The Provider will make available to the Secretary of the Department of Human Services or the Secretary's designee, access to data, records and all facilities in which service or administrative operations are performed to ensure compliance with the terms and conditions of the Agreement. The Department will monitor compliance with the conditions specified in the Agreement or herein. Monitoring will be conducted by staff within various offices of the Department, including but not limited to, the Division, the Bureau of Accreditation, Licensure and Certification; Office of Inspector General; and the Office of Contracts Administration. In addition, the Department of Healthcare and Family Services may monitor on a sample basis some agencies that are enrolled as providers under one of the Home and Community-Based Services Waivers for Persons with Developmental Disabilities.

The Division will share with the Provider any findings arising from the monitoring activities by the Division for review and corrective action. The Provider shall submit corrective action plans to the Division as requested, and shall comply with plans of correction approved or imposed by the Division. Monitoring may consist of, but is not limited to, the following:

  • Reviews of all required licenses and certifications
  • Reviews of all provider service and funding plans
  • Reviews of direct service provision
  • Reviews of alleged and substantiated cases of abuse and neglect
  • Reviews of provider quality assurance, records and activities including provider reviews of medication error
  • On-site reviews of client records, personnel files, agency and program policies and procedures, and financial records
  • On-site observations and interviews of clients, guardians, and agency staff (including, but not limited to, program supervisory and direct care staff)
  • Reviews of electronic data submissions and verification of data submissions or data accepted in lieu of electronic submission
  • Reviews of utilization patterns
  • Review training records
  • Review of follow up to CART recommendations, if applicable