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Idaho Health and Welfare shakes up department

The numbers speak for themselves. In 2007, the Idaho Department of Health and Welfare processed 3 percent of food stamp applications within one day, while it took an average of 19 days to sort out benefit requests.

Simon Shifrin

Simon Shifrin

By the end of 2009, the department was processing 25 percent of applications on the first day, with an average of eight days for all requests.

Business leaders know that a transformation like that in customer service doesn’t come automatically – or often easily.

So how did the state agency that processes food stamps and Medicaid and symbolizes byzantine bureaucracy to many Idahoans manage a makeover that has earned a rarely granted High Performance Award from global consulting firm Accenture?

How did the department shift from receiving federal penalties in 2005 and 2006 for high error rates in food stamp processing to earning several bonuses from the federal government? And at a time when average monthly caseload for department employees has skyrocketed (doubling from 1998 to 2009, including a 55 percent increase in food stamp recipients since 2007)?

Not surprisingly, administrators say technology has helped. The department launched a three-year, $30 million overhaul of the agency’s benefits eligibility system with the help of federal and state money, replacing a nearly 30-year-old computer system and automating more of the processing of applications.

But they say that’s only a small part of what happened.

Russ Barron, welfare administrator, said that changes to the department’s business operations were even more crucial.

Barron, who holds an MBA from Boise State University, and other administrators performed a comprehensive evaluation of the department’s procedures and tried to apply the principles of “lean office,” a philosophy that tries to trim inefficient office bureaucracy in the same way that “lean manufacturing” has transformed industrial production.

Here’s what they did:

They moved caseworkers to the front entrances of department offices in place of receptionists. When people walk in the door, they immediately speak to informed decision-makers.

That often means that clients don’t have to come back a second time to resolve issues or take up staff time with additional phone calls. It also ensures that easy-to-catch mistakes on applications, such as someone with no children applying for childcare benefits, never occur.

“How much work does that create for us as they’re waiting and waiting and calling and calling?” Barron said in an interview.

It was a counterintuitive change. (Aren’t receptionists supposed to be at the front of offices?) But it worked because the administrators spent months planning and working with staff on the changes, building support at all 28 of the department’s offices.

That also allowed them to consolidate more of the tasks that didn’t require face-to-face time at the department’s two processing centers.

The department also tried to eliminate other unnecessary steps in the application process and worked with operations managers to make sure the savings were achieved at all of the 28 offices.

Overall, the department says the changes have reduced back-end work by 70 percent, freeing up significant amounts of staff time.

And many of the productivity gains were actually achieved before full implementation of the computer system, which was completed in early November.

Accenture says all these changes set Idaho apart. The company was hired as a consultant on the project – with a two-year, $7 million contract – to help transfer the computer system that the company built for four counties in California. That system initially cost $200 million to build in California, but Idaho was able to take advantage of free licensing through the federal government.

Debora Morris, senior manager of systems integration and technology at Accenture in Austin, Texas, said many government agencies think new technology will fix everything. She has worked with agencies in Texas, California, Washington, Oregon, New Mexico and Louisiana on similar projects, but none have prepared in advance for a technology upgrade with this kind of business-minded strategy.

“Not to disparage our other clients, because our other clients are committed, but Idaho is exceptional in their approach,” she said. “Because they started at the point they did and didn’t think of it as just an IT project … they did it absolutely right. They started with the business process, the people they serve and worked from there to create this new system. … When government works right, this is the picture.”

Accenture gave the department a High Performance award in December, though it hasn’t been officially announced yet. Morris said criteria for the award are strict, and the company doesn’t even grant one annually.

I’m willing to venture there are some Idaho businesses that could learn a few things from our state government.


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