Welcome to San Diego! NAPIPM th Annual Education Conference

Transcription

1 Welcome to San Diego! NAPIPM th Annual Education Conference 1

2 POLICIES, PRACTICES & PEOPLE: PERFORMANCE-BASED CONVERGENCE IN ACTION NICK MACCHIONE, FACHE DIRECTOR COUNTY OF SAN DIEGO HEALTH AND HUMAN SERVICES AGENCY August 19, 2014

3 SAN DIEGO COUNTY 3.2 million residents 5th largest county in the U.S. Urban & rural, from coast to mountains to desert 18 municipalities, 18 Indian Sovereign Nations and several unincorporated towns 2010 Census White 48 % Hispanic 32% Asians 11% African-American 5% Native American 1% San Diego County is 4,200 square miles 3

4 SAN DIEGO COUNTY GOVERNMENT 4 Board of Supervisors publicly elected by District 5 Major Groups Health and Human Services Agency Created in 1998, Integrated Delivery System Public-private partnership emphasis $2+ billion annual budget 6,000 FTEs, 185 advisory boards ~ 1 million clients from Womb to Tomb Land Use and Environment Group Public Safety Group Community Services Group Finance and General Government

5 HEALTH AND HUMAN SERVICES AGENCY Departments: Aging & Independence Services Behavioral Health Services o Adult Mental Health o Children's Mental Health o Alcohol and Drug Services Child Welfare Services Public Health Services Eligibility Operations Regional Operations Administration oprogrammatic links to many County groups including: Probation, Sheriff, Housing, Libraries Impact the general public (3.2M) and clients at risk and at high risk/need (~1 M)

6 PROBLEM Lack of Exercise Poor Diet Smoking 6

7 RESULT Lead to Result in OVER BEHAVIORS DISEASES PERCENT No Physical Activity Poor Diet Tobacco Use Cancer Heart Disease & Stroke Type 2 Diabetes Lung Disease of deaths in San Diego

8 8 GRIM OUTCOME

9 COST ECONOMIC IMPACT: $4.6 BILLION IN SAN DIEGO COUNTY

10 SOLUTION Building Better Health Living Safely Thriving

11 LWSD APPROACH Change how service is provided to improve health and social wellbeing: Optimize existing healthcare, public health and social service resources to innovate service delivery, reduce waste and improve outcomes Create local accountability by all, not some Health & Safety-In-All-Policies Promote individual responsibility Achieve fiscal sustainability thru new payment reforms Connect the Unconnected thru modernized IT Advance evidence-based policy-making and planning

12 COLLABORATIVE BUSINESS MODEL The Harvard Human Services Value Curve Efficiency in Achieving Outcomes Generative Business Model Integrative Business Model Collaborative Business Model Regulative Business Model Effectiveness in Achieving Outcomes 12

13 DRIVING FACTORS Efficiency in Achieving Outcomes We re all in the business of serving the public. We need to work together to best leverage existing resources and meet shared goals. The management choices we make are influenced by: Generative Business Model Integrative Business Model Collaborative Business Model Business Case Imperatives and Visions Economy Budget Cuts and Accountability Legislation and Expectations Healthcare Reform, Title 4e, Welfare Reform Technology Changes Imposed and Advanced Regulative Business Model Effectiveness in Achieving Outcomes Human Services Value Curve, Antonio Oftelie

14 INTEGRATED SERVICES ACROSS THE LIFESPAN Drivers: Vision/Strategy Service Delivery Financing Workforce P3 in Action Children / Youth We Can t Wait Positive Parenting Program Kickstart Adults Behavioral Health / Primary Care Integration Summit Bridges to Recovery In-Home Outreach Team Older Adults Aging Summit Community Care Transition Program Passport to Healthy Aging Behavioral Health Services Primary Care Human Services 14

15 CHALLENGE How could the County of San Diego expand the capacity of its Family Resource Centers to meet greatly increased demand first for CalFresh (SNAP) and then Medi-Cal Expansion? Response: Re-engineered Eligibility Process, including a new state-of-the-art Access Customer Service Call Center. 15

16 PERFORMANCE CHALLENGE Performance Sept Calls Handled via Self-Service 10,612 Calls Answered 32,717 Abandoned Calls 13,978 Total Calls 59,969 Calls Answered Per Work Day 1,558 % Calls Answered 76.7% ACCESS Average Wait Time 39:02 Average Handle Time 14:52

17 PROJECT APPROACH Business Process Re-engineering Data Analysis Best Practices: Site visits to 211 San Diego, Orange County & San Bernardino Call Center Vendor Consultation Customer Feedback: Caller Surveys, Staff Focus Groups

18 ACCESS CENTER PROJECT SCOPE Staffing Immediate intervention Long term strategy Training Immediate intervention Long term strategy Call Center Performance Strategic Vision Tactical Management Interactive Voice Response (IVR)

19 ACCESS CENTER

20 WALLBOARD TRACKING ACTIVITY

21 PERFORMANCE MONITORING Performance Comparison Sept July 2013 July 2014 Calls Handled via Self-Service 10,612 18,909 15,081 Calls Answered* 32,717 56,694 66,440 Abandoned Calls* 13,978 13,567 12,461 Total Calls* 59,969 94,828 95,967 Calls Answered Per Work Day 1,558 2,709 3,020 % Calls Answered 76.7% 85.7% 87.0% ACCESS Average Wait Time 39:02 15:50 13:50 Average Handle Time 14:52 14:01 15:50 *ACCESS + 211

22 CUSTOMER SERVICE FEEDBACK I am satisfied with the Call Center. 60% 59% 64% 40% 20% 26% 11% 9% 30% Sep 2011 July % Strongly Disagree Disagree Neutral Strongly Agree Agree

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24 KEY TAKE-AWAYS: IT S ABOUT Common Vision Enables strategic alignment and silo-busting Business Imperative Innovate to adapt. Changing the Culture from Within We are in the wellness business. Customer, Customer, Customer Focus on the customer experience and pathways through the system. 24

25 FROM WELFARE AND SICK CARE TO WELLNESS Past Present and Future Transactional Transformative Volume-Based Value-Based Competitive Advantage Co-opetition Silos & Categorical Integrated System Connecting the Unconnected Sick Care/Social Welfare InterOptimibility Wellness 25

26 CALL TO ACTION How do we improve the wellness of our communities? 26

27 TO LEARN MORE Live Well San Diego Visit LiveWellSD.org Or us at

28 28 THANK YOU!