1. Chattanooga, TN March 30, 2004 Covering Kids & Families: Process Improvement Collaborative Minnesota Covering Kids & Families Project Improving Renewal Rates

2. Problem: Too many closures for failure to complete renewal process. On average, 25% of cases due for renewal in Minnesota close. Of those, 20% close for failure to return paperwork. Historically, Olmsted County has been close to the state average for MA closures due to failure to return information

3. Goal Statement Conduct small scale testing in Olmsted County to see what strategies improve renewal return rates Conduct telephone renewals, including languages other than English Provide phone reminders that renewals are due Change renewal notices so are more easily identifiable Enable health plans to assist with renewals Provide renewal notices in different languages Send more than one renewal notice

4. Small Scale Testing Done to Date Calling clients who had not yet returned renewals to remind them Sending Spanish-speaking clients their renewal notices and forms in Spanish

5. Phone Call Reminders What we did: Developed/tested script for calls Developed protocol for message leaving Selected 14 clients (from two workers) who had not returned renewals by mid month Called 7 in evening/7 during day Offered to assist with renewals Left messages for those not home

6. Phone Reminders (cont.) What happened: 5 families reached at night/2 families reached during the day 12 families eventually reached Only 2 families returned renewals on time 2 closed for correct reasons 5 families eventually reinstated;1 family pending

7. Phone Reminders (cont.) What we learned: Evening hours better time to call Learned more accurate reasons for case closures Did not get good response from those who we left messages with Calls did not significantly improve on-time returns but did achieve 67% response rate from one group/43% from other

8. Spanish Notices/Forms What we did: Translated renewal notice into Spanish Selected Spanish speaking clients due to renew in February Sent them Spanish notice and Spanish renewal form (also received English versions)

9. Spanish Notices (cont.) What happened: Sent Spanish renewals to 8 families 1 family was auto-newborn, so eliminated 2 families confused by two sets of renewals All 7 families returned renewal forms on time

10. Spanish Notices (cont.) What we learned: Achieved a 100% response rate Workers report Spanish population traditionally late in sending in renewals May need to test on larger population of clients and in other language populations

11. Small Scale Testing In Progress Post Card Reminders/Phone Renewals Post card reminders Two cards -one alerting them to renewal/one offering them option to renew over the phone Phone renewals Send postcard telling them someone will call to help with renewal over phone Health Plan Reminders Talking with health plan in Olmsted County Phone reminder, postcard or some other mechanism for notifying clients of renewal