RPM Chapter 11: Technical Information and References
Revised 09/09
11.5 Casework AnalysisCase Reviews
11.5.1 Overview of Casework Analysis
Management at all levels uses the case review process. The purpose of case reviews is to
· determine compliance with federal requirements and DRS policy
· assess the quality of your
· decision making
· application of the VR process, and
· ability to provide a clear and concise explanation of the consumer’s progress through the rehabilitation program as documented in the case record, and
provide confirming and corrective feedback that helps you enhance the quality of service delivery to your consumers by improving your
decisions about the rehabilitation process
use of community resources, and
case and caseload management
Types of case reviews include
· complete—a review of an entire case (electronic and paper), including a technical and purchasing review, when that case has reached at least the point of IPE development;
· limited—a compliance and quality review that is less than a complete review; and
· technical and purchasing—a review of only the technical and purchasing aspects of a case.
Area managers may also perform case readings of some or multiple cases in your caseload to identify your casework strengths and areas requiring improvement. Area managers are not required to document case readings.
Management uses case-file review forms to
· evaluate casework,
· provide confirming and corrective feedback that helps you improve the quality of service delivery to your consumers, and
· establish internal controls for monitoring corrective actions.
Case file reviews
· identify compliance and noncompliance with policy;
· address counselor judgment and decision making; and
· provide suggestions for improved
o decisions about the rehabilitation process,
o use of community resources, and
o case and caseload management.
For all case reviews,
· use case-file review forms; and
· enter a case note that reflects the type of review conducted, that is
o technical,
o complete, or
o limited.
Do not enter findings or corrective actions in the case note.
Use the following forms and procedures for each type of review:
· Technical case review—Complete the Document Review section of the
o DARS3421, Excellence in Service Provision—VR Case Review;
o DARS3454, Excellence in Service Provision—CRS Case Review; or
o DARS3469, Excellence in Service Provision—ILS Case Review.
· Limited case review—Identify the review areas on the case-review form.
A purchasing review is a limited case review. Use DARS3399, Purchasing Review, to note findings and corrective actions from the review of purchases for consumer goods and services.
· Complete case review—Review the entire case (electronic and paper), and document findings on the DARS3421 (VR), DARS3454 (CRS), or DARS3469 (ILS), as appropriate.
Case readings—Read all or a portion of many cases in a caseload to identify counselor casework strengths, as well as areas requiring improvement. Completing case-review forms is optional, but documenting which cases were read is required.
Area managers conduct case reviews and readings as part of their routine monitoring in compliance with unit and regional quality assurance and improvement (QA&I) plans.
Area managers
· monitor corrective actions and resolutions,
· maintain a record of corrective actions on the case-review form, and
· validate the correction by re-review of the case file.
Serious findings (that is, illegal, immoral, or unethical practices) must be reported upon discovery to the regional director.
11.5.2 How to Conduct a Case Compliance and Quality Reviews
The reviewer documents the compliance and quality review either in the local case review database or on the DARS3456, Compliance and Quality Case Review—VR using the Case Review Guide.
Area managers
· establish corrective actions to be taken,
· monitor corrective actions and resolutions,
· validate corrective actions by re-review of the case file,
· document validation in the local case review database or on the correct paper form, and
· report serious findings (that is, illegal, immoral, or unethical practices) upon discovery to the regional director.
Upon completion of a review, the manager
· documents the case review in the local case review database, and
· completes a case note in the consumer’s electronic file documenting the type of review conducted. No findings or corrective actions are entered in the case note.
The manager may purge the local case review database after two state fiscal years.
As an alternative to using the local case review database, the manager may document case reviews using the
· DARS3456, Compliance and Quality VR Case Review
· DARS3454, Excellence in Service Provision—CRS Case Review, or
· DARS3469, Excellence in Service Provision—ILS Case Review.
You or the rehabilitation services technician may informally maintain, separate from consumer case files, copies of the case review forms for the various DRS programs to help with your caseload management.
The area manager completes the appropriate case-review form:
· VR: DARS3421, Excellence in Service Provision—VR Case Review;
· CRS: DARS3454, Excellence in Service Provision—CRS Case Review; or
· ILS: DARS3469, Excellence in Service Provision—ILS Case Review.
After evaluating a counselor's work, the manager enters comments and guidance to the counselor in each area of the review form as needed, including
· identifying work that is
o exceptional (comments that recognize exceptional work are encouraged),
o acceptable, or
o deficient in some respect;
· commenting on any areas of disagreement or concerns; and
· suggesting improvements and/or innovations.
After completing DARS3421, the area manager files it (See 11.5.4 How to File a Case Review).
In completing a case review, follow the Excellence in Service Provision Users' Guide for quality results in monitoring.
When DRS staff in regional offices conduct case reviews with the case-review form, including purchasing reviews, they provide a copy of the form to the area manager for corrective actions and appropriate filing (see 11.5.4 How to File a Case Review).
11.5.3 How toTechnical and Purchasing Review Documentation
A manager or designee performs a technical and purchasing (T&P) review in conjunction with or separate from a complete compliance and quality case review. The T&P review determines whether
required paper documents exist in the case file,
· appropriate procedures were followed and documented for various services, and
· appropriate purchasing policies and procedures were followed.
The T&P may be completed in the local case review database or on a DARS3399, Technical and Purchasing Review—VR.
When reviewing documentation, use the electronic case file and the paper files to evaluate work performance in each of the areas. Follow the Documentation Guidance for Technical Reviews for quality results in monitoring.
11.5.4 How to File a Case Review Process Oversight
When a regional office staff member conducts a case review with the case-review form, the reviewer provides a copy of the form to the area manager for corrective action and filing.
The area manager
· maintains the official case-review forms, which are filed by caseload and fiscal year;
· ensures that the case review data is recorded in the electronic database,
· files all case-review forms (including the purchasing review form) separately from the consumer case file,
· files additional case reviews on the same consumer within the same fiscal year with the previous case-review form,
· completes a case note in the consumer's electronic case file to reflect only the review type (such as technical, limited, or complete), including purchasing reviews (no findings or corrective actions are entered in the case note),
· retains the case-review form for 24 months from the fiscal year in which the review was conducted, and
· may purge the case-review form after 24 months if the form has no further purpose or impact on current caseload activities.
When a difference in interpretation or findings exists between reviewers, the operations director for programs facilitates resolution.
The rehabilitation services technician and/or counselor may informally maintain, separate from consumer case files, copies of the case-review forms for the various DRS programs, to help with caseload management.
The Consumer Services Support (CSS) program director or program manager manages and oversees the case review process at the state level to ensure consistency in the application of the process.
Any questions about the case review process should be directed to the CSS program director.