Burning Down the Backlog · Average of 595 cases each 129 Calendar Work Days 100% Complete. 10/3/2019 10 BUILDING ON SUCCESS 2019 ... 8337 8191 7950 8078 7,640 7,630 7,805 6,729 6,749

10/3/2019

1

BUILDING ON SUCCESS 2019

Burning Down the Backlog

Michele D. Renkemeyer

Missouri Department of Social Services

Strategic Performance & Innovations Director

“Everyday Excellence”


10/3/2019

2



10/3/2019

3


• Negative (Current) and Positive (Future) Cycle• The Five Focusing Steps• Process / Value Stream Maps• Waste Exercise• Single Page Project Plans• Quick Start Guide• Work in Progress Boards• Huddles• Data Sharing/Visuals/Communications Plan

My Go To Tools


Child Abuse/Neglect Overdue Investigations

10/3/2019

4


Change Starts with

The People …..

.. Who do

the Work!


10/3/2019

5



Oct 2017 Nov 2017 Jan 2018 Feb – Sep 2018

Milestone 3: Set target, freeze non-essential work

“PAUSE”. No overdues by March 1, 2018

10/12/2017

Children’s DivisionSystem : CD’s Hotline & Investigation System (Overdue Investigations)System Goal : To protect children from abuse and neglect by assuring their safety and well-being with family, when possible, in a timely manner. Objectives : Increase capacity/manage work in process, increase family engagement/interaction, increase trust, decrease time families are in system

Milestone 1: Project approved by DSS Director and CD Director

Milestone 2: Train/introduce CD Staff to Theory of Constraints

(Utah Consultants)

11/26/2018

Milestone 4: Kick Off / Communication. Target

Announced: Zero Overduesby June 2018

01/08/2018

– Official

Launch

12/14/2017

Dec 2017

Employed other timeliness strategies, data collection, WIP boards, daily/weekly huddles

Sept 5, 2018

Milestone 5: 99.8% Improvement On 09/05/2018,15 overdues statewide; 99.8% improvement. ZERO overdues reached by all 5 regions (at some point) during Sept 2018.

Sept – Dec 2018

Milestone 6. Begin school year with ZERO and maintain throughout 2018 school yeat.

Jan – May 2019

Milestone 7: Monitor data through school months, track regional

difficulties, address aggressively

June – July 2019

Milestone 8: Team Meet to access overall success of

project and pain points. Reset for 2019 school year.

Data revelation

The Division Driver

Cari Pointer

10/3/2019

6


50

300

550

800

1050

1300

1550

1800

2050

2300

Kansas City

Northern

St. Louis

Southeast

Southwest

CA/N Overdue Report by Region

Jul 17 - May 18

Nu

mb

er

of

Ove

rdu

e R

ep

ort

s

July 1, 2017 March 2018

May 2018


0

100

200

300

400

500

600

700

800

900

1000

Kansas City

Northern

St. Louis

Southeast

Southwest

CA/N Overdue Investigations

& Assessments Excluding

Delayed Marker/Conclusions

(June - Sept 2018)

Inve

sti

ga

tio

ns/A

sse

ss

me

nts

E

xc

lug

in D

C

10/3/2019

7


0

25

50

75

100

125

150

175

200

225

250

275

300

325

350

375

400

425

450

Kansas City

Northern

St. Louis

Southeast

Southwest

True Overdue Investigations Only (Not in Delayed Conclusion)September 2018 through August 14, 2019


10/3/2019

8


FAMILY SUPPORT DIVISION / PROGRAM

INTEGRITY UNIT

CLAIMS REFERRAL PROCESS


Claim Referral: A referral for consideration/investigation of overpayment of public assistance benefits; Food Stamps, Temp Assist, Child Care, Medicaid, Energy Assistance, etc.

As of 04/09/2018, 8,337 Claim Referrals pending for period of 2013 to Present

Gemba: 14 Analyst / 1 Supervisor(Where the work is “happening”.)

Libraries/Caseloads looked like this……..A Hot Mess!

Avg # of Claims per Analyst: 596

Actual # of Claims per Analyst:

Analyst 1 400Analyst 2 500Analyst 3 800Analyst 4 350…and so on….

10/3/2019

9



How did we get a BIG WIN?

100

600

1100

1600

2100

2600

3100

3600

4100

4600

5100

5600

6100

6600

7100

7600

8100

8600

9-A

pr-

18

16-A

pr-

18

23-A

pr-

18

30-A

pr-

18

7-M

ay-1

8

14-M

ay-1

8

21-M

ay-1

8

28-M

ay-1

8

4-J

un-1

8

11-J

un-1

8

18-J

un-1

8

25-J

un-1

8

2-J

ul-18

9-J

ul-18

16-J

ul-1

8

23-J

ul-1

8

30-J

ul-1

8

6-A

ug-1

8

13-A

ug-1

8

20-A

ug-1

8

27-A

ug-1

8

3-S

ep-1

8

10-S

ep-1

8

17-S

ep-1

8

24-S

ep-1

8

1-O

ct-

18

8-O

ct-

18

15-O

ct-1

8

22-O

ct-1

8

29-O

ct-1

8

5-N

ov-1

8

12-N

ov-1

8

19-N

ov-1

8

Statewide Totals

!! Triage !!

14 Analysts

Physically Touched 8,337

Average of 595 cases each

129 Calendar Work Days

100% Complete

10/3/2019

10


Food Stamp Only Burn

Down

Backlog Analysis (Referrals pending

prior to 07/25/2018)

2-Nov-18 9-Nov-18 16-Nov-18 23-Nov-18 30-Nov-18 7-Dec-18 14-Dec-18 21-Dec-18 28-Dec-18 4-Jan-19 11-Jan-19 18-Jan-19 25-Jan-19 1-Feb-19 8-Feb-19 15-Feb-19 22-Feb-19Total Number of Reduction in Backlog

% Backlog Reduced

Beginning Backlog Phase I

8337-4593 -55.09%

Phase II Backlog 5878 5772 5673 5639 5564 5482 5370 5298 5217 5185 5085 4978 4866 4199 3964 3851 3744 -2134 -36.30%

Food Stamp Only (Includes Ready to Work Cases)

2175 2071 2152 1932 1855 1770 1596 1524 1443 1405 1325 1218 1151 1016 935 822 715

FS/TA/MA/CC 1968 Phase III

TA/MA/CC 1735 Phase IV


Milestone 3: Phase I Objective: Define and reduce backlog by 30%

Achieved: 10/31/20182,459 referrals eliminated (waste), processed, and/or

identified (Decrease in backlog: 30% 8,337-2,495)

through Work in Progress (WIP)

Dollar amount of established claims (1,459) is

$1,831,161.55 for Phase I (07/18-10/18).

Milestone 5: Phase II Objective: Define and eliminate Food Stamp only cases

Achieved: 04/30/20195,272 referrals eliminated (waste), processed, and or

identified. Reduced processing time to 1-10 days.

(Decrease in backlog: 64% 8,337 – 5,272)

Dollar amount of established claims (1,311) is

$2,300,003.62 for Phase II (11/18-04/19).

Milestone 6: Phase III Objective: 2-5 day processing times are locked in and we are in sustaining mode.

Achieved: 08/15/2019Big Push Triage (BPT 05/10/19) of Combo cases, 2,563 for the period of 2018 –

Back. Resulting in true number of cases to work

1) Process ALL Food Stamp cases first

2) Process all “Ready to Work” claims within 2-5 days

Dollar amount of established claims (627) is $1,110,699.12 for Phase III (05/19-07/2019).

May 2018Jun

2018Jul 2018

Aug 2018

Sept 2018

October 2018

Nov 2018

Dec 2018 – Feb 2019

Mar 2019

April2019

May 2019 Jun 2019 July 2019Aug – Sep

2019

Family Support DivisionProgram Integrity Unit Continuous Improvement ProjectTrisha Capriglione (Project Owner)

Problem Statement: Insufficient claim referrals (estimate of 8,337) made to the Family Support Division, Program Integrity Unit, during 2011 – 2018, for overpayment of public assistance benefits are preventing timely establishment of overpayment claims. Claim referral processing times range from 180 days to 1,095 days/3 years. This range has been allowed to exceed the target of 1 – 10 day processing time since at least January 2011 resulting high caseloads, unestablished claims, and un-recouped monies owed the State.

Goal/Objective: Eliminate the backlog of 8,337 insufficient claims referrals within nine (9) months, improve intake procedures within 90 days, and reduce processing times to 1-10 days.

20

Milestone 1:

Project approved

by DSS Director

and FSD Director.

Management

Kickoff Meeting

Milestone 2: PIU

All Staff Kickoff

Event / Commence

Phase I

Milestone 4: Focus on

Food Stamps Cases and

Reduce Processing Time

Claim Threshold State

Plan Amendment

Date of Discovery Definition Change

Request (State Amendment),

Eliminated wasted motion by

consolidating tasking queues

Milestone 7: Complete

Assessment of remaining

backlog. Reassess MA and all

other claims. Fully employ

management strategies and

improved procedures.

Milestone 8: All cases

prior to Jan 2019 are

processed/handled,

new intake procedures

fully implemented. Field

staff are trained/being

trained correctly.

FNS Claims Integrity

Review completed.

No findings!!

Eliminated Claims Hearing

Process from PIU Scope,

created “one-and-done”

process and weekly huddles

Provided an S.O.P. to

frontline staff, ensuring

fully kitted referrals

Streamlined

verification

process

Milestones achieved with:

1.No Added Technology

2.No Added Staff

3.No Added Cost to Agency

AE Medicaid

Clarification

10/3/2019

11


Family Support DivisionProgram Integrity Unit Continuous Improvement ProjectTrisha Capriglione (Project Owner)

21

[CATEGORY NAME], [VALUE]k

Phase I Began


Phase II Began


BPT Began

$0

$200

$400

$600

$800

May2018

Jun2018

Jul2018

Aug2018

Sep2018

Oct2018

Nov2018

Dec2018

Jan2019

Feb2019

Mar2019

Apr2019

May2019

Jun2019

Thousa

nds

Dollars Established by Month (in thousands)

Process Improvements� Reduced intake process from 185 days to 2 days

� Claims are now Ready-To-Work (full-kitted) prior to

reaching the Claims Analyst

� Actual claims processing times are reduced from 365+

days to 15 days

� Federal/State/FS Manual Policy (Changes/Revisions)

8337 81917950 8078

7,640 7,630 7,805

6,729 6,749 6,588

5,313 5,263 5,141

Overall Claim Reduction

8,337

7,454

6,8086360

58785482

5185

3964 38493528

20651683 1464

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

Predefined Backlog Reduction


272

272

225

225

319

319

304

304

228

228

278

278

278

278

274

274

228

228

181

181

161

161 1

81

181

211

211

195

195

247

247

233

233

199

199

244

244

131

131

128

128

152

152

148

148

104

104

141

141

223

223

292

292

350

350

326

326

263

263

234

234

256

256

485

485

325

325

393

393

179

179

327

327

259

259

224

224

210

210

112

112

157

157

233

233

237

0

50

100

150

200

250

300

350

400

450

500

Total Claims Established by Month

10/3/2019

12


320,6

34.3

5

333,1

26.1

8

578,7

62.4

4

330,5

38.6

9

355,4

79.8

6

333,9

69.6

5

469,2

87.4

7

411,0

64.2

6

366,6

97.5

9

284,2

66.9

2

258,3

95.7

4 348,6

41.9

4

421,0

79.4

6

357,6

28.3

0

477,1

35.9

1

456,9

50.3

7

328,1

74.4

9

496,9

40.7

4

236,7

72.1

5

206,1

46.5

0

407,2

87.5

2

337,7

57.4

7

147,8

72.7

5

169,7

46.1

6

268,9

18.4

6

526,6

74.7

0

437,5

47.8

9

328,1

71.8

6 409,3

99.9

1

336,9

07.1

2

396,1

72.0

3

606,0

76.4

1

393,7

70.6

1

435,1

42.5

0

338,6

68.7

0

663,4

90.6

5

538,0

07.0

0

295,8

83.2

4

301,2

56.8

0

162,6

97.2

3

267,0

16.6

4

421,3

25.4

2

422,3

57.0

6

0.00

100,000.00

200,000.00

300,000.00

400,000.00

500,000.00

600,000.00

700,000.00

Total Dollar Established by Month


1,1

78.8

0 1,4

80.5

6 1,8

14.3

0

1,0

87.3

0

1,5

59.1

2

1,2

01.3

3

1,6

88.0

8

1,5

00.2

3

1,6

08.3

2

1,5

70.5

4

1,6

04.9

4 1,9

26.2

0

1,9

95.6

4

1,8

33.9

9

1,9

31.7

2

1,9

61.1

6

1,6

49.1

2

2,0

36.6

4

1,8

07.4

2

1,6

10.5

2

2,6

79.5

2

2,2

82.1

5

1,4

21.8

5

1,2

03.8

7

1,2

05.9

1

1,8

03.6

8

1,2

50.1

4

1,0

06.6

6

1,5

56.6

5

1,4

39.7

7

1,5

47.5

5

1,2

49.6

4

1,2

11.6

0

1,1

07.2

3

1,8

92.0

0

2,0

29.0

2

2,0

77.2

5

1,3

20.9

1

1,4

34.5

6

1,4

52.6

5

1,7

00.7

4

1,8

08.2

6

0.00

500.00

1,000.00

1,500.00

2,000.00

2,500.00

3,000.00

Average Dollar Amount Per Claim by Month

10/3/2019

13


• The people doing the work (Gemba)

• Mindset

• The “Why”

• Inclusion and Transparency

• Hidden Capacity

• FOCUS

• Commitment and Rigor

• F-A-I-L; it’s your “First Attempt In Learning”

• No only means “next opportunity” not realized

• This is noble work; it is not for the self-serving

• Excellence is an everyday expectation

What Matters?


Burning Down the Backlog

Michele D. Renkemeyer

Missouri Department of Social Services

Strategic Performance & Innovations Director

573-751-2209

[email protected]

Documents

Burning Down the Backlog · Average of 595 cases each 129 Calendar Work Days 100% Complete. 10/3/2019 10 BUILDING ON SUCCESS 2019 ... 8337 8191 7950 8078 7,640 7,630 7,805 6,729 6,749