1. North Carolina Work Support Strategies (WSS) Aligned Certification Period (ACP) September, 2012 www.pcghumanservices.com

2. ACP Project Overview 2 As part of the Work Support Strategies initiative, this pilot was an effort to: Decrease churning (the likelihood of clients experiencing a lapse in benefits for reasons other than eligibility) Decrease the administrative duplication, and Support the efforts of clients to hold steady employment by reducing complicated enrollment processes In 2010, 67.7% of North Carolina SNAP clients were also receiving Medicaid. Shared clients across economic services programs are common in North Carolina. Similarly, there are often multiple certification periods for each program with different recertification schedules within one family.

3. Methodology 3 1.Defined FNS as the “anchor” program and the entry point through which clients were enrolled in the pilot. 2.Set the Pilot period to last from February 1, 2012 to April 30, 2012 3.Selected two counties to participate: Lenoir and Orange 4.Mapped business processes in both counties and worked with both counties to map pilot processes. 5.Expanded the scope of the pilot from walk-in clients to also include FNS mail-in and drop-off applications and recertifications starting in week nine.

4. Data Tracking 4 Data ElementDefinition Medicaid Programs Receiving Clients were entered individually by their FSIS number, as opposed to by case, since different members of the FNS case may be receiving different Medicaid programs. Valid responses included MPW, MIC, MAF, and NCHC. Result of FNS Application or Recertification This data point tracks whether the client’s FNS application or recertification was approved, denied, or withdrawn. Result of Medicaid Recertification This data point tracks whether the client’s Medicaid application or recertification was approved, denied, or withdrawn. The pilot counties collected and reported the following data to determine the effectiveness of this pilot.

5. Data Tracking 5 Data ElementDefinition Certification Period Alignment This data point tracks whether the client’s certification periods were successfully aligned or not. Valid responses included “Yes” (county staff manually aligned the certification periods as a result of this pilot), “no” (the client’s certification periods were not aligned before the pilot, and were not aligned as a result of the pilot), and “already aligned” (the client’s certification periods were aligned before implementation of this pilot policy). Reason Why Certification Periods Were Not Aligned This data point tracks why certification periods were not aligned. This is a free form field, and does not have prescribed valid answers.

6. Findings Enrollments In Lenoir County, 816 clients were enrolled in this pilot. In Orange County, 256 clients were enrolled in this pilot. Of all 1,066 clients enrolled in the pilot in both counties, the majority of clients were receiving MIC over other Medicaid programs. 69.6% were receiving MIC, while 30.2% were receiving MAF. 6

7. Findings Alignments Of the 1,066 clients from both pilot counties, 85.1% (908) did not have aligned FNS and F&C MA certification periods prior to being enrolled. Of the 908 clients whose certification periods were not aligned prior to this pilot, 51.0% (463) were aligned as a result of this policy. The remaining 49.0% (445) of cases could not be aligned for one of a variety of reasons. The most common reason certifications could not be aligned was because the client’s next certification period was more than 6 months in the future. Of the cases that could not be aligned, 69.9% (311) were due to this reason. 7 If the policy was extended for the Q1 cohort still receiving FNS and Medicaid, 97% would have aligned certification periods within 9 months as a result of this policy.

8. Key Contacts Carolyn McClanahan Chief, Medicaid Eligibility Unit NC Division of Medical Assistance 919-855-4000 Dean Simpson Chief, Economic & Family Services NC Division of Social Services 919-527-6330 8 Public Consulting Group 617-426-2026 Rachel Goldstein Public Consulting Group 828-214-3614 Erin Henderlight

9. 9 Public Consulting Group, Inc. 148 State Street, Tenth Floor, Boston, Massachusetts 02109 (617) 426-2026, www.publicconsultinggroup.com