Table of contents

1. Future DHS Business Processes Insight TeamOverview of current state (as-is) business processesOctober 26, 2010

2. Table of contents

3. Purpose • Introduce the FBP insight team to the as-is business process documentation project • Provide initial guidance on key considerations for the insight team to ponder as the team embarks on creating high level/conceptual renditions of future business processes

4. Background • Project timeframe: February 2010 – June 2010 • Scope: discover and document “Program Fulfillment” business processes • Approach: horizontal view of IMA and vertical view of FSA • Team: SoorajBalgobin, Alicia Porter (SSR), Trenita Savage (SSR) • Documentation: Business Processing Modeling Notation (BPMN) 1.2 • Deliverable: detailed process models created in Visio

5. Key observations • Highly manual and paper-based processes – lots of transmittal creation, ‘paper pushing’, spreadsheet based logs • DIMS I will convert paper-records to electronic files • DIMS II will implement automated workflows • IMA – some processes (e.g. eligibility determination) uniform across service centers; intake varies depending on service center lay out • FSA – program silos; duplication of many activities across programs (e.g. intake)

6. Key observations (cont.) • IMA Technology: • One core eligibility and benefits disbursement system – ACEDS • Outdated mainframe technology and not user-friendly, not intuitive … • …but it does eligibility well and all the data is in one place • FSA technology • Manual logs • Excel spreadsheets • Access database • Proliferation of Quickbase databases

7. Key observations (cont.) • IMA • All key processes and business functions are undertaken internally except for TANF Employment Program (TEP) which is outsourced to vendors • FSA • Some programs fully outsourced (e.g. Fatherhood Initiative, CSBG, Shelter) • Some core functions (e.g. case management, outreach services) for some programs are also outsourced

8. DHS process hierarchy/taxonomy

9. Level 1 decomposition Department of Human Services CORE PROCESSES 1. Program Development 2. Program Fulfillment 3. Program Compliance 4. Customer Service 5. Support processes

10. Program Development 1. Program Development 1.1 Design Program 1.2 Construct Program 1.3 Maintain Program

11. Program Fulfillment 2. Program Fulfillment 2.1. Acquire customers 2.7 Close cases 2.2 Capture Request for Assistance 2.3 Determine eligibility 2.4 Administer benefits 2.5 Deliver social services 2.8 Report program performance 2.6 Maintain cases 2.2.1 Record RFA 2.3.1 Conduct eligibility interview 2.4.1 Dispense benefits 2.5.1 Provide case management services 2.6.1 Record “case changes” 2.7.1 Close case and forward to archives 2.8.1 Capture performance data 2.2.2 Review RFA 2.3.2 Verify customer assertions 2.4.2 Claw back benefits 2.5.2 Coordinate cases across stakeholders 2.6.2 Process “case changes” 2.7.2 Register and archive closed cases 2.8.2 Analyze performance 2.2.3 Schedule processing of RFA 2.3.3 Certify customer for requested benefits 2.4.3 Issue notices to customer 2.7.3 Retrieve closed cases from archives 2.8.3 Disseminate performance analysis & data

12. Process fulfillment- FSA 2. Program Fulfillment Strong Families Adult Protective Services CSBG 100% - fully outsourced to UPO Fatherhood Initiative 100% - fully outsourced Homeless Services Refugee Resettlement Teen Parent Assessment HOMELESS PREVENTION SHELTER – N/A FULLY OUTSOURCED TO TCP HOMELESS RE-HOUSING HPRP – PREVENTION ERAP PSHP – INDIVIDUALS VASH HPRP – RAPID RE-HOUSING PSHP – FAMILIES

13. Program Compliance 3. Program Compliance 3.1 Ensure customer compliance 3.2 Mitigate benefit fraud 3.3 Ensure program integrity 3.1.1 Monitor compliance 3.2.1 Identify suspected fraudulent activity 3.3.1 Design targeted review criteria 3.1.2 Report compliance 3.2.2 Investigate suspected fraudulent activity 3.3.2 Conduct program reviews 3.1.3 Take action for non-compliance 3.2.3 Dispose of fraud investigation 3.3.3 Report results of program reviews 3.3.4 Act on review results

14. Customer Service 4. Customer Service 4.1 Manage customer interaction 4.2 Manage customer complaints 4.1.1 Respond to customer inquiries 4.2.1 Record customer complaints 4.1.2 Respond to customer requests 4.2.2 Investigate complaints 4.2.3 Dispose of complaint investigation

15. Support processes 5. Support processes 5.1 Program budgeting 5.2 Personnel 5.3 Contracting & procurement 5.5 Facilities management 5.7 Systems development & support 5.8 Training 5.4 Vendor performance monitoring 5.6 DHS performance monitoring

16. Close cases

17. Close cases 2. Program Fulfillment 2.7 Close cases 2.7.1 Close case and forward to archives 2.7.2 Register and archive closed cases 2.7.3 Retrieve closed cases from archives

18. Overview • IMA • One common process across all service centers and across programs except for Medicaid only cases • Process formalized • Walk through IMA close case process • FSA • Close case process less formalized • Process decentralized to individual programs and varies by program • Walk through the TPAP close case process

19. Things to ponder • What does “closing a case” mean in a world where the case records are electronic files? • How can we engineer a common close case process that accounts for variation in documentation requirements across programs? • How do we appropriate and incorporate customer data at third party service provider prior to closing case? • Is it feasible to have one master case file for every customer regardless of program? Any confidentiality implications?

20. Assessment

21. Overview • IMA • Today, an assessment is not a pre-requisite to receiving benefits. • Today, TANF recipients who are referred to employment services vendors undergo a vendor administered assessment • An assessment will become a pre-requisite to receiving TANF when the redesigned TANF Employment Program (TEP) is implemented (target: July 1, 2011) • The assessment will focus on assessing the customer’s barriers to self-sufficiency with increased emphasis on education and skills barriers

22. DHS TANF Universal Service Delivery Model LOW PERSONAL, HEALTH, AND OTHER BARRIERS MODERATE/HIGH LOW MODERATE/HIGH EDUCATION, EXPERIENCE, AND SKILLS

23. Overview • FSA - Assessments are heavily used across various programs • PSHP – Vulnerability surveys • APS – Initial Risk Assessment • Strong Families – Comprehensive assessment

24. Things to ponder • Clearly, most programs only require an application and not an assessment. How do we convince customers that a holistic assessment is worth their time? Policy implications? • Every program will dive deep in specific aspects of the customer’s circumstances. How do we create an assessment or a suite of assessments that provides a generalist view of the customers and only dive in specific areas when needed. • Who will administer the assessment and when is it done?

25. Case management

26. Case management vs. wraparound case management With an emphasis on coordination of services to address the complex needs of customers, wraparound case management is a set of activities that aim to deliver a more comprehensive set of services to achieve positive outcomes for the customer. Key wraparound case management activities include an in-depth assessment of a customer's situation, defining the customer's long-term and short-term goals, developing a detailed and individualized service plan to achieve the customer's goals, and coordinating applicable services to ensure that the customer is making progress according to the service plan. The wraparound case manager functions as the lead in assuring care and service coordination.

27. Overview • IMA • Given the nature of the nature of the benefits provided by IMA, there is little case management done • TEP vendors provide case management services to TANF recipients that have been referred to the vendors • Case management services focused primarily on helping customer secure education/training programs and gaining employment

28. Overview • FSA • Given the social service nature of FSA’s services, case management is a core function in FSA • PSHP – case management is outsourced and focused on accessing and maintaining housing • VASH, TPAP, SF, APS – case management is undertaken in-house • HPRP and ERAP – case management is outsourced

29. Case management is fundamentally a semi structured process… • … meaning that there is no set sequence in which the activities must be performed • However, core activities are: • Needs assessment • Goal definition • Development and amendment of plan to achieve goals • Linking customer to other service providers • Monitoring of customer progress against plan • Coordination of services to remove barriers • Coordination of services to ensure customer is deriving benefit from services provided by third parties

30. Things to ponder • Can we define a case management process that will work well across all programs or are we better off defining an overarching case management framework for DHS and let each program implement its process that complies with the principles of the framework? • Lately, case management has been getting a lot of attention from standards bodies (e.g. OMG) and software vendors seeking to come up with case management solutions. So, it is probably worth investigating what the hype is about.

31. Family Plan

32. Case management and family plan go hand-in-hand • A family plan is developed whenever case management service is provided • While the plans target different goals, may look different and are called different names (IRP, SSP, service plan), they share many common elements: • Goals • Synthesized information from assessment • Steps that the customer will take to achieve goals • Activities customer will participate in • Timeframe • Contingency plan • Responsibilities of case manager and customer

33. Things to ponder • Like case management, it will be valuable to define a framework for a family plan along with guidance on the what, when, who, how.