor performance evaluations? Preparation for Onsite Monitoring

  27. Getting Ready What has to be done to schedule the visit? Subcontractor monitoring – what were providers told about how their subcontractors would be monitored (Sec. 308.2 F)? Is the AAA going to monitor subcontractors alone, with the provider, or accept the provider’s monitoring? Will the use of subcontractors affect where documentation is located? If yes, may affect how many days it takes to monitor a provider. Will you be coordinating with other monitors as well as the provider to schedule the onsite visit? Does your region coordinate monitoring reviews with another region for multi-county providers? Take note of the AAA’s written procedures for scheduling reviews with service providers. Preparation for Onsite Monitoring

  28. Getting Ready Planning, reviewing, making copies, organizing materials – all this preparation is time-consuming, but you will appreciate how prepared you feel walking through the door for the onsite visit! Preparation for Onsite Monitoring

  29. Use of ARMS Reports Joe Dzugan – Piedmont Triad Regional Council AAA David Rosado – Eastern Carolina Council AAA Tina Miller – Western Piedmont AAA

  30. Networking Lunch • Noon – 1:30 pm

  31. Region P

  32. How did this project all start? Volunteered for a planning project with the NCDAAS Wanted to explore new ideas for future planning

  33. Role of ECC-AAA Keep Aging Planning Boards informed Keep Service Providers informed Assist in current and future planning

  34. We had to ask ourselves the basic questions Who are our customers? What is our mission and what do we know about our customers? Where do our customers live? When can we begin educating our customers and stakeholders Why are we doing this?

  35. Region P 9 Counties - 5,770 Square Miles Carteret Craven Duplin Greene Jones Lenoir Onslow Pamlico Wayne

  36. Total Population 2005 - 2030

  37. Population 60+ 2005 – 2030

  38. Carteret County • Largest city/town – Morehead City Aging Planning Board meets monthly • Discusses expenditures, plans projects, discusses needs for older adults • Agencies that provide services to Older Adults through HCCBG/NBG: • Carteret Senior Services • Carteret DSS • Coastal Community Action, Inc. • Legal Aid of NC

  39. CravenCounty • Largest city/town – New Bern • Aging Planning Board meets every other month • Reviews expenditures, reviews program service delivery, • Agencies that provide services to Older Adults through HCCBG/NBG: • Craven DSS • Craven County Health Dept. • Coastal Community Action, Inc. • Legal Aid of NC • Craven County DOT

  40. LenoirCounty • Largest city/town – Kinston • Aging Planning Board meets monthly • Discusses expenditures, program evaluation • Agencies that provide services to Older Adults through HCCBG/NBG: • Lenoir DSS • Lenoir COA • Coastal Community Action, Inc. • Legal Aid of NC

  41. Wayne County • Largest city/town – Goldsboro • Aging Planning Board meets monthly • Agencies that provide services to Older Adults through HCCBG/NBG: • WAGES – outcomes based performance measurescompiled • Wayne SOA

  42. What do we already have? Census data ARMS data – changes monthly Mapping software/GIS Software 3rd party data

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