Quality Assurance for Firms

As required by law, L&I established criteria to monitor the quality and effectiveness of vocational rehabilitation services, and to make referrals based on its criteria. Its Quality Assurance (QA) team helps firms have the tools and resources they need. Meeting QA criteria facilitates high quality, worker-centric vocational services.

L&I collaborated with a group of private vocational providers, firm owners, and Return to Work Partnerships (RTW) staff to establish the QA criteria. The criteria emphasize a worker-centric approach and the prevention of long-term work disability. The four foundational pillars of preventing long-term work disability are:

  • Prevent a confusing process
  • Prevent unnecessary delays
  • Prevent unnecessary duration
  • Prevent unclear return to work expectations

Vocational firms receiving referrals from L&I must comply with the quality assurance (QA) requirements in law, rule, and policy.

For more information, see Quality Assurance Requirements.

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QA Requirements

Firms that wish to receive referrals from L&I must comply with quality assurance (QA) requirements in law, rule, and policy.

L&I sets QA requirements in the Vocational Firm Quality Assurance Plan, verifies firms are meeting QA standards, and holds firms accountable to do the following:

Quality Assurance Plan

The Quality Assurance (QA) Plan:

  • Outlines requirements for managing and monitoring VRC performance for each referral type.
  • Defines the QA elements for each referral type.
  • Sets expectations for firms to report data and participate in QA discussions with L&I.
  • Requires the firm to designate a QA representative (can be the firm owner, manager, or qualified VRC) to be responsible for administering the plan and attending QA meetings with L&I.
  • Must be signed by the firm owner or manager.

Quality Assurance Data Elements

Using L&I’s standard data template, firms track VRC activity and send QA data each month.

Each referral type has specific Quality Assurance Elements.

L&I will give firms at least 60 days' notice of changes in QA elements, reporting frequency, or other intended updates to QA expectations.

Reporting data on QA elements

  • L&I measures QA elements at a system level.
  • The system assigns referrals based on the number of available counselors in a service area.
  • Data submitted does not impact the number of referrals a firm receives.
  • L&I is committed to making data-driven and evidence-informed decisions to help injured workers heal and return to work.

Validation

L&I’s Quality Assurance Program team members validate data by reviewing claims, meeting with firms, and providing feedback. Validation meetings typically occur 2-4 times per year. Validation meetings are opportunities to build the partnership with L&I, discover opportunities for development, and highlight the ways counselors are helping workers get back to work. The validation process includes the following steps:

  1. L&I randomly selects a small collection of claims for the firm’s review.
  2. L&I sends the firm the list of claims and validation questions.
  3. The firm reviews the list of claims and provides answers to the validation questions.
  4. L&I reviews the claims and the firm’s response to the validation questions.
  5. L&I meets with the firm to discuss findings, highlight successes, and identify opportunities for improvement.
  6. L&I provides a QA plan addendum that documents the discussion.
  7. The firm owner or manager signs and returns the addendum to L&I, agreeing to implement the areas of focus listed in the addendum.

Interim Check-ins

In between validation meetings, the QA team will schedule interim check-ins and provide topics in advance. These meetings allow firms to ask questions, review progress, and receive additional support from the QA team.

Authentication

L&I asks firms periodically to “authenticate” the number of interns and vocational counselors. This may include confirmation of VRC-assigned service locations, verification of intern start dates, and other firm-staffing data.

QA Compliance

L&I monitors the quality and effectiveness of a firm’s vocational services by validation of engagement, monthly data review, and activity reporting. To do this, L&I requires close partnership and good communication with firms. For example, quality and effectiveness can’t be measured if firms don’t send monthly QA data on time.

Roles and responsibilities

Vocational firm

  • Understands expectations for doing business with L&I.
  • Submits required documentation and data on time.
  • Participates in the QA process and actively works to meet requirements.
  • Asks for help to understand QA requirements if needed.

L&I’s Quality Assurance Program

  • Provides firms with clear expectations.
  • Provides individualized instructions and action plans.
  • Supports firms in their efforts to maintain compliance.
  • Takes action when a firm is out of compliance.

L&I’s Private Sector Rehabilitation Services (PSRS)

  • Assists with QA team with the compliance process when suspension is needed.

What is non-compliance?

Common examples of non-compliance include, but aren’t limited to:

  • Failing to provide evidence that vocational services are in alignment with QA elements and WAC requirements.
  • Sending monthly QA data late or not at all.
  • Providing required documents late or not at all.
  • Missing or rescheduling validation meetings repeatedly.
  • Not acting or improving on addendum action items.
  • Not responding to L&I communication attempts.

How to return to compliance

L&I wants each firm to be successful and understands circumstances can be complex and unique. L&I uses a set process to address non-compliance based on the compliance issue type: administrative issues or service delivery issues. The QA team documents compliance issues at any time during the validation process and provides firms with instructions on how to return to compliance.

For more information, see the Vocational Firm Quality Assurance Compliance Management Process.

Questions or concerns?