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External links to other sites are intended to be informational and do not have the endorsement of the Texas Department of State Health Services.

FY07 Quality Management Review Tools and Instructions

Core Tool - Items in This Tool Apply to All DSHS Contactors
BCCCS
Case Management
CSHCN
Genetics
Primary Health Care (PHC)
School Health
SDI
Texas Health Steps
Title V - Part A
Title X - XX
WIC

Program tools are used to review contractors monitored by the Quality Management Branch. Instructions are provided for each program tool. The instructions follow the number sequence of the appropriate program tool. Please utilize these tools for self assessment of your agency.

For information on downloading any of the documents on this page please visit the DSHS File Viewing Information Page.

Core Tool (FY07) - Items in this tool apply to all DSHS contractors.
Core Tool (87KB, DOC)
Core Tool Instructions (51KB, PDF)
Child Abuse Record Review Tool (34KB, DOC)

BCCCS (FY07) - Items in this tool apply to all Breast and Cervical Cancer Control (BCCCS) contractors. For more information visit the BCCCS website.
BCCC Tool (65KB, DOC)
BCCCS Tool Instructions (28KB, PDF)
BCCCS Record Review Tool (50KB, DOC)

CSHCN (FY07)- Items in this tool apply to Children with Special Health Care Needs (CSHCN) Case Management and CSHCN Specialty Services. For more information visit the CSHCN website.
CSHCN COHP Tool FY07 (145KB, DOC)
CSHCN COHP Instructions FY07 (43KB, DOC)
CSHCN Clinical Services Tool (146KB, DOC)
CSHCN Clinical Services Tool Instructions (59KB, PDF)
CSHCN Case Management Tool (125KB, DOC)
CSHCN Case Management Tool Instructions (67KB, PDF)
CSHCN Family Supports and Community Resources Tool (120KB, DOC)
CSHCN Family Supports and Community Resources Tool Instructions (32KB, PDF)

Genetics (FY07) - Items in this tool apply to all Title V-Genetics contractors. For more information visit the Genetics Program website.
Genetics Tool (67KB, DOC)
Genetics Services Tool Instructions (82KB, PDF)
Genetics Services Clinical Record Review Tool (35KB, DOC)
Genetics Services Prenatal Clinical Record Review Tool (36KB, DOC)
Eligibility and Billing Record Review Tool (43KB, DOC)

Primary Health Care (PHC) (FY07) - Items in this tool apply to all PHC contractors. For more information visit the Primary Health Care website.
PHC Tool (77KB, DOC)
PHC Tool Instructions (38KB, PDF)
Eligibility and Billing Record Review Tool (43KB, DOC)
Clinical Record Review Tool (40KB, DOC)

School Health (FY07) - Items in this tool apply to all School Health (SH) contractors. For more information visit the School Health website.
School Health Tool (62KB, DOC)
School Health Tool Instructions (44KB, DOC)
Clinical Record Review Tool (40KB, DOC)

SDI (FY07) - Items in this tool apply to all Standard Delivery Integration (SDI) contractors.
SDI Tool (62KB, DOC)
SDI Tool Instructions (51KB, DOC)
Eligibility and Billing Record Review Tool (43KB, DOC)
Clinical Record Review Tool (40KB, DOC)

Texas Health Steps (FY07) - Items in this tool apply to all Texas Health Steps providers reviewed by QMB. For more information on Targeted Case Management for Pregnant Women and Infants and Texas Health Steps Medical Case Management, visit the Texas Health Steps website.
Texas Health Steps Tool (45KB, DOC)
Texas Health Steps Tool Instructions (33KB, DOC)
Clinical Record Review Tool (40KB, DOC)

Title V - Part A (FY07) - Items in this tool apply to all Title V-Part A contractors.
Title V Part A Tool (81KB, DOC)
Title V Part A Tool Instructions (55KB, DOC)
Eligibility and Billing Record Review Tool (43KB, DOC)
Clinical Record Review Tool (40KB, DOC)

Title X-XX - (FY07) Items in this tool apply to all Title X and Title XX Family Planning contractors. For more information on Title X-XX visit the Family Planning website.
Titles X-XX Tool (105KB, DOC)
Titles X-XX Tool Instructions (44KB, DOC)
Eligibility and Billing Record Review Tool (43KB, DOC)
Clinical Record Review Tool (40KB, DOC)

WIC - (FY07) Items in this tool apply to all Special Supplemental Nutrition Program for Women, Infants and Children (WIC) contractors.
Fiscal Self Audit Instructions (43KB, DOC)
WIC Tool (170KB, DOC)
WIC Fiscal Tool (194KB, DOC)
Food Delivery Self Audit (56KB, DOC)

Explanation for WIC Worksheets (FY07):
These worksheets apply to all WIC contractors. Record reviews must be documented and include all areas described below. The Recap worksheet is not required as part of the self audit. Foxfire reports can be used to obtain participant's names and ensure compliance in the different review criteria. These reports can be found at http://www.dshs.state.tx.us/wichd/default.shtm
Eligible (65KB, DOC)
Ineligible (45KB, DOC)
Midpoint (41KB, DOC)
Formula (47KB, DOC)
Employee (46KB, DOC)
Enhanced (50KB, DOC)
Referral (35KB, DOC)
Record Available (36KB, DOC)
Date of First Visit (44KB, DOC)

Explanation for WIC Clinical Checklist:
The WIC Checklist applies to all contractors who have a WIC site-monitoring visit scheduled. To expedite the review, please have the documents that are listed on the checklist available at the time of the Entrance Conference.
Clinical Checklist (44KB, DOC)

Last Updated December 5, 2006