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Eligibility Business Process Re-engineering & Conversion to a Task-Based Model

Eligibility Business Process Re-engineering & Conversion to a Task-Based Model. (Lessons Learned - Successes Achieved) Presented by: Kim Forrester Health & Human Services Agency County of San Diego. Background.

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Eligibility Business Process Re-engineering & Conversion to a Task-Based Model

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  1. Eligibility Business Process Re-engineering & Conversion to a Task-Based Model (Lessons Learned - Successes Achieved) Presented by: Kim Forrester Health & Human Services Agency County of San Diego

  2. Background • The County’s eligibility determination performance and productivity trends indicated: • Areas of excellence: Food Stamp Accuracy • Areas for system-wide improvement: • Timely processing of applications within State mandated timeframes - inconsistent • Low Medi-Cal productivity ratio • Low Food Stamps participation • Public assistance eligibility determination processes and operations needed to be refreshed and aligned with CalWIN system

  3. Vision for the Future • A regionalized eligibility determination system that: • Delivers benefits efficiently and accurately to eligible clients • Strengthens the region’s healthcare safety net • Promotes good nutrition and self-sufficiency among low-income San Diego County residents

  4. BPR Project Goals • Establish joint governance • Document and implement consistent core processes • Improve eligibility and clerical training • Improve performance, productivity, and flexibility

  5. BPR Participation and Partners • More than 200 staff • Front-line eligibility & clerical staff and supervisors • Managers • Union representatives participated • UCSD Center for Management Science and Health evaluated progress and measure the impact of changes brought about by the BPR • Community partners and advocates were engaged and regularly updated during the BPR process

  6. How the new task based process works…

  7. Implement a task based eligibility determination process… • In a task based FRC, all HSS: • Work in Task Groups • Perform specific tasks • No assigned caseloads • Emphasize team approach • Process same-day applications

  8. Task Groups Organizational Model Same Day Applications Status Reports Renewals General Tasks Changes Pending

  9. Prior to transitioning to task based and same day intakes… • Family Resource Centers (FRC) must: • Complete case imaging • Train 100% of their eligibility staff in multi-program • Establish a Call Center to support operations

  10. Implementation • Phased-in implementation of task based to all FRCs to evaluate Best Practices and Lessons Learned • April 2009: Pilot office • July 2009: 5 FRCs • Oct 2009: 3 largest offices • Supported by ACCESS Customer Service Center

  11. What is ACCESS • Centralized contact center • Extension of HHSA’s Family Resource Centers • Serves customers and providers (CW, MC, FS, GR, CAPI) • ACCESS staff have same qualifications as FRC staff and take case actions

  12. ACCESS Calls by Program

  13. Implementation • Implementation of Same Day in all FRCs – completed in Nov 2009 • Self-Service functionality in April 2010 for ACCESS • “No Wrong Door” policy

  14. Key Accomplishments

  15. Key Accomplishments • Met increasing demand for public assistance without increasing staff • Reduced wait times for an intake interview • Reduced variation in service • Increased productivity and efficiency • Improved customer service training for eligibility staff

  16. Meeting Increasing Demand

  17. Improving Timely Application Processing

  18. Outcomes: Productivity & Satisfaction • According to UCSD’s Final Evaluation Report, the BPR project: • Improved productivity by 39% (original goal was 20-25%) • Improved client satisfaction by 22%

  19. Outcomes: Partnerships • Full implementation of the Face to Face Waiver allowed working with partners in new ways: • Open pathways to apply • By Phone through San Diego 2-1-1 • Community Partners • Benefits CalWIN

  20. Lessons Learned The BPR development/implementation process included plans for frequent communication, balancing staffing, and technology enhancements as well as avenues to engage community partners. Looking back additional suggestions: • Communication • Additional Community Involvement • Technology and Staffing

  21. Next Steps: Questions?

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