Compliance with Regulatory and Contractual Requirements G-02

PURPOSE:

The purpose of this policy is to identify methods for reviewing community service provider (CSP) compliance with applicable regulatory and contractual requirements consistent with K.A.R 30-64-27.

POLICY:

Sedgwick County Developmental Disability Organization (SCDDO) will regularly review services provided by CSPs to assure they continue to meet applicable regulatory and contractual requirements.

PROCEDURES:

1. Each licensed CSP must immediately notify SCDDO anytime their regulatory body issues written notice to the provider of a determination of noncompliance. The CSP shall submit all documentation to include: issuance of noncompliance, corrective action plans, approvals, and resolution of the finding.
2. The CSP must cooperate with SCDDO in assuring that action has been taken to correct the issues of noncompliance and that effective measures are implemented to ensure such noncompliance does not re-occur.
3. SCDDO Quality Assurance (QA) staff will monitor quality for all CSP’s through site visits, documentation review, and stakeholder interviews.
4. Sources for QA monitoring activities may include but are not limited to:
   1. Quality Assurance Committees (QAC) reports;
   2. Critical Incident Reports;
   3. Adult/Child Protective Service findings;
   4. Fraud, waste, or abuse reports;
   5. Financial or billing records;
   6. Customer satisfaction surveys;
   7. Complaints or concerns brought to the attention of SCDDO.
5. The results of QA activities will be discussed with the CSP who is expected to take action when requested and develop internal systems for quality improvement.
6. SCDDO will report QA activities as required by KDADS policy and contract.
7. If the CSP demonstrates a pattern of failing to correct identified deficiencies, SCDDO will provide written notice to the provider describing the deficient areas, expectations for improvement, and a period of time during which corrections must be made.
8. If the CSP fails to correct the identified deficiencies or if the CSP’s noncompliance creates a dangerous situation to the health, safety, or welfare of any individual or individuals, SCDDO may take any or all of the following actions:
   1. Place the CSP on probationary status for a specified amount of time during which it is expected the CSP will take immediate action to correct the deficiencies. During the probationary period the CSP may not accept new referrals.
   2. Impose penalties in an amount not to exceed $125.00 per day for each violation from the specified date forward until the CSP complies.
   3. Suspend all or part of the payments provided for in the Developmental Disabilities Service Agreement (affiliation agreement).
   4. Implement any action allowed by the current affiliation
   5. Terminate the affiliation
9. CSPs who have had their affiliation agreement terminated may not re-apply for affiliation until they provide evidence they are able to comply with all requirements. Such evidence may include restructuring of organization, revised policies, additional training or changes in personnel.
10. CSPs may appeal any of these actions using dispute resolution procedures identified in SCDDO Policy A-04.