Quality Assurance and Monitoring

Quality Assurance and Monitoring A. The Division will establish and maintain an assurance process that ensures a quality case management program and the delivery of necessary covered services that appropriately address the individual needs. The provider agrees to share data as part of the quality assurance program timely upon request by the Division. B. The providers will make available to the Division the documentation/records maintained for case management services with the following information: 1. The name of eligible client, 2. Dates of case management services, 3. The nature, content, and units of the case management services received and whether goals specified in the care plan have been achieved, 4. Whether the client has declined services in the care plan, the need for and occurrences of coordination with other case managers, 5. The time line for obtaining needed services, 6. The time line for reevaluation of the plan, 7. Case Management Needs Assessment to determine the services needed and requested by the individual, 8. Service Coordination and Linkage to identify, assess, and link eligible individuals with the appropriate medical, social, and educational services to ensure that appropriate services are being provided while reducing duplication of services, and 9. Individual Service Monitoring to assure that all services are being appropriately delivered according to the Individualized Family Service Plan (IFSP) and in accordance with the established time lines.