Understanding how NC Fast impacts County Workload 1

2 Timothy Scott Business Process Consultant Black Belt Six Sigma Black Belt Trevor Thomason Business Process Consultant Green Belt Six Sigma Green Belt Mecklenburg County Understanding how NC Fast impacts County Workload

Meeting goals… 3 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”

Determining Time Standards & Understanding Capacity Phase 1 4

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…” subjective How can we take these subjective comments objective and respond with objective data? 5

Rodney Adam’s, Director ESD, had a business problem… 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? 6

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 8 

9 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

10 Understanding time in business processes… - Touch Time (TT) - Wait Time (WT) – Does the process STOP and wait for something to be completed How can we apply industrial engineering practices to solve this business problem?

11 Understanding time in business processes… - Touch Time (TT) - Wait Time (WT) - Cycle Time (CT) – Overall time for task to be completed How can we apply industrial engineering practices to solve this business problem?

12 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

13 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…

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

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17 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

18 Complete process map…

19 Identify key tasks…

20 Task 1 Task 2 Task 3 Task 4 Task 5 Task 6 Identify key tasks…

21 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?

22 Tool selection and criteria… ToolDurationFrequencyComplexity Timed with a stop watch – (observer) Short touch time (TT)Very RepetitiveSimple to moderate Self-timed by worker (tracking sheets) Medium to long TTRepetitive to uniqueSimple to complex Self-work sampling (15 minute increments) Medium to long TTVaried to uniqueModerate to complex actions Job shadowing (observer)AnyVaried to uniqueModerate to complex actions Data extracted from automated system Any  UNDERSTAND Business CULTURE 

23 Tool selection and criteria… ToolDurationFrequencyComplexity Timed with a stop watch – (observer) Short touch time (TT)Very RepetitiveSimple to moderate Self-timed by worker (tracking sheets) Medium to long TTRepetitive to unique Simple to complex Self-work sampling (15 minute increments) Medium to long TTVaried to uniqueModerate to complex actions Job shadowing (observer)AnyVaried to uniqueModerate to complex actions Data extracted from automated system Any  UNDERSTAND Business CULTURE 

24 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”

Create tracking tool and train staff on usage… 23

Identify skill type across sample population 24 Identify sample size, participants & skill level…

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) 25

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

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

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32 *Estimates – Time study has not been conducted for these activities **Based on proposed process to manually close case in EIS and re-key as new streamlined application in NCF. TOTAL

FNS: New Application 33 From start to finish, the average touch time to completely process a New FNS Application should take… 110 – 125 min.(Electronic) 110 – 130 min. (Electronic & paper)

34 From start to finish, the average touch time to completely process an FNS Re-certification should take… 45 – 55 min.(Electronic) 50 – 60 min. (Electronic & paper) FNS: Re-Certification

MA: New Application – NON MAGI 35 From start to finish, the average touch time to completely process a New MA Application should take… 130 – 140 min.(Electronic) 130 – 150 min. (Electronic & paper)

To Do List: 36 ProgramActivity / Next Steps FNS ChangesDetermine times for… 1) Income 2) Household 3) Deductions MA ChangesDetermine times for… 1)English 2)Bilingual MA Re-CertificationsDetermine times for… 1)English 2)Bilingual MA Applications (Non-MAGI)Determine times for… 1)Face to face 2)Mail/fax/drop-offs 3)ePASS 4)FFM Transfers Work FirstDetermine time for… 1)Client Application & Assessment 2)Case Management Long Term CareDetermine time for… 1) Application process 1) Re-Certification

It’s important to understand the amount of variability… Reduce the amount of variability; compress the upper and lower control limit 35 Managing variability in processes… Common Cause Variation & Special Cause Variation

Developed a forecasting model 36

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

Disciplined and pragmatic approach to determine capacity 40

Determining Time Standards & Understanding Capacity Phase 2 41 Capacity Model

42 Demonstration

43 Questions?

44 Timothy Scott Business Process Consultant Black Belt Six Sigma Black Belt Trevor Thomason Business Process Consultant Green Belt Six Sigma Green Belt Mecklenburg County Understanding how NC Fast impacts County Workload

45 Thank you…