COUNTY DSS WORKLOAD ANALYSIS Name Title County Name

Caseload Trends – Active Cases List considerations here – specific to the county List baseline staffing numbers

Key Business Drivers Much has changed since 2007 Caseloads have grown XX% since 2007 NC FAST – A new integrated case management system Introduction of new customer service channels: ePASS Portal Federal Facilitated Marketplace (FFM) / healthcare.gov Affordable Care Act (ACA) – Entirely new eligibility rules for most Family and Children’s Medicaid programs Work Support Strategy (WSS) state and county organizational changes to supports new service delivery models

NC FAST Impacts A New Way of Serving Clients A case management system supporting multiple benefit programs; replaces multiple legacy systems that have been in place for a long time and are familiar to county workers Captures considerably more data than legacy systems Information not in legacy systems must be keyed as part of case conversion process (e.g., data only in paper case files prior to NC FAST) System makes eligibility determinations based on rules built into the system and data entered by the case worker, so there is little subjectivity on those decisions with NC FAST Automation provides more consistent and accurate benefit determination; however there is a significant learning curve to overcome for county workers

New Application Channels Applications Coming from Multiple Sources ePASS is a web-based application portal introduced with NC FAST that allows clients to submit applications for FNS or Medicaid through the Internet With the introduction of the FFM / healthcare.gov in October 2013, new Medicaid applications are generated and sent to NC for NC-based applicants who are pre- screened as potentially eligible for Medicaid All of the traditional ways of applying for benefits (county DSS offices, mail in applications) remain in place Many of the applications received through ePASS or healthcare.gov are missing information and require additional follow-up with the clients before the applications can be processed

Affordable Care Act (ACA) Impacts Changes to Most Eligibility Rules Affects approximately 60% of Medicaid cases effective January 1, 2014 Intended to ultimately simplify eligibility determination Utilizes a new eligibility rule set based on income tax modified adjusted gross income (MAGI); a significant change from prior Medicaid rule set County workers have to collect new/different data from clients Medicaid clients (both existing and new) have to provide different information to become/remain on Medicaid that they have not had to provide before

Timeline Considerations Assimilating ACA and NC FAST Q New FFM process implemented; recertification of MAGI-based Family and Children Medicaid and Work First programs Q2 / Q – Continuing to come up the ACA learning curve; processing Family and Children Medicaid and Work First programs Q – Conversion of Medicaid and any remaining Work First programs to NC FAST 2015 – Processing of converted Medicaid, Work First, and FNS cases Q – New Child Care process implementation in NC FAST

Work Support Strategies Formalize and strengthen county and state partnerships Develop organizational culture that supports new service delivery models Build infrastructure to support new service delivery models Communicate the vision for a new service delivery models Increase capacity for data collection and analysis Reduce burdensome policies and procedures Perform staff development and readiness activities

Staffing Impacts Projected Staffing Requirements for 2014/2015 Based on an analysis of case processing times, caseload trends, and staff productivity projections we need xx - yy more resources in order to process our county’s workload in a timely manner