Time Reporting Follow-up Presentation May 2018
This presentation is a follow-up to the Time Reporting presentation from May 31, 2018, discussing the importance and outcomes of time entry for county agency staff. It covers reasons for time reporting, how to understand and implement time entry, and its significance in increasing county revenues.
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Time Reporting Follow up from May 2018 Presentation Cindy Bayles & Julie Spurgeon, Financial Operations Division Rosie Miske, Sherburne County March 20, 2019 Minnesota Department of Human Services | mn.gov/dhs 1
Introduction This presentation is a follow up to the Time Reporting presentation that was done on May 31, 2018 at the SSIS Fiscal Mentor Meeting. We will be discussing the same information from the May meeting. Every slide in this presentation may not be covered during this presentation. County submitted attachments will also be reviewed (full copies of submitted attachments May materials were only partials). Minnesota Department of Human Services | mn.gov/dhs 2
Introduction - continued DHS does not require 100% time reporting. So why do county agency staff have to do time entry? That s a REALLY good question! So besides the obvious reason, because we said so, we will attempt to explain why you have to do time entry, how to get staff to understand time entry, the importance of it, and the outcomes of good time reporting INCREASED COUNTY REVENUES! Minnesota Department of Human Services | mn.gov/dhs 3
Introduction - continued SSIS uses BRASS codes as the basis for tracking county social service activity both client-specific and non-client specific. Time reporting is how SSIS knows that a social worker performed a particular BRASS service with a particular client on an exact date. There is no requirement in SSIS that workers document 100% of their time, although some agencies choose to use 100% time reporting for payroll or other purposes. Time reporting provides agencies with data in order to meet state and federal reporting requirements, generate claims and perform service planning. Minnesota Department of Human Services | mn.gov/dhs 4
Introduction - continued DHS does require county social services staff to log their time to a BRASS code when they provide that service as defined in the BRASS bulletin. The current BRASS bulletin is 18-32-12. Further information on staff provided costs and allocation, please see the current SEAGR bulletin 18-32-04 Attachment B. A standard definition for hours of staff service (column D on the SEAGR Report, DHS-2557) used to allocate "Social Services Administration" has become very important. Consistency among agencies, comparability of average staff costs, and even some program grant earnings depend upon staff hours reported. Minnesota Department of Human Services | mn.gov/dhs 5
Top 10 Reasons for Time Reporting 5. Documentation & time entry helps in court activity 10. Because we said so 9. Helps the bottom line 4. Enhances the quality of service delivery 8. Additional staffing justification 3. Allows for out-of-office worker support 7. Great management reports that can be used for multiple purposes 2. Get credit for the work YOU do! 6. Ensures consistency and equity among social service units And the #1 Reason: 1. TIME = MONEY Or in other words: Time = $$ Minnesota Department of Human Services | mn.gov/dhs 6
Top 10 Reason For Time Reporting 10. Because we said so This handout can be a handout at the County level. This may be your new policy. 9. Helps the bottom line. If staff are doing time reporting, you are ensuring that all your possible billable time and TCMS are bringing in revenue. Accurate and complete time entry ensures a good audit trail for TCM and Waiver Case Management claiming. 8. Additional staffing justification. If staff are posting ALL of their time, time reports can be used as documentation on time usage, services delivered, etc. for additional work required from one year to the next for Child Protection (for example) or MnCHOICES (which is a drastic increase). More time is needed for MnCHOICES time reporting shows the justification for additional workers. Another reason for time reporting if staff record ALL of their time, it can be imported into your payroll system and lessens the duplicating of time entry into two systems. Minnesota Department of Human Services | mn.gov/dhs 7
Top 10 Reason For Time Reporting - continued 7. Great management reports that can be used for multiple purposes. Just think of the various ways the director can use these reports! Including as management reports, several reports could be used for the annual report, use as a Board reports, use as part of the explanation for additional staff, etc. 6. Ensures consistency and equity among social service units. When there are policies and standards in place, all workers are on the same playing ground with the same rules/expectations. It s fair and equitable among all staff among all units. 5. Documentation & time entry helps in court activity. Insufficient time entry can make or break a child protection (CP) case. Should a case be brought to court, the worker may be required to testify to their documentation so this needs to be accurate and complete. If documentation is not done in a timely manner it leads to missed contacts or inaccurate documentation. Remember if it is not documented it did not happen! Minnesota Department of Human Services | mn.gov/dhs 8
Top 10 Reason For Time Reporting - continued 4. Enhances the quality of service delivery Service delivery benefits when all workers involved have access to information on what has been done in a case, helps avoid duplication and can better show history of what strategies have worked best with a client or family. Time entry and documentation ensures that compliance with audit standards (and TCM compliance) is followed and that the quality of service delivery meets standards. With busy/heavy caseloads, referencing case records can be helpful to case managers and supervisors ensuring delivery of services. 3. Allows for out-of-office worker support. If out-of-office employee is documenting all their time in SSIS, supervisors are able to use that time documentation for evaluation to make certain of out of office time is being used appropriately and therefore more like for supervisor to be okay with working at home and possibly allowing other do the same. It also helps when an emergency situation arises and the primary worker is not available to handle the situation that a co-worker providing coverage can determine the best course of action. 2. Get credit for the work YOU do!Rather than records and reports or correspondence, wouldn t you rather add the time entry with a program and activity along with the workgroup? This is then considered direct client program time. Minnesota Department of Human Services | mn.gov/dhs 9
Top 10 Reason For Time Reporting - continued And the #1 Reason: 1. TIME = MONEY Or in other words: Time = $$ Yes, time reporting can lead to increased revenue! More time = more revenue = more staffing = less caseload per worker Minnesota Department of Human Services | mn.gov/dhs 10
Why Do Time Reporting? Social Service staff have many responsibilities and one of those is to earn reimbursement that funds positions and the services that they provide to clients. Worker with different assignments have access to different uncapped federal and state revenue (CW-TCM, MH-TCM, Waiver & AC, RSC, VADD-TCM). Time reporting can help in tracking performance of social service staff. Time reporting provides agencies with data in order to meet state and federal reporting requirements and to generate healthcare claims. Otter Tail County in 2011 they stopped doing 100% time reporting. Comparing 2010 and 2012 to 2011, they noticed a drop in their monthly average contacts and their monthly eligible contacts which of course resulted in a loss of TCM revenues. They calculated an average direct time decrease of 29%. They have resumed doing 100% time reporting. Minnesota Department of Human Services | mn.gov/dhs 11
Impact of SSIS Data Minnesota Department of Human Services | mn.gov/dhs 12
Time Reporting PROS Able to track less productive workers and potentially missed contacts and revenues. This reinforces why you have the staff that you do. It gives you some tangible thing to show your Board what staff have been doing during their work day. Break down the numbers and use graphs to show the Board the amount of time staff spend in different areas. Documents the real time that goes into case management for families and the other tasks workers do that takes time. Helps to measure how much the service costs compared to the outcome achieved. Measures what work is being done. Getting credit for the work you do! Supports maximization and timeliness of revenue/billing. Minnesota Department of Human Services | mn.gov/dhs 13
Time Reporting PROS - continued No duplicate data entry: time reporting data complete and entered timely in SSIS for claiming. Helps to ensure that monthly contacts with children in continuous placement is achieved. This is a federal CFRS requirement. Several Counties and staff know their time needs to be completed for payroll. Claiming time and payroll time are equal to support claim amounts. Minnesota Department of Human Services | mn.gov/dhs 14
Time Reporting CONS Social workers would rather NOT do it. Workers feel it is time consuming to document time that is not billable or needing documentation for SSIS or other purposes. No time entry = no idea of how time is spent. When not accurate possibility of lost and missing BILLABLE time which means LOST REVENUE! Minnesota Department of Human Services | mn.gov/dhs 15
Time Reporting Policy or Procedure? SSIS Time Reporting Policy (57 Counties Responding) Written Policy 18% Work in progress 5% No Policy 77% Minnesota Department of Human Services | mn.gov/dhs 16
Does Your County Have a Time Reporting Policy or Procedure? If your county does not currently have a time reporting policy or procedure in place, you might want to start consider writing and implementing one! Help workers get credit for the work that they do! Copies of time reporting policies and procedures from the following counties are being provided to you: Crow Wing, Meeker, Nobles, Pope, St. Louis, Sherburne, Wabasha and Wright. Review these and take the words/phrases that would work in creating the policy or procedures for your county! A policy in place ensures consistency throughout working units and staff will know the expectations. Minnesota Department of Human Services | mn.gov/dhs 17
Time Reporting Percentages Minnesota Department of Human Services | mn.gov/dhs 18
Set Expectations Of the 57 responding counties, 39 counties (68%) had 100% time reporting. 53 counties out of the 57 responding counties had some sort of time reporting standards this is a whopping 93%. Workers need to know what is expected of them. If you have expectations written in a policy or procedure and they are aware of it, it is easier to enforce compliance. Minnesota Department of Human Services | mn.gov/dhs 19
Benchmark Client Related Time Minnesota Department of Human Services | mn.gov/dhs 20
Two Tiered Approach We know that one size doesn t fit all . Some counties have created a 2 tiered approach when it comes to time reporting. For some counties, the two tiered approach is based on case loads and program areas. What is a 2 tiered approach? Making staff account for 100% of their time and then setting % for program/client related time. For example Nobles and Sherburne County require 100% time reporting and 80% must be client related. The two tiered approach is used by for some counties to ensure revenue is being claimed/generated. Minnesota Department of Human Services | mn.gov/dhs 21
Time Reporting Deadline Minnesota Department of Human Services | mn.gov/dhs 22
Set Time Reporting Deadlines Be sure to have FIRM set time reporting deadlines! Timely and accurate reporting by staff is important for several reasons besides giving you time to review and fix issues. You need to make sure that fiscal has the information that they need to complete and submit their quarterly financial reports. Missed time in SSIS entered after fiscal has filed their quarterly reports with FOD is never reported to FOD. Time reporting is used to generate reports through which counties earn their capped grant allocations and is used to document trigger events so that Targeted Case Management (TCM) is billed to DHS or Managed Care Organizations. Time reporting is also used to document other services so that they can be billed. Through the SEAGR allocation process, staff-provided services (expenditures) are allocated a portion of overhead (administrative) costs. Minnesota Department of Human Services | mn.gov/dhs 23
SEAGR Staff Provided Service Average Cost Per Hour County total staff costs / total staff hours = SEAGR staff average cost per hour Hourly rate * hours in each BRASS code = estimated staff expenditures Reporting too few hours = high cost per hour Reporting too many hours = low cost per hour Staff need to be careful not to inflate their time. Are workers reporting 8 hours a day? It s not likely that any worker will have worked 8 full hours on BRASS code activities. Current BRASS bulletin is #18-32-12. 100% of BRASS code defined activities does not necessarily = 100% of staff time. There are no BRASS codes for lunch breaks, other breaks, etc. Minnesota Department of Human Services | mn.gov/dhs 24
SEAGR Staff Provided Service Average Cost Per Hour - continued Staff does not have to be face to face with a client to record time. Know your BRASS codes. Most workers will only use 5 -6 of the 184 codes! Workers must be consistent in reporting time educate and re-educate. Set up a process and reference (cheat) sheets to aid workers. If a worker is setting up delivery of a purchased service such as respite care (BRASS 189) but not personally providing the actual service, the worker should report their time under case management (in this example BRASS 193 General Case Management) while the actual respite care cost is a PURCHASED SERVICE. Minnesota Department of Human Services | mn.gov/dhs 25
SEAGR Staff Provided Service Average Cost Per Hour - continued Estimated staff expenditures have several limitations: Overhead costs are shown under staff expenditures yet some of these costs would logically be used to administer and supervise purchased service activity. Your director and board needs to be aware of this in case they think that eliminating staff and contracting out the services would be cheaper for the county. Usually a single rate (cost per hour) is being used for all the county s BRASS codes. But a service provided by a social worker with a Masters in Social Work is more costly than a service provided by a lower paid case aide. One hour of staff time is most probably not equal between different BRASS codes. Minnesota Department of Human Services | mn.gov/dhs 26
SEAGR Staff Provided Service Average Cost Per Hour - continued SEAGR Staff Provided Service Average Cost per Hour Scenarios TOTAL STAFF COSTS (line 24 from SSFR) stays the same - staff hours changed Total Staff Costs $6,500.00 $6,500.00 $6,500.00 An increase in staff hours, decreases the cost per hour A decrease in staff hours, increases the cost per hour Total Staff Hrs. 100.00 125.00 75.00 Cost per Hour $65.00 $52.00 $86.67 * consider this the base TOTAL STAFF COSTS (line 24 from SSFR) changed - staff hours stay the same Total Staff Costs Total Staff Hrs. Cost per Hour $6,500.00 $7,500.00 $5,500.00 100.00 100.00 100.00 $65.00 $75.00 $55.00 * consider this the base An increase in Total Staff Costs $ (line 24 from SSFR), increases the cost per hour A decrease in Total Staff Costs $ (line 24 from SSFR), decreases the cost per hour Minnesota Department of Human Services | mn.gov/dhs 27
SEAGR Staff Provided Service Average Cost Per Hour - continued TOTAL STAFF COSTS (line 24 from SSFR) and staff hours change Total Staff Costs Total Staff Hrs. Cost per Hour $6,500.00 100.00 $65.00 * consider this the base $6,000.00 75.00 $80.00 $6,000.00 125.00 $48.00 $7,000.00 75.00 $93.33 $8,000.00 125.00 $64.00 A decrease in Total Staff Costs (line 24 from SSFR) and a decrease in staff hours = increases the cost per hour A decrease in Total Staff Costs (line 24 from SSFR) and an increase in hours =decreases cost per hour An increase in Total Staff Costs (line 24 from SSFR) and a decrease in staff hours =increases cost per hour An increase in Total Staff Costs (line 24 from SSFR) and an increase in staff hours =decreases cost per hour Minnesota Department of Human Services | mn.gov/dhs 28
Time Reporting can Earn Revenues for Grants Grants reported in SEAGR & paid from the DHS-2895 Grants reported & paid through SEAGR Adult Mental Health Initiative (AMHI) Child Protection CSP Family Assessment Response CMH Screening and CMH Respite Family Group Decision Making Moose Lake Alternative Family Support Grant Transition to Community Parent Support Outreach Mankato Crisis Center SELF ACT Startup VCA & Title XX Crisis Services Day Training and Habilitation CART DD SILS Minnesota Department of Human Services | mn.gov/dhs 29
Time Reporting Earns Revenues for Grants - continued For more information on the grants listed on the previous slide, please refer to the current SEAGR bulletin #18-32-04. Attachment E provides further details on the grants reported and paid through SEAGR. For more information on the grants paid through the DHS-2895, please refer to your DHS-2895 for a listing of the grants and eligible BRASS codes. BRASS code information is available in bulletin # #18-32-12 Minnesota Department of Human Services | mn.gov/dhs 30
Time Reporting & Health Care Claiming TCM is part of Medicaid and is an uncapped federal revenue. It is primarily used for case management to specific populations Child Welfare (CW-TCM), Children s Mental Health (CMH-TCM), Adult Mental Health (AMH-TCM) and Vulnerable Adult or Developmental Disabilities (VA/DD-TCM). TCM rates are calculated. The purpose of the rate setting process if to set a rate for each target group that reflects the county s cost of providing case management services on a monthly basis. A basic formula is used for all targeted case management rates. Information used to determine the rates include the SSTS cost pool (from the social service fund report, DHS-2556), results from the SSTS and the average number of all clients receiving case management services provided by agency staff (which is from the TCM-CSR report). Minnesota Department of Human Services | mn.gov/dhs 31
Time Reporting & Health Care Claiming- continued Accurate time reporting = an accurate rate! Counties need to bill that a specific worker provided TCM to a specific client TIME REPORTING! TCM rates are not affected by the lack of time reporting because it is the SSTS Cost Pool that is part of the TCM formula, however unreported time on the SEAGR does not match what is reported (claiming). Bottom line time reporting is accountability of staff and hours (time). Time = $ Minnesota Department of Human Services | mn.gov/dhs 32
Time Reporting & Health Care Claiming- continued Contact Documentation All client contacts and information necessary for claiming should be entered into SSIS for each contact made. For example, if you have 3 client contacts in one month, enter all client contacts in SSIS. The first claim is paid but all other claims documented that month could be reviewed in an audit to ensure a valid claim was made. Do not over inflate your time reported! For example, if you make a phone call to a client and do not connect, do not enter 15 minutes in chronology. When you call that person again and finally do connect, combine the two time entries into one 15 minute contact. You know it did not take 15 minutes to call and get no one! Minnesota Department of Human Services | mn.gov/dhs 33
Time Reporting & Health Care Claiming - continued MA will pay for services for up to one year from the date of services so most counties will get their MA dollars. This is one reason some county staff feel that timely reporting of time is not an issue. When they get it entered a claim can be made. Here are examples of where time reporting can make a difference: NON-TCM claims: On 3/6/19, Worker A and Worker B provide the same service to the same client on the same day (this is allowable, although uncommon). Worker A enters their time and the claiming person generates a claim batch. A claim is created. Minnesota Department of Human Services | mn.gov/dhs 34
Time Reporting & Health Care Claiming - continued Worker B does not yet have their time entered and nothing is included in that claim with Worker A s time. Now worker B enters their time after the claim batch has been submitted. No claim in SSIS would be created because there was already a claim for that date and service. If the claim was submitted outside of SSIS, it would still be denied. REVENUE LOST! Had the time been entered timely, the two time records would have been combinedand paid the full amount. You can send the money back and create a new claim that would include both time records, but this is time spent doing something over again! Minnesota Department of Human Services | mn.gov/dhs 35
Time Reporting & Health Care Claiming - continued TCM Claims: On 3/6/19, Worker A and Work B both provide the same service to the same client on the same day. Worker A enters their time and the claiming person generates a claim batch. A claim is created. Worker B does not yet have their time entered and nothing is included in that claim with Worker A s time. The total dollars paid is the same so that is not as big an issue. However, if this claim is audited and the one time record does not pass the audit, the second workers time is not included in the claim (valid contact) and therefore the claim dollars would have to be paid back. REVENUE LOST! Minnesota Department of Human Services | mn.gov/dhs 36
TCM-CSR Report This presentation can be found on the AMSSA website: http://amssaconference.blogspot. com Look for 2017 Conference Documents Title: TCM CSR Presentation This presentation explains the TCM CSR report line by line with explanation of BRASS codes used. Minnesota Department of Human Services | mn.gov/dhs 37
Fiscal & Worker Working Together From: SSIS Fiscal Fiscal & Worker Working Together Reference Updated 9/21/2015 Minnesota Department of Human Services | mn.gov/dhs 38
Fiscal & Worker Working Together - continued From: SSIS Fiscal Fiscal & Worker Working Together Reference Updated 9/21/2015 Minnesota Department of Human Services | mn.gov/dhs 39
Fiscal & Social Service Supervisor Working Together Accounting staff are neutral and reporting actual information. Brings consistency to all social service unit(s). Better awareness of what s happening in the agency. Build relationships between fiscal and social services. Work together. Be a team. Learn the basics of the programs in other areas. Fiscal pays the bills Social Services brings in the revenues. Fiscal/accounting staff provide trend reports to social service unit(s). Share information. Be proactive not reactive. Minnesota Department of Human Services | mn.gov/dhs 40
Good Material to Review! This presentation is worth a second look! You can find the full presentation on the AMSSA website: http://amssaconference.blogspot.com Look for 2016 Conference Documents Title: Measures+ Reports+ Training+ Accountability = Revenue Maximization This presentation has great tips on how to maximize your county revenues! Minnesota Department of Human Services | mn.gov/dhs 41
What Works In Your County? SURVEY RESPONSES FROM COUNTIES: Having staff understand the big picture Setting deadlines for time entry Having the supervisors & director on board Daily time entry either beginning of the day for prior day or end of day for the current day FOLLOW THROUGH Spreadsheet review Protected time for time entry Tying the expectation to staff performance reviews Open trainings E-mail reminders Minnesota Department of Human Services | mn.gov/dhs 42
What Doesnt Work In Your County? SURVEY RESPONSES FROM COUNTIES: DOING NOTHING Assuming that time reporting is happening Not reviewing reports Stressing dollars and revenues with social workers this is not high on their list! Minnesota Department of Human Services | mn.gov/dhs 43
County Submitted Attachments Anoka SSIS Best Practice Guide. Why we like it: Gives insight on valid reasons why case notes and time entry is important. Rose Fischer, Fiscal Supervisor, and other supervisors and fiscal staff. Clay - Time and Revenue by Worker. Why we like it: It provides management reports on revenue by all categories. Clay also prepares pie charts to show their board. Brown Examples of time reporting and revenue earned by employee. Why we like it: The first time Cindy saw this report was maybe 5 -8 years ago. This is a tool a successful tool used by fiscal. Brown County gets it! Kudos to their director Tom Henderson, Crow Wing SSIS Time Reporting Guide. Why we like it: Very detailed on time reporting based on different activities. Minnesota Department of Human Services | mn.gov/dhs 44
County Submitted Attachments - continued Dakota 100% Time Reporting Screenshots and Time Reporting Picks Grid. Why we like them: Great examples of internal time reports. The screen shot with the little note of select who the case is regarding and not the parents, only the child, helps with TCM rates. Another great example is their activity spreadsheet that shows the different activities that they allow in program areas. Lac qui Parle - Staff Costs spreadsheets. Why we like them: This is an example of how a small county has made the effort to make staff accountable in time reporting. In essence Lac qui Parle is doing great follow-up as would large counties who have more resources available. Minnesota Department of Human Services | mn.gov/dhs 45
County Submitted Attachments - continued Olmsted SSIS Training Resources. Why we like it: They have the resources available to use technology as part of their overall SSIS training. The FAQ section leads to better consistencies. portions of policy and best practice is part of their training. Sherburne SSIS Mentoring Checklist. Why we like it: Sherburne is also consistent with their training based on a common mentoring checklist for social services staff for all units. Follow- up is completed and fiscal staff spend time with new workers after the new worker has completed their first month of time entry. Sherburne County also St. Louis SSIS Time Recording. Why we like it: St. Louis County offers a very consistent approach of time reporting. There are additional lab opportunities offered. We appreciate how Minnesota Department of Human Services | mn.gov/dhs 46
County Submitted Attachments - continued tells staff where time should go. Also addressed is time inflation, records and reports, and correspondence. Washington Revenue Generated by Worker spreadsheets. Why we like them: Their packet of attachments was quite impressive! Their internal reports cover a spreadsheet for each funding source. Minnesota Department of Human Services | mn.gov/dhs 47
Reviewing Time - Where to Start The first page of this report is worth reviewing! The first section is Non- Program related time for the period. Could any of this time be moved to client specific? Did you know that if your county has a time standard percentage on client related time, the time reported on non-program related time is not included? Minnesota Department of Human Services | mn.gov/dhs 48
Reviewing Time - Where to Start - continued In general, when reviewing Unit or Worker Details, pay close attention to the % for Non-program related, Program related/non-workgroup specific and Program related/workgroup specifics and Total time. Sherburne County requires 100% time reporting with 80% being client related. Seeing a large deviation from county specified averages for a worker type (TCM, Waiver, etc.) might indicate a larger overall problem with how a worker is time reporting. Non-program related time - Time during a worker s usual full-time work day/hours which cannot be billed against. This includes PTO, trainings and administrative activities that are not able to be directly related to a program or specific workgroup. Minnesota Department of Human Services | mn.gov/dhs 49
Reviewing Time - Where to Start - continued Program related/non-workgroup specific time Time that is not case specific but can be billed towards administration of specific program. This might include time a worker is working as Person of the Day for a particular program, taking calls/questions pertaining to specific programs. Also could include necessary training that would be needed to administer a program. Program related/workgroup specific Time that is directly billable to a specific program under a client s program specific workgroup. For example, this might include required case management activities with/for a client/family under their specific workgroup. Minnesota Department of Human Services | mn.gov/dhs 50
