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 an Utilization Review, or (3) a provider’s compliance with the Service System Standards and Indicators.
- The first step in accessing the Peer Review process is to request a review by YFT’s Executive Director within 10 working days of the YFT review service. The request should originate from either the CPS caseworker’s supervisor, the provider’s Executive Director or the Clinical Director. A provider request must be in writing and be postmarked within 10 working days of the original YFT review. A CPS supervisor request must be made within five (5) working 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 in writing of the results of this subsequent review, which must be postmarked or emailed within five (5) working 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) working days of YFT’s notification.
- Failure to request a review by the Peer Review Committee within the designated time frames will invalidate the request.
- YFT will forward the letter and the documentation within 3 working days to the DFPS State Office (Service System Program Specialist). The DFPS Program Specialist will notify the Peer Review Committee of the request within three (3) working days.
- The Peer Review Committee meets on an as needed basis. All requests received within 10 working days of the next Peer Review Committee meeting will be reviewed the following month. These reviews are based on the documentation submitted by the CPS supervisor or the provider, which were initially submitted to YFT. The CPS supervisor or provider may also make a verbal presentation to the Peer Review Committee.
- Peer Review Committee decisions are based on a majority vote of the Committee and their recommendations will be forwarded to the Assistant Commissioner for Child Protective Services for review. This Assistant Commissioner will make a decision and notify the CPS supervisor or provider within five (5) working days.
- Any adjustments or changes made by this Peer Review process are retroactive to the original dates involved in the YFT review service.