P&P August 2016

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Where Did Things GoWrong?

inadvertently neglected to keep existing business processes and tech- nology updated. The agency reverted to manual processes that only exac- erbated the problem in the lobby and throughout the organization. To manage the overloaded lobby, the department added a DMV type of ticketing system, requiring every client to take a ticket and see a front desk worker whether the client was there for a scheduled appointment, walking in, dropping off documents, or making a simple change in name or address. For walk-ins, the agency bypassed a built-in round-robin feature in the appointment management software that automatically distributes clients to case- workers based on availability, as defined by automated business rules established by the agency. Instead, a clerical worker manually assigned each client. HowDid They Turn Things Around? CCDHS partnered with Northwoods to do a Health Check, where

abarrus County Department of Human Services’ clients were frustrated by a con- fusing lobby and long waits, which had a ripple effect on the agency’s

The department was performing well until the economic downturn hit. From 2008 to 2013, the number of Cabarrus County residents eligible for Medicaid increased by 33 percent. The number of residents eligible for food and nutrition services increased by 62 percent. The agency also faced many of the same pressures as other agencies across North Carolina and the country: � An influx of clients seeking Medicaid through the Affordable Care Act � Adjusting to the new case man- agement system, NC FAST, which initially created a backlog as workers learned to enter applications and recertifications � High caseloads during traditionally busy times, including Thanksgiving, the end of the school year, and crisis and energy assistance seasons

efficiency and service delivery. The department redesigned its lobby, upgraded technology, and modernized business processes to reduce client and caseworker frustration and process applications for services much faster. Walking into Cabarrus County Department of Human Services (CCDHS) is like night and day for people who need economic assistance. Before a recent business process overhaul and modernization of the lobby, clients often waited in long, con- fusing lines. They were frustrated, as were the caseworkers trying to help. To improve service delivery, the agency redesigned the lobby, updated its appointment management software, and modernized business processes to provide services more holistically and more quickly to clients.

The agency worked hard to keep up with the volume of clients, but

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Policy&Practice   August 2016