MISSOURI CACFP MONITORING

1
MISSOURI CACFP MONITORING  

• MONITORING REVIEW POINT AND GRADE SCORING SYSTEM
•  
• 0 to 10 POINTS A Grade - Next Review in 2 to 3
  years
• 11 to 20 POINTS B Grade Next Review in 1 to 2
  years
• 21 to 26 Points B- Grade Review in 6 to 12
  months
• 27 or more Points C Grade Seriously Deficient
  with 90 day follow-up
•  
• NOTE There may be variations of theses grades
  and time for follow-up based on the frequency and
  severity of the problems identified.
•  

2
LIST OF FINDINGS GROUPS
3
LIST OF FINDINGS with POINT VALUE by
GROUP RECORDKEEPING
4
RECORDKEEPING, Continued
5
MEAL OBSERVATION
ADULT DAY CARE
6
SANITATION
SPONSOR OF CENTERS
7
MENUS/FOOD PURCHASES
8
FOOD SERVICE CONTRACT CONTRACTORS
INFANT MEAL REQUIREMENTS
SERIOUSLY DEFICIENT
9
LIST OF CORRECTIVE ACTIONS
10

• Seriously Deficient Determination Guidelines
• Points/Grade Score Typically not for a first (1
  yr.) review SD with 90 day follow-up from a
  Monitoring Review or
•  Inadequate Milk Receipts 3 months in a row from
  a previous review finding/CAP requirement
• Knowingly fraudulent or unlawful

11
What is a Serious Deficiency?

• When SD is declared, MDHSS will
• Completely define circumstances
• Be consistent
• Once declared, only one of two outcomes possible
• Successful corrective action or
• Propose termination and disqualification

12
What is a Serious Deficiency?

• Critical factors
• Frequency and Severity
• Frequency How often does it occur?
• Isolated error or
• Systemic, reoccurring problem

• Severity How bad is the error?

13
The Next Step - The SD Notice

• Fully describe the SDs
• Outcome of corrective action
• Corrective action deadline
• Identify the RP/RIs
• Institution is determined SD
• Persons who cause the SD are RP/RIs

14
The SD Notice

• SD determination not subject to appeal
• Inadequate CA by deadline
• Proposed termination of agreement
• Proposed disqualification
• Status of program payments during CA
• Voluntary termination disqualification

15
Corrective Action

• Regulations set maximum timeframes for completing
  CA
• SD Notice must specify
• Outcomes needed to correct the SD
• Deadline for taking action

16
CA Timeframes

• Maximum of 90 days - most SDs
• More than 90 days - SDs involving management
  systems or processes
• Less than 30 days - SDs involving unlawful
  practices

17
Corrective Action ? Up to 90 Days

• Training
• Monitoring
• Certain recordkeeping problems
• Some performance standards problems

18
Corrective Action ? Over 90 Days

• Longer period for corrective action
• Computer system changes
• Certain personnel
• Must have Corrective Action Plan  
• Within 90 days
• Milestones for completing specific tasks
• Final completion date

19
Corrective Action ? Up to 30 Days

• Unlawful practices
• Concealing
• Past performance problems
• Criminal background
• Submitting
• False or fraudulent claims
• False information on application

20
30 Days From When?

• Definition of Notice
• Received upon delivery
• By mail either certified mail return receipt,
  or
• Received on date sent
• Fax, or
• Email
• If undeliverable, considered received 5 days
  after it was sent

21
Is the SD Fully and Permanently Corrected?

• Review documentation
• Onsite review

22
Resolution of CASD is Not Corrected

• Notice of Proposed Termination/DQ
• Send to
• Executive Director
• Board Chair
• RP/RIs
• Copy to FNSRO
• Update SA list

23
Status of Program Payments

• General rule Participation, including
  payments, continues during the SD process
• Two exceptions
• New institutions declared seriously deficient
• Suspended institutions
• MDHSS continues to pay valid claims

24
Status of Program Payments (cont.)

• SA will only pay valid portion of claim
• SA review institutions claim
• Determine valid portion
• Pay valid portion
• Deny invalid portion (ex. inadequate milk
  receipts)

25
Key Points

• An appeal must always be offered before
  terminating an institutions agreement.
• MDHSS must specify CA deadlines and must conform
  to regulation maximums
• MDHSS may pay an institutions valid claims
  during the CA period, except
• New institutions not yet on Program
• Suspended institutions

26
Key Points (cont)

• The 3 CA time periods are up to 30 days, up to
  90 days, and over 90 days
• For false claims, 30 days is the maximum amount
  of time for CA
• The SD notice is always sent to two principals
• Executive director and Board chair, or
• For-profit or public institutions, principals
  with positions comparable to these