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1 Welcome to San Diego ! NAPIPM 2014 34 th Annual Education Conference.

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Presentation on theme: "1 Welcome to San Diego ! NAPIPM 2014 34 th Annual Education Conference."— Presentation transcript:

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

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  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

4 SAN DIEGO COUNTY GOVERNMENT 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 4

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 o Programmatic 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 6 Lack of ExercisePoor DietSmoking PROBLEM

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

8 GRIM OUTCOME… 8

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

10 Building Better Health Living Safely Thriving SOLUTION

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 Effectiveness in Achieving Outcomes Regulative Business Model Generative Business Model Integrative Business Model Collaborative Business Model Outcome Frontiers 12

13 DRIVING FACTORS 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:  Business Case – Imperatives and Visions  Economy – Budget Cuts and Accountability  Legislation and Expectations – Healthcare Reform, Title 4e, Welfare Reform  Technology Changes – Imposed and Advanced Efficiency in Achieving Outcomes Effectiveness in Achieving Outcomes Regulative Business Model Generative Business Model Integrative Business Model Collaborative Business Model Outcome Frontiers Human Services Value Curve, Antonio Oftelie

14 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 INTEGRATED SERVICES ACROSS THE LIFESPAN Drivers:  Vision/Strategy  Service Delivery  Financing  Workforce  P3 in Action Drivers:  Vision/Strategy  Service Delivery  Financing  Workforce  P3 in Action Behavioral Health Services Primary Care Human Services 14

15 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 CHALLENGE

16 PERFORMANCE CHALLENGE PerformanceSept 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 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 PROJECT APPROACH

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

19 ACCESS CENTER

20 WALLBOARD TRACKING ACTIVITY

21 PERFORMANCE MONITORING Performance ComparisonSept. 2011July 2013July 2014 Calls Handled via Self-Service 10,612 18,90915,081 Calls Answered* 32,717 56,69466,440 Abandoned Calls* 13,978 13,56712,461 Total Calls* 59,969 94,82895,967 Calls Answered Per Work Day 1,558 2,7093,020 % Calls Answered 76.7% 85.7%87.0% ACCESS Average Wait Time 39:02 15:5013:50 Average Handle Time 14:52 14:0115:50 * ACCESS + 211

22 CUSTOMER SERVICE FEEDBACK “I am satisfied with the Call Center.”

23

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 TransactionalVolume-BasedCompetitive AdvantageSilos & CategoricalConnecting the UnconnectedSick Care/Social Welfare Present and Future TransformativeValue-BasedCo-opetitionIntegrated SystemInterOptimibility 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 THANK YOU! 28


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