Policy & Practice June 2015

Scoping Emerging Trends Texas’s population has grown and continues to grow rapidly. The increasing numbers of individuals and families have translated to greater demand for services from the Texas Health and Human Services Commission (HHSC). Between 2007 and 2012, HHSC experienced a 46 percent increase in its caseload. If the population growth continues as expected, by 2020 there will be an additional 20 percent greater need for public human services. Population is just one of the impacts on caseload. Less predictable factors such as unforeseen natural disasters and changes in policy can also place a strain on resources. In order to meet current demands and prepare for the future within the confines of current resources, HHSC has taken a proactive approach to redesigning its system for greater efficiency and effectiveness for both its staff and clients. The reality is that staffing growth does not parallel population growth. Because of this, HHSC leadership has focused its transformation strategies on creating more capacity within existing resources. Workforce Retention. The first strategy is focused on retaining current HHSC employees in order to keep experienced and competent staff on the job. Four primary areas are lever- aged to increase workforce retention: 1. Work-life balance: This is achieved by reducing extensive overtime requirements and ensuring that the eligibility process is as efficient as possible so that caseloads are man- ageable on an individual basis. 2. Development: HHSC demon- strates a commitment to employee growth by providing opportunities

Screenshots of the Your Texas Benefits app.

success. The group established prac- tices to reduce duplication of effort. They mapped the processes, identi- fied efficiencies, looked at how many people touched a case, and measured how long it took to determine eligi- bility. They standardized intake and eliminated unnecessary steps, while retaining legal requirements and only the necessary customer interactions. Management molded the workgroup’s recommendations into a cohesive plan. Incoming work was triaged based on complexity of need. Real- time data and resource management were brought into play to maintain reasonable workloads and support fluid staff assignments. The result is a highly coordinated, customer-friendly system from application start to issuing benefits. A pilot program to test the changes kicked off June 10, 2014, at Houston’s Meadowfern HHSC benefit office, where the workload stress was the highest. Leaders also recognized that for the change to be effective it had to be rolled out incrementally with strong staff support. Since March 2015, the new processes have been tested in a total of 35 pilot sites. Results of lessons learned will be compiled and adjustments made prior to state-wide implementation of the new processes in late 2015. Technology. Technology can also bring large efficiencies to the table. HHSC has had an aggressive approach to deploying digital technology solu- tions over the last five years and

for professional development and advancement for exemplary staff. 3. Active voice: Staff has the ability to offer input and voice an opinion about upcoming changes in pro- cesses. This gives them a feeling of engagement while ensuring that all changes are informed by the front- line employees that are actually conducting eligibility work. 4. Communication: Provide ongoing updates on key initiatives so the entire workforce understands the strategic direction HHSC is taking and why. Process Improvement. Texas leadership examined other states, primarily Florida and Utah, to learn about their best practices and decided to proactively conduct a redesign of the benefit eligibility process. The goals of the redesign are to free up lost capacity by reducing activities that do not add value, and decrease the days it takes to determine eligibility. HHSC knew that the best employees for redesigning the process were those that are con- ducting the current process. Forty field workers and first-line supervisors from HHSC offices across the state were brought together to form a workgroup to redesign the eligibility process from start to finish. The group was provided with a skilled change agent consultant and management support, but they designed the new system themselves and, therefore, were invested in its

Stephanie Muth is the deputy executive commissioner for the Office of Social Services at the Texas Health and Human Services Commission (HHSC).

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Policy&Practice June 2015