FSSA releases details of new eligibility system

Press release from the Family and Social Services Administration:

FSSA Releases Details of New Eligibility System – The Hybrid System

Indiana’s Family and Social Services Administration has been known for bad customer service, subpar timeliness, and high error rates in the way it determines eligibility for Medicaid, Food Stamps (SNAP) and Temporary Assistance for Needy Family (TANF) programs. From 1990 to 2002, Indiana was fined eight times for more than $60 million by the federal government for its failure to make decisions on SNAP eligibility in a timely manner. Thirty-five percent of the Medicaid long-term care applications (FFY 2003) and 25 percent of the TANF applications (FFY 2006) approved by FSSA contained errors, and in FFY 2005, FSSA paid SNAP recipients $33.9 million more than they were entitled.

It was this crisis that led Governor Mitch Daniels in 2005 to begin the process of developing a system that would serve our clients better by offering more options to apply, a more accountable and efficient system, and a better customer service environment. What was then called the Eligibility Modernization project was intended to change the eligibility system from one where modern forms of access, such as the Internet and interactive voice response (IVR) systems, were not available. A system where 48 percent of FSSA clients found it difficult to reach their caseworker and 15 FSSA employees, along with 21 of their co-conspirators were convicted of welfare fraud.

As is common knowledge, the Eligibility Modernization project did not achieve many of the goals it set out to accomplish. Timeliness and accuracy remained low, and clients often complained of poor customer service. As a result, earlier this year, Governor Daniels and Secretary Anne W. Murphy cancelled the state’s contract with International Business Machines (IBM), the company that had served as the prime contractor for the Eligibility Modernization project.

Since cancellation, FSSA has been working tirelessly to develop a new system to determine eligibility that would incorporate the lessons learned from both the old, pre-modernized system and the modernized system. FSSA began by soliciting input from providers, clients, advocates, employees, and the general public. FSSA established an email address (hybridinput@fssa.in.gov) and received hundreds of responses from individuals sharing their experiences and suggestions. FSSA also received responses by mail from individuals who did not have access to email. Additionally, FSSA created a small working group of providers and advocates from all around the state to provide input to the Division of Family Resources’ (DFR) team as they were developing a hybrid.

The Hybrid System, detailed here, is a direct result of the lessons learned from pre- and post-modernization; input from clients, advocates, providers and the general public; and the work done by DFR staff. As the pilot region rolls out, FSSA will continue its dialogue with clients, advocates, providers and the public by keeping the email address activated, and establishing advisory groups in each region as they roll-out to continually receive updates on how the Hybrid System is working.

The Hybrid Plan:

After considering many different regions, the Vanderburgh Region will be the first to roll-out sometime in January (the exact date will be released in a subsequent announcement). The Vanderburgh region contains Daviess, Dubois, Gibson, Knox, Perry, Pike, Posey, Spencer, Vanderburgh, and Warrick counties.

• The largest difference between the Hybrid System and the modernized system will be an increased focus on face-to-face contact.
  • County office staff will be increased. This staff will transfer from the Service Centers (more information on staffing changes in Vanderburgh County and changes to the Service Centers are detailed below).
  • Team Concept: FSSA caseworkers (SEMs) and contractor staff will be formed into teams that will work together on cases.
  • Clients will be served by a team in their county (as opposed to the modernized system, where your case could be handled by employees from all over the state).
  • Each team member will have the personal knowledge to assist their clients with their case.
  • Teams will allow newer workers to be paired with more experienced workers to learn from their example.
  • The two-tiered system will remain.
    • Under the two-tiered system, a different employee approves benefits than the employee who processes the case. This adds more accountability and allows mistakes to be corrected early.
    • Each team will contain both tiers.
    • The two-tiered system has helped to eliminate claims of employee fraud since it was instituted.
  • The increased options to clients seeking to apply for benefits, make changes to their case, or receive information or help with their case will remain.
  • Clients will still be able to fax/mail documents.
  • Clients who wish to call and talk to one of their team members will have their calls automatically transferred to their local office rather than a centralized call center (as was the case in the modernized system).
  • Clients will still be able to call the IVR to receive information on their case 24 hours a day, 7 days a week.
  • Clients will still be able to apply on the internet and complete their application by using the electronic signature.
• To reflect a shift to a more personalized, locally based system, FSSA will now be communicating directly with area providers and advocates.
  • In the modernized system, FSSA contracted outreach and problem resolution to a vendor. In the Hybrid System, FSSA will communicate directly on a regional basis with providers and advocates. (For regional contact information, go to https://www.in.gov/fssa/dfr/4081.htm)
  • Providers and advocates will also receive periodic updates from FSSA on any changes or relevant information.
• In the Hybrid Regions:
  • Regional Managers will have more control of day-to-day operations.
  • There will also be a Deputy Manager and additional supervisors to help in the management of the local offices.
  • In the Vanderburgh Region: 20 employees will be transferred from the Service Center to the county offices.
    • The remaining employees in the Service Center will staff the Change Center.
      • Change Centers are regional centers that will handle:
        • Medicaid-only redeterminations
        • All changes related to cases in their region
        • Processing of Food Stamp Interim Reports
        • Hoosier Healthwise Applications
        • Benefit Recovery
• Document Center
  • There will be a centralized document center charged with attaching documents to the appropriate cases.
• County Offices
  • County Offices will be equipped to help clients with all aspects of their cases.
    • Clients can apply, fax, or scan documents
    • Clients may talk to one of their team members
    • Specialized workgroups will exist for the Aged, Blind, and Disabled population
• Contract Information:
  • Rather than contracting with one large entity, as was done in the modernized system, FSSA is in the process of establishing individual contracts with its vendors.
    • This will allow FSSA more direct control and management of their contracts and will improve responsiveness and accountability.
  • The contracts being established by FSSA have these major features:
    • The contract lengths are shorter than the contract with IBM.
    • The contracts are predicate upon the contractors meeting performance measures
• Time-line for Hybrid System implementation:
  • There is no time-line. FSSA will watch the pilot region carefully to make sure the Hybrid System is working before it begins planning the next region. Once the next region is determined, FSSA will announce the choice to the public.

Additional Information:

• All other counties will remain under the system they currently have. Clients should operate as usual until FSSA announces any changes coming to their county.
• As the Hybrid Plan was being developed, FSSA remained in constant contact with its federal partners.
• During the implementation of the Hybrid Plan in the Vanderburgh Region, FSSA will continue working to improve timeliness, accuracy, and the client experience in the remaining regions.