The IGHL Quality Assurance department has been part of the agency’s administrative team since 1987. Our mission is to manage the programming and services standards of the agency and to monitor the results of our efforts in implementing these standards, while also being the primary liaisons with government regulatory agencies. This monitoring occurs in several ways…
Program Success Reviews
The foundation of our Quality Assurance efforts involves the implementation of our “Program Success Review” protocol, which looks at all of the essential elements of each of our programs/service areas; from person-centered services to the physical environment. Reports are generated and distributed, “plans of correction” are solicited and approved if needed and those plans are monitored through their completion.
The Incident Review and Management process
All agency consumer “incidents” are filed, investigated and managed by Quality Assurance staff, interacting with agency program staff, the OPWDD Incident Management Unit, the NYS Justice Center, local authorities and the agency Incident Review Committee.
The agency Incident Review Committee membership includes front-line agency staff, a family member, members of the Board of Directors and a consumer representative.
Medicaid Billing Reviews
100% of agency-generated Medicaid billing requests are reviewed by Quality Assurance staff, after two preliminary reviews by program staff and prior to those requests being submitted to our Finance department for final billing.
Quality Assurance staff then perform random sample “retrospective” billing reviews to insure that a percentage of those previously approved bills can be justified.
The Quality Assurance department also provides:
- Our annual “Consumer and Family Satisfaction Survey”
- The management of the agency “Human Rights Committee.”
- Bi-weekly training during new staff agency “orientation”,
- Annual “Quality Assurance” training at each program,
- Monthly remedial “Success with Billing” training,
- Unannounced overnight fire-drill exercises, and,
- Special new topic staff training sessions, such as the recent Behavioral Plan of Service process, the newest Nutritional Services guidelines, the MIPS approval process and an orientation to the new NYS Justice Center.