MMISR impacted

1. The journey redesign workshop generated solution ideas that could be implemented to improve the client experience during escalation and inquiry management • Assignment Letters Client Escalations MMISR impacted • Standardize Process • Simplify Triage • Promote Resources 1 • Tailor Unified Portal member landing page to individual's specific eligibility, enrollment, benefits, budget balances, and open action tracking 8 • Develop single decision tree to triage customer concerns at all points of contact (i.e. CSC, online bot, OOS/golden rods, etc.) 12 • Capture member’s care team (e.g., those involved in managing the member’s care such as care coordinator, providers, case mangers, etc.) on member profile in Unified Portal 9 • Create Escalation Unit to address all customer concerns regardless of where the concern is received (e.g., OOS, mail boxes etc.) 2 • Automatically alert member of action items with appropriate point of contact for questions 13 • Notification of concern and resolution to involved care team members (e.g., those involved in managing the member’s care such as care coordinator, providers, case mangers, etc.) 3 • Develop a consolidated resource section/FAQ that can be accessed via any HSD website or portal 10 • Consolidate complaint mailboxes across all divisions 4 • Develop online chat feature using a bot to collect general information about inquiry and connect user with the correct resource or SME 11 Generate reports to track and trend customer complaints/escalations for program improvement 14 • Internal group chat capability for involved care team members through Unified Portal 5 • Translate all HSD materials, online resources and communication into user's native language 15 • Real-time sync of changes to member information across all systems and departments 6 • Track all customer concerns, questions, and escalations to identify systemic problems, proactively solve issues, develop internal/external training, and update resources 16 • Reevaluate member notification preference options and ensure all communication follows member preference (including escalation/inquiry resolution) 7 • Provide and promote electronic/video trainings for members and providers to help them understand resources, processes, and program benefits 17 • Expand ASPEN access to all MAD staff for case comment input SOURCE: Redesign workshop

2. The solution ideas were then synthesized and prioritized to identify a set of immediate actions and strategic investments to consider • Assignment Letters Client Escalations • Immediate actions • Strategic investments to consider • Process Changes1 i • Develop a tracking mechanism for customer escalations to identify systemic problems, proactively solve issues, develop internal/external trainings, and update resources • Unified Portal landing page tailored to individual's specific eligibility, enrollment, benefits, budget balances, and open action tracking (e.g., status of assignment letters/golden rods, fair hearings, etc.) ii • Develop single decision tree to triage customer concerns at all points of contact (e.g., electronic form with question prompts) • Automatically alert members of actions required (e.g., recertification, program changes, etc.) with appropriate point of contact for questions to simplify the member’s experience iii • Generate reports to track and trend customer complaints/escalations for program improvement • Develop online chat feature using a bot to collect general information about inquiry and connect user with the correct resource or Subject Matter Expert (SME) iv • Notification of concern and resolutionto involved care team members 3 • Organizational Changes2 v • Consolidate mailboxes across all divisions creating one mailbox to address all customer inquiries • Language translation feature that automatically translates all HSD materials, online resources, and communication into user's native language by detection of client’s computer and phone settings vi • Provide and promote electronic/video trainings for members and providers to help them understand resources, processes, and program benefits • Real-time sync of changes to member information across all systems and departments • System changes vii • Expand ASPEN access to all MAD staff for case comment input • Customer’s care team is captured in the Unified Portal for the management of the customer’s care to include notification of any escalations and resolutions as well as group chat capability 3 viii • Reevaluate member notification preference options and ensure all communication follows member preference (including escalation/inquiry resolution) • Create Escalation Unit with subject matter experts for all program areas to address all customer concerns/questions ix • Develop consolidated resource section/FAQ that can be accessed through any HSD website or portal x • Implement caller ID system that pulls up client information/profile upon calling • Internal group chat capability for involved care team members via Unified Portal 3 1 Process changes are improvements that can be implemented within MAD 2 Organizational changes require collaboration across divisions and/or agencies (e.g. DOH, Long-term Aging Services, etc.) 3 Care team refers to all parties involved in managing the member’s care such as care coordinator, providers, case managers, etc.

3. Ten actions have been identified to enable the near-term changes to measurably improve the Client experience • Assignment Letters Client Escalations • MMISR SOLUTIONS MODULES IMPACTED • IMMEDIATE ACTIONS • OUTCOMES ENABLED i • Develop a tracking mechanism for customer escalations to identify systemic problems, proactively solve issues, develop internal/external trainings, and update resources • Report that proactively identifies systemic problems to drive program improvements • Data Services • Benefit Management Services • Quality Assurance ii • Develop single decision tree to triage customer concerns at all points of contact (e.g., electronic form with question prompts) • Simplify customer’s experience through question prompts for capturing and resolving customer concerns • Unified Portal • Benefit Management Services • Quality Assurance iii • Generate reports to track and trend customer complaints/escalations for program improvement • Trend customer complaints/escalations to improve programs and proactively address concerns • Quality Assurance iv • Notification of concern and resolution to involved care team members • Closed feedback loops and decreased number of concerns that go unresolved • Unified Portal v • Consolidate mailboxes across all divisions creating one mailbox to address all customer inquiries • Simplify customer’s experience and creating one point of entry for inquiries received by email • Unified Portal • Benefit Management Services • Quality Assurance vi • Provide and promote electronic/video trainings for members and providers to help them understand resources, processes, and program benefits • Increased knowledge of resources provided by MAD Improved member control due to increased education and knowledge about their specific programs and processes • Unified Portal vii • Expand ASPEN access to all MAD staff for case comment input • Systematic tracking of individual customer concerns Fuller view of member case history viii • Reevaluate member notification preference options and ensure all communication follows member preference (including escalation/inquiry resolution) • Quicker access to members to relay notification, updates, etc. Improved client experience • Unified Portal • Benefit Management Services ix • Develop consolidated resource section/FAQ that can be accessed through any HSD website or portal • Simplify customer’s experience • Unified Portal x • Implement caller ID system that pulls up client information/profile upon calling • Quicker assessment of client inquiry or concern • Data Services SOURCE: Team Analysis

4. Client Escalations and Inquiry Management Future State Deep Dive • R= Responsible, A= Accountable, C= Consulted, I=Informed Process Phases Client Inquiry 1 Client Inquiry 1 Client Inquiry Escalation and Assignment 3 Research and Resolution 3 Research and Resolution 3 Research and Resolution 3 Research and Resolution Research and Resolution 3 Research and Resolution • 1 • 2 • 3 Process Steps & Description Process Steps & Description Customer accesses the resource page on the Unified Web Portal for contact information to escalate their concern Member accesses their tailored Unified Web Portal landing page to utilize the chat feature to address their questions and/or concerns Chat feature addresses member's questions and/or concerns or transfers the concern to the Escalation Unit. Escalation unit receives customer concern in real time Customer concern is tracked, researched, and resolved by Escalation Unit in real time - if possible, resolved at initial contact. Through the internal portal, Escalation Unit resolves concern. Customer and Care Team is automatically notified. If Escalation Unit cannot resolve concern, Subject Matter Experts (SME) may be engaged through an alert in real time via the internal portal. SME has 24 hours to research and resolve. If Escalation Unit cannot resolve concern, Subject Matter Experts (SME) may be engaged through an alert in real time via the internal portal. SME has 24 hours to research and resolve. Subject Matter Expert researches concern and if applicable, engages other resources. Through the internal portal, Subject Matter Expert resolves the concern. Care Team is automatically notified. Through the internal portal, Subject Matter Expert resolves the concern. Care Team is automatically notified. Tailor Unified Portal member landing page to individual's specific eligibility, enrollment, benefits, budget balances, and open action tracking that will inform the client of any issues that need to be resolved. In addition, provide direct inks to program specific contacts. Tailor Unified Portal member landing page to individual's specific eligibility, enrollment, benefits, budget balances, and open action tracking that will inform the client of any issues that need to be resolved. In addition, provide direct inks to program specific contacts. Tailor Unified Portal member landing page to individual's specific eligibility, enrollment, benefits, budget balances, and open action tracking that will inform the client of any issues that need to be resolved. In addition, provide direct inks to program specific contacts. Escalation Unit will address all customer concerns received via chat feature through the unified portal or by direct customer contact. Escalation Unit will address all customer concerns received via chat feature through the unified portal or by direct customer contact. Escalation unit will directly communicate with customers and address any concerns in real time. If Subject Matter Experts need to be engaged, the Escalation Unit will use a decision tree to triage the customer's concern. Escalation unit will directly communicate with customers and address any concerns in real time. If Subject Matter Experts need to be engaged, the Escalation Unit will use a decision tree to triage the customer's concern. MAD SME reviews and researches the issue and may contact ISD via chat feature (specific ISD Office) for demographic/eligibility issue to be resolved in real time. ISD receives issue via chat feature alert and resolves case and updates ASPEN with information; ISD informs MAD of the update in real time. MAD SME notifies the client and notifies other concerned parties of the resolution real time MMISR Interface MMISR interface through Unified Portal MMISR interface through Unified Portal MMISR interface through Unified Portal MMISR Interface through Unified Portal MMISR Interface through Unified Portal MMISR Interface through Unified Portal MMISR Interface through Unified Portal MMISR interface Unified Portal MMISR interface Unified Portal MMISR interface Unified Portal Bureaus/Agencies Escalation Unit AChat Bot RCare Team I Escalation Unit AChat Bot RCare Team I Escalation Unit AChat Bot RCare Team I Escalation Unit A and RSubject Matter Expert RCare Team I Escalation Unit A and RSubject Matter Expert RCare Team I Escalation Unit A and RSubject Matter Expert RCare Team I Escalation Unit A and RSubject Matter Expert RCare Team I Escalation Unit ISubject Matter Expert A and RCare Team I Escalation Unit ISubject Matter Expert A and RCare Team I Escalation Unit ISubject Matter Expert A and RCare Team I Touch-points with Client 1 1 1 1 1 1 Handoffs 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors 2-5 Handoffs between departments, divisions and contractors Systems Involved Consolidate all the phone numbers to one location on HSD website Consolidate all the phone numbers to one location on HSD website Consolidate all the phone numbers to one location on HSD website Unified Portal Unified Portal Unified Portal Unified Portal OmniCaid, ASPEN Unified Portal Unified Portal Facts + Figures The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process The number of Golden rods that MAD receives yearly could be significantly reduced , and they could be resolved more efficiently by implementing the new escalation process Staff time 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) 40-50% reduction in staff time ( timely completion ,and all concerned parties informed at the same time) Pain Points This will create one stop shop for the customers. In addition this will reduce number of hand-offs This will create one stop shop for the customers. In addition this will reduce number of hand-offs This will create one stop shop for the customers. In addition this will reduce number of hand-offs Escalation unit will resolve client's concerns real-time. If needed, will use a decision tree to triage customer concerns to appropriate SMEs within the Division directly to communicate and address any concerns in real time through the chat feature on Unified Portal. Escalation unit will resolve client's concerns real-time. If needed, will use a decision tree to triage customer concerns to appropriate SMEs within the Division directly to communicate and address any concerns in real time through the chat feature on Unified Portal. Escalation unit will resolve client's concerns real-time. If needed, will use a decision tree to triage customer concerns to appropriate SMEs within the Division directly to communicate and address any concerns in real time through the chat feature on Unified Portal. Escalation unit will resolve client's concerns real-time. If needed, will use a decision tree to triage customer concerns to appropriate SMEs within the Division directly to communicate and address any concerns in real time through the chat feature on Unified Portal. MAD SME will work with other stakeholders and notifies the client and other concerned parties of the resolution real time through Unified Portal MAD SME will work with other stakeholders and notifies the client and other concerned parties of the resolution real time through Unified Portal MAD SME will work with other stakeholders and notifies the client and other concerned parties of the resolution real time through Unified Portal