Chapter 2: Monitoring Process

2.1 Introduction Contract Monitoring

As part of their contract with the Department of Assistive and Rehabilitative Services, Division for Blind Services (DBS), contract service providers agree to permit monitoring of all contractual functions. Monitoring reviews may include:

 observation of evaluation/training sessions;  product delivery;  service performance;  consumer records;  on-site inspections;  provider qualifications;  all financial records, documentation, and management control systems relating to the provision of products or services; and  all documents, records, or other information relating to the health, safety, or welfare of DBS consumers.

DARS monitors the purchase of products and services for DBS consumers. The monitoring process includes verification that

 purchases meet all contract terms and specifications,  supporting documentation is received promptly, and  accurate invoices are submitted in a timely manner.

Service providers may be required to submit corrected reports or invoices for any that are found to be inaccurate or inadequate.

2.2 Ongoing Monitoring Review

All DARS-contracted service providers are subject to periodic monitoring. The objective of programmatic and financial monitoring is to ensure that the provider complies with all

 applicable rules and regulations,  DARS policies and procedures, and  contract terms and conditions.

DARS may conduct contract monitoring through a variety of methods. Monitoring may be conducted as a desk review in a DARS office or as an on-site review at a provider’s facility. A service provider’s records related to the contracted provision of goods and services must be made available as requested by DARS. Provider records must document compliance with applicable standards. Typically, DARS provides notice of upcoming monitoring, but may conduct unannounced monitoring reviews.

To schedule a routine review, DARS sends an appointment letter to the service provider. The appointment letter provides

 the date, time, and location of the review,  information about the scope of the review, and  instructions on how to prepare for the review.

DARS monitoring reviews typically consist of three parts:

 entrance conference,  records review, and  exit conference.

At the entrance conference, the lead monitor (LM)

 introduces the monitoring team;  explains the process, purpose, and scope of the review;  requests designation of provider staff member(s) who will work with the monitoring team; and  ensures that the work area is acceptable (if the review is conducted at the provider’s facility).

During the records review, the monitoring team reviews the provider’s files and compares information in them with information in DARS files.

When the records review is finished, the exit conference is held. The exit conference is a meeting between the provider’s staff and the monitoring team. The exit conference is usually held where the records review was completed, or may occasionally be a teleconference.

At the exit conference, the LM verbally communicates

 the preliminary review results,  any anticipated recoupment amount,  notice that DARS will send a findings report, if applicable,  the process for a response or rebuttal, and  the importance of meeting all follow-up time frames. 2.2.1 Report of Monitoring Review Results

For routine monitoring reviews, the LM sends the contract service provider a written findings report. If no issues were noted, the provider receives a closeout letter.

In a findings report, DARS requests that the service provider submit

 a corrective action plan (CAP), or  additional documentation that would resolve the findings.

The service provider is responsible for implementing the CAP and for taking any other measures needed to correct all of the deficiencies noted.

2.2.2 Corrective Action Plan

If DARS has requested a CAP, the service provider must submit the following by the date requested in the findings report:

 a complete CAP,  any applicable financial restitution, or  all documentation needed to present a rebuttal.

DARS may accept the CAP or require changes to it. If the service provider does not submit an acceptable CAP or make financial restitution when required, DARS may take adverse action against the provider in accordance with contract terms.

2.2.3 Monitoring Review Closeout

If there are no findings or when the monitoring team accepts the CAP, DARS sends the provider a monitoring review closeout letter.

2.3 Contract Noncompliance and Performance Deficiencies

DARS may temporarily suspend a contract provider from providing services for reasons such as

 suspected fraud,  consumer abuse, and  failure to perform services according to the specifications and terms of the contract.

Depending on the nature of the noncompliance, DARS may require the contract provider to return to compliance before providing further services.

DARS may take further adverse action in conjunction with or instead of requesting a corrective action plan. In serious noncompliance situations, DARS may terminate a contract or debar a provider from future DARS service contracts without allowing the provider to take corrective action.

DBS staff in local field offices continuously monitor the products and services that are purchased for DBS consumers.

The ongoing monitoring process includes verification that the purchase meets contract terms and specifications, that all supporting documentation is received promptly, and that accurate invoices are submitted in a timely manner.

Additionally, regional program support specialists in the local offices may require contract service providers to produce records on an as-needed basis.

Providers may be temporarily suspended from providing services if, in the opinion of DBS staff, circumstances require this action. Examples of such circumstances include -- but are not limited to -- suspected fraud, consumer abuse, failure to meet contract specifications, and/or failure to perform according to the terms and conditions of the contract.

2.3 In-Depth Monitoring

2.3.1 Overview

DBS staff in local field offices and the Central Office in Austin monitor the products and services that are purchased for DBS consumers. The in-depth monitoring process: utilizes risk assessment tools at the state level to identify providers to be monitored, includes both programmatic and financial reviews, and may occur periodically or as needed.

2.3.2 Preparing for the Monitoring Review

Notifying the Contractor

A least thirty days before the date of the contractor monitoring review, the lead monitor (LM) sends an appointment letter to the contractor, with a copy to all monitoring team members and the contract manager.

Monitoring review appointment letters differ in content and format by contractor type.

Each appointment letter contains the following: monitoring review notice; review date and time; names of monitoring team members scheduled to perform the review; contract number(s) and effective date(s) of contract(s), if applicable; a copy of service-specific checklists to be used during the review, which allows for contractor to gather and organize the required information; authority to conduct the monitoring review; a request for the contractor to confirm the appointment and assign a designated contact person; and name and contact information of the lead monitor, who can answer questions regarding the review.

2.3.3 Unscheduled Monitoring Visits

DBS staff may conduct unscheduled monitoring visits when deemed appropriate by DBS.

Unscheduled monitoring visits may be conducted for reasons including, but not limited to, any change that may substantially alter the quality of services provided to DBS consumers.

2.4 Monitoring Process

Conducting the Monitoring Review

Monitoring reviews for facility-based contractors are conducted at the contractor's facility. All other reviews are conducted at the DARS office, as determined by the LM.

The monitoring review consists of three parts:

Entrance Conference

LM introduces monitoring team members, explains monitoring process and areas to review, identifies each team member's area of expertise, requests contractor assign a person to work with the team, and requests contractor assign team a work area to use, when conducting review at the contractor's facility.

Records Review

Monitoring team completes appropriate checklists, reviews contractor files, and compares information in contractor files with information in DARS files.

Exit Conference

LM debriefs the contractor about preliminary review results, and informs the contractor a detailed written report of the review will be sent in about 20 business days.

2.5 Following the Monitoring Review

Once a monitoring review is completed, the following procedures apply.

Lead Monitor

Within 20 business days after the review, sends findings report (cover letter and report) to contractor.

Contractor

Within 20 business days after date of findings report, must respond to the finding with a corrective action plan (CAP); financial restitution, if required; and/or rebuttal of the finding, including documentation to substantiate the rebuttal.

Lead Monitor

If the contractor's response is acceptable, within five business days after receipt of the contractor's response, sends a closeout letter to the contractor, with copies to monitoring team members and the contract manager. 2.6 Failure to Correct Noncompliance

DBS notifies the provider, in writing, of the consequences of continued noncompliance if a provider fails to respond to findings that require corrective action within 20 business days of the monitoring report and/or the provider's proposed CAP is determined to be unacceptable.

Written notification includes how the contractor violated terms of the contract or purchase order, failed to take corrective action, and/or make financial restitution; corrective action that must be taken to resolve the problem(s), including financial restitution, if required; deadline for compliance with corrective action and for making financial restitution, if required; and adverse actions and other consequences that could result from non-compliance with required corrective actions.

2.7 Failure to Meet Contract Standards

Failure to meet DBS contract standards is a disservice to DBS consumers, and may result in suspension of the contract service provider's approved status until all deficiencies have been corrected.

Failure to meet standards may result in recoupment of funds.