APPENDIX B

TRIPARTITE QUALITY REVIEW OPTIONS

APPENDIX B

Tripartite Quality Review Options(1)

Appendix B explains the various options for performing quarterly tripartite quality reviews of nonmonetary determinations.

Legend for Options

HS = Host State reviewer or State being reviewed.

OS = Other State reviewer within the Region or visiting State.

RO = Regional Office reviewer.

TB = Tie Breaker reviewer when two reviewers are not in total agreement regarding the outcome of a case.



Option 1. (HS+OS+RO) This option is the preferred option for performing quality reviews of nonmonetary determinations at least once per year. The review(s) would be performed on-site by a team comprised of a QPI expert from the Host State, a QPI expert from one Other State within the Region, and a QPI expert from the Regional Office. Each of the reviewers would evaluate and score one-third of the sample of cases and would evaluate and score another one-third of the sample of cases previously scored by a different reviewer. If the two reviewers are not in total agreement regarding a case, the case would be evaluated and scored by a third reviewer.

Option 2. (HS+OS+RO) This option for performing quality reviews of nonmonetary determinations would be performed by a review team comprised of the same three parties as in Option 1 except that the review would be performed by the parties at their respective offices rather than on-site at the Host State. Under this option, the Host State would mail one-third of the sample of cases to each of the other two reviewers to evaluate and score. The reviewer in the Host State would also evaluate and score one-third. The cases scored by each of the three reviewers would be mailed to the designated second reviewers. If the two reviewers are not in total agreement regarding the outcome of a case, the case would be evaluated and scored by a third reviewer.

Option 3. (HS+OS/RO with OS/RO as TB) This option for performing quality reviews of nonmonetary determinations would be performed by a review team comprised of two parties (Host State reviewer and either an Other State reviewer or a Regional Office reviewer) who would independently evaluate and score all the cases in the sample. The third party (the Other State or Regional Office party who was not one of the two reviewers) will review those cases in which the two reviewers were not in total agreement regarding the outcome of a case. This option can be performed on-site or by mail (as in Options 1 or 2). (Option 3 should be used only when an Other State reviewer or a Regional Office reviewer is unable to participate full-time in the review.)

Option 4. (HS+OS+OS) This option for performing quality reviews of nonmonetary determinations would be performed by a review team comprised of one party from the Host State and two parties from Other States (either two different States or the same State). As in Option 1, each of the three reviewers would evaluate and score one-third of the sample of cases and would evaluate and score another one-third of the sample of cases previously scored by a different reviewer. If the two reviewers are not in total agreement regarding the outcome of a case, the case would be evaluated and scored by a third reviewer. This option can be performed either on-site or by mail (as in Options 1 or 2). (Option 4 should be used only when the Regional Office reviewer is unable to participate in the review.)

Option 5. (HS+HS+OS/RO or HS+HS+HS) This option is the least desirable one for performing quality reviews of nonmonetary determinations. The review would be performed by a review team comprised of two parties from the Host State and one party from either an Other State or the Regional Office, or, if no outside parties are available, all three parties from the Host State. As in Option 1, each of the three reviewers would evaluate and score one-third of the sample of cases and would evaluate and score another one-third of the sample of cases previously scored by a different reviewer. If the two reviewers are not in total agreement regarding the outcome of a case, the case would be evaluated and scored by a third reviewer who would be the tie breaker. This option can be performed by mail when there is a non-Host State reviewer. (This option should be used only when both Other State and Regional Office reviewers are unable to participate in the review.)

Below are examples of tripartite quality review schedules for performing quarterly reviews of nonmonetary determinations for all States within a Region using the above options. The examples reflect schedules of reviews in Regions with four States and six States as is the case in the majority of the Regions.

Some Regional Offices or States may wish to participate in more on-site reviews than others at certain times. Regional Offices and States have complete flexibility in planning and coordinating their review schedules for each quarter. However, each Regional Office must ensure that the review schedule provides for it to participate in at least one on-site review of each of its States in one quarter a year.



Example 1

State
Reviewed		 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
A A+B+RO
1
O		 A+A+D
5
O		 A+B+C
4
O		 A+B+RO
2
M
B     B+A+RO
2
M		 B+C+RO
1
O		 B+B+A
5
O		 B+C+D
4
O
C C+D+A
4
O		 C+D+RO
2
M		 C+D+RO
1
O		 C+C+B
5
O
D D+D+C
5
O		 D+B+A
4
O		 D+C+RO
2
M		 D+A+RO
1
O

    

Legend For Example:

Letters = States RO = Regional Office

Numbers = Options

O = On-site M = Mail


Example 2

State
Reviewed		 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
A A+B+RO
1
O		 A+F+D
4
O		 A+B+C
4
O		 A+B+RO
2
M
B B+F+RO*
3
M		 B+C+RO
1
O		 B+A+F
4
O		 B+C+D
4
O
C C+D+A
4
O		 C+E+RO*
4
M		 C+D+RO
2
O		 C+C+E
1
O
D D+C+E
4
O		 D+B+A
4
O		 D+C+RO
2
M		 D+A+RO
1
O
E E+F+RO
1
O		 E+B+D
2
M		 F+F+E
5
O		 E+F+B
4
O
F F+A+D
4
M		 F+E+RO
1
O		 F+E+RO
2
M		 F+A+RO
2
M



Legend For Example

Letters = States RO = Regional Office

* = Tie Breaker

Numbers = Options

O = On-site M = Mail

1. The Host State and Regional Office must agree, in advance, on the review option selected for each quarter.