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Tiffinie Miller-Sammons, E&EA Deputy Director
Sue Krey, E&EA Program Operations Manager
October 15, 2019
The current work Projected workload Quality of service
How much? How well? Is any one better off?
Strategy to maximize resources Questions
2
Agenda
County Comparison
County
MA caseload
on 12/31/13 Pre-ACA
MA caseload
on 7/31/19
MA caseload growth
since 2013
% of MA growth post-
12/31/13
FTE addition
2013-2015
**FTE requests
2016-2019
Total FTE
additions
Ratio of new staff to new cases 2019
Anoka
22,215
32,685
10,470 47% 18 3 21 1:499
Dakota
21,325
36,218 14,893 70% 17 11 28 1:532
Ramsey
58,277
80,478
22,201 38% 26 12 38 1:584
Scott
5,384
9,983
4,599 85% 7 2 9 1:511
Stearns
10,332
16,229
5,897 57% 7 4 11 1:536
Washington
9,599
17,013
7,414 77% 9 3 12 1:618
Caseload History
0%
2%
4%
6%
8%
10%
-
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Unemployment Rate Singles Case Food Support Medical Assistance Family Cash
Ave
rage
Mon
thly
Cas
eloa
ds D
akota County U
nemploym
ent Rate
Source: Minnesota Department of Employment and Economic Development and Dakota County Department of Employment and Economic Assistance
1,365
3,250
8,250
36,218
2019/2020 Impacts to the Work
Increase Staff Time- Mandated program integrity
work; AVS, PDM, and ROP Limitations in system functionality Federal Tax law changes System and internal Child Support
referral process improvements Enhanced integrated service
delivery within E&EA and with Social Services and Corrections
Decrease Staff Time- Address Wizard streamlined
address change and county case transfer process
Improvement to METS to MMIS interface
Continued improvements on eligibility notice to customers
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
Maxis-Pre ACA All Maxis METS 8/1/19 METS Projected 2021 All cases in METS
Hou
rs P
er M
onth
Misc. Work
Walk-ins
Phone Calls
METS to MX work
Change in Circumstances
PDM in METS
6-month renewals in Maxis
Dail Messages
Reports/Tasks
Renewal Re-entries
Renewals
Applications
AVS
Workload Comparison
21,325
36,218
25,500 25,276
36,218
Monthly Average METS Health Care Applications
0
200
400
600
800
1000
1200
1400
1600
Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19
Paper Applications Online wth worker intervention Online with no worker intervention
0
10
20
30
40
50
60
70
2017 2018 2019
Day
s of
Pro
cess
ing APPLICATIONS
DOCUMENTSRENEWALSApplication TargetDocument TargetRenewal Target
Quality Measure: Timely Processing
How Well?
0500
10001500200025003000350040004500500055006000
2016 2017 2018 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19
# of
Cal
ls
Answered vs. Abandoned Calls
Answered Calls
Abandoned Calls
Quality Measure: Phones
0123456789
101112
Min
utes
Wait Time vs. Time to Abandoned
Waiting Time
Time to Abandon
Performance Objective <5 minutes
How Much?
How Well?
96% of Dakota County’s residents have health
insurance coverage. 14% of Dakota County’s residents are receiving
Medical Assistance 4,695 MA clients receive WIC each month 4,745 of MA recipients receive waivered
services An average of 6,388 MA recipients receive Child
& Teen Checkup benefits each month
Is any one better off?
Continued process improvement Shift current E&EA staff and support to METS Targeted teleworking Overtime based on return of investment Maintain improved random moment Resource ratio remains inline with other counties Continuously evaluating the cost benefit of various
strategies
At the end of the day, greatest efficiencies come from system functionality.
Strategies used to Maximize our Resources
Questions?
$0.00
$2,000.00
$4,000.00
$6,000.00
$8,000.00
$10,000.00
$12,000.00
$14,000.00
$16,000.00
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Act
ual S
pend
ing
2017
2018
2019
Projected
Overtime Spending
Yearly Spending Projection Actual 2015 $75,123 $79,321 2016 $179,891 $43,393 2017 $60,000 $28,892 2018 $35,000 $34,513 2019 $58,247 $44,747.30 - 10/1/19
ACA Caseload Impact to Date Pre MNsure
Medical Assistance (MA)
Cases
2013 Projected MA
Enrollment through 3/14/15
Average Monthly MA
Enrollment as of 07/31/19
21,325 26,818 36,218
26% (Projected)
70% (Actual)
Dakota County Health Care: Cases by System
34,911 35,470 36,377 37,421 37,244 36,218
05,000
10,00015,00020,00025,00030,00035,00040,000
June 2014 June 2015 June 2016 June 2017 July 2018 July 2019
Cas
es
METS
MNCareto MA
Maxis
Dakota County is represented on all of the following: County Roles and Responsibilities METS Project Management Team ended Jan 2019 County Advisory Committee (meets with members of
METS Executive Steering Committee) Integrated–Executive Steering Committee Enterprise Architecture Board AMC Health Care Work Group County presence on State workgroups
Advocacy for functional system
Medical Assistance
• Oversight by DHS • Administered by Counties • ACA brought extended eligibility and more cases
MinnesotaCare • Administered by DHS
MNsure (program and agency) • Private Health Plans • Tax Credits • Small business support
Minnesota’s Health Care Programs
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