1. 1. 

   Optional Support - We may offer, or a DDS may request, performance support at any time the regular monitoring and review process reveals support could enhance performance. The State does not have to be below the initial performance accuracy rate of 90.6 percent to receive performance support. Support will be offered, or granted upon request, based on available resources.

2. 2. 

   Mandatory Support - We will provide a DDS with performance support if regular monitoring and review reveal quality performance standards are not met for two consecutive calendar quarters.

Performance support may include, but is not limited to, any or all of the following:

1. 1. 

   A review of cases processed by the DDS emphasizing adherence to written guidelines.

2. 2. 

   A request that necessary administrative measures be implemented.

3. 3. 

   Federal personnel to perform onsite and virtual reviews, conduct training, or perform other functions needed to improve performance.

1. When a DDS falls below the quality threshold for one quarter, SSA may:

• •

  Request a quality action plan and/or

• •

  Request to meet with regional and site representatives

2. When a DDS falls below the quality threshold for two consecutive calendar quarters, SSA will:

• •

  Inform the appropriate parties in writing of quality concerns with the site and a summary of actions taken.

• •

  Allow the DDS a 6 month adjustment period to implement quality action plan

  • –

    During the 6 month adjustment period, SSA will:

    • •

      Foster ongoing communications with the DDS regarding:

      • –

        Status of internal and external quality reviews on Initial claims

      • –

        Quality analyses (e.g. Top 3 deficiency types)

      • –

        Refresher training efforts

    • •

      Review Group 1 deficiencies cited during the two consecutive calendar quarters to identify potential trends.

    • •

      Perform a detailed analysis of the cited cases - consider possible outliers.

    • •

      Work with the DDS to identify specific training needs.

    • •

      Assist the adjudicating component as needed with requests for clarification of policies and/or targeted refresher training.

• •

  After the 6 month adjustment period, SSA will continue to monitor the site closely to ensure quality stays above threshold.

  NOTE: These performance standards apply to all sites including Federal adjudicating sites.