kaizen, lean and six sigma in ohio state government - six sigma … · 2014-10-08 · snap...

SNAP APPLICATION PROCESS IMPROVEMENT

Six Sigma Project Report Out Scott Anderson, Zach Kromer, Amy Doup Auditor of State March 11, 2013

1

SNAP BACKGROUND

SNAP Mission: To disburse food benefits to qualifying Ohioans.1

SNAP Structure: SNAP Process: SNAP Performance:

2

1 AOS Definition

SNAP BACKGROUND

SNAP Mission: To disburse food benefits to qualifying Ohioans.

SNAP Structure: State Supervised, County Administered.

SNAP Process: SNAP Performance:

3

SNAP BACKGROUND - STRUCTURE

4

State Supervision

County Administration







SNAP BACKGROUND



SNAP Process: Application Intake, Verify Eligibility, Disburse Food Benefits.

SNAP Performance:

5

SNAP BACKGROUND - PROCESS

6

Verify Eligibility

Application Intake

Disburse Food

Benefits

Ongoing Client Notifications via Mail

1 2 3

SNAP BACKGROUND



SNAP Process: Process Applications, Verify Eligibility, Disburse Food Benefits.

Performance: ????

7

PROBLEM STATEMENT

SNAP Process has room for efficiencies. <LEAN Solution>

SNAP Program performance is not being systematically measured in Ohio. <Six Sigma Solution>

8

Team conducted process mapping in 4 counties across the State.

9

LEAN ANALYSIS – PROCESS MAPPING

10

Application Submitted

(Food Stamps/ Medicaid/Cash)

75%Mail/Hardcopy

Drop box/Fax-Print

25%Online via E-

Gateway

Date Stamp Applications

Send Applications to Screening Unit

Separate Application

- voting page- application

Signature?

Send Form Letter Back to Client to

Sign

AYES

Screening- Auto Open

- Auto Date Stamp

Enough on App to Clear?

Call Client to Gather More Info

B

NO

YES

NO

2%Benefit Bank and Social Security

Mail/Drop box:- 1 day to receive

Fax:- 2 days to receive

Sent to e-gateway

- Non-Expedited- No Recertification

Prepared By: Ross Klosterman

Hamilton County

A Enough on App to Clear?

Put Through Clearing Process

Sort by Application Type:

- Cash/Medical/Food Stamps

Clear each SS #(IQIG)

Is SS# Already in the System?

Check Each Case # for Being Open

(IGCP)

Open Case?

Check for Medical Coverage

(IQEL)

Medical Coverage?

C

B

YES

NOYES

YES

Call Client- will put local

address if address issue 120/250/day

election

NO

Time to Arrive:Online/Mail/Drop box: 1 day

Fax: 2 days YES

NO

Create and Register Each

Child and Mother with a Case #

NO

PAIN POINTROMPIR Driver- Individual ss #

Case Worker Classification(Delay)

Day 2-3C Open Case?

Register in CRIS-E (to clear in e-

gateway)

Create New Case Number

Application # Created(ARAD)

- Name of Client- Address

- Date Stamp

List All Household Members

(ARIR)

Statewide Check for Clearance ID Match?

Option of New Individual to CRIS-E

Registration Ends in CRIS-E(ARCR)

Add Notes to (ARRC) Case #

Open Case Notes (CLRL)

Schedule Client Appointments

(AMS)- We Call

- they can’t call in

Client Comes in or Calls (20 min/case)

All Documents Received?

List Sent to Client

Docs put in system (on-base)

13 Days to Escalate if not Touched

Case Worker will Review Pending Status Everyday

Application Approved or

Denied

Notices of Approval/Denial

from State

NO YES

Day 9

Day 19

NO

NO

YES

65% Show Rate When Come In

Phone – 20% Approved

Walk-In – 75% Approved

YES

Have 10 Days to get back Docs (1 week normally)

Will shorten to hit 30 day cycle if needed

5 Business days for Appointment

55 to 60 per day that is scheduled out of 250

CRIS-E Cycletime

6 min – 15 min2.3 people per app

2 people staff

County Mail City Mail

Day 4

Slowness of system for processing

- Matching characters is pain point

Scioto County <Process Name>

File

Zilla

(FTP

)E

-Gat

eway

Fax

Mai

lD

ropo

ff

Front desk Ticket Wait in lobbyMeet with

customer service representative

Reroute ticket

Wait or sent appointment letter

Sent appointment letter

Create record in JFS Solution

Open mail

IntakePut into document imaging

Pulled by central processing Screen/register

Documents pushed to

document imaging

Worked by dedicated staff Notifies Screener

E-Gateway ScreenedClick on info sheet

Application generated in

CRIS-E

A

Review open case Print applicationDeny application in CRIS-ENew or Open?

Open

Sent to intake for screening

Pull out of system queue

Interviewer walks to lobby

No Wait

Wait

BNew

D

C

A

Answer phone?

Appointment letter 10 days

out

Appointment set

Phone interview?

Pull from system queue

Pull from system queue

Show up?

Notice of missed interview

Complete interview

Call clientSeparate scheduled Client Answer?

Notice of missed interview (NOMI)

letter

No

Yes

Yes

Technical assistant calls

clients for appointment

New or Open?

Register individuals

Review open case

New

Open

B

No

Yes No

Yes

DC

No

E

E

All documents?

Case Determination

Checklist given or sent to client

Returned all documents?

Scan documents at central location Scans to E-Copy Add SS # and

Index documentsDictate interview in

CRIS-E

Send email to unemployment to

verify

10 Days for client to return documetns

Yes

No

Wait 11-12 days to check for

documents

Approved

Check on day 30 before approve/

deny

Partial/No documents received

All documents received

All documents received?Yes

No

Run driver with reason code to

deny

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Franklin County Process Map

E-G

atew

ayM

ail

Fax

Dro

poff

Client signs log

Front desk worker screens

log (in order received)

App reviewed by screener

(expedited/FS/Medicaid?)

Scan documents in

Phone call is made

Register client based on what info

is available

Fax arrives in e-mail box (worked

by designated person)

Appt letter sent

Documents pushed to

document imaging

Dedicated worker for E-Gateway

pulls applications off

Group receives mail and splits

based on program/purpose

Wait?

NOMailed

appointment letter (10 days out)

Option to walk in again

Register Client

Application routed to proper unit (dependant

upon minor childnren)

Assigned to case

manager

Worker goes to

lobby to get client

Client completes initial interview

with case workerClient in lobby?

Case worker calls client for initial interview

Complete phone

interview and run SVRQ (24-

72 hrs)

Client available?

No Answer

Send notice of appt (10 days) through mail

Checklist pulled off of NW forms-completed

electronically and mailed-added workers email address to send docs

Phone # available? Answer?

Appt letter sent



Assigned to case

manager



Screen documents in

Scan/transfer verification docs

and apps into imaging system



Register Client



Assigned to case

manager

Automatic ARAD created

Notify E Gateway case worked on and manually deny

take off list

If duplicate case, manually deny

with special coding in CRIS-E and

update info

<Process Name>

Em

ail

Dro

poff Scan/transfer

docs into imaging system

Receive verification docs via email/drop

off/fax/mail

Utilize NW search tools to route to case

Eligibility determined off

of required documents in file by day 30

Documents put in electronic workflow for eligibility worker-worker

responsible for ver docs in NW off of their email

account

Goal: 5 days to process all documents as they are receivedWorkers have 1 processing day a week for documentation

? Placed in CRIS-E screens with

missing verifications

All required docs in?

No@ 20 days CRIS-E send a

notice of missing documentation with all

required areas marked with a ?

Worker monitors center email

account

Correct center?

Forward to correct center

Route to registration See Blue Box in Mail for next

steps

Franklin County

Cuyahoga County

Dro

p-O

ffE

-Gat

eway

Mai

l

Applications divided out

Appt letter mailed with checklist & return envelope

Schedule intake slot

Application pulled from system by

dedicated worker

Sent to be cleared and registered in

CRIS-E

CSA-Call Applicant (if no

phone # but, email address-can email

client)


Client answers?

Assign to worker next in rotation

Schedule regular intake slot


CSA scans application into

NW systemNotify registration

Notify registration client is not waiting

CSA clears for current/recent

activityApplicant waiting?Application

received in lobby

Assigned to worker for initial verification call

Client is registered in CRIS-E

Screen for expedited

Client is handed appt letter with

checklist


CSA scans application into

NW w/ sticky note client not waiting

Client answers?


Conduct client verification and

expedited screening


expedited screening


expedited screening



Notes:Cuyahoga operates neighborhood centers, if an application comes into the wrong center (via zip code) it is scanned into the shared NW system and put into the correct center’s workflowIf an applicant has listed an email address only, the appointment letter will be emailed to the client.

Mail received at central mail center


Client answers?

Assign to worker next in rotation

Application pulled to be cleared and

registered in CRIS-E




expedited screening

CSA-Call Applicant (if no

phone # but, email address-can email

client)

Applications scanned into NW system workflow

Cuyahoga County

Team conducted process mapping in counties across the State.

Process mapping revealed 2 areas of opportunity: 1) Mailing of client notifications. 2) Verification (proof) of client eligibility.

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MAILING OF CLIENT NOTIFICATIONS

WASTE (MUDA) Ohio’s SNAP program

spends millions in postage costs from client mailings.

PROBLEM Ohio’s SNAP program

does not currently have the IT infrastructure in place for mass email notification.

SOLUTION Send Notifications to clients

electronically via email.

SOLUTION The Office of Health

Transformation can incorporate this capability into the new benefits eligibility system.

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MAILING OF CLIENT NOTIFICATIONS

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Estimated Annual SNAP Notices 1 2,312,690

Estimated Annual Paper Cost 2 $1,103,384.36

Adoption Rate Paper Notices Avoided Estimated E-Notice Cost Net Savings

10 Percent 3 231,269 $2,771.40 $107,567.04

40 Percent 3 925,076 $4,560.00 $436,793.74

55 Percent 4 1,271,979 $3,539.40 $603,322.00

Annual Savings Estimation

Team conducted process mapping in counties across the State.

Process mapping revealed 2 areas of opportunity: 1) Mailing of client notifications. 2) Verification (proof) of client eligibility.

15


County Eligibility Workers spend the bulk of their time verifying proof-of-eligibility along several dimensions, including:

Identification Earned Income Unearned Income Shelter Expense Utility Expense Child Care Expense

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ELIGIBILITY VERIFICATION

ELIGIBILITY VERIFICATION – CURRENT STATE

17

18

What if this process could be reduced to a single step?

ELIGIBILITY VERIFICATION

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1. DATA BROKERING 2. WORKFLOW

Crawls 30+ available electronic databases containing eligibility information.

Consolidates electronic data into a single screen for caseworker use.

e-Find [Electronic Data Brokering Portal] Functionality

EFFI

CIEN

CIES

GAI

NED

• Eliminates mailing. • Eliminates scanning. • Reduces burden on the

SNAP beneficiary who now does not have to provide paper documents.

• Eliminates separate document lookups.

• Reduces caseworker data entry error.

• Eliminates need for follow-up with client due to missing paper documentation.

ELIGIBILITY VERIFICATION - SAVINGS

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General Assumptions

SNAP New Applications 669,646

eFind Development Costs $2,200,000

Case Worker Annual Compensation 45,000

Hours per FTE 2,080

Pay Rate Inflation 3%

Scenario Minutes SNAP

Baseline - Extrapolating Utah's Results to Ohio Annual Savings 3,621,883

Reduction in Minutes per New Application 15 Payback Period 0.61

5-Year ROI 163%

Conservative - (Time Study of ID, SSN, Unearned Income) Annual Savings 1,207,294


5-Year ROI 47%

Aggressive - Real-time Enrollment Annual Savings 6,519,390


5-Year ROI 296%

•Replace snail mail with email. •Annual Savings = $603,322

1. e-Notification

•Replace paper verification with electronic verification.

•Annual Savings = $3,621,883

2. Data Brokering

Portal

23

LEAN SOLUTION SUMMARY

PROBLEM STATEMENT

SNAP Process has room for efficiencies. <LEAN Solution>

SNAP Program performance is not being systematically measured in Ohio. <Six Sigma Solution>

24

Quality Control

•Error Rate •County-by-County

Costs

•Cost-per-Application

•Derived through caseworker time spent per Application.

25

SIX SIGMA ANALYSIS In the current state, Ohio’s SNAP program can measure neither…

Current State QC “look-back” desk review to determine error rate. Determines overall Ohio error rate. Uses a sample of 1,020 cases (out of 600,000+)

Major Shortcoming: the sample is not large enough to draw inferences into the error rates of individual counties.

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SIX SIGMA ANALYSIS – QUALITY CONTROL


COUNTY DEPARTMENT OF JFS SAMPLES DRAWN (2011)

Cuyahoga County 212

Franklin County 130

~~~~~~~~~~~~~

Lake County 19

Muskingum County 17

~~~~~~~~~~~~~~

Van Wert County 1

Noble County 0

State Median 15

State Range 0 to 212

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Q: How to determine adequate sample size for a county? A: Reverse-engineer the t-test. So sample mean = population mean… …for a desired confidence interval: Rearrange to determine sample size (n)

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Minimum county sample size given our known parameters in the SNAP program:

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E (Max Error we Tolerate) 3%Sigma (Population Std Dev) 7%Confidence Interval 95%Associated t-score 2.262n= 27.86

In the SNAP program… Variable Unit Cost = Cost per Application Cost per Application = (Caseworker time per case *

Caseworker wage) In a manufacturing setting, this would be the

cost to produce their “widget.” Recommending: The CRIS-E replacement be

designed to capture this unit cost in the counties.

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SIX SIGMA ANALYSIS - COSTS

SIX SIGMA ANALYSIS – FUTURE STATE WITH COST AND ERROR RATE

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0

5

10

15

20

25

30

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

County X

Timeliness %

Error Rate %

Avg. Minutes to CompleteApplication

Process ImprovementIntroduction Date