DFPS Service System – Peer Review Process
The purpose of Peer Review is to provide an appeal process of Youth for Tomorrow’s (YFT) services regarding the results (1) of an Initial Service Authorization, (2) of a Utilization Review, or (3) a provider’s compliance with the Service System Indicators.
- The first step in this process is to submit a written request for a review by YFT’s Executive Director within 5 business days of the YFT review service. The request must provide the reason that the requestor is appealing the determination. The request should originate from either the CPS caseworker’s supervisor or the provider’s Executive Director or the Clinical Director. A provider request can be in writing or submitted electronically to email@example.com and is identified as a peer review request. The request must be submitted or postmarked within 5 business days of the original YFT review. A CPS supervisor request must be made within five (5) business days of the YFT data upload into IMPACT. The requests should include ONLY the documentation that was available at the time of the original review and exit briefing with YFT.
- YFT’s Executive Director and Quality Assurance Committee will review the original documentation and notify the CPS supervisor or the provider and the DFPS State Office Program Specialist in writing of the results of this subsequent review, which must be in writing within five (5) business days of receipt of the request and record.
- If the CPS supervisor or provider disagrees with this second review by YFT, the person originating the appeal may submit a written request to YFT requesting a review by the Peer Review Committee. This request must be postmarked or emailed within five (5) business days of YFT’s notification.
- YFT will forward the letter and the documentation within 3 business days to the DFPS State Office (Service System Program Specialist). The DFPS Program Specialist will submit the appeal to the Peer Review Committee within three (3) business days from the date of receipt. After receipt of appeal, the Peer Review Committee will review the complete packet of information used to make the Service Level determination by the Contractor and make a written recommendation of the appropriate Authorized Service Level to the CPS Associate Commissioner for final decision.