The Fairfax County Department of Family Services recently received the Virginia Department of Social Services 2017 I3 Local Recognition Award in the category of Business Process Improvement for its extraordinary work in centralized appeals.
The DFS Centralized Appeals Unit, in the Self-Sufficiency Division, was established to facilitate coordination between DFS and its stakeholders. The unit is in charge of scheduling potential appeal hearings, receiving all appeal related documentation and responding in a timely manner to all Department of Medical Assistance Services and VDSS appeal requests. Programs evaluated within the unit are all Medicaid eligibility case actions, Supplemental Nutritional Assistance Program, Temporary Assistance for Needy Families, General Relief and Refugee Cash Assistance Programs. Between 2015 and 2016, Fairfax County received a total of 1,434 requests for appeals from both the DMAS and VDSS.
The unit initiates the appeal process by conducting a thorough case review to ensure appropriate case action and benefit accuracy for all appeal requests. If improper case action was taken or case re-evaluation must be conducted, the unit initiates all case correction prior to the scheduled appeal hearing in an attempt to obtain an administrative resolution or withdraw the request for appeal if the appellant is satisfied with the outcome. The work of this unit assisted staff in a reduction in appeals slots from 95 to 72 slots, which enabled the unit to have a specific protected day in order to process appeal cases and/or work on summaries.
DFS no longer has issues with timely appeals summaries, being present for appeals hearings, and clients getting timely resolution and re-evaluation of their cases on a regular basis. The efficiency and effectiveness within the unit allows workers to focus on case details and provide quality appeal summaries to the state within specified timeframes and to be prepared during the hearings with the expertise knowledge required.
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Questions or need more information about this news posting?
Contact Amy Carlini by email or call 703-324-7758, TTY 703-222-9452.
Learn more about the Department of Family Services.