Page 1 of 23

Flexible Interview Scheduling:

Five Innovative Models to Improve Access to the

CalFresh Interview

November 2018

Page 2 of 23

Acknowledgements

This report would not have been possible without the generosity of California County and nonprofit staff willing to share their time and expertise. We are grateful to those that helped shape these findings and develop strong recommendations to increase access to the interview process in more counties.

Alexandra Danino, San Francisco-Marin Food Bank

Alexis Fernandez, California Department of Social Services

Andrew Cheyne, California Association of Food Banks

Apple Coan, Humboldt County DHHS

Assmaa Elayyat, County Welfare Directors Association of California

Becky Gershon, California Association of Food Banks

Caitlin Docker, Code for America

Frederick Nara, Oregon DHHS

Heidi McHugh, Food for People

Jared Call, California Food Policy Advocates

Jessica Paran, Marin County DHHS

Joel Campos, Second Harvest Food Bank of Santa Cruz County

Lainie Gray, Santa Cruz County HSD

Laurel Johnson, Humboldt County DHHS

Margarita Cabral - Ventura County HSA

Peri Weisberg, San Francisco County HAS

Stephanie Nishio, California Association of Food Banks

Teresa Baker, Stanislaus County HSA

Tiana Wertheim, San Francisco County HSA

About the Alliance to Transform CalFresh

The Alliance to Transform CalFresh is composed of leading non-profit organizations that have come together

to advance an ambitious but pragmatic goal: move California from a 66% participation rate in CalFresh

(among the last in the nation) to an 80% participation rate, with no county below 70% by the end on 2019 in

order to significantly reduce hunger in our state. Founding members include the California Association of

Food Banks, California Family Resource Association, California Food Policy Advocates, Los Angeles Regional

Food Bank, SF-Marin Food Bank, Western Center on Law and Poverty, and Catholic Charities of California.

Principal author: Jennifer Tracy, Consultant. Alliance to Transform CalFresh

For more information, visit TransformCalFresh.org or contact Jennifer Tracy, jennifer@jenntracy.com.

Page 3 of 23

Table of Contents

Introduction Page 4

Goal and methodology Page 5

Business Process Improvements to Increase Interview Rates Page 6

Churn Page 6

CalFresh Interview Scheduling: Evolving to Meet the Needs of Hungry Californians Page 8

Measuring the Impact of Flexible Interview Scheduling Models Page 9

Flexible Interview Scheduling: Five Models Page 11

Case Studies: Flexible Interview Scheduling in Action Page 12

Recommendations Page 17

Box 1 – Interview Scheduling Requirements Page 4

Box 2 – FNS Waiver On-Demand vs. Flexible Models: Compare and Contrast Page 5

Box 3 – Why does CalFresh churn happen? Page 7

Box 4 – Culture of Access Page 8

Box 5 – First Contact Resolution and Integrated Interviews Page 13

Figure 1 – The Churn Cycle Page 6

Table 1 – Contact Center Data from Counties Implementing Flexible Interviews Page 10

Appendix

I. Stanislaus County Notice of Action Language for Block Scheduling Page 21

II. Ventura County Recertification NOMI Flier – English and Spanish Page 22

Page 4 of 23

Introduction

In 2018, the CalFresh program serves approximately 4 million Californians, about 1 in 10 residents. Over the past decade, stakeholders from state, county, and nonprofit entities have worked to increase participation rates from 50.9% in 2010 to about 71.8% of eligible people as of 2016.1

Nevertheless, according to the Lost Dollars, Empty Plates report from the California Food Policy Advocates, families in California counties miss out on $2.5 billion federal CalFresh/SNAP dollars annually that could be spent in local communities.2

Research has documented numerous barriers that stymie CalFresh participation,3 but missed interviews is one of the most common reasons for customers “dropping out” during the certification or recertification process, with research indicating that more than one in five applicants fail to complete their interview.4

In 2016, students at the UC Berkeley Goldman School of Public Policy looked into opportunities to modernize CalFresh, including telephonic signature, notifications, consumer-driven options for scheduling interviews, and implementation of on-demand interviews. The students referenced research on missed interviews and estimated that on-demand interviews would reduce the number of “lost” applicants (those that don’t complete the process) by at least 10-22 percentage points.5

As noted in Box 2, the federal waiver for “on-demand” interviews requires implementation for all households county-wide, and requires counties to provide specific administrative reports at regular intervals, including the impact on client access, average interview wait times,

1 CDSS Data Dashboard, http://www.cdss.ca.gov/inforesources/Data-Portal/Research-and-Data/CalFresh-Data-Dashboard. PRI 2016. Accessed September 2018 2 California Food Policy Advocates. Lost Dollars, Empty Plates 2016. https://cfpa.net/CalFresh/CFPAPublications/LDEP-FullReport-2016.pdf 3 Examples of research include: Increasing CalFresh Participation through Medi-Cal In-Reach: Data & Practical Strategies, 2017. http://transformcalfresh.org/wp-content/uploads/2016/05/ATC-DE-Opportunites-Recs-Report_062017.pdf; Call Centers in Other States, 2017. http://transformcalfresh.org/wp-content/uploads/2016/05/Call-Centers-in-Other-States-June-2017.pdf; Telephonic Signature in California Counties, 2016. http://transformcalfresh.org/wp-content/uploads/2016/05/Telephonic-Signature-in-California-Counties-Survey-Results-2016-1.pdf; CalFresh Application Experience Project, 2015. http://transformcalfresh.org/webinars/sf-marin-food-banks-calfresh-application-experience-project/ 4 According to research from Vakil Kuner, cited in Modernizing the CalFresh User Experience, page 3: 22% of applicants did not complete the process due to missed interview. http://www.sfmfoodbank.org/wp-content/uploads/2016/10/FINAL-REPORT-Modernizing-the-CalFresh-User-Experience-6.14.2016-1.pdf 5 San Francisco-Marin Food Bank. Modernizing the CalFresh User Experience, 2016. http://www.sfmfoodbank.org/wp-content/uploads/2016/10/FINAL-REPORT-Modernizing-the-CalFresh-User-Experience-6.14.2016-1.pdf

Box 1: Interview Scheduling Requirements According Federal and California state requirements, the

CWD must:

Give an appointment date and time for intake

and recertification telephone interviews [7 C.F.R.

§ 273.2(e)(3); MPP § 63-300.46.]

Give a customer at least 10 days from the date

of the interview or by the end of the certification

period (whichever is less) to submit verifications

(with exceptions). [7 C.F.R. § 273.2(f); MPP § 63-

300.5(a)(1).]

Page 5 of 23

timeliness, customer service, etc. These requirements limit the California County Welfare Departments’ (CWDs) ability to mitigate risk by testing the new process with a small set of clients, make improvements, and then roll out the on-demand interview model to their entire caseload. The statewide on-demand waiver that California received in 2014 expired without implementation and was not renewed.

The impact of ongoing barriers to interview affects both the clients and county staff. They increase the workload for the CWDs and don’t provide a positive customer experience when attempting to access CalFresh benefits.

As counties in California prepare for the implementation of SSI Cash-out Reversal in the summer of 2019, where an estimated 369,000 SSI recipients with unique and varied needs will be eligible to enroll in CalFresh, the need for greater scheduling and interview options has never been more apparent.

Goal and Methodology

The goal of this report is to better understand the various ways CWDs have increased access to the intake and recertification interviews, outside of the federal on-demand waiver, by offering more flexibility in providing the interview.

The author reached out to several CWDs to find out how they may be using interview scheduling alternatives to engage customers to complete their interview at intake or recertification. In speaking with six counties and three community based organizations (CBOs) the author identified five primary models that summarize the key aspects of what are considered “flexible interview scheduling” models.

These interview alternatives are not “on-demand” in the formal sense, and do not require the FNS waiver, but they still meet the intention of providing customers an opportunity to

Box 2: On-Demand vs. Flexible Scheduling Models: Compare and Contrast

The FNS on-demand waiver allows the State agency to waive interview scheduling requirements (see Box 1), allowing households to call anytime within specified hours for interviews.

The flexible interview scheduling models still include interview scheduling, but provide options for customers to have their interview completed outside of that time.

The FNS on-demand waiver requires implementation for all households county-wide. The flexible interview scheduling models, however, can be modified to fit a county’s resources and

capacities, without them having to conform to specific on-demand requirements outlined by FNS.

The FNS on-demand waiver requires counties to provide specific administrative reports at regular intervals, including the impact on client access, average interview wait times, timeliness, customer service, etc.

We encourage counties to analyze data and information about the success of their model, but it is not required as part of the flexible interview scheduling models.

https://fns-prod.azureedge.net/sites/default/files/2013-toolkit.pdf http://www.cdss.ca.gov/lettersnotices/EntRes/getinfo/acl/2014/14-20.pdf

Page 6 of 23

complete their interview based on their own availability within the standard timeline. These models, along with the examples that illustrate them, are explored in this report. Ensuring eligible customers can keep their CalFresh benefits helps reduce hunger and bring more federal dollars into the local economy. Partnerships with CBOs and CWDs can grow, creating more opportunity to foster improvements, exchange perspectives, and promote positive community relationships.

Business Process Improvements to Increase Interview Rates

As technology has advanced, CWDs have been adopting new ways to connect customers with their services and improve their experiences. Telephone interviews were among the first changes in the application process to be widely implemented.

To increase self-service options, CWDs have also worked with their consortia and third-party vendors to create online application processes. Additionally, many counties have started using electronic signatures, including telephonic signatures, to complete applications and other documents over the phone. These changes have culminated in real opportunities for greater flexibility in scheduling and conducting interviews.

Churn

We can explore the impact of missed interview in part by looking at the churn rate in California. Churn is the process of CalFresh recipients not getting benefits or losing benefits and reapplying again within one-to-three months.”6

Research from Food and Nutrition Service (FNS) of the US Department of Agriculture (USDA) shows that households that churn “…tended to be younger, non-White, more likely to have children, and employed compared to non-churners. Additionally, households with either gross income above 100 percent of poverty or no income were most likely to churn.”7

When CalFresh recipients “churn off” from the program it most frequently happens at a reporting time, either SAR7 or Recertification. The reasons they may “churn off” can usually fall into one of two categories: “eligibility-based churn” or “administrative churn.”

6 San Francisco-Marin Food Bank. CalFresh Churn Report, 2016 https://www.sfmfoodbank.org/wp-content/uploads/2018/06/CalFresh-Churn-Report-SFMFB-3.2017.pdf, page 1-2 7 USDA, Understanding the Rates, Causes, and Costs of Churning in the Supplemental Nutrition Assistance Program (SNAP), 2014. https://www.fns.usda.gov/snap/understanding-rates-causes-and-costs-churning-supplemental-nutrition-assistance-program-snap

Appointment Notice Sent

EW calls the

Customer

No Answer/No Response

Customer benefits are

denied

Customer reapplies Fig. 1: The

Interview Churn Cycle

Page 7 of 23

Eligibility-based churn is related to variables that make the household ineligible for CalFresh, such as being overcome based on the household size, or having some other factor that changes the eligibility status of members of the household.

Administrative churn is related to the business process aspects of obtaining benefits such as: verification submission, interview completion, and eligibility determination. (Figure 1: The Churn Cycle.)

No county will ever reach 0% churn because inevitably there will always be some people coming on and off the program due to eligibility reasons. However, counties are making efforts to reduce administrative churn, as they do have options to mitigate barriers related to verifications, interview, and quality control.

Learn more about churn in Box 3.

Since 2013, statewide rates of churn have gone up and down slightly, but overall have remained somewhat stagnant. The most recent data from CDSS’s CalFresh Data Dashboard shows statewide rates of churn in 2017 averaged about 13.1%, which is about the same as the average for 2013 (13%). The lowest individual county rates of churn during those periods were about 1.2% and 3.5% respectively,8 which suggests County Welfare Departments (CWDs) have the opportunity to reduce rates of churn.

8 CDSS Data Dashboard, http://www.cdss.ca.gov/inforesources/Data-Portal/Research-and-Data/CalFresh-Data-Dashboard. Total Churn. Solano and Santa Cruz Counties showed the lowest rates of churn. Accessed September 2018

Box 3: Why does CalFresh churn happen?

“[Most] CalFresh recipients have to complete two regular reports in order to remain on benefits: the semi-annual report

(SAR7) and the annual recertification.

We have all experienced the chore of renewing annual memberships or subscriptions. Sometimes it’s easy: you get a

reminder email, you log in and update your account, and you receive confirmation that everything is settled.

But sometimes it’s not: an inconspicuous notice gets buried in the mail, or the turnaround is tight and you have to hunt for

the necessary documents. Sometimes the notice is incomprehensible, and you don’t realize that you’re about to lose

services. Maybe you tried to call, but customer service is only open when you’re at work, or the length of the call queue is

interminable. Before you know it, the deadline has passed, and you’ve lapsed. Unfortunately for CalFresh recipients, the

program’s reporting recertification requirements are a recipe for churn. To recertify every year, most CalFresh recipients must

(1) complete and mail a paper form to the county office; (2) re-submit documents verifying household income and expenses

and any changed circumstances; and (3) complete an interview with a county worker.”

“CalFresh Churn: What is it and how do we fix it?” 2017, from the San Francisco-Marin Food Bank

https://www.sfmfoodbank.org/wp-content/uploads/2018/06/CalFresh-Churn-Report-SFMFB-3.2017.pdf, page 1-2

See also “Lessons Churned: Measuring the Impact of Churn in Health and Human Services Programs on Participants and

State and local Agencies.” 2015, from the Center on Budget and Policy Priorities.

https://www.cbpp.org/sites/default/files/atoms/files/3-20-15fa.pdf

Page 8 of 23

CalFresh Interview Scheduling: Evolving to Meet the Needs of Hungry Californians

Usually, when a person applies for CalFresh through an out-of-office means (or sometimes even when applying in the office), they will be given the next available appointment time, often written in a mailed letter, which could be days or even weeks away. Recertification interviews are also scheduled based on the calendar of the CWD.

Though there is a lack of data to pinpoint the exact frequency, anecdotal information from a variety of stakeholders suggests that this approach often results in missed interviews when the scheduled time doesn’t fit with a customer’s availability.

When a customer does attempt to attend an interview that has been scheduled without their input, it may result in missed work hours, extended hold times, or “games of phone tag” as customers try to reach someone to reschedule their appointment. Customers have also reported they don’t receive any call at all. This is likely because many counties call from a blocked or restricted number, so customers don't think the county called them. Sometimes, clients will receive an interview appointment letter after their interview time has already passed and have trouble rescheduling.9

CWDs have been using evolving technology and business processes to step up to the challenge of reducing missed interviews in order to increase the interview completion rates. Working with eligibility workers, clerks, and outreach partners, they have looked at interview availability through the lens of the “culture of access,” (see Box 4) and developed a number of ways to connect with customers for their interview outside of a pre-scheduled date and time.

9 Phone interview with Caitlin Docker at Code for America. September 17, 2018

Box 4: Culture of Access

As part of their planning for flexible interview model implementation, some CWDs started their business process reengineering

by exploring and clarifying the values of their workforce.

Counties that took on this effort facilitated important processes to recognize and lift up the ideals that their staff strive to

uphold. Phrases such as “people helping people” and “I am the other worker” were identified in order to foster a culture of

improvement through support, growth, and a desire to help their communities thrive.

In the “culture of access” or sometimes called the “culture of eligibility” workers are not considered to be an “army of clericals

following scripts” but instead they are “decision makers whose job it is to find out how the person can be eligible.” The culture

within the department shifts to a focus on helping people rather than being focused on avoiding a mistake.”*

Culture change also looks like supporting workers by ensuring they have the tools and business processes to do their jobs

efficiently and effectively. Putting scanners at every desk and connecting each telephone to the language line are all ways that

CWD leadership can support workers in meeting the needs of their customers and increasing overall efficiency in their workforce.

*Phone interview with Greg Kunz from the Idaho Department of Human Services, April 21, 2017

Interview with Greg Kunz, Idaho Department of Human Services, April 21, 2017.

Page 9 of 23

In conversations, CWDs have noted that by investing more of their resources at the front end to connect with customers for the interview they have seen less work at the back end as they have reduced re-application and recertification churn.10

Making interviews more accessible can increase program participation and decrease rates of churn (see Table 2, which shows an overall reduction in rates of churn, and participation rates that either increased, or decreased at rates lower than the state average).

When customers can provide input into their interview time, they’re more likely to be able to keep their work hours, have less back-and-forth to get their interview, and be less stressed overall about the process. Meanwhile, eligibility workers may be able to wrap up the entire interview and even verification processing in “one touch,” thus reducing administrative burden.

Often developed with a specific goal in mind, such as reducing recertification churn or connecting with customers at the point of application, five models appear to be in use in California counties. The models tend to lend themselves to one interview type or another (i.e., intake or recertification), but often the model can be used for both.

As you can see from the illustrative examples on pages 11-15, these models are not mutually exclusive, and counties interested in improving their business processes can adopt one or more of them in order to meet their performance and customer service goals (Stanislaus County’s model on page 14 is an example of leveraging multiple approaches).

Measuring the Impact of Flexible Interview Scheduling Models

There is a dearth of comparable data available to show conclusive findings. However, the

information below is a starting place for county welfare departments to create working

assumptions about what adopting a flexible scheduling model might mean in terms of

workforce capacity and performance improvements.

Table 1 shows the approximate ratio of contact center staff and caseload. Counties have

expressed concern about the potential impacts to their contact centers and phone lines and

this information offer counties a sense of where they can start exploring options for

implementing flexible interview models.

Another way to look at the efficacy of the models is to explore performance metrics.

For example, application approval rates between October 2016 and May 2018, the period

during which the interviewed counties were implementing their flexible interview models,

were slightly better for all but one county, versus the consortium average for the same

period.11

10 Phone interview with Humboldt County July 5, 2018. “It was a mental shift to recognize that the front end work

saves so much time on the back end.”

11 https://public.tableau.com/profile/diana.jensen#!/vizhome/CalFreshApplicationOutcomes/GettingStarted

Page 10 of 23

Implementing counties have been tracking their own outcomes. Marin County reported that

about 10% of customers that missed their scheduled interview use their flexible model to

complete the interview. Ventura reported that they saw a 26% increase in completed

recertifications within one year of implementing “flexible interview scheduling.”

More analysis is needed to understand the how flexible scheduling can be improved and the

overall impact it can have on customer outcomes and business process efficiency.

County, Consortia

and

Implementation Date

Intake vs

Recertification

Model Type(s)

Staffing Level vs

Caseload

Average queue times

Humboldt – C-IV

End of 2014-April 2017

Intake only Client Initiated Interviews

and Interview Warm Calling

Staff processing calls: 39 +13 to be hired

CalFresh Caseload: 11,824

7 minutes and 31 seconds

Marin – C-IV

Early 2018

Recertification Only

Ready to Interview

Staff processing calls: 13 +2 to be hired

CalFresh Caseload: 6,023

2 minutes or less

Santa Cruz - CalWIN

End of 2016-Apr 2017

Intake and Recertification

Client Initiated Interviews and Ready to Interview

Staff processing calls: 80 total (but not all taking

calls at once)

CalFresh Caseload: 14,085

7 minutes and 45 seconds

Stanislaus – C-IV

Early 2015 – April 2017

Recertification only

Block Scheduling, Client Initiated Interviews, One Call Resolution, Ready to

Interview, Interview Warm Calling

Staff processing calls: 12 +3 to be hired

CalFresh Caseload: 36,797

Less than 20 minutes

Ventura - CalWIN

End of 2017

Intake and Recertification

Ready to Interview

Staff processing calls: unknown

CalFresh Caseload: 33,502

2:26-4:26 minutes

Table 1: Contact Center Data from Counties Implementing Flexible Interview Scheduling

Page 11 of 23

Flexible Interview Scheduling: Five models

1. Client Initiated Interviews (See examples from Humboldt, Santa Cruz, and Stanislaus Counties)

A customer calls the CWD contact center or specific CWD phone number when they are ready to interview. This is usually immediately after submitting an application or recertification through the online portal or via fax. Once connected, the CWD will either conduct the interview right away or schedule a convenient time. The CWD still sends the appointment letter when the interview is not completed right away.

This model is most often used in partnership with a community partner doing CalFresh Outreach. This model may include a special phone number just for these customers. It can work for both recertification and out-of-office intake interviews, including those that qualify for expedited service.

2. Interview Warm Calling (See examples from Humboldt and Stanislaus Counties)

When a new application or recertification is received by the CWD, a clerk or eligibility worker calls the customer with the goal of immediately transferring them to an eligibility worker for the interview, or to schedule an interview at a convenient time. For recertifications, this “warm call” process can also be used towards the end of the month to reach any customers that missed their interview (see the Stanislaus County’s model on page 14).

This model works well for recertifications and out-of-office intakes, including those that qualify for expedited service.

3. Interview Block Scheduling (See example from Stanislaus County)

The appointment letter offers the customer a window of time on a certain day (e.g., 2 hours starting at 10am) to call in for their interview. The block time staggers calls to keep queue times low. Customers can also call outside of the designated block of time if necessary. The implementing county found that most people call at the beginning of the block of time, so they stagger start times accordingly with case load (e.g., at the hour or half hour). If a customer does not call in to complete their interview, a Notice of Missed Interview (NOMI) is sent.

This model may work best for recertifications and out-of-office intakes that do not qualify for expedited service.

4. Ready to Interview (See examples from Marin, Santa Cruz, and Ventura Counties)

The appointment letter has an appointment time, but also includes language that the customer can call anytime during a 30-day window. The customer can contact the office at their convenience, or wait for the call from the eligibility worker at the stated appointment time.

This model may work best for recertifications and out-of-office intakes that do not qualify for expedited service.

5. One-Call Resolution Interview (See example from Stanislaus County)

Customers may call the county for non-interview needs such as reporting (e.g., change of address). If they call within 30 days of their recertification deadline, a worker will offer to conduct the interview in addition to completing the other request the customer has called about.

This model works best for recertifications.

Page 12 of 23

Case Studies: Flexible Interview Scheduling in Action

Humboldt County – C-IV

Models Implemented: Client Initiated Interviews and Interview Warm Calling

The impetus for the Humboldt County client initiated interviews (referred to as “client cold

calls” by Humboldt County staff) process was to prepare for the ACA requirements by

“getting the process right” for CalFresh intakes first. Other goals for the model were to

reduce missed interviews, reduce work on the back end (and overall) by investing effort on

the front end.

Humboldt’s call center-based model launched in 2014 and works like this: A customer

contacts the call center by phone12, usually with the assistance of a CBO. The application

can be taken over the phone with an electronic signature or faxed by the CBO partner.

Sometimes an immediate interview is not possible. In these cases a calendar shared

internally between workers is used to set up a convenient time for the customer.

Customers who qualify for CalFresh expedited service processing will be scheduled for an

interview within three days. Due to the number of remote customers, those who have more

vulnerability and limited access to the phone might be fit in to the schedule sooner than

people with a lower need and greater access to a phone.

In this model, while call center eligibility workers can do an interview (and will if

necessary), they most often triage calls and forward interview-ready customers to an

intake worker located at the main office who is completing phone interviews. This allows

call center staff to be available for the next phone call.

If an application is received by mail or the online app, or some other process where the

customer isn’t readily available, the “interview warm calling” model is initiated. An

eligibility worker will contact the client to either give a warm handoff for the interview or

schedule it for a convenient time.

This process is also used for people calling to reschedule: if a worker and the customer are

both available, the customer will be interviewed by the call center staff or transferred to an

available intake worker to complete the interview right away.

Workers are empowered to make decisions about customer needs in ways that best model

Humboldt County’s culture shift toward their vision of “people helping people live better

lives.”

Stats: The average queue time is about seven and a half minutes. There are 39 eligibility

workers at the contact center, including lead workers and supervisors (13 vacancies are in

the process of being filled). Humboldt County has about 10,936 active CalFresh cases, and

29,747 active Medi-Cal cases as of June 2018.

12 Current regulations “give CWDs [the CWDs have] the option of allowing households to complete a telephone interview without a scheduled appointment by calling the CWD or the CWD call center.” http://www.cdss.ca.gov/lettersnotices/EntRes/getinfo/acl/2014/14-20.pdf

Page 13 of 23

Marin County – C-IV

Model Implemented: Ready to Interview

Marin’s process started in early 2018 with the goal of improving participation by reducing

recertification churn. An appointment time is mailed, but in the appointment letter they

offer to the customer the chance to call in at their convenience anytime during office hours

before the end of the recertification month.

When a customer chooses to call in, they are connected with an eligibility worker to do the

interview. If the contact center has high call volume, the eligibility worker may suggest a

reschedule, but will use discretion if someone has limited phone access in order to

complete the interview while the person is available. Every worker has access to a

telephonic signature option if necessary. The customer may still need to submit

verifications in order to complete the process.

Stats: Average queue times are about two minutes or less and they have about 15 eligibility

workers taking calls with a CalFresh caseload of about 6,023 as of July 2018. Since

implementing this process, about 10% of customers that miss their scheduled interview

time have been able to complete their interview using the “ready to interview” option.

Box 5: First Contact Resolution Also referred to as “one and done,” the idea of First Contact Resolution is that eligibility staff assisting clients via phone

will spend the requisite time needed to resolve issues or complete processes without the customer having to contact

the office again.

This may take the form of addressing the reason for the customer’s call while they are on the phone; it may include

identifying any other issues that can be addressed (such as a needed verification or upcoming SAR7); and it may require

completing tasks after the call with the customer has ended. But the goal is to address the stated, and if possible the

unstated, needs of the customer with only one contact, thereby reducing the overall time spent on the case and easing

the burden to both the customer and the CWD staff.

In research shared at the 2017 Call Center Learning Collaborative, the Alliance to Transform CalFresh presented data

from 3 other states and 4 counties in Colorado that correlates First Contact Resolution models with longer handles

times, but less calls overall per case.

http://www.cdss.ca.gov/Portals/9/CalFreshResourceCenter/ATCCallCentersinOtherStates.pdf?ver=2017-06-21-113932-843

Integrated Interviews Integrated Interviews are a form of First Contact Resolution. Integrated interviews attempt to include as much of the

application or recertification process as possible while connected with the customer. An integrated interview may

include filling out the application or recertification with the customer, using an electronic or telephonic signature if on

the phone, and using electronic verifications, collateral contacts, and sworn statements (backed up by electronic

verifications when possible) to complete the interview and certification process within one contact.

Page 14 of 23

Santa Cruz County – CalWIN Models Implemented: Ready to Interview, Client Initiated Interviews

Inspired by the desire to have a true “no wrong door” approach, ease the process for

customers, reduce the number of missed interviews, and increase approval rates, Santa

Cruz has developed options for customers to call in for their interview over the last two

years.

In the “ready to interview” model, launched in October 2016, CalFresh customers applying

through an external process (e.g., mail, online) are sent the required appointment notice

which includes the scheduled date and time of their intake interview. It’s not listed on the

notice, but if a customer calls to reschedule (before or after their scheduled interview time)

a Benefits Representative (BR) in the Phone Customer Service Center (PCSC) will conduct

the interview over the phone. If there is a high call volume, calls can also be routed to BRs

at other offices. Every BR has access to telephonic signature (implemented in April 2015) in

order to complete remaining verifications. The interview process takes about an hour.

For the client initiated interview model (referred to as the “Second Harvest Food Bank

Telephone Interview”), the county partners with the Second Harvest Food Bank Santa Cruz

County CalFresh outreach staff. The outreach staff help people complete the CalFresh

application and submit verifications using either MyBenefitsCalWin.org or GetCalFresh.org.

The outreach worker dials in to the Santa Cruz County PCSC and, using a special extension,

connects the customer to a dedicated queue that is staffed by BRs. The customer completes

the interview over the phone and, when possible, the outreach staff submit any remaining

verifications through the online application portal.

Stats: The average queue time in July 2018, for example, averaged about 7.75 minutes and

the time to determination averaged about 14.2 days. There are about 80 BRs assigned to

take calls, but not all of them are on the phones at the same time. Of 717 applications

received in July 2018, 661 (92.19%) were approved within required processing (30 days)

timeframes. The wait time for the client initiated interview model queue (in partnership

with the Second Harvest Food Bank) is usually less than 15 minutes and the time to

determination can be same day, if all required verification are submitted.

Page 15 of 23

Stanislaus County – C-IV

Models Implemented: Interview Block Scheduling, Client Initiated Interviews, One Call Resolution,

Ready to Interview, Interview Warm Calling

Stanislaus implemented interview block scheduling (locally referred to as “Flexible Cal-

Fresh Recertification Interview model”), in March 2015 with the goal of reducing the steps

in the recertification process and the number of missed interviews. CalFresh households

are sent a recertification packet with an appointment date and a 2 hour window of time for

the customer to call in for their interview. (See Appendix I for Noticing language.)

Stanislaus County found that customers are more likely to call at the start of their

appointment window of time, so chose to spread out the calls by scheduling the two-hour

window of time at the top of each hour.

To better manage the wait time, Stanislaus County uses a scheduling process to distribute

recertifications for seniors and people with disabilities, Spanish speaking, and people who

are homeless so they are spread out among the general population calls. These special

populations tend to require either shorter or longer calls.

They try to keep queue wait times to 20 minutes or less, and will divert calls to back up

workers outside of the contact center if the queue reaches 60 minutes or more. Some

customers may choose to leave a voice message if the wait time is longer than 20 minutes.

In those instances, a worker returns the call within 24 hours and conducts the

recertification interview if the customer is available.

For outbound calls, instead of displaying the contact center 800 number, the Cal-Fresh

Recertification unit has a county local designated phone number, which has helped to

mitigate the problem of people not answering blocked or unknown numbers.

Through this process the eligibility workers save time not chasing down each customer due

for an interview. Clerical staff handle reminder calls and assists with conducting cold calls

(using a warm hand off to an available eligibility worker when call volume allows).

Additionally, Stanislaus County employs a number of stop-gaps to complete the interview

whenever possible:

Interview customers that call in outside the appointment window, either before or

after their interview was scheduled, so long as it is within the last month of their

certification period (Ready to Interview model);

Interview customers that call the recertification line for another reason within 30

days of their recertification deadline (One Call Resolution Model).

And later in the month, as scheduled interviews slow down or during low call

volume, workers will cold call the customers that missed their interview window in

an effort to reach the customer and complete the interview (Interview Warm Calling

model).

Before implementing this system, their rate of missed interview during the first attempt

was very high, estimated at more than 90%. Since the block scheduling processes were

Page 16 of 23

implemented, including the backstops of “ready to interview” options and “one call

resolution,” they now have about 70-80% of customers completing their interview, with

about half of the customers calling during their scheduled window.13

Average queue times are about 20 minutes and days to determination is about 8 days. The

rate of missed interviews is 20% to 30%. There are about 12 eligibility workers handling

an average of 2000 CalFresh recertifications per month.

Ventura County – CalWIN

Model Implemented: Ready to Interview

Ventura County started their “ready to interview” model (which they call “reverse

recertification process”) in Oct 2017 with the goal of reducing churn and increasing

participation and dual enrollment with MediCal.

For recertifications, a customer will receive a packet with a scheduled appointment time. A

specific worker is assigned to call them for the interview. However, if the customer misses

the appointment time, the county will send a Notice of Missed Interview (NOMI) with a flier

that explains they can call in at any time during business hours to complete their interview.

(See Appendix II.)

When a customer calls in, they go through the Interactive Voice Response (IVR) system to

join the queue for CalFresh applications and recertifications, and speak with the next

available worker.

Ventura County practices “one-and-done” by using an integrated interview process and

telephonic signature to complete the recertification, including verifications, in “one touch”

whenever possible (use of The Work Number, collateral contact, etc.).

This process is also used for intake appointments for returning (eg, “churned”) customers

or brand new customers: they call in to the queue and, using the IVR, get connected to an

available worker, to go through the integrated interview process in one call.

In August 2018 they processed 624 recertifications and 564 SAR7s. The average handle

time is 15:32 to 20:02 minutes for these calls. Their average queue times in August 2018

were 2:26-4:26 minutes.

The county has seen a 26% increase in completed recertifications since this process was

implemented (data from April 2017, compared to April 2018).

13 Data shared from Stanislaus County, September 20, 2018.

Page 17 of 23

Recommendations for Flexible Interview Scheduling Implementation

The interviews on which this research was based were primarily with County Welfare Departments, thus most of the recommendations are primarily related to their peers, and divided into topical categories. Additional recommendations for CDSS, Community-Based Organizations, and the SAWS development and migration are below.

CDSS

1. Issue guidance about county telephone numbers not needing to be blocked, along with reissued guidance about EW’s leaving voice messages for clients.

2. Develop funding for and work with community partners to translate notices into threshold languages and/or review existing translations.

3. Update guidance on verifications.

a. Update the 2011 guidelines with a focus on supporting streamlined processes, such as noting the instances where verifications are sufficient and “not questionable.”

b. Encourage counties to implement strategies to reduce excessive verifications which can lengthen the interview and determination processes unnecessarily.

c. Work with the Civil Rights Unit to develop research on the rates of excessive verification for non-English speakers and people of color. Share the results with counties and encourage them to implement implicit bias training that incorporates all aspects of the eligibility process. Consider developing training on this topic.

Counties

1. Culture of the workforce

a. Start with a good feel for where your organization is in terms of culture. It is easy to focus on procedure, but there needs to be a “culture of access” in place that is motivated to support the change. Engaging and aligning culture is an ongoing process.

b. Link the intended change to what matters to staff and their values related to supporting individuals and families; that’s where the rubber hits the road.

c. Engage lead workers as well as leadership in implementation of the model(s).

d. Allow room for mistakes as things are being figured out. Mistakes are opportunities to learn and there needs to be freedom to share mistakes without fear in order to improve.

e. Be prepared to make changes when necessary (for example, when extremely short staffed, workers may need to focus on handling calls more quickly and scheduling interviews for a later date instead).

Page 18 of 23

f. Engage with the disability access coordinator to improve access for all.

2. Implementation

a. Complete a soft rollout using before and after stats to assess the model.

b. Ensure strong communication between the IVR/contact center manager and the intake and recertification teams managers (or equivalent).

c. Already having call center software licenses for their workers allows for expansion with minimal additional investment.

d. Develop a well-researched IVR/phone tree that can direct customers to the information they need without having to speak to a worker, or into the correct queue with a limited number of decision points.

e. Connect with the county’s data analyst to make sure that you will be able to track progress and see trends in churn, percentage of new applicants who complete their interview, etc. so that you can see if the new business process is having the intended results.

3. Working with Partners

a. When partnering with a CBO to implement a flexible interview process, assign a staff person as the liaison available for direct contact to help ensure a strong the communication process for reporting concerns and successes along the way.

b. Work with a community partner to pilot a process with a manageable number of applicants in order to get the process right before expanding.

c. Start with a partner that is interested in helping to get the process right and that will be open to communicating concerns.

d. Explain the jargon and make sure it is clear to partners.

e. Over-communicate about how things are going when the project launches (e.g., check in with the application assister after each call in order to quickly identify what’s working well and what needs to be improved).

4. Integrated Interviews

a. Maximize options such as electronic verifications, collateral contacts, sworn statements, and real-time image uploads in order to reduce the number of touches.

b. Continue training to reduce over-verification, which can lengthen the interview and determination processes, and reduce participation unnecessarily.

5. Block Scheduling

a. Staff the unit appropriately and have a backup plan for when workers are absent.

b. Stagger the phone call start times.

Page 19 of 23

c. Spread out unique populations within the calls from the general population.

6. General Recommendations a. Consider using auto-dialers, text messaging, or clerks to call with

appointment reminders in order to encourage people to complete their interview.

b. When sending fliers to notify customers about the interview options, use bright colored paper; do this for an extended period of time to ensure that existing customers cycle through at least once (note that some households have a longer certification period and may need the notice up to 36 months after initial determination).

c. Communicate with CBO partners when necessary (eg, during high call volume) to limit contact center impacts.

d. Map the customer experience and work with partners to identify ways to make the process accessible to all people. In particular, plan a model that will meet the needs of vulnerable populations such as SSI recipients.

e. Focus on First Contact Resolution at call centers and beyond (see Box 5).

f. Use a prerecorded Rights and Responsibilities as part of the electronic/telephonic signature; the eligibility staff can use the down time to do administrative work to complete the interview process during the recording.

g. Develop funding for and work with community partners to translate notices into threshold languages and/or review existing translations.

Community Based Organizations

1. Partner with the CWD to ensure understanding of the county’s processes and the customers’ options so that customers can be informed.

2. Encourage CalFresh customers to reach out to the CWD themselves to schedule their interview if necessary; they don't have to wait for the appointment letter.

3. Share success stories with your CWD to highlight the ways models are supporting customers, reducing churn, and improving the interview process.

4. When partnering with your CWD to implement a flexible interview process, share your insights and suggestions in a timely and thoughtful way.

5. Coordinate with your CWD about the best dates to refer your customers. For example, Mondays and after holidays they might see the most demand.

SAWS development and migration

1. Identifying technology and business process options that support integrated interviews (see Box 5).

2. For procurement, require that calendaring options (either within the system or as ancillary systems) can be connected to the portal to allow customers and CBOs to book an interview appointment time and location/method (in person or on the

Page 20 of 23

phone). In the future, this may be an additional way to ensure customers can connect with their interviewer.

3. Include auto-dialers and text messaging services in core or ancillary systems for all counties.

4. Portal and online options should automatically opt customers in to text and/or email reminders, with the option for customers to opt themselves out.

Page 21 of 23

Appendix

I. Stanislaus Notice of Action Letter – Block Scheduling Language

YOU MUST CALL US AT (209) 558-1750 TO COMPLETE YOUR PHONE INTERVIEW This appointment will last approximately one hour. Your CalFresh certification period ends on ##/##/####. If you want to continue receiving CalFresh benefits, you must complete the entire recertification process. In order to process your recertification, you must complete the following 3 steps prior to ##/##/####: 1. Submit your completed forms * Your CalFresh recertification packet is enclosed. Please complete the forms to the best of your ability; sign, date, and return them within 5 days from receipt of this letter. 2. Complete your CalFresh recertification phone interview * You must call us on your scheduled appointment date between #:## #M and ##:## #M. 3. Provide requested verifications* Submit verifications of all household income and any other verifications requested from you by the County. IMPORTANT REMINDERS * YOU MUST COMPLETE YOUR SCHEDULED PHONE INTERVIEW and the steps listed above to prevent a delay or discontinuance of CalFresh benefits. * If you need to change your appointment, please call (877) 652-0734 to reschedule your appointment. *If there is a need to be interviewed in person or if you need help completing the paperwork, please come to the office on your scheduled appointment date and bring all verifications of income.

Page 22 of 23

Page 23 of 23