Lassen County, California

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Quality Oversight/Compliance Program

Our Mission

The mission of the Quality Oversight Department is to assist, educate, and support the Health and Social Services departemnt of Lassen County with quality assurance and quality improvement. Quality Oversight is to ensure compliance with State and County regulations, monitor the departments and to detect and prevent fraud, unethical behavior or practices, and to ensure timely, effective, and efficient services.

Activities

• Develop policies and procedures.
• Monitor compliance with regulations.
• Setting goals and objectives withing the Department.
• Collecting data on systems performance.
• Focus groups (employees, customers)
• Develop roles and responsibilities of quality assurance support staff within each Department.

Quality Assurance vs. Quality Improvement

The difference between Quality Assuance and Quality Improvement is that Quality Assurance is usually associated with monitoring compliance with regulations. Quality improvement is a process whereby a provider continuously works to enhance the quality of its services above the basic level of quality achieved by its Quality Assurance activities.

Staff

Tiffany Armstrong, Program Manager Quality Ovesight
Haley Jensen, Compliance Officer & QA/QI Administrative Assistant
Cheryl Floyd, QA/QA Social Worker
Cheryl Damm QA/QI Public Health Nurse

Compliance Program

The Compliance Program was implemented to ensure compliance with: (1) the Integrity Agreement (between Lassen County and the Office of the Inspector General of the Department of Health and Human Services); (2) the federal Medicaid Managed Care regulations (Tiltle 42, Code of Federal Regulations, Chapter 4, Section 436.608: Program Integrity Requirements) requiring mental health plans to have a compliance program designed to guard against fraud and abuse, and; (3) Federal health care program requirements related to mental health services. The Compliance Program's scope is limited to mental health services only.

The Compliance Office develops and implements policies, procedures, and practices to assist in these compliance efforts. The responsibilites of this office include analysis of departments' risk, oversight and monitoring of internal and external audits and investigations related to compliance, coordinating compliance training and education, investigating and resolving compliance issues and promoting awareness and understanding of the positive ethical and moral practices consistent with the mission and values of the County and those required by all applicable laws, regulations, rules, or guidelines.

Reporting a violation or suspected non-compliance

The County prohibits relatiation against any person making a report. Any person (employee or contractor) enganing in any form of retaliation will be subject on disciplinary or other appropriate acction.

All applicable employees and contractors (including contractor's employees and sub-contractors) are expected to report any activity that may violate Lassen County's Compliance Program's misson, standards, and any applicable law, regulation, rule, or guideline.

Employys and contractors may report anonymously or using any of the contact methods indicated above. The goal of all reporting methods is to provide opportunities for the identificaton, investigation, correction, and prevention, of inappropriate activities.