090.010 Contract Monitoring

1.0 Purpose

To establish guidelines for TB/HIV/STD Section programs to evaluate, monitor, and provide technical assistance through program reviews to contracting agencies to ensure the delivery of appropriate HIV/STD services in Texas.

2.0 Authority

Texas Administrative Code, Chapter 25, §98.08 HIV Program Review; Code of Federal Regulations (CFR) §92.40 Monitoring and Reporting Program Performance; Title II of the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 and amendments of 1996; Health and Safety Code §85.040 Evaluation of Funded Programs; HIV/STD Policy 020.050 Public Complaints and Allegations Related to the Delivery of HIV or STD Programs

3.0 Background

The TB/HIV/STD Section is responsible for conducting reviews of programs funded by the Section. In an effort to evaluate the quality of HIV and STD services provided, Section programs must develop monitoring systems, conduct program reviews, and provide written reports to contracting agencies and appropriate DSHS staff.

4.0 Definitions of Key Terms

Priority I - contracting agencies scheduled to be reviewed within the next six (6) months, based on program defined risk assessment.

Priority II - contracting agencies scheduled to be reviewed within the next 12 months, based on program defined risk assessment.

Priority III - contracting agencies scheduled to be reviewed within the next 24 months, based on program defined risk assessment.

Special Review - a review that is initiated based on a complaint or allegation of: 1) a potential threat to the health and/or safety of a client, 2) possible misuse of funds, 3) possible contract violations, or 4) possible substandard programming.

5.0 Contract Monitoring

To fulfill the requirements of monitoring and reporting program performance as described in §92.40 of the CFR, the TB/HIV/STD Section will assess program compliance and the quality, quantity, and appropriateness of services being delivered by conducting on-site program reviews. Section staff responsible for program monitoring will prioritize program reviews annually by applying a risk assessment on each contracting agency. Reviews will be prioritized into three categories: Priority I, Priority II, and Priority III. Special reviews will not fall under these categories and may be conducted as deemed appropriate.

Reviews promulgated by allegations of an immediate and/or serious threat to a client must be handled in accordance with HIV/STD Policy 020.050, Public Complaints and Allegations Related to the Delivery of HIV or STD Programs.

5.1 Risk Assessments

Section programs must establish risk assessment tools to evaluate contractors before prioritizing them. Such assessment tools will consider elements important to successful contractor administrative and program performance. For example:

• stable, ongoing programming,

• correction of problems identified in past DSHS reviews,

• high level of compliance with program standards,

• appropriate staffing patterns,

• accurate and timely reports,

• meeting program objectives,

• quality documentation systems, and

• timely resolution of client complaints.

To the extent that contractors have these elements in place for a DSHS contract, that contract will receive a lower priority rating (II or III). A priority rating should not be construed as a predictor of success or failure; it is simply a gauge for staff within the Section who are responsible for oversight of contract work to determine the need for program monitoring and technical assistance for each contract.

5.2 Time Lines

Section programs are responsible for developing procedures for conducting program reviews. Procedures should clearly indicate the time lines in which reviews will be completed. The time lines should correspond with the priority time frames defined in the "Definition of Key Terms" section of this policy. Exception: Special reviews may be conducted by appropriate DSHS staff at any time.

5.3 Monitoring Tools

Program review monitoring tools must be developed for documenting findings, recommendations, and the quality of performance of contractors. Monitoring tools must be approved by the appropriate Division or Program Director or their designee prior to use. Any deviation from using the standardized monitoring tool for a routine review must be approved by the Division or Program Director or their designee in advance.

6.0 Completion of Reviews and Notification of Findings

Monitoring tools should be completed and distributed to the contractor reviewed within 45 calendar days after the review is conducted. The Section program must provide written notification to the contractor and provide a copy to the appropriate Division or Program Director when unable to complete the monitoring tool within the 45-day deadline. Notification to the contractor must include the expected completion and distribution date of the report. A summary of findings and recommendations will be provided to appropriate DSHS staff.

7.0 Revision History