Changing the Human Service Delivery System

1. Changing the Human Service Delivery System Idaho’s Design & Implementation of an Effective and Efficient Service Delivery System

2. Idaho State Population: ~ 1.5 million Benefits Program Services: TAFI, AABD, SNAP, Medicaid, Child Care Assistance SNAP Program ~ 83,000 cases ~ 204,000 participants (~14%) Organization: 27 18 Field Offices 3 Processing Centers Central Business Office (Boise) Benefit/Eligibility Workers: ~ 350 Statewide (all programs) X Idaho Benefit Programs -- Division of Welfare

3. Presentation Outline Pain Points Want It Poor Performance Guiding Principles Measured Outcomes See It Customer Processes Operational Designs Making the Change The Road Map Do It Other (Larger) Outcomes Managing Today Idaho Benefit Programs -- Division of Welfare

4. Idaho’s Challenges (Pain Points) • High Error Rates • Untimely Case Work • High Workloads • Stagnant Productivity • Inconsistent Eligibility • Low Staff Morale • Difficulty implementing changes/mandates • Difficulty implementing automation Idaho Benefit Programs -- Division of Welfare

5. Performance Idaho Benefit Programs -- Division of Welfare

6. Historical Interventions • Measure errors…then train policy • Track timeliness…focus on oldest cases • Measure work…spread “pain” evenly • Encourage staff to work faster • Monitor compliance to policy…then train policy • Treat all staff the same • Choose strategies/options based on individual “wants” • Choose minimum automation/use manual workarounds Idaho Benefit Programs -- Division of Welfare

7. Historical Performance Management • Request additional FTE to offset workload increases or federal mandates (Making change = more positions) • Review completed work; use findings to ‘fix’ problems or conduct ‘awareness’ training to prevent reoccurrence (Case Reviews & Training will solve most problems) • Respond to federal mandates using compliance as a primary measure of success (Policy is King) • Invested in measurement and reporting strategies to solve a variety of problems (Resource Utilization Study, Case Reviews) Idaho Benefit Programs -- Division of Welfare

8. Guiding Principles • Create a Process-driven Business Design • Create Capacity (minimize steps and time to do a job) • Automate redundant tasks (but incrementally) • Improve the customer’s experience (not ours) • Describe/Share what’s changing; everyone participates • Everyone improves the process not just the ‘reviewer’ • Do what works: specialists and generalists • Make process and performance outcomes visible • Learn as we go; make mistakes and recover Idaho Benefit Programs -- Division of Welfare

9. Idaho’s Measured Outcomes Today • Accuracy and Timeliness are at all time highs • Productivity has improved by more than 3x since 2003 • Cost per case has decreased by ~48% since 2003 ( $20M in 2010 ) Idaho Benefit Programs -- Division of Welfare

10. Customer’s Process: Traditional • Multiple steps • Multiple visits • Delays • Confusion • Idaho: 21 days Idaho Benefit Programs -- Division of Welfare

11. Customer’s Process: Re-engineered • Get the customer to make immediate contact with Decision Maker • Take immediate action at first contact whenever possible • Create specific processes for Customer for Re-evals and Changes • Organize workforce as needed • Limited calendaring; link application & verification; help the customer when possible • Evaluate what is really needed to complete the action Idaho: 1 hour Idaho Benefit Programs -- Division of Welfare

12. Idaho’s Operational Designs One Number One Process Statewide Support Idaho Benefit Programs -- Division of Welfare

13. Statewide Design and Outcomes Business Design Prioritize Critical Work Standardization of Work Process Driven Design Flexible Workforce We Drive Customer Interaction Case Management Discipline Outcomes Greater Customer Satisfaction Improved Staff Morale Greater Productivity More accurate eligibility More adaptable to change Idaho Benefit Programs -- Division of Welfare

14. Local Offices Decision Makers Face to Face Applications “Walk-ins” Customer: Questions & Issues Business Design Same Day Service Decision Maker Upfront Focused Interviews Informed Choice Outcomes Eliminated backlogs 85% of customers have services in one day Improved eligibility accuracy Improved Customer Service Idaho Benefit Programs -- Division of Welfare

15. Virtual Decision Makers Phone Interactions Applications Web-initiated (click to talk) Phone-initiated Mail-initiated Targeted Partner support Customer: Questions & Issues Business Design Applications processing by phone Same Day Service Immediate contact to Decision Maker Focused Interviews Telephonic Signatures Outcomes Reduce paper-based applications Complete Informed Choice Greater Access (rural areas/office closures) Improved Customer Service Idaho Benefit Programs -- Division of Welfare

16. Specialized Maintenance Phone Interactions Re-evaluations Changes Business Design Streamlined re-evaluation process No required visits to office Decision Makers Up Front Touch Cases Once Outcomes Huge Productivity Gains Greater Accuracy All Re-evaluations completed Idaho Benefit Programs -- Division of Welfare

17. Customer Service Generalists Phone Interactions Mail Receipt and Scanning Customer: Questions & Issues Business Design Standardized Phone Scripts Specialized Training Integrated with 211 Services Referrals Outcomes Lower Abandonment Rate All Mailed Documents Scanned Consistent responses Idaho Benefit Programs -- Division of Welfare

18. Making the Change I’m going to fly away Idaho Benefit Programs -- Division of Welfare

19. Making the Change • Business champions implement change • Managers know the vision, the direction, & operation details • Invest in culture; say what you are doing and do it • Everyone serves the end user and the customer Idaho Benefit Programs -- Division of Welfare

20. Idaho Benefit Programs -- Division of Welfare

21. Larger Outcomes (less measurable) • Improved customer satisfaction • Improved access • Re-evaluations timely (no interruptions) • Greater flexibility (implement change quickly) • Greater capacity (productivity increased) • Greater consistency (easier to navigate) • Improved staff morale (not buying-in; participating in) • Organizational culture of change and improvement • Rapid delivery of services (timeliness improved) • Low QC error rates (accuracy improved) Idaho Benefit Programs -- Division of Welfare

22. Working Today: New Interventions • Focus on processes…processes drive improvements • Quick “decision making”…minimize number of actions required to complete work • Measure and respond to customer volume…flexible staffing models to address daily volume of customer traffic • Focus staff on priority work • Measure performance by actions and completion of work…shift priorities accordingly • Balance between specialization and generalization • Create culture of change and continuous improvement • Technology becomes a partner in change not an answer to a problem Idaho Benefit Programs -- Division of Welfare

23. New Performance Management • Ensure decision making occurs at the earliest point possible within the system • “Problems First”: Focus on problem solving, not placing blame • Ensure leadership is collectively focused on priorities – no more “pet projects” • Everyone owns performance collectively…Policy no longer drives priority setting and decision making • Initiatives and workload are not measured by the number of staff required but rather the number of actions required • Lean principles are used in the design and development of service delivery (operations) and automation Idaho Benefit Programs -- Division of Welfare

24. Questions and Discussion Contacts: Russ Barron – Administrator: (208) 332-7258 Greg Kunz – Deputy Administrator: (208) 334-5714 Lori Wolff – Deputy Administrator: (208) 334-6599 Rosie Andueza – Food Stamps Program Manager: (208) 334-5553