Policy & Practice June 2015

as they understand how changes on the horizon personally benefit them and their customers. Leadership also looks to create a culture of fun to help staff and clients embrace the new changes. For example, in 2014 there was a Lobby Computer Championship in which offices competed against each other on increasing client use of lobby computers. The goal of the contest was to educate clients and staff on all of HHSC’s self-service offerings. This created excitement, creativity, and sharing best practices across the state. Offices that excelled went on the road to serve as mentors to others. For example; one clerk started a new approach to helping people in the lobby. Seeing that it was effective, other staff voluntarily followed. This clerk and her manager then went out and worked a day in many of the lobbies across the state, helping other staff get comfortable with increased customer interaction. Private-public partnership. Part of HHSC’s strategy in meeting growing caseload demand is a commitment to Community Partner collaboration and recruitment. Community Partners fall under many different categories such as domestic violence shelters, schools, libraries, or food banks but they all share the common goal of offering clients additional locations to apply for benefits on YourTexasBenefits.com. HHSC has nearly doubled its number of Community Partners in the last 18 months to 1,000+ partners. This reduces the workload for Texas HHSC case management staff and provides more convenient options for clients. Making a Real Impact HHSC leadership credits all of these strategies working together holistically when it comes to the positive results the agency has been experiencing. The improvements have allowed the state to serve more people without an increase in staff

resources. The eligibility caseload has increased 16 percent since FY 2011 while the number of eligibility staff has remained relatively constant. The increase in self-service directly correlates to reduced turnover and decreasing overtime. Average days to disposition are decreasing, and same-day dispositions are increasing. For example, in 2007, only 58 percent of SNAP applications were processed on time, and the state had a 7 percent error rate—well above the national average. In 2014, 97 percent of applica- tions were processed on time, and the SNAP error rate was 0.68 percent—an all-time low for Texas and among the best in the nation. In 2014, the federal Health Insurance Marketplace sent more than 268,000 new applications to Texas. Despite this new influx of work, client applications stayed on track and accurate in eligi- bility determinations. The decrease in overall office visits helps state staff devote more time to those who need extra help. As of December 2014, 70 percent of client applications are now submitted online, up from 14.6 percent in January 2012. The ability to upload required docu- ments, like a paycheck stub, and send it to the state on YourTexasBenefits. com and now, the Your Texas Benefits smartphone app, has led to a decline in vendor payments for document imaging from $7.8 million in 2012–2013 to $6.3 million in 2013–2014. Payments for call centers and document processing fell $12.7 million between FY 2012 and FY 2014 while the monthly caseload increased by more than 600,000 during the same period. Where to Learn More Other stories of agencies from around the country can be found at http://aphsa.org/content/APHSA/en/ pathways/TransformationsinAction. html.

continues to plan ahead for the future. The two technology cornerstones are focused on providing clients with a portfolio of self-service options via the web site, YourTexasBenefits.com, and a Your Texas Benefits smartphone app. YourTexasBenefits.com offers clients the ability to apply, renew, and report changes for their benefits at any time and anywhere. The app is focused primarily on features easily done by smartphone, such as uploading docu- ments and signing up to receive case alerts via e-mail or text message. The increased use of self-service options helps manage workloads by reducing data entry, client traffic, and calls to eligibility offices or call centers. This allows staff to focus on their core function of making accurate and timely eligibility decisions. Vendor costs are also reduced because fewer documents are imaged and call volume is decreased. Short-term plans in 2015 for self- service are the ability to opt-out of mail reminders as well as a newly rede- signed YourTexasBenefits.com based on client input. To ensure high utilization, none of the new technological advances are rolled out without user testing and robust staff training. Communications. Effective com- munications play a key role in adoption of any changes. Every channel of communication—e-mail, videos of staff working together to design the process, newsletters, a robust network of Change Champions (comprised of field staff), and face-to-face meetings with staff— has been used to promote new strategies to every worker in every HHSC office and to other stakeholders as well. Proactive and frequent communica- tion has helped quell any fears among staff that they would be forced out of their jobs or expected to work longer hours at breakneck speed. Workers are more invested in their performance

The increased use of self-service options helps manage workloads by reducing data entry, client traffic, and calls to eligibility offices or call centers. This allows staff to focus on their core function of making accurate and timely eligibility decisions. Vendor costs are also reduced because fewer documents are imaged and call volume is decreased.

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June 2015   Policy&Practice