***All questions refer to Performance Measures data for fiscal year 20XX***
NOTE: The information on this questionnaire should be obtained for each selected measure . This can be accomplished by filling out a questionnaire for each measure
OR
CLEARLY identifying information collected for each measure on one questionnaire.
Please note that:
1.
Please provide sufficient detail in order to reduce the amount of follow-up that will need to occur during fieldwork.
2.
If you have any questions or comments, contact XX
Staff
A.
Employee(s) responsible for this measure:
Title(s):
What phase of the data process are they responsible for? (collection, calculation, reporting, etc.
Length of time responsible for this function:
B.
Is this an aggregate measure? That is, to calculate this measure, is data that was calculated for another measure used in the calculation? If so, please identify the calculated data and provide the name, title, and telephone number of the employee who collected and calculated that data.
Policy and Procedures for Gathering Data
A.
Do you have documented policies and procedures for the collection of this data? Where are these polices and procedures kept?
B.
Have there been revisions to procedures? If so, have the manuals been updated?
C.
Please provide a hardcopy or electronic copy of the documented procedures.
Measure Definition
A.
Is the measure definition specific to ensure consistent calculation on an ongoing basis? Is there any part of the definition that may be, or has been, interpreted differently by different people?
B.
Please explain in detail how the entity interprets the measure definition.

Summary document(s)
A.
Who prepares the summary document(s)?
B.
What form does the summary document take? Is it a spreadsheet, an internally generated list, or a report from an automated system database? If available, please provide an electronic copy of fiscal year 20XX summary document(s).
Process of Data Collection
A.
Please describe the process of collecting the performance measure data. Start with the first activity that creates the data and include all critical steps to the delivery of the data to the agency
Performance Measurement coordinator. Include:

Identification of physical files, data elements, manual logs, automated databases, manual entries, review steps, etc.

Identification of all automated systems used to collect or calculate data, who has access, what level of access, and what applications are used to obtain the data.
B.
If the information comes from a third party, please provide information on the procedures followed to ensure that the information received is accurate.
Data Retention- source documents
A.
What are the source documents or source computer screens for this measure? Where are the source documents kept or on what computer system and screen would this information be found?
B.
How long is the computerized information available? When new data is available is the previous data overwritten?
Calculation
A.
How is the performance measure calculated? Please provide explanations for all factors affecting the measure. Provide documentation of the calculation.
B.
If a database is used to help calculate the measure, please include an explanation of the role of the database in measure collection. Also provide a copy of the computer program code, SQL statement, or formula that calculates, counts, or flags data for collection. Include with the program code an explanation of the calculation.
C.
Is the calculation reviewed by anyone? If changes are required, what are the procedures? For fiscal year 20XX, please provide documentation verifying that reviews of calculations were completed periodically.
Source: Adapted from Guide to Performance Measures Management, 2006 Edition, State
Auditor’s Office of Texas, Report #06-329