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

Idaho Benefit Programs -- Division of Welfare 2 July 8, 2010 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: Field Offices 3 Processing Centers Central Business Office (Boise) Benefit/Eligibility Workers: ~ 350 Statewide (all programs) X Idaho

Idaho Benefit Programs -- Division of Welfare 3 July 8, 2010 Want It See It Guiding Principles Measured Outcomes Operational Designs Pain Points Poor Performance Do It Making the Change The Road Map Other (Larger) Outcomes Managing Today Presentation Outline Customer Processes

Idaho Benefit Programs -- Division of Welfare 4 July 8, 2010 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 July 8, 2010 Performance

Idaho Benefit Programs -- Division of Welfare 6 July 8, 2010 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 July 8, 2010 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 July 8, 2010 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 July 8, 2010 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 July 8, 2010 Customer’s Process: Traditional Multiple steps Multiple visits Delays Confusion Idaho: 21 days

Idaho Benefit Programs -- Division of Welfare 11 July 8, 2010 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 July 8, 2010 Idaho’s Operational Designs One Number One Process Statewide Support

Idaho Benefit Programs -- Division of Welfare 13 July 8, 2010 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 July 8, 2010 Local Offices Decision Makers 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 Face to Face Applications “Walk-ins” Customer: Questions & Issues

Idaho Benefit Programs -- Division of Welfare 15 July 8, 2010 Virtual Decision Makers 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 Phone Interactions Applications Web-initiated (click to talk) Phone-initiated Mail-initiated Targeted Partner support Customer: Questions & Issues

Idaho Benefit Programs -- Division of Welfare 16 July 8, 2010 Specialized Maintenance 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 Phone Interactions Re-evaluations Changes

Idaho Benefit Programs -- Division of Welfare 17 July 8, 2010 Customer Service Generalists Business Design Standardized Phone Scripts Specialized Training Integrated with 211 Services Referrals Outcomes Lower Abandonment Rate All Mailed Documents Scanned Consistent responses Phone Interactions Mail Receipt and Scanning Customer: Questions & Issues

Idaho Benefit Programs -- Division of Welfare 18 July 8, 2010 I’m going to fly away Making the Change

Idaho Benefit Programs -- Division of Welfare 19 July 8, 2010 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 Making the Change

Idaho Benefit Programs -- Division of Welfare 20 July 8, 2010

Idaho Benefit Programs -- Division of Welfare 21 July 8, 2010 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 July 8, 2010 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 July 8, 2010 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

Questions and Discussion Contacts: Russ Barron – Administrator: (208) Greg Kunz – Deputy Administrator: (208) Lori Wolff – Deputy Administrator: (208) Rosie Andueza – Food Stamps Program Manager: (208)