Internal
Compliance Unit · Oregon Employment Department

Paid Leave Oregon
Compliance Program V3

A new standard for compliance review — built for accuracy,
grounded in Oregon law, and designed for what's next.

Ed Rose
Compliance Manager · Oregon Employment Department
July 2026
Overview

Today's Agenda

1
Where We StartedThe V1/V2 compliance review framework
2
What the Data ShowedMay 2026 compliance report insights
3
What Changed in V3Redesigned scorecards: Basic Claims & Eligibility
4
The Rule & Statute LayerAn entirely new dimension of compliance review
5
Platform & TechnologySmartsheets, Compliance Hub, and the digital Assigner
6
Rollout TimelineCS3 testing now · CS2 training August 3
Foundation

What Compliance Review Does

📋
Tracks Decision Accuracy
Measures whether staff decisions on paid leave claims align with policy, procedure, and Oregon law.
📊
Surfaces Trends
Aggregates findings into monthly reports that identify systemic patterns and training opportunities across the program.
🔁
Drives Improvement
Provides program leadership with data-driven insights to support coaching, policy refinement, and process improvement.
⚖️
Protects Claimants
Ensures Oregonians receive the benefits they've earned — correctly determined and properly documented.
Who conducts reviews

Compliance Specialist 2 (CS2) and Compliance Specialist 3 (CS3) staff complete structured scorecard reviews on assigned claims — using approved procedures and data from the Frances system.

Background

The Previous Framework

Established December 2025 · Two scorecards · CS2 & CS3 responsibilities
Scorecard 1
Basic Claims
  • ✓
    Employer Information (EI)
  • ✓
    Leave Type – Allowed (LIA)
  • ✓
    Leave Type – Denied (LID)
  • ✓
    Employer Notification of Leave (NOL)
Scorecard 2
Benefit Eligibility
  • ✓
    Not Currently Employed (NE)
  • ✓
    Not Covered Employment (NC)
  • ✓
    Late Application (LA)
  • ✓
    Week Claimed Late (WCL)
  • ✓
    Other Coverage: UI & Workers' Comp
  • ✓
    Equivalent Plans (Sim. Coverage & Active BY)
  • ✓
    Penalty Waiver (PW)
Review Approach
How It Worked
  • →
    Manual Excel "Assigner" sheet for case routing
  • →
    Compliance note created manually in Frances
  • →
    Yes/No branching with error sub-categories
  • →
    Benefit Payment Impact (BPI) captured per error
  • →
    Monthly report provided to program leadership
May 2026 · Compliance Snapshot

What the Numbers Told Us

19,908
Claims Processed
Allowed + Denied · May 2026
84.2%
Allowed Decision Accuracy
Overall compliance rating · 681 reviewed
92.9%
Denied Decision Accuracy
Overall compliance rating · 794 reviewed
Key Findings
Decision Accuracy — Strong

Most decisions are correct. Leave type determinations run 87–98% compliance across issue types.

Documentation — Room to Grow

Documentation quality ranges 58–83%. The gap isn't in what staff decide — it's in capturing why.

Period Range — Inconsistent

Period range accuracy for eligibility issues sits at 68.5% overall — a consistent error pattern across multiple issue types.

The Opportunity

We need more than whether an error occurred. V3 tells us why it happened and what it cost the claimant.

Rationale

Why V3? Three Identified Gaps

1
Limited Error Specificity

The old system flagged that an error occurred. The new system identifies exactly which type of error — enabling more targeted coaching, policy feedback, and trend analysis across the program.

2
No Statutory Grounding

Previous reviews checked process adherence, but did not verify decisions against Oregon Administrative Rules (OARs) or Oregon Revised Statutes (ORS). V3 adds that verification layer directly to the review process.

3
Coverage Blind Spots

Self-employed claimants, Designated Representative interactions, the Appeals process, and Assistance Grant applications were not reviewed under the prior framework. V3 covers all of them.

The Shift

From reviewing process adherence → to also verifying statutory compliance. A significant maturation in the program's rigor and accountability.

V3 Overview

Three Scorecards. One Comprehensive Picture.

Scorecard 01
Basic Claims
Rebuilt as a true decision-tree flow. Reviews Employer Information, Leave Type (Allowed & Denied), and Employer Notification of Leave.

Adds two new scored metrics: pre-determination leave date accuracy and decision letter verification.
Rebuilt · May 2026
Scorecard 02
Eligibility Issues
All 9 benefit eligibility issue types now share consistent branching logic. Period range checks and decision letter verification are fully standardized — reviewers follow the same path regardless of issue type.

Case routing handled by the new digital Assigner.
Rebuilt · May 2026
Scorecard 03
Rule & Statute Compliance
A brand-new scorecard anchored to Oregon law. Every question is tied to a specific OAR or ORS citation. Covers 8 claim categories — including four coverage areas that were never reviewed before.

80+ questions. Frances navigation embedded directly in the scorecard.
New in V3
Scorecard 01

Basic Claims — What Changed

Before · V1 / V2
Procedural SOP: long step-by-step Word document reviewers worked through manually
Yes/No per metric; open text for errors — inconsistent capture across reviewers
Leave date & schedule accuracy was a procedural check — not a scored metric
Decision letter review was a procedural check — not captured in data
4 issue areas with general error structure
→
After · V3
True decision-tree flow: each answer routes automatically to the correct next question
Specific multi-choice error categories — standardized across every reviewer
New — LIA-2 / LID-2: Were leave dates and schedule correct prior to determination? Now a scored metric.
New — LIA-3 / LID-3: Were correct decision letters sent to claimant and employer? Now scored with letter ID captured.
Same 4 issue areas — refined, formalized, and fully consistent
Scorecard 02

Eligibility Issues — What Changed

Before · V1 / V2
9 issue types — each with its own section in a long procedural SOP
Period range failure reason was not captured uniformly across issue types
Decision letter review was embedded in procedural steps, not scored
Error sub-questions varied in consistency across the 9 issue types
Case assignment managed via manual Excel Assigner sheet
→
After · V3
Same 9 issue types — now with identical, standardized branching logic across all
Formalized PR-2: Period range failure reason now captured (period from, period to, or both)
Formalized DL-1: Decision letter accuracy is now a scored metric — letter ID captured on every error
All 9 issue types follow identical logic — reviewers always know their next step
Case assignment handled by the new digital Assigner — no more Excel
New in V3

Rule & Statute Compliance Scorecard

80+ questions anchored directly to Oregon Administrative Rules (OAR) and Oregon Revised Statutes (ORS)

6
Benefit Eligibility
17
Claim Decision
5
Designated Rep ✦ New
7
Appeals ✦ New
9
Assistance Grants ✦ New
19
Equivalent Plans
14
Self-Employed ✦ New
Core
Claims Section
OAR / ORS Anchored
Every question is tied to a specific rule or statute. Reviewers see the citation directly in the scorecard.
Frances Navigation Embedded
Step-by-step Frances system navigation is built into each question — eliminating guesswork for reviewers.
4 New Coverage Areas
Self-employed claimants, Designated Representatives, Appeals, and Assistance Grants — all reviewed for the first time.
Platform

Technology & Tools

All V3 infrastructure is built and ready — scorecards, dashboards, and case assignment in one platform.
📋
Digital Scorecards
All three scorecards built in Smartsheets / Compliance Hub. Branching logic is enforced digitally — reviewers are guided through the correct path automatically, with no ambiguity.
📊
Real-Time Dashboards
Live compliance data visibility for the team and leadership. Replaces the manual, Excel-dependent reporting cycle with automated, always-current metrics and trend visibility.
📁
Digital Assigner
Case assignment is now handled digitally — eliminating the manual Excel "Assigner" sheet entirely. Reviewers see their assigned cases directly in the platform.
Platform note

Built in Smartsheets and the AI-powered Compliance Hub. All tools have been tested by CS3 staff during the familiarization phase and are confirmed ready for CS2 training.

Rollout

Training & Implementation Timeline

May – July 2026
Build & Development Complete
All three scorecards, dashboards, and the digital Assigner built and finalized. SOPs and procedures documented. Tools validated internally.
Now · July 2026
CS3 Testing & Familiarization
CS3 staff are actively using all V3 tools — testing scorecards, validating the Assigner workflow, and building hands-on familiarity ahead of full deployment.
August 3, 2026
CS2 Training Begins
Structured one-month training for all CS2 staff on V3 tools, updated procedures, and the new Rule & Statute scorecard. CS3 staff serve as peer resources.
~September 3, 2026
Full Team Deployment
Training complete. Full compliance unit operational on V3. First V3 monthly report to program leadership to follow shortly after.
Paid Leave Oregon · Compliance Unit

A More Rigorous,
Data-Rich Compliance Program

Built on what we know, grounded in Oregon law, and designed for what's next.

Better Error Intelligence
We now know not just that an error occurred, but exactly why — enabling targeted coaching and systemic fixes.
Statutory Compliance Verified
Every decision reviewed against the actual Oregon rules and statutes that govern the Paid Leave program.
Full Program Coverage
Self-employed, Designated Rep, Appeals, and Assistance Grants now reviewed for the first time.
Questions?
Ed Rose · Compliance Manager · Oregon Employment Department