Tiffinie Miller-Sammons, E&EA Deputy Director

Sue Krey, E&EA Program Operations Manager

October 15, 2019

The current work Projected workload Quality of service

How much? How well? Is any one better off?

Strategy to maximize resources Questions

2

Agenda

County Comparison

County

MA caseload

on 12/31/13 Pre-ACA

MA caseload

on 7/31/19

MA caseload growth

since 2013

% of MA growth post-

12/31/13

FTE addition

2013-2015

**FTE requests

2016-2019

Total FTE

additions

Ratio of new staff to new cases 2019

Anoka

22,215

32,685

10,470 47% 18 3 21 1:499

Dakota

21,325

36,218 14,893 70% 17 11 28 1:532

Ramsey

58,277

80,478

22,201 38% 26 12 38 1:584

Scott

5,384

9,983

4,599 85% 7 2 9 1:511

Stearns

10,332

16,229

5,897 57% 7 4 11 1:536

Washington

9,599

17,013

7,414 77% 9 3 12 1:618

Caseload History

0%

2%

4%

6%

8%

10%

-

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Unemployment Rate Singles Case Food Support Medical Assistance Family Cash

Ave

rage

Mon

thly

Cas

eloa

ds D

akota County U

nemploym

ent Rate

Source: Minnesota Department of Employment and Economic Development and Dakota County Department of Employment and Economic Assistance

1,365

3,250

8,250

36,218

2019/2020 Impacts to the Work

Increase Staff Time- Mandated program integrity

work; AVS, PDM, and ROP Limitations in system functionality Federal Tax law changes System and internal Child Support

referral process improvements Enhanced integrated service

delivery within E&EA and with Social Services and Corrections

Decrease Staff Time- Address Wizard streamlined

address change and county case transfer process

Improvement to METS to MMIS interface

Continued improvements on eligibility notice to customers

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

Maxis-Pre ACA All Maxis METS 8/1/19 METS Projected 2021 All cases in METS

Hou

rs P

er M

onth

Misc. Work

Walk-ins

Phone Calls

METS to MX work

Change in Circumstances

PDM in METS

6-month renewals in Maxis

Dail Messages

Reports/Tasks

Renewal Re-entries

Renewals

Applications

AVS

Workload Comparison

21,325

36,218

25,500 25,276

36,218

Monthly Average METS Health Care Applications

0

200

400

600

800

1000

1200

1400

1600

Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19

Paper Applications Online wth worker intervention Online with no worker intervention

0

10

20

30

40

50

60

70

2017 2018 2019

Day

s of

Pro

cess

ing APPLICATIONS

DOCUMENTSRENEWALSApplication TargetDocument TargetRenewal Target

Quality Measure: Timely Processing

How Well?

0500

10001500200025003000350040004500500055006000

2016 2017 2018 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Aug-19

# of

Cal

ls

Answered vs. Abandoned Calls

Answered Calls

Abandoned Calls

Quality Measure: Phones

0123456789

101112

Min

utes

Wait Time vs. Time to Abandoned

Waiting Time

Time to Abandon

Performance Objective <5 minutes

How Much?

How Well?

96% of Dakota County’s residents have health

insurance coverage. 14% of Dakota County’s residents are receiving

Medical Assistance 4,695 MA clients receive WIC each month 4,745 of MA recipients receive waivered

services An average of 6,388 MA recipients receive Child

& Teen Checkup benefits each month

Is any one better off?

Continued process improvement Shift current E&EA staff and support to METS Targeted teleworking Overtime based on return of investment Maintain improved random moment Resource ratio remains inline with other counties Continuously evaluating the cost benefit of various

strategies

At the end of the day, greatest efficiencies come from system functionality.

Strategies used to Maximize our Resources

Questions?

$0.00

$2,000.00

$4,000.00

$6,000.00

$8,000.00

$10,000.00

$12,000.00

$14,000.00

$16,000.00

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Act

ual S

pend

ing

2017

2018

2019

Projected

Overtime Spending

Yearly Spending Projection Actual 2015 $75,123 $79,321 2016 $179,891 $43,393 2017 $60,000 $28,892 2018 $35,000 $34,513 2019 $58,247 $44,747.30 - 10/1/19

ACA Caseload Impact to Date Pre MNsure

Medical Assistance (MA)

Cases

2013 Projected MA

Enrollment through 3/14/15

Average Monthly MA

Enrollment as of 07/31/19

21,325 26,818 36,218

26% (Projected)

70% (Actual)

Dakota County Health Care: Cases by System

34,911 35,470 36,377 37,421 37,244 36,218

05,000

10,00015,00020,00025,00030,00035,00040,000

June 2014 June 2015 June 2016 June 2017 July 2018 July 2019

Cas

es

METS

MNCareto MA

Maxis

Dakota County is represented on all of the following: County Roles and Responsibilities METS Project Management Team ended Jan 2019 County Advisory Committee (meets with members of

METS Executive Steering Committee) Integrated–Executive Steering Committee Enterprise Architecture Board AMC Health Care Work Group County presence on State workgroups

Advocacy for functional system

Medical Assistance

• Oversight by DHS • Administered by Counties • ACA brought extended eligibility and more cases

MinnesotaCare • Administered by DHS

MNsure (program and agency) • Private Health Plans • Tax Credits • Small business support

Minnesota’s Health Care Programs