The Sampson County Department of Social Services is trying to reduce system inefficiencies, improve customer experience and ensure successful implementation of health care reform as part of a statewide push, all while dealing with “record growth” in caseloads.
A phase-by-phase automation through N.C. FAST (Families Accessing Services through Technology) is anticipated to be a huge step toward more efficient and cost-effective service. Sampson DSS director Sarah Bradshaw called it “one of the biggest priorities for next fiscal year,” during a presentation this week at the Sampson County Board of Commissioners planning session.
The first wave of automation, involving the Food and Nutrition Services (FNS) program, has already been launched. As kinks continue to be worked out, the next deadline for implementation has been set for October 2013.
N.C. FAST is a system of automated tools for DSS workers to quickly assess the clients’ needs and determine if they are eligible for public assistance. It is designed to improve the way the N.C. Department of Health and Human Services and county Departments of Social Services do business.
Along with giving caseworkers the tools to quickly identify and assess client needs and determine eligibility, N.C. FAST will allow for comprehensive management so cases can be tracked, information shared and services coordinated across program areas and county lines securely and confidentially.
“We have been dealing with a lot of cases, a lot of work, but when you have a paper system and not a paperless system, it’s kind of a mess,” said Bradshaw.
The N.C. FAST program, already implemented for FNS, that mess has been alleviated somewhat. That first phase of N.C. FAST was fully launched in November 2012, involving new equipment, software, temporary staff and overtime. The next wave of implementation will be “Project 2&6,” automation for Work First (Temporary Assistance for Needy Families, or TANF), Medicaid, Special Assistance and Long Term Care.
Currently at DSS, there is a continued growth in clientele and caseloads. Bradshaw offered statistics to illustrate that point.
In January 2008, there were 14,569 recipients of Medicaid in Sampson. In January 2013, there were 17,462. In the FNS program, there were 3,770 county cases in January 2008. Five years later, the number stands at 5,745.
“That is a humongous increase,” Bradshaw noted.
The same can be seen in child care. Five years ago, there were 72 children in foster care, where there is now 120.
And growing caseloads have highlighted inefficiencies in systems, not only in Sampson, but across the state.
Bradshaw said there is duplication of paperwork and unnecessary paperwork, inconsistencies in eligibility rules across programs and multiple reception and intake procedures that can be frustrating and confusing for all parties involved. That includes DSS staff and the families who are telling their stories multiple times to multiple people.
As a result, the state is on a parallel track toward a business redesign that will simplify programs and align eligibility procedures, while also implementing N.C. FAST, Bradshaw noted.
DSS officials have touted the “one-stop” application process N.C. FAST offers, in which the person will give eligibility information just one time, to one worker. Staff is able to spend less time on administrative tasks and more time assisting families. The end result, Bradshaw said, will be no wrong door for accessing benefits and an end to silo-based work, where improved customer service is provided by universal workers.
“When this is all said and done and implemented, there will not be an individual Medicaid worker, a Food and Nutrition worker or a Child Care worker,” said Bradshaw. “There will be one worker — a universal worker. We look forward to improved customer service and all of this reducing operational costs.”
County cost
For 2013-14, that will mean updated computer equipment for staff, computer software licenses, scanning equipment temporary staff, overtime for current full-time staff, additional clerical support and training. Public awareness and outreach work will also be a part of that effort.
“With the Food and Nutrition program alone, there were days about a week or so ago, that we got about 400 calls a day. It’s unmanageable,” said Bradshaw. “It’s because the system changed and there’s problems, hiccups across the state. We’ve gotten plenty of calls and concerns from people. If you can’t process their case quick enough because the system is slow, a person is not getting their Food and Nutrition Services benefits loaded and they literally don’t have food in the house.”
The projected cost to implement Project 2&6 for N.C. FAST would encompass a laserfische license, server, support and backup, as well as computers, dual monitors, scanning stations and maintenance on scanners. On the personnel side, temporary staff will be needed to scan and convert paperwork.
There were three temporary workers hired for the FNS conversion, and that was quickly doubled. There are three times more Medicaid cases involved, and a firm October 2013 deadline to get the automation of those cases completed.
The total cost comes to $315,000. About $140,000 has already been built into the DSS budget, with FNS having already been accounted for in the automation process. The difference would be a little over $175,000 in additional funds needed. Of that $175,000, 51.5 percent would be paid with federal dollars, an additional 1 percent would be paid through state funds and the remaining 47.5 percent would have to come from county funds.
That county cost would be $83,166.42 in additional county expense.
“That could fluctuate, just depending,” said Bradshaw. “It is going to involve a lot of temporary staff.”
Chris Berendt can be reached at 910-592-8137 ext. 121 or via email at cberendt@civitasmedia.com.
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