Washington D.C.’s Department of Health Care Finance
Washington D.C.’s Department of Health Care Finance is a trailblazer, reinventing caseworker training and support.
DHCF is DC residents’ gateway to health and human services.
The Department of Health Care Finance (DHCF) is the District of Columbia’s Medicaid agency, charged with improving health outcomes by providing residents access to comprehensive, cost-effective, quality healthcare services. In 2013, DHCF launched the District of Columbia Access System (DCAS), an integrated eligibility system for Medicaid, the Supplemental Nutrition Assistance Program (SNAP),Temporary Assistance to Needy Families (TANF) and other programs.
“At least one in two DC residents touch our agency at some point, and our user base continues to grow,” says Paul Hunt, DHCF’s organizational change management lead, “which means we need to think about things like how to serve more residents more efficiently, ways to provide a more intuitive customer experience and how to do that all without sacrificing support for employees.”
HHS organizations are evolving.
DHCF’s goals reflect a larger trend sweeping health and human services (HHS) agencies. The 2010 Patient Protection and Affordable Care Act changed longstanding approaches to determining eligibility for benefits, placing new emphasis on the use of technology to qualify consumers for assistance.1 To encourage greater integration of state eligibility systems, the federal government also allocated funding to states investing in eligibility and enrollment systems.2 In response, states began to strengthen the connections between their health and human services program sand increase data interoperability and systems integration, also referred to as integrated eligibility.
Integrated eligibility systems serve as a watering hole for people to learn about and apply for a broad range of HHS programs. The unified, consistent user interface across services makes it easier for clients to enroll in programs for which they are eligible. Such systems can also potentially speed up the benefits approval processes, improve the customer experience and streamline enrollment steps — all while lowering administrative costs.
Migrating to an integrated eligibility system however represents a significant change. It requires HHS agencies to look at how they conduct business from one program to the next, and train caseworkers to use new technology systems that determine eligibility across a range of programs rather than just one. The key to success during this transition is employee training and support.
Hunt was tasked with leading this shift at DHCF, driving change management activities as well as developing an end-user transformation strategy.
“As we were migrating to a new integrated eligibility and enrollment system, we needed to think about how we would enable our staff to adapt and thrive in this new environment, as well as lay the foundation for District residents to apply for all types of HHS benefit programs via any channel on this platform.”
“We can see where there may be training gaps across the agency, or if certain individuals need more support in specific areas. Having that data will make us more efficient and effective in our approach to training.”
Introducing a self-directed knowledge base and support system.
Hunt and his team launched myDCAS, a centralized caseworker portal and knowledge access sytem built on the FedRAMP-authorized Salesforce Service Cloud. MyDCAS serves as a contact center and case management solution in one, providing employees the information they need to help answer constituent eligibility questions and process applications within a single system.
MyDCAS includes a Salesforce-based knowledgebase with step-by-step guides, training videos and FAQs (including a Yelp-like rating system) previously spread across multiple locations.
“Employees can check the FAQs to find answers about the DCAS implementation overall, the impacts of it, things they should be aware of,” says Hunt. “They can get answers to their questions very quickly and easily.”
The knowledgebase also includes a self-service ticketing system that allows employees to submit a ticket directly to the help desk and enables caseworkers to check the status of tickets they’ve submitted. Finally, MyDCAS integrates third-party systems, including Drupal pages that house static information like intake forms, eligibility applications and more, as well as a custom learning management system that allows employees to take online courses or register for training.
“The system was built to be seamless,” says Hunt. “It’s intuitive and provides employees a very natural way to get the information they need. It also provides a simple way for them to escalate up to different levels of support, whether it’s the help desk or additional training.”
The results: simplified support and more effective caseworker training.
Today, rather than searching PDF-based job aids, DHCF employees can find the information they need using MyDCAS. This ensures they aren’t accessing outdated or inaccurate data. It also means they spend less time searching for the information they need or on the phone with the help desk. A month into the MyDCAS launch, DHCF was already experiencing a drop in help desk calls.
Meanwhile, analytics embedded in the myDCAS portal enable DHCF to fine tune caseworker training based on the questions asked or issues raised.
“We’re not throwing everything at the wall just to see what sticks anymore,” says Hunt. “We can see where there may be training gaps across the agency, or if certain individuals need more support in specific areas. Having that data will make us more efficient and effective in our approach to training.”
Once fully implemented, DCAS will touch multiple agencies across the District. Between caseworkers, district employees and partners, the agency will go from supporting about 900 users to supporting about 4,000 users. DHCF leaders are confident myDCAS will provide caseworkers a more advanced support system, more accurate information and access to continuous training so they can provide fast, consistent support to the growing number of constituents in need of services.
“Even as the number of residents seeking our services grows, we’ll be able to serve them efficiently,” says Hunt. “We’ll enable a more intuitive customer experience without sacrificing support for our valued employees.”