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Challenge accepted: Fixing the traditional
call-for-service
model

05.24.22

Read this if you are a Police Executive, City/County Administrator, or elected government official responsible for a law enforcement agency. 

Are your officers overwhelmed with workload? Have you been asked to do more with less? Is your agency struggling with maintaining sworn staffing levels? Has your community been questioning why the police respond to things that might be more appropriately handled by others?

If you answered yes to one or more of these questions, your agency might benefit from a comprehensive analysis of your police call-for-service (CFS) response model. 

Increasing CFS workloads

Many police agencies in the US have been struggling with increasing CFS workloads, while simultaneously facing ever-tightening budgets and unprecedented attrition and vacancy rates. As a result of these challenges and national trends calling for police response reform, many police departments have started to ask a very simple question: “Is there a better way?”

Considering alternatives to police CFS response is not new. In fact, many agencies already use some form of CFS diversion, whether through a telephone response unit (TRU), online reporting, mobile apps, or the use of non-sworn personnel. What is different and new in the most recent discussion is the understanding that this conversation is not simply about providing these alternatives as possible options.

It is about considering fundamental changes to how police departments do business, including identifying collaboration opportunities with other organizations and in some cases outsourcing certain CFS types entirely.

Despite growing interest among police agencies in identifying alternatives to the traditional police CFS model, many have struggled to deliver an objective process that can produce meaningful results, and in some cases, suggested revisions have met with resistance from staff, elected officials, and community members.   

Best-practices approach to call for service response model

The best-practices approach to conducting an Essential CFS Evaluation should be one that is highly collaborative, but also expand beyond the walls of the police department. The 21st Century Policing Task Force final report explains:

Law enforcement agencies should work with community residents to identify problems and collaborate on implementing solutions that produce meaningful results for the community… and do things with residents in the co-production of public safety rather than doing things to or for them. 

Determining possible alternatives to traditional CFS police response requires substantial data collection and analysis to inform and guide outcomes and recommendations. It also requires a thorough and comprehensive process that considers:

  • Legal mandates
  • Immediate response needs
  • Potential risk
  • Workload volumes by CFS type
  • Operational policies and training
  • Alternative resources, whether or not they currently exist
  • Community priorities and expectations
  • Fiscal impacts

The cost of providing consistent and effective public safety services is one of the more critical reasons for considering CFS response alternatives. Although officer salaries vary by state, region, or department, the cost of staffing a non-sworn position is typically 40%-45% of the cost of a sworn officer.  

There is a common reason why the legal profession has attorneys and paralegals, the medical profession has doctors and physician’s assistants, and why many ambulance companies have moved to a paramedic and emergency medical technician (EMT) team, as opposed to staffing two paramedics in one ambulance. Cost is a driving force in these examples and the same circumstances are present in the law enforcement industry (among others). A well-trained non-sworn police staff member can handle a variety of CFS that do not require the presence of a sworn officer—likely at half the cost. Shifting the work burden from sworn to non-sworn personnel benefits officers by freeing them up to perform tasks that require an officer to respond, and it benefits the department and community by reducing costs. 

Beyond the issue of cost, there is also increasing conversation about the effectiveness and appropriateness of using police personnel to manage a variety of CFS types, including mental health incidents and those involving the unhoused, for example. Regardless of the CFS type, it is critical to use a process that involves influential participation by both providers and consumers. 

Making changes to the traditional police CFS response model is involved and it requires a thoughtful approach. BerryDunn has developed an Essential CFS Evaluation process that considers numerous critical factors to produce data that police staff, community and elected leaders can rely upon in making critical decisions about future public safety needs. 

If you are curious or have questions about our Essential CFS Evaluation process, our dedicated Justice & Public Safety team is available to discuss your organization’s needs.

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Principals

  • Doug Rowe
    Principal
    Justice and Public Safety
    T 207.541.2330

BerryDunn experts and consultants

Read this if you are a member or leader of a policing agency. 

Due to recent events, community members have taken to the streets nationwide to demand what they deserve from the police as a starting point: social and procedural justice. 

Social justice is an essential component of healthy, effective communities. It is based on a fair and just relationship between individuals and society. Social justice demands that those in the community feel safe—including feeling safe from the police. Feeling safe starts with procedurally-just policing. Procedural justice in policing is the principle that forms the foundation of the community’s willingness, individually and aggregately, to accept the actions of the police, obey laws, participate in the criminal justice system, and partner with law enforcement to reduce crime and disorder, and is dependent on the community’s acceptance of policing actions as fair and equitable. Procedural justice consists of four primary pillars:

  1. FAIRNESS
    Being fair in processes
  2. VOICE
    Providing the opportunity for voice 
  3. TRANSPARENCY
    Being transparent in actions
  4. IMPARTIALITY
    Being impartial in decision-making

Achieving social and procedural justice within policing requires meaningful change and reform that must extend beyond prior efforts. 

Across the United States, communities are calling for revised policies, targeted training, increased accountability, and better screening of police candidates. All of these efforts are important and should be explored. However, these same efforts have been pursued since community-oriented policing (COP) became popular in the 80s and 90s, and even as COP gained additional interest and momentum following a series of high-profile excessive-force incidents that trace back nearly a decade. Despite substantial focus on these areas within the law enforcement industry, concerns over systemic racism, biased policing, and a lack of trust between the police and the community continue to persist.

Community Co-production Policing: The crucial next step

The current policing environment calls for broad and deep reforms in the operations and collaborative culture of police agencies. This level of reform requires a coordinated effort to reframe the police department as a community-owned resource, and can be accomplished through engaging a Community Co-production Policing (CCPP) model. Implementation of the CCPP model, developed by BerryDunn in collaboration with practitioners and community members across the country, merges and unifies police agencies and communities through multiple collaborative pathways, resulting in shared responsibilities in areas such as guidance, oversight, and the development of policies, operational strategies, public safety priorities, and other shared goals.  

Co-production expands the focus of traditional community-oriented policing and includes a greater level of community participation and involvement in key policing strategies that affect the community. The key distinction is that while community-oriented policing is informative, interactive, allows for community input, and is often collaborative with regard to problem solving, co-production involves a greater level of influence and involvement by the community regarding the overarching policing strategies and priorities that ultimately affect those being served by the police agency.  

Building trust and confidence with the community

From a co-production policing perspective, influence and involvement from the community form the foundation for trust and confidence in the police agency and agreement in the processes, procedures, and practices used in pursuit of public safety for those who live in or visit the community. This level of involvement serves as a persistent external accountability process, which helps ensure consistent alignment between community desires and expectations and the actions the police use to meet them. 

Co-production is a collaborative process, not an oversight process. It involves working together to cooperatively co-produce public safety, in a respectful and thoughtful manner that places value on mutuality.

Below, the goals and predicted outcomes of the CCPP model are outlined. Accomplishing the CCPP goals is expected to produce the predicted outcomes, and these new positive outcomes address the longstanding negative outcomes that remain unresolved within the policing industry.

Community Co-Production Policing Goals and Predicted Outcomes
CCCP GOALS PREDICTED OUTCOMES
Reducing fractionalism: The inharmonious separation which has occurred between the community and those responsible for policing it. Increased community trust: Because the community shares decision-making authority in substantive policing matters, they will have shared ownership over the results.
Creating transparency: There can be no more secrecy in accountability or policymaking, or in determining strategies to address and reduce crime and disorder. Enhanced public safety: Trust is the cornerstone to solving crimes, and when trust is established, people will more readily assist in public safety matters affecting them.
Balancing power: Those who police the community must have the authority to do so, however, police department governance should be a shared responsibility. Improved racial/diversity equity: Diverse partnerships lead to greater understanding, which in turn, changes perspectives, beliefs, and behaviors.


The public outcry for police reform provides cities, towns, and counties with a rare opportunity to affect how their communities are policed in the future. This opportunity involves transforming policing towards a collaborative model where the police departments of the future are increasingly community-based and community-operated. BerryDunn’s CCPP model can help communities achieve this level of police reform and transformation. 

For more information on community policing

Mitch Weinzetl and BerryDunn’s public safety consulting team are leading this unique service. Our independence and objectivity enables a facilitation-based approach to engaging stakeholders across the community with the goal of collaborating on a future community policing model that addresses the need for public safety in a way that is informed and inspired by the community that the police departments serve. 

To learn more about how the CCPP model can help reconnect your police department and your community, contact Michele Weinzetl.
 

Article
Policing in America: Time for a change

Read this if you are a police executive, city/county administrator, or elected government official responsible for a law enforcement agency. 

Who you gonna call? 

Law enforcement agencies provide essential services to our communities vital to maintaining order and public safety. These critical organizations always answer the call, and they are prepared for every type of disaster imaginable: floods, hurricanes, tornadoes, blizzards, train derailments, and even... a pandemic?

Police agencies plan, prepare, and train for disasters, and are particularly adept and agile in their response to them. As an industry, law enforcement agencies are also very good at helping one another in times of need. When there is a major disaster in your community, your agency can always count on neighboring departments sending you some much needed resources―that is, unless everyone has the same problem. Then what do you do?

Although law enforcement agencies are very capable, their strength is in sprinting, not running marathons. Even the best and most-qualified police agencies struggle with the strain of long-lasting disasters, particularly when there are no other resources to help. That is when having the right patrol-schedule design can be critical. If your patrol schedule is inefficient in the first place, managing a lengthy disaster or critical event will magnify those inefficiencies, exhausting your personnel and fiscal resources at the same time.

Flaws in patrol schedule design = reduced efficiency

Flaws in the patrol schedule design often contribute to reduced efficiency and suboptimal performance, and design issues may work against your ability to maintain operational staffing during critical times of need. So, how do you know if your patrol schedule is serving you well? 

To help agencies evaluate their patrol schedules, BerryDunn has developed at free tool. Click here to measure your patrol schedule against key design components and considerations. If your agency scores low in this self-assessment, it may be time to consider making some adjustments. 

The path to resolving inefficiencies in your patrol work schedule and optimizing the effective deployment of patrol personnel requires thoughtful consideration of several overarching goals:

  • Reducing or eliminating predictable overtime
  • Eliminating peaks and valleys in staffing due to scheduled leave
  • Ensuring appropriate staffing levels in all patrol zones or beats
  • Providing sufficient staff to manage multiple and priority Calls for Service  in patrol zones or beats
  • Satisfying both operational and staff needs, including helping to ensure a proper work/life balance and equitable workloads for patrol staff

Accomplishing these goals requires an intentional approach, customized to your agency’s characteristics (e.g., staffing levels, geographic factors, crime rates, zone/beat design, contract/labor rules). BerryDunn can help your agency assess the patrol schedule, and if necessary, provide guidance and assistance on implementation of a more effective model. 

If you are interested in a patrol work-schedule assessment or redesign or a patrol staffing study, our dedicated Justice & Public Safety consultants are available to discuss your organization’s needs.

Article
Continuity of patrol operations in a COVID-19 environment

Read this if you are a police executive, city/county administrator, or elected government official, responsible for a law enforcement agency. 

“We need more cops!”  

Do your patrol officers complain about being short-staffed or too busy, or that they are constantly running from call to call? Does your agency struggle with backed-up calls for service (CFS) or lengthy response times? Do patrol staff regularly find themselves responding to another patrol area to handle a CFS because the assigned officer is busy on another call? Are patrol officers denied leave time or training opportunities because of staffing issues? Does the agency routinely use overtime to cover predictable shift vacancies for vacations, holidays, or training? 

If one or more of these concerns sound familiar, you may need additional patrol resources, as staffing levels are often a key factor in personnel deployment challenges. Flaws in the patrol schedule design may also be responsible, as they commonly contribute to reduced efficiency and optimal performance, and design issues may be partially responsible for some of these challenges, regardless of authorized staffing levels.
 
With community expectations at an all-time high, and resource allocations remaining relatively flat, many agencies have growing concerns about managing increasing service volumes while controlling quality and building/maintaining public trust and confidence. Amid these concerns, agencies struggle with designing work schedules that efficiently and optimally deploy available patrol resources, as patrol staff become increasingly frustrated at what they consider a lack of staff.

The path to resolving inefficiencies in your patrol work schedule and optimizing the effective deployment of patrol personnel requires thoughtful consideration of several overarching goals:

  • Reducing or eliminating predictable overtime
  • Eliminating peaks and valleys in staffing due to scheduled leave
  • Ensuring appropriate staffing levels in all patrol zones or beats
  • Providing sufficient staff to manage multiple and priority CFS in patrol zones or beats
  • Satisfying both operational and staff needs, including helping to ensure a proper work/life balance and equitable workloads for patrol staff

Scheduling alternatives

One common design issue that presents an ongoing challenge for agencies is the continued use of traditional, balanced work schedules, which spread officer work hours equally over the year. Balanced schedules rely on over-scheduling and overtime to manage personnel allocation and leave needs and, by design, are very rigid. Balanced work schedules have been used for a very long time, not because they’re most efficient, but because they’re common, familiar, and easily understood―and because patrol staff are comfortable with them (and typically reluctant to change). However, short schedules offer a proven alternative to balanced patrol work schedules, and when presented with the benefits of an alternative work schedule design (e.g., increased access to back-up, ease of receiving time off or training, consistency in staffing, less mandatory overtime), many patrol staff are eager to change.

Short schedules

Short schedules involve a more contemporary design that includes a flexible approach that focuses on a more adaptive process of allocating personnel where and when they are needed. They are significantly more efficient than balanced schedules and, when functioning properly, they can dramatically improve personnel deployments, bring continuity to daily staffing, and reduce overtime, among other operational benefits. Given the current climate, most agencies are unlikely to receive substantial increases in personnel allocations. If that is true of your agency, it may be time to explore the benefits of alternative patrol work schedules.

A tool you can use

Finding scheduling strategies that work in this climate requires an intentional approach, customized to your agency’s characteristics (e.g., staffing levels, geographic factors, crime rates, zone/beat design, contract/labor rules). To help guide you through this process, BerryDunn has developed a free tool for evaluating patrol schedules. Click here to measure your patrol schedule against key design components and considerations.

If you are curious about alternative patrol work schedules, our dedicated justice and public Safety consultants are available to discuss your organization’s needs.

Article
Efficient police patrol work schedules―By design

Read this if you have a cybersecurity program.

This week President Joe Biden warned Americans about intelligence that indicated Russia may be preparing to conduct cyberattacks on our private sector businesses and infrastructure as retaliation for sanctions applied to the Russian government (and the oligarchs) as punishment for the invasion of Ukraine. Though there is no specific threat at this time, President Biden’s warning has been an ongoing message since the invasion began. There is no need to panic, but this is a great time to re-visit your current security controls. Focusing on basic IT controls goes can make a big difference in the event of an attack, as hackers tend to go after the easy, low hanging fruit. 

  1. Access controls
    Review and understand how all access to your networks is obtained by on-site employees, remote employees, and vendors and guests. Make sure that users are maintaining strong passwords and that no user is connecting remotely to any of your systems without some form of multi-factor authentication (MFA). MFA can come in the form of a token (in hand or built-in) or as one of those numerical codes you have delivered to your phone or email. Poor access controls are simply the difference between leaving your house unlocked versus locked when you leave to go somewhere. 
  2. Patching
    One of the most common audit findings we have to date and one of the biggest reasons behind successful attacks is related to unpatched systems. Software patches are issued by software providers to address vulnerabilities in systems that act as an unlocked door to a hacker, and allow hackers to leverage the vulnerability as a way to get into your systems. Ensuring your organization has a robust patch management program in place and that systems are up-to-date on needed patches is critical to your security operations. Think of an unpatched system like a car with a broken window—sure the door is locked, but any thief can reach through the broken window and unlock the car. 
  3. Logging 
    Account activity, network traffic, system changes—these are all things that can be easily logged and with the right tools, configured to alert you to suspicious activity. Logging that is done correctly can alert management to suspicious activity occurring on your network and notifies your security team to investigate the issue. Consider logging and alerting like your home’s security camera. It may alert you to the activity outside, but someone still needs to review the footage and react to it to mitigate the threat.  
  4. Test backups and more
    Making sure that your systems are successful backed up and kept separate from your production systems is a control we are all familiar with. Organizations should do more than just make sure their backups are performed nightly and maintained, but need to make sure that those data backups can be restored back to a useable state on a regular basis. More so than backups, we also often hear in the work we do that our client’s test only parts of their disaster recovery and failover plans—but have never tested a full-scale fail-over to their backup systems to determine if the failover would be successful in the event of an event or disaster. Organizations shouldn’t be scared to do a full-scale failover test, because when the time comes, you may not have the option to do a partial failover and just hope that it occurs successfully. Not testing your backups is like not test driving a car before you buy it. Sure it looks nice in the lot, but does it actually run? 
  5. Incident Management Plan 
    We often review Incident Management Plans as part of the work we do, and often note that the plans are outdated and contain incorrect information. This is an ideal time to make sure your plans are current and reflect changes that may have occurred, like your increasingly remote work force, or that systems have changed. An outdated Incident Management Plan is like being sick and trying to call your doctor for help only to find out your doctor has retired. 
  6. Training—phishing attacks
    Hackers’ most common approach to gain access to systems and deploy crippling ransomware attacks is through phishing campaigns via email. Phishing campaigns trick a user into either providing the hacker with credentials to log into systems or to download malware that could turn into ransomware through what appears to be legitimate business correspondence. Training end-users on what to look for in verifying an email’s authenticity is critical and should be seen as an opportunity that benefits the entire organization. Testing users is also critical so management understands the current risk and what is needed for additional training. Security teams should also have other supporting controls to help prevent phishing emails and detection tools in place in case a user does fall for an email. Not training your employees on security is like not coaching your little league team on how to play baseball and then being surprised you didn’t win the game because no one knew what to do. 

In the current environment, information security is an asset to any organization and needs to be supported so that you can protect your organization from cyberattacks of all kinds. While we can never guarantee that having controls in place will prevent an attack from occurring, they make it a lot more challenging for the hacker. One more analogy, and then I’m done, I promise. Basic IT controls are like speedbumps in a neighborhood. While they keep most people from speeding (and if you hit them too fast they do a number on your car), you can still get over them with enough motivation. 

If you have questions about your cybersecurity controls, or would like more information, please contact our IT security experts. We’re here to help.

Article
Cyberattack preparation: A basics refresher

When we meet with hospital boards to review the results of their audit, we are most often asked to share what we are seeing in the industry—and how their hospital compares with others in our client base. As we (hopefully) emerge from the COVID-19 pandemic, I wanted to see where we are as an industry after two challenging years. In reviewing our own benchmarking data, and reading this very comprehensive CFO Outlook Survey by BDO, it reinforced that these are challenging times indeed. 

The pressures of top line sustainability, cost containment, and recruitment and retention of talent are very real. And while healthcare providers are seasoned to the continual challenges and opportunities, the difference going forward, post-pandemic, will be what this looks like for rural providers without the influx of stimulus funds and beyond the initial surge of postponed surgeries. Based on the BDO survey, 69% of healthcare organizations surveyed expect an increase in profitability. Is your organization prepared to take the steps to make it happen? What is your financial resilience outlook?

You can read the survey here. If you would like to discuss further, please contact our Hospital Consulting team. We’re here to help.
 

Article
Healthcare survey: A comprehensive look at the industry

Read this if you work in finance or accounting or rely on financial reporting information.

Does your financial close process provide the information you need to make educated business decisions? 

Timely reporting of financial results is key to stakeholder decision making. As a result of market and regulatory obligations, companies and organizations are confronted with increasingly strict guidelines for the delivery of timely, accurate reports. Enormous amounts of information on transactions must be processed in a limited timeframe. This requires a great deal of effort on the part of your accounting and finance teams. 

The typical financial close process can be broken down into the following segments:

While this workflow seems straightforward enough, the financial close is not a single flat process, but the combination of many interrelated and often codependent processes—each with its own stages. The closing and reporting process is complex, and involves many different data suppliers and dependencies. Think your billing department, accounts payable, cash receipt, procurement, and more. All of these areas are likely to have data inputs that go into your financial close.
 

It often ends up looking like this when you consider each task:


 
To make the situation more challenging, as companies and organizations grow, the closing process can become more onerous and take longer to complete. Tasks in the financial close process are often added to an existing process—a process that may be more reactionary and based in historical practice, and may not have been well thought-out or planned for the current environment. Adding these tasks and increasing data inputs and outputs adds additional pressure to an incredibly important, but often forgotten task: analysis.

The majority of finance departments spend the bulk of their time on the financial close itself. Unfortunately, this can lead to delays, uncovering mistakes well after the fact, and reports lagging behind current business operations. The later the analysis is performed and the reports are distributed, the less useful they become for decision making. 

Financial close optimization

The good news? There is a strategy to optimize your financial close process, called financial close optimization, or fast closing. Fast closing is the periodic and structured closing and reporting process, in which all knowledge about the financial facts is collected and distributed to stakeholders more quickly.

There is an emerging trend for more frequent financial reporting, which allows companies and organizations to be more nimble and responsive to financial results, especially when facing an unprecedented crisis like the COVID-19 pandemic. Optimizing the financial close process allows for quicker reporting of business results to give stakeholders a more timely financial picture.

We understand the scarcity of human and financial resources continues to prove challenging to financial teams. Creating a culture of continuous improvement is a challenging task for almost any finance team—but given the benefits of a fast closing and the increased costs of a longer close, is this something that can be ignored any longer?

Look out for our next article on tips and strategies to optimize your financial close, which can lead to:

  • Freeing up resources to provide finance teams more time for a deeper analysis of operating performance and other strategic objectives
  • Providing more accurate and timely reporting
  • Improving the organization’s audit readiness 
  • Lessening the need for traditional routine tasks 
  • Increasing focus on clients, patients, and customers by spending more time looking ahead to possible opportunities. 

If you have any questions on how to improve your financial close, please contact us. We’re here to help.

Article
Financial close: Increasing complexity calls for improving processes  

Read this if you are at a public health agency.

As public health workforce challenges worsen through retirements, burnout, and added need for public health workers highlighted by the COVID-19 pandemic, funding levels for public health remain increased for the time being. This provides opportunities for states to leverage federal programs and funding streams to help ensure a strong and capable public health workforce to meet the needs of all communities. An important consideration for states is the level of cultural competence among their public health workforce.

Cultural competence: Definition and benefits

Cultural competence refers to the capacity to function effectively, both as an individual and an organization, in relation to community members’ cultural beliefs, behaviors, and needs. It allows public health professionals to provide more effective public health services to individuals and communities with cultures different from their own—through awareness, respect, and willingness to learn about cultural differences. The necessity of cultural competence in public health is especially timely due to new and existing disparities that have been highlighted by COVID-19 outcomes and the ripple effects of the pandemic.

Benefits of a culturally competent public health workforce include greater public trust in the public health system, more equitable and effective public health services, improved understanding of existing barriers and community health status, and the potential to reduce disparities and improve both healthcare access and health outcomes in historically marginalized communities.

As many states face significant workforce gaps and challenges in recruiting, training, and retaining staff, it is important to leverage best practices and key indicators of success to inform a sustainable and effective approach for workforce development. States may benefit from assessing gaps in cultural competence and related skills, and by identifying specific cultural competency areas and abilities they aim to achieve in the workforce. A strategic approach is necessary for maximizing the sustainability and long-term benefit of federal funding opportunities, such as those for public health workforce development in rural areas. 

Strategies and best practices for developing a culturally competent public health workforce 

There are many steps you can take toward building cultural competence in your agency. Some of them include:

  • Develop and implement a periodic assessment of workforce cultural competence, and training to measure improvement and incorporate up-to-date best practices
  • Recruit diverse staff to reflect the culture and demographics of communities, including the provision of linguistic support
  • Create and improve pipeline training programs by collaborating with local colleges, universities, and schools of public health and identifying existing gaps in the workforce and in public health educational opportunities 
  • Support inter-professional education and teams for community-based interventions, to foster collaboration between public health and healthcare professionals in the community to better meet needs 

Important first steps to improve and foster cultural competence in the public health workforce include setting goals related to building community partnerships and what those partnerships will achieve. 

Other steps for building cultural competence 

Additionally, collecting diversity data and demographic characteristics of the public health workforce, measuring and evaluating performance of the public health workforce and public health services, and reflecting community diversity within the workforce are necessary for developing a workforce that supports community cohesion and trust of community members. These steps can help you assess where you can strengthen services and how communities can be better reflected in the public health services they receive. Effective communication and language access are also critical steps to improve and foster cultural competence in the public health workforce.

BerryDunn can provide state public health and human services agencies with strategic policy and programmatic guidance and management support to maximize the benefits of federal programs to facilitate public health workforce development. 

If you have any questions about your specific situation, or would like more information, please contact our Public Health Consulting team. We’re here to help.

Article
Developing a culturally competent public health workforce

Read this if your State Medicaid Agency is planning Medicaid Enterprise System enhancements.

Are you a system integrator (SI) or a State Medicaid Agency (SMA) implementing or enhancing a Medicaid system or specific module? Have you considered how decisions made during design and implementation could impact the federal Payment Error Rate Measurement (PERM) reviews for SMAs?

The goal of PERM is to measure and report an unbiased estimate of the true improper payment rate for Medicaid and Children’s Health Insurance Program (CHIP). Every state is reviewed once every three years using a sample that includes both fee for service (FFS) and managed care (MC) payments. A state assigned error rate is not the only consequence resulting from the PERM review; there are also financial implications.

Risk reduction from PERM review

Maintaining a focus on PERM review factors when making decisions during design and implementation can protect states by reducing the risk of:

  • Submitting change requests (CR) during implementation, which can result in additional cost and time
  • Implementing changes to existing Medicaid systems during maintenance and operations
  • Findings reported during certification efforts
  • Refunding federal dollars due to improperly paid claims
  • A reduction in federal match on all claims paid

It is also important to understand the benefits of a dedicated PERM team within the state organization that includes members from the system vendor and outside PERM experts. These benefits include providing states an additional level of security to help ensure a positive outcome to the federal PERM review, helping to protect federal funding.

Having a dedicated team will help ensure all decisions made during system updates and/or implementations are made while keeping focus on PERM requirements and the further impacts of PERM reviews, saving time and remaining compliant.

Plan ahead for best results

When planning for a new module or Medicaid system request for proposal (RFPs), consider PERM-related requirements to help ensure all PERM needs are met to prevent errors and repayment of federal funds. Including PERM requirements can also help your agency ensure federal compliance and successful PERM audits. Doing so will likely reduce the amount of time system integrators spend re-working earlier development decisions and help ensure claim payments are processed, and eligibility determinations are made in accordance with federal and state regulations.

If you have questions about PERM or your specific situation, please contact our Medicaid Consulting team. We’re here to help.

Article
PERM success for Medicaid agencies through system implementations