Designing and Implementing Social Safety Nets for the poor - The case of Andhra Pradesh, India

1. Designing and Implementing Social Safety Nets for the poor - The case of Andhra Pradesh, India Presentation made at World Bank, Washington DC By K.Raju Prl secy to Govt, RD dept Andhra Pradesh 24th March 2009

2. The Outline of the Session • Snap shot of Social Safety Nets available for the poor in AP • What is unique about AP’s case • How it is done? • The Lessons

3. The Snap shot… • Food security • Pensions to the old, widows and Disabled • Death and disability insurance • Health insurance • SHG women Co-contributory pension scheme • National Rural employment guarantee Scheme

4. What is unique about AP case • The Scale (the coverage) • Targeting efficiency • SHGs and their federations as prime movers • Low transaction cost and high efficiency in delivering the benefits • High transparency thru ICT

5. The Scale (the Coverage)

6. Targeting efficiency • Targeting by SHGs of Women and their federations • Universal coverage • Self targeting

7. The Targeting

8. SHGs and their federations as prime movers • Trust and last mile connectivity • Targeting and enrolment • Awareness among the beneficiaries • Grassroots level monitoring support • Insurance – Claim settlement responsibilities • Grievance reddressal

9. Public Sector Private Sector People Sector Co-production model

10. 10 • Tie up with an Insurance Company • Nodal Agency for the scheme • Maintain data base and Call Centre • Issue Certificate of Insurance/Bonds • MIS • Capacity building of its staff and community • Pay out solatium within 24 hours through • Bima Mithras ZS • Planning and Monitoring • Training of VOs • Claim documentation • Office bearer is member of Area Committee MS • Member education • Enrollment • Collection of premium • Reporting claims • Facilitate documentation of claims VO SHGs SHGs SHGs SHGs SHGs SHGs

11. Social Security Pensions Old Age Pensions Poor and above 65 years of Age : 44.74 lakhs No. of Old age pensions : 44.35 lakhs Pensions to Widows Poor & Widow of age above 18 yrs : 18.40 lakhs No. of Widow Pensions : 17.41 lakhs Pensions to persons with Disabilities Poor and disabled, any age : 8.34 lakhs No. of Pensions for PWDs : 8.28 lakhs Total Social Security Pensions : 71.53 lakhs Total Budget for 2009-10 : US$ 400.8 millions

12. Pensions Rs.200 per month to be delivered to Old Age, Weavers & Widow pensioners Rs.500 per month to be delivered to disabled persons The pension amount to be delivered in their habitation on 1st of every month Individual pass book to record the transactions

13. Total Transparency ensured All transactions through software: Eligible persons list Sanction of pensions Acquittance list Monthly disbursement status Reports & Analysis

14. 14 SOCIAL SECURITY PENSIONS

15. 15 SOCIAL SECURITY PENSIONS

16. 16 SOCIAL SECURITY PENSIONS

17. 17 SOCIAL SECURITY PENSIONS

18. Disbursement of Pension through Smartcard Bank Server Pension fund to each account Project Director D.R.D.A Office Cash movement Point of Service (PoS) Smart Card Customer Service Point (CSP)

19. Biometric validation of Smart Card

23. Please Visit www.ssp.ap.gov.in

24. Community managed death and disability Insurance

25. Products /Schemes for the SHG members & their Spouses • Aam Aadmi Bima Yojana– for 38.00 lakhs landless agricultural laborers –mostly men (only for Rural) • Janasree Bima Yojanafor remaining 52.00 lakhs or more Spouses of SHG members (Both Rural & Urban) • Other Group Insurancefor all the 90.00 lakhs SHG women (both Rural & Urban)

26. Products /Schemes for the SHG members & their Spouses

27. Products /Schemes for the SHG members & their Spouses

28. Scholarships for children For children studying from 9th to 12th classes: Rs. 1200 per annum 28

29. Scholarships for children 29 • Tie up with an Insurance Company • Nodal Agency for the scheme • Maintain data base and Call Centre • Issue Certificate of Insurance/Bonds • MIS • Capacity building of its staff and community • Pay out solatium within 24 hours through • Bima Mithras ZS • Planning and Monitoring • Training of VOs • Claim documentation • Office bearer is member of Area Committee MS • Member education • Enrollment • Collection of premium • Reporting claims • Facilitate documentation of claims VO SHGs SHGs SHGs SHGs SHGs SHGs

30. Call Center Operations 30

31. Claims process and settlement mechanism at a glance Phone Call Centre located in ZS Claim village Payment of interim relief to the bereaved nominee/family Phone Rs.5000/- Bima Mithra & One Committee Member Visit ATM • Area Committee member completes claim documentation and sends to Call Center wherein the documents are processed and send then electronically to LIC

32. Web Based Claim Settlement Process

33. Policy Holder Details in the Web portal

34. District wise Policies - AABY

35. District Wise Status of Claims - AABY

36. AABY – Detailed Stage Wise Claims

37. AABY – Detailed Stage Wise Claims

38. Status of Settlement of Claims (as on 14.03.09)

39. Scholarships 08-09 No .of Children : 2,14,406 Amount Disbursed : Rs. 12,86,43,600/- (First Half-yearly payment @ Rs. 600/- per child)

40. Bima Mithra Drawing Cash to distribute Solatium to bereaved family Distribution of Solatium to the bereaved family

41. Hospitalization Expenses in AP

42. Rajiv Aarogyasri A PUBLIC – PRIVATE – PARTNERSHIP ( NOT A CONVENTIONAL INSURANCE SCHEME ) • AAROGYASRI TRUST REGULATOR • INSURANCE COMPANY RISK COVERAGE • NETWORK HOSPITALS SERVICE PROVIDER • DISTRICT ADMINISTRATION MOBILISATION • FED. OF SELF HELP GROUPS HEALTH WORKERS (AAROGYA MITHRAS) • SOFTWARE COMPANY TECHNOLOGY SOLUTIONS 42

43. Main Features Universal Coverage All BPL Families (2.03 crores) Cashless treatment Up to Rs 2 lakhs in a year Health Workers 3394 Aarogyamithras Health camps 8058 camps so far. Simple Procedure Health card/White Card

44. Main Features Cost Borne by the Government Diseases Identified Packages For end-to-end treatment Choice of Hospital Left to patients Monitored On-line : 24 hour basis Implementation : Aarogyasri - I through Insrnc co Aarogyasri – II directly by Trust

45. Aarogya-Mithras NW Doctors Insurance Doctors Trust Doctors Trust CEO Banks Citizens AAROGYASRI IMPLEMENTATION Trust Administration /Insurance Company PHC’S/ CHC’S AREA HOSPITAL DIST HOSPITALS DIRECT HEALTH CAMPS ACCIDENT SITES CM CAMP OFFICE Preliminary Verification Preauthorization Monitoring Claim Processing Treated Patient Claims Patient Payments Diagnosis Admission Treatment Billing Follow Up Bed Capacity Patient Records BPL Data Medicines Inventory Health Camps Data Inventory Patients Feedback Financial Data Network Hospital • Workflow designed by Trust and Technology Solution Provided By TCS Ltd

46. Infrastructure and Manpower

47. Network Hospital – Responsibilities(365 hospitals empanelled) Organize Health Camps once in a week. Separate Reception and Registration. Dedicated Medical Coordinator (RAMCO-Doctor), Camp Coordinator Free Transport to and from Mandal HQ for in-patient. Free food for in- patient Free consultation, diagnostics and treatment, irrespective of surgery Cashless services Follow-up consultation and distribution of follow-up medicines provided by the Trust Provide Computer, Printer, Scanner, Digital camera,Webcam and 2mbps connectivity.

48. Category wise surgeries/Therapies (23-03-09)

49. Category wise surgeries/Therapies ( 23-03-09)

50. Hospital - surgeries/Therapies ( 23-03-09) Gender - surgeries/Therapies ( 23-03-09) Age - surgeries/Therapies ( 23-03-09)