Understanding how NC Fast impacts County Workload

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Understanding how NC Fast impacts County Workload

Timothy Scott Business Process Consultant Six Sigma

Black Belt

[email protected]

704-591-5007 Trevor Thomason Business Process Consultant Six Sigma

Green Belt

704-363-5447

Mecklenburg County

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Meeting goals…

• Establish time “standards” in NC Fast • Help counties understand how NC Fast impacts their business/budget • Review how counties can measure, track, and analyze the productivity of staff working in NC FAST • Discuss the data we have today • Understand how we captured this information • Are we missing any data • Determine next steps • Review

“Capacity Model”

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Determining Time Standards & Understanding Capacity

Phase 1

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How is NC Fast impacting your county… “NC Fast is slow and processing applications is taking longer...” “Our clients are waiting longer to get their benefits…” “Staff is working more overtime to handle our workload…” “We don’t have enough people in our office to handle the additional work it takes to process a claim…” “My County Commissioners want to understand how this is impacting our ability to serve our citizens…” “How is NC Fast impacting county workload…” How can we take these

subjective

comments and respond with

objective

data?

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Rodney Adam’s, Director ESD, had a business p roblem… • How is NC Fast impacting our ability to process applications?

• How many people do I need on staff for FY 2015 budget?

• How many applications can I process with the staff I have?

• What service level can be reasonably achieved?

…What is the current capacity in Mecklenburg County?

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• Be flexible • Develop DSS Strategic Plan • Partner to develop a “Consolidated Services Model” • Increase communication • Increase learning and continuous quality

We NEED to understand capacity

Move from “Reactionary” to “Predictive” …Tactical to Strategic …Random to Balanced …Unanticipated to Planned

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How can we apply industrial engineering practices to solve this business problem?

• Understanding time in business processes … - Touch Time (TT) –

How long it takes to complete a task 9

How can we apply industrial engineering practices to solve this business problem?

• Understanding time in business processes … - Touch Time (TT) - Wait Time (WT) –

Does the process STOP and wait for something to be completed 10

How can we apply industrial engineering practices to solve this business problem?

• Understanding time in business processes … - Touch Time (TT) - Wait Time (WT) - Cycle Time (CT) –

Overall time for task to be completed 11

How can we apply industrial engineering practices to solve this business problem?

• Understanding time in business processes … - Touch Time (TT) - Wait Time (WT) - Cycle Time (CT)

Touch Time + Wait Time = Cycle Time 12

How can we apply industrial engineering practices to solve this business problem?

• • Completed process maps for key activities across DSS… Identified the major business tasks or “chunks of work” in process maps… How long does it take to complete the task?

How often does this event happen?

How complex is the task?

Consider business culture… 13

Real world example… How much does it cost to replace a muffler on my 2007 Toyota pick-up truck?

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How do you establish Time Standards?

1. Understand repair procedure (

process map

) 2. Conduct time study with a fully trained technician (

gather data from case worker

) 3. Allow for non-productive time - locating vehicle, pulling into service bay, test drive after repair… (

non-productive time

) 4. Establish time standards

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Complete process map…

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Identify key tasks…

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Identify key tasks…

Task 1 Task 2 Task 4 Task 5 Task 3 Task 6 20

Considerations for time study tool selection • How long does it take to complete the task –

DURATION?

(days, hours, minutes, seconds…) • How often does this event happen -

FREQUENCY?

(yearly, monthly, weekly, daily, hourly…) • How complicated is the business process -

COMPLEXITY?

• (simple, moderate, requires specialization…) Employee / department differences –

VARIATION?

• (novice, solid performer, expert / job function) Leader / team attitude –

CULTURE?

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Tool selection and criteria…

Tool

Timed with a stop watch – (observer) Self-timed by worker (tracking sheets) Self-work sampling (15 minute increments) Job shadowing (observer) Data extracted from automated system 

Duration Frequency

Short touch time (TT) Very Repetitive Medium to long TT Medium to long TT Any Any Repetitive to unique Varied to unique Varied to unique Any Simple to moderate Simple to complex Moderate to complex actions

Complexity

Moderate to complex actions Any UNDERSTAND Business CULTURE 

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Tool selection and criteria…

Tool

Timed with a stop watch – (observer)

Self-timed by worker (tracking sheets)

Self-work sampling (15 minute increments) Job shadowing (observer)

Duration Frequency

Short touch time (TT) Very Repetitive

Medium to long TT

Medium to long TT Any

Repetitive to unique

Varied to unique Varied to unique Data extracted from automated system  Any Any

Complexity

Simple to moderate

Simple to complex

Moderate to complex actions Moderate to complex actions Any UNDERSTAND Business CULTURE 

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What are the business tasks and factors we should study?

• • • • • • • • • • Medicaid programs… Work First… Food and Nutrition programs… Size of County… Demographic differences… Representative sample… Data collection time frame… Number of study participants… Tenure of employees… How you train study participants… Is this data collection model “

Repeatable

” and “

Reproducible

”

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Create tracking tool and train staff on usage…

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Identify sample size, participants & skill level…

Identify skill type across sample population 24

Factors to consider when determining capacity:  Employee productivity  Number of meetings  Vacation, sick days and holidays  Training requirements  Team building days  Overtime considerations  Workdays per year (256 days)  Employee skill level (Expert, Solid Performer, Novice)  Type work done (duration, frequency, complexity, variation, culture)

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Food and Nutrition Services New Application Processing (Touch Time per Task - Minutes) 114 Minutes of Total “ Average Touch Time” 19 mins 14 mins 23 mins 16 mins ISSI Search and Registration n=40 NC FAST Search & Registration n=29 Keying Application in NCF & Assigning n=21 Updating ISSI n=50 1 – 50 mins 1– 31 mins 1 – 58 mins 3 – 75 mins Data ranges for each step in FNS Application Processing 42 mins Processing Application n=37 3 – 90 mins n = number of samples taken for a specific step 26

Medical Assistance New Application Processing (Touch Time per Task - Minutes) 126 Minutes of Total “Average Touch Time” 10 mins 18 mins ISSI Search and Registration n=40 NC FAST Search & Registration n=45 28 mins Keying Application in NCF & Assigning n=21 15 mins Updating ISSI n=50 1 – 31 mins 1 – 97 mins 1 – 112 mins 3 – 51 mins 55 mins Processing Application n=37 1 – 228 mins Data ranges for each step in MA Application Processing n = number of samples taken for a specific step 27

Touch Time in MINUTES Food & Nutrituion Changes * Household Changes

Bilingual

Income Changes

Bilingual

Misc. Changes

Bilingual

TOTAL

Touch time by skill Touch time by change type Touch time Bilingual vs English

Novice n Novice n Household

34

Bilingual

38

n

24

n

15

Solid

28 73

Solid

32

Income

27

English

28

OVERALL TOTAL Touch time n (sample size)

* 1 case incomplete

30 78 n

30

n

31

n

63

n

27 3

Expert

28 38 21 23.3

n

9 15 4 20

Expert

28

Misc.

30

n

48

n

23

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Touch Time in MINUTES Food & Nutrition Re-certifications * Timely

Bilingual

Untimely

Bilingual

Late

Bilingual

TOTAL

Touch time by Skill Touch time by Recert type Bilingual vs English only

Novice

41 55 37 62 42

n

41 11 4 3 1

Solid

36 49 45 50 42

Novice

40

Timely

46

Bilingual

47

n

190

n

60

n

74

Solid

49

Untimely

43

English

38

n

21

n

105

n

151

n

41 44 7 1 12

Expert

33 25 33 27

n

38 15 6 1

Expert

41

Late

31

n

14

n

60

OVERALL TOTAL Touch time n (sample size)

* 17 cases incomplete

41 225 29

Method of Application M/F/D Face-to-face e-PASS FNS (Interview/Screen/Queue) MA (Interview/Screen/Queue) 5 minutes 45 minutes * 5 minutes * 5 minutes 45 minutes * 5 minutes * FNS (Processing) 115 minutes 75 minutes * 115 minutes * MA (Processing) 115 minutes TOTAL TOTAL 120 minutes 75 minutes * 120 minutes * 115 minutes * 120 minutes * *Estimates – Time study has not been conducted for these activities Program FNS MA Screen/Queue Re-Certification 5 minutes 5 minutes ** 40 minutes 115 minutes ** Total 45 minutes 120 minutes ** **Based on proposed process to manually close case in EIS and re-key as new streamlined application in NCF.

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FNS: New Application

From start to finish, the average touch time to completely process a

New FNS Application

should take… 110 – 125 min.

110 – 130 min. (Electronic) (Electronic & paper)

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FNS: Re-Certification

From start to finish, the average touch time to completely process an

FNS Re-certification

should take… 45 – 55 min.

50 – 60 min. (Electronic) (Electronic & paper)

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MA: New Application – NON MAGI

From start to finish, the average touch time to completely process a

New MA Application

should take… 130 – 140 min.

130 – 150 min. (Electronic) (Electronic & paper)

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To Do List:

FNS Changes Program MA Changes MA Re-Certifications MA Applications (Non-MAGI) Work First Long Term Care Activity / Next Steps

Determine times for… 1) Income 2) Household 3) Deductions Determine times for… 1) English 2) Bilingual Determine times for… 1) English 2) Bilingual Determine times for… 1) Face to face 2) Mail/fax/drop-offs 3) 4) ePASS FFM Transfers Determine time for… 1) Client Application & Assessment 2) Case Management Determine time for… 1) Application process 1) Re-Certification

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Managing variability in processes… Common Cause Variation & Special Cause Variation

It’s important to understand the amount of variability… Reduce the amount of variability; compress the upper and lower control limit 35

Developed a forecasting model

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Developed a forecasting model

Given the application volume stated above, this is the number of staff needed to process claims 37

Disciplined and pragmatic approach to determine capacity

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Determining Time Standards & Understanding Capacity

Phase 2

Capacity Model

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Demonstration

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Questions?

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Understanding how NC Fast impacts County Workload

Timothy Scott Business Process Consultant Six Sigma

Black Belt

[email protected]

704-591-5007 Trevor Thomason Business Process Consultant Six Sigma

Green Belt

704-363-5447

Mecklenburg County

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Thank you…

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