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.

Office of Inspector General


Quality Assurance

WV WORKS

Quality Assurance Annual Report

FY 2004

Completed: February 28, 2005

Marilyn Trout
Assistant Director

Phone:
(304) 558-0630

FAX:
(304) 558-1992
STATE OF WEST VIRGINIA
DEPARTMENT OF HEALTH AND HUMAN RESOURCES
OFFICE OF INSPECTOR GENERAL Martha Yeager Walker
Joe Manchin III
State Capitol Complex Secretary
Governor
Building 6, Room 817-B
Charleston, West Virginia 25305
Telephone (304) 558-2278 FAX (304) 558-1992

MEMORANDUM

Date: February 28, 2005

To: Molly Jordan, Inspector General

From: Marilyn Trout, Assistant Director


Division of Quality Assurance

Subject: WV WORKS Quality Assurance Report FFY 2004


http://intranet.wvdhhr.org/reports.htm

The WV WORKS Report for Federal Fiscal Year 2004 has been
completed and is attached. Federal sanctions based on error
rates no longer apply to public assistance programs beginning in
FFY 1997. This report will provide information regarding
Quality Assurance findings for purposes of assisting management
staff in their corrective action planning. Since corrective
action planning is necessary for all errors, the payment error
rate is figured using Underpayments, as well as Overpayments,
and Ineligibles.

Our dollar error rate was: This year Last year


Payment Error Rate 3.69% 2.32%
Agency Payment Errors 37.4% 78.2%
Client Payment Errors 62.6% 21.8%

The five principal causes of payment errors were:

1. Earned Income – 31.2%


2. Unearned Income – 27.3%
3. Living Arrangement/Benefit Group -12.5%
4. Bank Accounts - 11.7%
5. Residency – 7.7%
Molly Jordan
WV WORKS Annual Report-Page 2
February 28, 2005

These five eligibility factors account for 86.7% of all case errors and
90.4% of all error costs and should be specifically considered in
corrective action planning.

We will share this report with appropriate staff. Responsibility for


corrective action is with the Office of the Commissioner, Bureau for
Children and Families, Planning and Quality Improvement. However,
Office of Inspector General, Division of Quality Assurance staff are
available to discuss this report with interested individuals and render
any assistance possible.

If you have any questions or need more information please let me know.
Table of Contents

WV WORKS Quality Assurance Report FY 2004

Executive Summary..................................................1

Recent Trends in the Error Rate....................................2

When Errors Occur/Miscellaneous....................................3

Graph - WV Error Rates for Last Six Years..........................4

Graph - Leading Error Causes.......................................5

Graph - Error Prone Elements.......................................6

Pie Chart - Agency and Client Errors...............................7

Map - QA Error Rates by County.....................................8

QA findings by County..............................................9

QA findings by Region ............................................10

QA findings by District...........................................11

History of QA findings by County: 2002 - 2004.....................12

History of QA findings by District: 2002 - 2004...................13

Analysis of Quality Assurance Findings.........................14-15

Corrective Action Recommendations.................................16


1
Executive Summary

The Personal Responsibility and Work Opportunity Act Of 1996 (a.k.a. Welfare
Reform) removed the federal requirement for states to conduct a Quality
Control program in the WV WORKS Program. Fiscal sanctions based on payment
error rates no longer apply to this program beginning with FY 1997. Although
not federally required, the agency made the decision to continue with payment
accuracy reviews to help ensure the integrity of the WV WORKS Program.

Quality Assurance sampled 494 WV WORKS cases for this fiscal year
(approximately 41 cases per month) and completed 421 cases totaling $141,266
in paid benefits. The 73 cases not reviewed represent cases in which the
families moved out of state, were sampled twice in a six-month period, the
client refused to cooperate, etc.

It is important to keep in mind that Quality Assurance data is a collection


of facts drawn from all 421 cases. Statistical conclusions are most valid
only when applied on a statewide basis. With this in mind, findings for each
county office can be found on page 9. Findings for the regions and districts
can be found on pages 10 and 11. The county and district findings for the
last three years can be found on pages 12 and 13. The number of case samples
for individual offices is small; therefore, the reliability of the data
enables only general conclusions and trend identification.

The state reported Payment error rate for FY 2004 is 3.69 percent. This
error rate represents an increase from the 2.32 percent error rate reported
for FY 2003. As indicated earlier, the federal Quality Control requirement
has been removed as well as the sanctions associated with the former Quality
Control system. However, it is important to identify the costs of the errors
so that management decisions about corrective action can be made.

WV WORKS expenditures for FFY 2004: $73,603,989


Payments in error (3.69%): $ 2,715,987

Given the WV WORKS expenditures for FY 2004, we estimate the dollar amount of
expenditures issued in error to be $2,715,987. The analysis that follows
takes a closer look at the type of errors, how they occur and how they might
be prevented. Most of the analysis that follows is based on error rates that
include underpayments. Underpayments do not represent misspent funds, but
they do indicate that mistakes have been made in the amount of payment to
recipients. It is important to ensure that recipients receive the correct
amount of benefits.
2

Trends in the Payment Error Rate

The WV WORKS payment error rate increased from two percent (2%)
for FY 2003 to four percent (4%) for FY 2004. The following is a
table of the top error elements for FY 2004 compared to FY 2003
and FY 2002.

The Average Annual Cost (AAC) in the chart below is figured based on:

(1) the 3-year Error Dollars of a particular Element (X);


(2) the 3-year Total Amount Reviewed where Y equals $440,557;
(3) the 3-year Average Total Expenditure where Z equals $71,972,307.

Ex: Step 1: X divided by Y = N (3-year Payment Error %)


Step 2: Z multiplied by N = Average Annual Cost (AAC)

(X) (AAC)
Error Dollars Error Dollars Average Element’s
Element FFY02 FFY03 FFY04 3 yr Annual 3yr
Cost % of Error Cost
Household Composition $ 962 $ 169 $ 650 $1,781 $ 290,956 13.4%
Assets $ 854 $ 401 $ 610 $1,865 $ 304,679 14.0%
Earned Income $1,101 $1,094 $1,629 $3,824 $ 624,714 28.8%
Unearned Inc $2,437 $1,556 $1,423 $5,416 $ 884,794 40.8%
Residency $ 0 $ 0 $ 401 $ 401 $ 65,510 3.0%

Each element’s 3-year Error Cost percentage is figured based on


the Total Cost of Errors ($13,287) for FY 2002 – FY 2004. The
graph on page 5 recaps the percentages as follows:

1. Unearned Income at 40.8% is the largest contributor to


our error rate for this time period. ($5,416 ÷ $13,287)
2. Earned Income at 28.8% is the second largest
contributor to our error rate for this time period.
($3,824 ÷ $13,287)
3. Assets at 14.0% rank third in leading causes of errors
for this time period. ($1,865 ÷ $13,287)
4. Household Composition at 13.4% ranks fourth in leading
causes of errors for this time period. ($1,781 ÷ $13,287)
5. Residency errors at 3.0% rank as the fifth leading
cause of errors for this time period. ($401 ÷ $13,287)
3

‚ Causes of Error:

The Agency was responsible for 50% of the errors and 37.4% of the
error costs. Clients were responsible for 50% of the errors and
62.6% of the error costs. 43.3% of these errors and 54.6% of the
error costs are due to intentional misrepresentation of facts by
Clients. The remaining 45.4% of all error costs could be
prevented without increasing the amount of verification of
information provided by clients.

‚ When errors occur:

66.7% of the errors occurred during or persisted through the last


case action (application or redetermination), while 33.3% of the
errors were due to changes between eligibility determinations.
This indicates that there is a need for more thorough case
actions.

The Agency was responsible for 55% of the errors during case
actions, and 40% of the errors between case actions. Clients
were responsible for 45% of the errors during case actions, and
60% of the errors between case actions. Agency errors during
case actions accounted for the largest percentage of all errors
at 36.7% and are an error concentration worthy of special
attention.

‚ Miscellaneous:

The graph on page 4 shows the case and payment error rates in
West Virginia since FY 1999.

The graph on page 5 shows leading causes of errors for FFY 2002 -
FFY 2004.
4
West Virginia Department of Health and Human Resources
Office of Inspector General
Quality Assurance Unit

WV WORKS Case and Payment Error Rates


West Virginia FFY 1999 - 2004

16

14

12

10
Error Percentages

0
FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004

Case Rate
Payment Rate

wvwsanc FY04
5
WV WORKS Leading Error Cause Comparison
Percent of Error Costs
FY2002 - FY2004

LEADING ERROR CAUSE COMPARISON


FY 2002 - FY 2004
45%

40%
Percent of Payment Errors

35%

30%

25%

20%

15%

10%

5%

0%
%

.0%
.8%
.8%

4.0

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Leaders FY04
6
WV WORKS Error Prone Elements: FFY 2004

Payment % Rate
Case % Rate
40

35

30
Percent of All Errors

25

20

15

10

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errprone FY04
7

WV WORKS Agency Errors - Major Error Elements: FY 2004

Agency Payment Errors Agency Case Errors

Basic Requirements Assets Basic Requirements Assets


Earned Income Unearned Income Earned Income Unearned Income
Other Other

Client Payment Errors Client Case Errors

Basic Requirements Assets Basic Requirements Assets


Earned Income Unearned Income Earned Income Unearned Income
Other Other

agclient - FY04
WEST VIRGINIA DEPARTMENT OF HEALTH AND HUMAN RESOURCES 8

OFFICE OF INSPECTOR GENERAL


DIVISION OF QUALITY ASSURANCE
HANCOCK

BROOKE
ERROR RATE BY COUNTY
OHIO

 4%and UNDER
MARSHALL
 4.1% to 10%
MONONGALIA
WETZEL
 10.1% to 15% MORGAN
MARION BERKELEY
TYLER PRESTON
 OVER 15% PLEAS- MINERAL
ANTS TAYLOR JEFF-
HAMPSHIRE ERSON
DODD- HARRISON
RIDGE
WOOD
RITCHIE
BARBOUR TUCKER GRANT
HARDY
WIRT LEWIS
CAL- GILMER
UPSHUR
JACKSON HOUN
RANDOLPH
MASON ROANE
BRAXTON PENDELTON

PUTNAM WEBSTER
CABELL CLAY

KANAWHA
NICHOLAS POCAHONTAS

LINCOLN
WAYNE
BOONE FAYETTE
GREENBRIER

MINGO QUALITY ASSURANCE


LOGAN
RALEIGH WV WORKS Findings FFY2004
WYOMING SUMMERS MONROE

MCDOWELL MERCER
9
WV WORKS Error Rates by County FFY 2004
Error Payment
County Cases Case Errors Case Error % Payment Payment Error %
01 Barbour 5 0 0.0% $1,637 $0 0.0%
02 Berkeley 19 1 5.3% $6,659 $51 0.8%
03 Boone 11 1 9.1% $3,657 $262 7.2%
04 Braxton 5 3 60.0% $1,529 $561 36.7%
05 Brooke 5 0 0.0% $1,730 $0 0.0%
06 Cabell 21 1 4.8% $7,618 $55 0.7%
07 Calhoun 4 0 0.0% $1,060 $0 0.0%
08 Clay 1 1 100.0% $401 $401 100.0%
09 Doddridge 2 0 0.0% $802 $0 0.0%
10 Fayette 14 3 21.4% $5,417 $623 11.5%
11 Gilmer 2 0 0.0% $432 $0 0.0%
12 Grant 1 0 0.0% $453 $0 0.0%
13 Greenbrier 3 0 0.0% $676 $0 0.0%
14 Hampshire 3 1 33.3% $1,327 $258 19.4%
15 Hancock 4 0 0.0% $1,515 $0 0.0%
16 Hardy 0 0 ----- $0 $0 -----
17 Harrison 16 0 0.0% $5,709 $0 0.0%
18 Jackson 9 0 0.0% $2,856 $0 0.0%
19 Jefferson 7 0 0.0% $2,010 $0 0.0%
20 Kanawha 38 3 7.9% $12,746 $511 4.0%
21 Lewis 3 1 33.3% $1,151 $349 30.3%
22 Lincoln 12 0 0.0% $4,024 $0 0.0%
23 Logan 15 1 6.7% $5,336 $387 7.3%
24 Marion 5 0 0.0% $1,496 $0 0.0%
25 Marshall 12 0 0.0% $4,327 $0 0.0%
26 Mason 7 0 0.0% $2,278 $0 0.0%
27 Mercer 28 2 7.1% $8,722 $197 2.3%
28 Mineral 4 0 0.0% $1,131 $0 0.0%
29 Mingo 12 0 0.0% $3,917 $0 0.0%
30 Monongalia 4 0 0.0% $1,248 $0 0.0%
31 Monroe 5 0 0.0% $1,621 $0 0.0%
32 Morgan 3 0 0.0% $931 $0 0.0%
33 McDowell 18 1 5.6% $5,938 $401 6.8%
34 Nicholas 8 1 12.5% $2,763 $188 6.8%
35 Ohio 6 0 0.0% $2,433 $0 0.0%
36 Pendleton 1 0 0.0% $349 $0 0.0%
37 Pleasants 2 0 0.0% $663 $0 0.0%
38 Pocahontas 1 0 0.0% $349 $0 0.0%
39 Preston 3 0 0.0% $791 $0 0.0%
40 Putnam 7 0 0.0% $2,333 $0 0.0%
41 Raleigh 19 2 10.5% $5,918 $101 1.7%
42 Randolph 3 0 0.0% $882 $0 0.0%
43 Ritchie 1 0 0.0% $226 $0 0.0%
44 Roane 5 0 0.0% $1,273 $0 0.0%
45 Summers 4 2 50.0% $846 $178 21.0%
46 Taylor 1 0 0.0% $340 $0 0.0%
47 Tucker 0 0 ----- $0 $0 -----
48 Tyler 2 0 0.0% $741 $0 0.0%
49 Upshur 10 1 10.0% $3,564 $40 1.1%
50 Wayne 9 1 11.1% $2,793 $137 4.9%
51 Webster 6 0 0.0% $2,629 $0 0.0%
52 Wetzel 3 0 0.0% $721 $0 0.0%
53 Wirt 3 1 33.3% $1,215 $75 6.2%
54 Wood 18 2 11.1% $6,136 $143 2.3%
55 Wyoming 11 1 9.1% $3,947 $301 7.6%
Total 421 30 7.1% $141,266 $5,219 3.7%
10

WV WORKS Error Rates by Region FFY 2004


Error Payment
Region Cases Case Errors Case Error % Payment Payment Error %

I 89 3 3.4% $30,454 $218 0.7%


II 146 7 4.8% $48,831 $1,352 2.8%
III 63 4 6.3% $21,225 $698 3.3%
IV 123 16 13.0% $40,756 $2,951 7.2%
Total 421 30 7.1% $141,266 $5,219 3.7%

WV WORKS Error Rates by Region FFY 2002-2004


Error Payment
Region Cases Case Errors Case Error % Payment Payment Error %

I 257 18 7.0% $87,944 $2,575 2.9%


II 452 26 5.8% $158,273 $5,217 3.3%
III 199 10 5.0% $65,841 $1,628 2.5%
IV 376 30 8.0% $128,499 $5,865 4.6%
Total 1284 84 6.5% $440,557 $15,285 3.5%

Regional WV WORKS Error Rates


FFY 2004
3 Year Total

8.0%

7.0%

6.0%

5.0%
Error Rate

4.0%

3.0%

2.0%

1.0%

0.0%
I II III IV State

Region
11
WV WORKS Findings by District FFY 2004
Error Payment
District Cases Case Errors Case Error % Payment Payment Error %

Region I
Brooke/Hancock/Ohio 15 0 0.0% $5,678 $0 0.0%
Calhoun/Gilmer/Wirt 9 1 11.1% $2,707 $75 2.8%
Harrison 16 0 0.0% $5,709 $0 0.0%
Marion/Monongalia 9 0 0.0% $2,744 $0 0.0%
Ritchie/Pleasants/Doddridge 5 0 0.0% $1,691 $0 0.0%
Tyler/Wetzel/Marshall 17 0 0.0% $5,789 $0 0.0%
Wood 18 2 11.1% $6,136 $143 2.3%

Region II
Boone 11 1 9.1% $3,657 $262 7.2%
Cabell 21 1 4.8% $7,618 $55 0.7%
Jackson/Roane 14 0 0.0% $4,129 $0 0.0%
Kanawha 38 3 7.9% $12,746 $511 4.0%
Lincoln 12 0 0.0% $4,024 $0 0.0%
Logan 15 1 6.7% $5,336 $387 7.3%
Mason 7 0 0.0% $2,278 $0 0.0%
Mingo 12 0 0.0% $3,917 $0 0.0%
Putnam 7 0 0.0% $2,333 $0 0.0%
Wayne 9 1 11.1% $2,793 $137 4.9%

Region III
Barbour/Taylor/Preston 9 0 0.0% $2,768 $0 0.0%
Berkeley/Jefferson/Morgan 29 1 3.4% $9,600 $51 0.5%
Grant/Hardy/Pendleton 2 0 0.0% $802 $0 0.0%
Hampshire/Mineral 7 1 14.3% $2,458 $258 10.5%
Lewis/Upshur 13 2 15.4% $4,715 $389 8.3%
Randolph/Tucker 3 0 0.0% $882 $0 0.0%

Region IV
Braxton/Clay 6 4 66.7% $1,930 $962 49.8%
Fayette 14 3 21.4% $5,417 $623 11.5%
Greenbrier/Monroe/Pocohonta 9 0 0.0% $2,646 $0 0.0%
McDowell 18 1 5.6% $5,938 $401 6.8%
Mercer 28 2 7.1% $8,722 $197 2.3%
Nicholas 8 1 12.5% $2,763 $188 6.8%
Raleigh 19 2 10.5% $5,918 $101 1.7%
Summers 4 2 50.0% $846 $178 21.0%
Webster 6 0 0.0% $2,629 $0 0.0%
Wyoming 11 1 9.1% $3,947 $301 7.6%

Totals 421 30 7.1% $141,266 $5,219 3.7%


12
WV WORKS Error Rate by County FFY 2002 -- 2004
Error Payment
County Cases Case Errors Case Error % Payment Payment Error %
01 Barbour 15 1 6.7% $4,570 $100 2.2%
02 Berkeley 50 1 2.0% $17,489 $51 0.3%
03 Boone 30 2 6.7% $9,624 $408 4.2%
04 Braxton 11 4 36.4% $3,452 $622 18.0%
05 Brooke 16 1 6.3% $4,535 $106 2.3%
06 Cabell 71 2 2.8% $26,038 $145 0.6%
07 Calhoun 8 0 0.0% $2,364 $0 0.0%
08 Clay 7 2 28.6% $2,555 $702 27.5%
09 Doddridge 8 0 0.0% $2,953 $0 0.0%
10 Fayette 49 6 12.2% $17,078 $1,689 9.9%
11 Gilmer 2 0 0.0% $432 $0 0.0%
12 Grant 7 1 14.3% $1,817 $128 7.0%
13 Greenbrier 13 0 0.0% $3,621 $0 0.0%
14 Hampshire 9 1 11.1% $3,265 $258 7.9%
15 Hancock 10 0 0.0% $3,586 $0 0.0%
16 Hardy 5 0 0.0% $1,529 $0 0.0%
17 Harrison 50 3 6.0% $17,718 $514 2.9%
18 Jackson 20 4 20.0% $6,313 $862 13.7%
19 Jefferson 23 0 0.0% $7,544 $0 0.0%
20 Kanawha 116 11 9.5% $40,160 $2,358 5.9%
21 Lewis 14 2 14.3% $4,729 $449 9.5%
22 Lincoln 35 0 0.0% $11,452 $0 0.0%
23 Logan 37 2 5.4% $13,407 $453 3.4%
24 Marion 16 0 0.0% $5,101 $0 0.0%
25 Marshall 28 1 3.6% $9,845 $52 0.5%
26 Mason 27 2 7.4% $9,439 $741 7.9%
27 Mercer 74 2 2.7% $25,525 $197 0.8%
28 Mineral 12 0 0.0% $3,999 $0 0.0%
29 Mingo 50 0 0.0% $18,140 $0 0.0%
30 Monongalia 12 1 8.3% $4,414 $398 9.0%
31 Monroe 13 0 0.0% $4,793 $0 0.0%
32 Morgan 5 0 0.0% $1,232 $0 0.0%
33 McDowell 61 4 6.6% $20,915 $571 2.7%
34 Nicholas 22 1 4.5% $7,737 $188 2.4%
35 Ohio 34 2 5.9% $12,106 $215 1.8%
36 Pendleton 1 0 0.0% $349 $0 0.0%
37 Pleasants 3 0 0.0% $1,064 $0 0.0%
38 Pocahontas 2 0 0.0% $538 $0 0.0%
39 Preston 10 0 0.0% $3,170 $0 0.0%
40 Putnam 16 0 0.0% $6,014 $0 0.0%
41 Raleigh 58 6 10.3% $19,989 $1,312 6.6%
42 Randolph 10 0 0.0% $3,264 $0 0.0%
43 Ritchie 5 0 0.0% $1,418 $0 0.0%
44 Roane 11 1 9.1% $3,377 $29 0.9%
45 Summers 11 3 27.3% $3,399 $230 6.8%
46 Taylor 6 1 16.7% $2,077 $59 2.8%
47 Tucker 4 0 0.0% $1,239 $0 0.0%
48 Tyler 3 0 0.0% $1,081 $0 0.0%
49 Upshur 28 3 10.7% $9,568 $583 6.1%
50 Wayne 39 2 5.1% $14,309 $221 1.5%
51 Webster 19 1 5.3% $6,496 $53 0.8%
52 Wetzel 5 0 0.0% $1,466 $0 0.0%
53 Wirt 5 2 40.0% $1,869 $295 15.8%
54 Wood 52 8 15.4% $17,992 $995 5.5%
55 Wyoming 36 1 2.8% $12,401 $301 2.4%
Total 1284 84 6.5% $440,557 $15,285 3.5%
13
WV WORKS Findings by District FFY 2002 -- 2004
Error Payment
District Cases Case Errors Case Error % Payment Payment Error %

Region I
Brooke/Hancock/Ohio 60 3 5.0% $20,227 $321 1.6%
Calhoun/Gilmer/Wirt 15 2 13.3% $4,665 $295 6.3%
Harrison 50 3 6.0% $17,718 $514 2.9%
Marion/Monongalia 28 1 3.6% $9,515 $398 4.2%
Pleasants/Ritchie/Doddridge 16 0 0.0% $5,435 $0 0.0%
Tyler/Wetzel/Marshall 36 1 2.8% $12,392 $52 0.4%
Wood 52 8 15.4% $17,992 $995 5.5%

Region II
Boone 30 2 6.7% $9,624 $408 4.2%
Cabell 71 2 2.8% $26,038 $145 0.6%
Jackson/Roane 31 5 16.1% $9,690 $891 9.2%
Kanawha 116 11 9.5% $40,160 $2,358 5.9%
Lincoln 35 0 0.0% $11,452 $0 0.0%
Logan 37 2 5.4% $13,407 $453 3.4%
Mason 27 2 7.4% $9,439 $741 7.9%
Mingo 50 0 0.0% $18,140 $0 0.0%
Putnam 16 0 0.0% $6,014 $0 0.0%
Wayne 39 2 5.1% $14,309 $221 1.5%

Region III
Barbour/Taylor/Preston 31 2 6.5% $9,817 $159 1.6%
Berkeley/Jefferson/Morgan 78 1 1.3% $26,265 $51 0.2%
Grant/Hardy/Pendleton 13 1 7.7% $3,695 $128 3.5%
Hampshire/Mineral 21 1 4.8% $7,264 $258 3.6%
Lewis/Upshur 42 5 11.9% $14,297 $1,032 7.2%
Randolph/Tucker 14 0 0.0% $4,503 $0 0.0%

Region IV
Braxton/Clay 18 6 33.3% $6,007 $1,324 22.0%
Fayette 49 6 12.2% $17,078 $1,689 9.9%
Greenbrier/Monroe/Pocohonta 28 0 0.0% $8,952 $0 0.0%
McDowell 61 4 6.6% $20,915 $571 2.7%
Mercer 74 2 2.7% $25,525 $197 0.8%
Nicholas 22 1 4.5% $7,737 $188 2.4%
Raleigh 58 6 10.3% $19,989 $1,312 6.6%
Summers 11 3 27.3% $3,399 $230 6.8%
Webster 19 1 5.3% $6,496 $53 0.8%
Wyoming 36 1 2.8% $12,401 $301 2.4%

Totals 1284 84 6.5% $440,557 $15,285 3.5%


14

The graph on page 6 charts the error prone elements and the
relation of Payment and Case percentages.

The pie chart on page 7 shows Agency/Client errors for FFY 2004.

Quality Assurance findings for county, region, and districts can


be found on pages 9 - 13. A map on page 8 shows the county
payment error rates, by group, for FFY 2004.

Note: These county, region, and district statistics are provided


for purposes of payment accuracy and are not intended to
represent a valid county, region or district error rate. Quality
Assurance error rate findings are accurate, under Federal
regulations, only when considered on a statewide basis for an
entire Fiscal year.

Analysis of Quality Assurance Findings

‚ Cause of WV WORKS Errors

Agency Errors accounted for 50% of the total errors and 37.4% of
total error payments. The following causes of errors were
identified and are important in management’s corrective action
planning.

Error Cause % of total error cases


Misapplied Policy 20.0%
Indicated Action Not Taken 26.7%
Other 3.3%

Client Errors accounted for 50% of the total errors and 62.6% of
total error payments. Although client errors are sometimes
unavoidable, causes of client errors are still important to
review for purposes of management’s corrective action planning.

Error Cause % of total error cases


Unreported change 36.7%
Incorrect information reported 13.3%
15

Thirteen (13) of the fifteen (15) client errors were reported as


Misrepresentation and referred to Investigations and Fraud
Management (IFM).

‚ Error Characteristics for WORKS Errors

The following chart depicts which specific characteristics


caused the most errors reported for WORKS in FFY 2004.

CHARACTERISTIC MOST ERROR PRONE


Type of Most Recent Action Application
Time Since Most Recent Action 1 Year or More
Size of the Assistance Payment $300-$399
Shelter Arrangement Renting
Income in Benefit Group Earned
Employment Status of Caretaker 30+ Hours Employed
Relative

‚ Error Elements for WV WORKS Errors

The following chart defines the specifics of the element in


error for the errors which were reported for WORKS FFY 2003.

ELEMENT MOST ERROR PRONE


Basic Program Requirements Household Composition
Resources Bank Accounts
Earned Income Wages and Salaries/Self Employment
Unearned Income 25% Reduction of WV WORKS check
Other Computations
16

Corrective Action Recommendations

As the Division of Quality Assurance completed activity on


selected cases and analyzed the data collected, a list of
corrective action suggestions was developed that may help in
reducing errors and improving payment accuracy in the WV WORKS
Program. These suggestions are intended to assist with
corrective action planning at all levels of management. Many of
the suggestions are repeated from previous reports. The
repetition of these suggestions serves as a reminder of error
prone situations or as an emphasis of important information.

‚ Identification of training needs of workers...error


findings would suggest:

(a) careful interviewing for household composition and


assets, with emphasis on Bank Accounts
(b) refresh of change reporting requirements
(c) refresh of verification policy
(d) anticipation and recording of determination of
countable earned income
(e) follow-up on alerts generated by RAPIDS
(f) use of case comments (CMCC & CMIC)
(g) policy refresh training for contributions
(h) careful use of RAPIDS in coding and follow-up for
work-around and override situations.

‚ Supervisory review of cases...error findings would suggest


review is needed for:

(a) case comments


(b) unearned income
(c) earned income
(d) assets

‚ Obtain root cause of error from field staff along with


responses to potential error reports
‚ Improve staff communication and data exchange with Bureau
for Child Support Enforcement
‚ Minimize RAPIDS Work-arounds

A strong and effective corrective action plan can cut costs by


improving payment accuracy.