Mar 13, 2013 ... This form is used when you provide assistance to a beneficiary with a concern or
issue. ... Issue form and forward to the Missouri SMP Office.
Missouri SMP Volunteer Specialist Activity Form What volunteer role conducts the activity reported on this form? The One on One Specialist What activity is to be reported on this form? This form is used when you provide assistance to a beneficiary with a concern or issue. The beneficiary’s caregiver or family member(s) may also be in attendance. The activity can take place over the phone or in person, such as, at a community event or group education session. Please keep in mind, the question/assistance must be related to the SMP mission, i.e. Medicare fraud, the SMP program, how to become a volunteer, how to read a MSN, general Medicare information, etc. If you suspect potential fraud, error, or abuse, record your time spent, then complete the SMP Complex Issue form and forward to the Missouri SMP Office. How do I fill out this form? At the top right of the first page record your name, county, and the month/year. Please use one form per county per month. Record your sessions as follows: • Look down the left side for the primary topic that was covered. • Looking to the right for the next empty square, record the time in minutes you spent with the person. • Do the same for each person you counseled (inquiries). This allows the number of inquiries plus the time spent to be recorded in SMARTFACTS. • If there is not a category that matches you effort use the “Other” category. However, please provide a description of the “Other.” • All issues must be related to Medicare or consumer issues in order to be counted in SMARTFACTS. What are some examples? • A request for information about becoming an SMP volunteer. • A request for information that is best provided by another agency and you explain how to contact the other agency. • Basic, individualized education about how to read an MSN • Basic, individualized education about how to recognize fraud, error, and abuse NOTE: As mentioned before, one-on-one sessions that happen at a community event or group education session may also be counted in addition to the event. In either case, privacy considerations as described in the Volunteer Handbook must always be considered.
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SMP Outreach Event Tracking Form, A. Community Outreach Event What volunteer role conducts the activity reported on this form? The Distribution Specialist What activity is to be reported on this form? This form is used when you staff information booths at a health or senior fair, or exhibit at a conference to increase community awareness. To count as a community outreach/education event, it must be staffed by a Missouri SMP trained representative. Community Event vs. Dissemination Activity: Distributing materials to locations or events that are not staffed by Missouri SMP representatives are not reportable as a community event to the OIG. Examples: leaving materials at a library, printing the Missouri SMP phone number on pharmacy bags, etc. How do I calculate the estimated number of people reached? For community outreach/education events which take place in person: • Estimates of the number of people potentially reached should be made by using a tick-mark for each person that approaches your booth to take materials and/or speak with an SMP staff or volunteer or by counting the number of brochures / materials distributed. You should not automatically count the total event attendance as your estimate for the number of people reached. • If, however, each participant at a conference or fair is given SMP information as part of their conference bag or materials (SMP flyers, brochures, etc.), the total number of participants at the event can be counted as the “estimated number of people reached”. NOTE: One-on-one sessions that occur during an outreach / education event can be counted separately on the Missouri SMP Volunteer Specialist Activity Form. The same is true for group education sessions offered by the SMP at a conference or fair where the SMP is also hosting an exhibit or booth. How do I calculate the Time Spent? The time spent should include any time spent doing SMP work which includes time spent: • Assembling materials for an upcoming exhibit • Reading Missouri SMP email updates or newsletters • Reviewing/researching SMP manuals • Traveling to and from an exhibit location.
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SMP Outreach Event Tracking Form, B. Group Educational Session What volunteer role conducts the activity reported on this form? The Presentation Specialist What activity is to be reported on this form? Group Educational Sessions are defined as formal gatherings led by Missouri SMP Staff, partners, or volunteers to educate recipients, family members, caregivers, and others on detecting fraud, waste, and abuse in the healthcare system and services offered by the Missouri SMP Program. Presentations are given to groups, small or large. The presentation may or may not include the use of PowerPoints, visual aids, handouts, or other presentation tools and techniques, even performances or skits, as long as the content fulfills the SMP mission. Events conducted electronically, such as webinars, teleconferences, tele-town halls, etc. may be counted as group education sessions as long as they include some form of formal presentation on Medicare fraud, error, or abuse, and/or the SMP program and mission. NOTE: Most presentations include some form of Q&A. However, if one-on-one sessions occur after a group education session, separately from the presentation Q&A, they can be counted separately on the Missouri SMP Volunteer Specialist Activity Form. How do I calculate the estimated number of people reached? Count the number of attendees in the audience at the presentation. For the number of participants at an events conducted electronically, you can count everyone who was connected to or logged into the event. How do I calculate the Time Spent? The time spent should include any time spent doing SMP work which includes time spent: • • • • •
Practicing to give a presentation Assembling materials for an upcoming presentation Reading SMP email updates or newsletters Reviewing/researching SMP manuals. Time spent traveling to and from the presentation location.
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SMP Media Event Tracking Form What volunteer role conducts the activity reported on this form? The One on One Specialist, Distribution Specialist, and Presentation Specialist What activity is to be reported on this form? A media event is defined as “any individual airing or publishing of media (e.g., print, radio, television, or electronic) to educate individuals about detecting fraud, waste, and abuse in the healthcare system and services and/or Missouri SMP program services.”
NOTE: Any media contact must be approved by the Missouri SMP Office. What are the Media Strategies? • Newsletters, by project A newsletter completely devoted to the definition of media event above, ie, the Missouri SMP Volunteer Connection. A copy of the newsletter is not required to be submitted with the report. • Newsletters Articles, written for others An article published in a newsletter that is related to the definition of media event above, ie, Senior Center Newsletter. A copy of the newsletter is not required to be submitted with the report. • Newspaper, media releases PSAs (Public Service Announcements) submitted to newspapers. PSAs are supplied by the Missouri SMP Office via the “Missouri SMP Bulletin: ” emails. If you have an idea for a PSA, please work with the Missouri SMP Office prior to any submission to the media. • Newspaper, Op-Ed If you see an opportunity or would like to write a “Letter to the Editor” please work with the Missouri SMP Office. • Website This activity is very similar to newsletter article definition. The PSAs supplied by the Missouri SMP Office can be posted to a website, such as, the AAA’s or Senior Center’s website. In addition, posting the PSA to Facebook also counts and should be reported.
NOTE: For the following strategies, please work through the Missouri SMP Office when you see an opportunity: Radio – Interviews, Radio – PSA, Television – Interviews, and Television – PSA.
How do I calculate the Time Spent? The time spent should include all time spent on the media event. 3/13/2013
