Information

  • Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Administration

  • The Subcontractor maintains and has available for review an administrative folder containing the current Part B Base/State Services/HOPWA contracts.<br>

  • There is evidence that the subcontractor icon target with the annual goal for the clients to be served and units of service to be provided in each service category.

  • The subcontractor is on target with budget expenditures and if not there is a plan in place to correct over or under spending.

  • The administrative cost is within 10% for the Ryan White and State Services contracts.

  • There is evidence that the subcontractor is in compliance with the Payer of Last Resort Policy of DSHS.

  • The agency has a contract with the established Medicaid provider, or has a justification for not contracting with such entity.

  • The agency has written and established policies in place meeting HIPAA requirements for Security of Records.

  • The agency has written and established policies in place meeting HIPAA requirements for Retention of Records.

  • The agency has written and established policies in place meeting HIPAA requirements for Release of Records.

  • The agency has written and established policies in place meeting HIPAA requirements for Transfer of Records.

  • The agency has written and established policies in place meeting HIPAA requirements for Archiving Records.

  • The agency has written and established policies in place meeting HIPAA requirements for Destruction of Records.

  • The agency has a written confidentiality policy to protect client information and documents, to include (but not limited to):<br> Payments made on behalf of client. <br> Caller ID

  • There is a signed statement maintained in the personnel/volunteer record stating that the contents of the administrative folder have been reviewed by staff.

  • There is evidence that quarterly reports and other requested information are submitted on time.

  • There is evidence of memorandums of understanding or other type of collaborative agreements with service providers.

  • There is evidence that all fees received are reported as program income.

Personnel and Staffing

  • The agency has written personnel policies.

  • The agency has a current organizational chart showing the lines of responsibility and authority.

  • There are job descriptions, including minimum qualifications and credentials for each position, both staff and volunteer.

  • All positions are occupied by individuals with appropriate qualifications, training and experience as required by job descriptions.

  • There is a method for conducting annual performance evaluations of personnel which assesses technical skills and knowledge, and identifies needs and opportunities for continuing education and training

  • There is a written orientation plan for new staff that includes familiarization with agency goals, policies, and service delivery.

  • There is a signed confidentiality statement in each employee's or volunteer's file.

  • Personnel records are maintained confidentially.

  • All project staff funded under the contracts have been hired. (List currently funded staff and vacancies.)

  • Staff vacancies are communicated to the AA within 24 hours for ARIES deactivation.

  • There is a plan to fill any Staff vacancies that remain unfilled longer than 90 days.

  • The agency has a process in place to verify certification/licensure credentials for professional staff, and for maintaining verifications of current status if applicable.

  • An application form is completed for each volunteer.

Case Management

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.