Understanding how NC Fast
impacts County Workload
1
Understanding how NC Fast
impacts County Workload
Timothy Scott
Trevor Thomason
Business Process Consultant
Business Process Consultant
Six Sigma Black Belt
Six Sigma Green Belt
timothy.scott@mecklenburgcountync.gov
704-363-5447
704-591-5007
Mecklenburg County
2
Meeting goals…
• 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”
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Determining Time Standards
& Understanding Capacity
Phase 1
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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…”
How can we take these subjective comments
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?
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•
•
•
•
•
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
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
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How can we apply industrial engineering
practices to solve this business problem?
•
Understanding time in business processes…
- Touch Time (TT)
- Wait Time (WT) – Does the process STOP and wait for
something to be completed
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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) – Overall time for task to be completed
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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
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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…
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Real world example…
How much does it cost to replace a muffler on my 2007 Toyota
pick-up truck?
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15
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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
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Complete process map…
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Identify key tasks…
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Identify key tasks…
Task 1
Task 2
Task 3
Task 6
Task 4
Task 5
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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?
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Tool selection and criteria…
Tool
Duration
Frequency
Complexity
Timed with a stop watch –
(observer)
Short touch time (TT)
Very Repetitive
Simple to moderate
Self-timed by worker (tracking
sheets)
Medium to long TT
Repetitive to unique
Simple to complex
Self-work sampling (15 minute
increments)
Medium to long TT
Varied to unique
Moderate to complex
actions
Job shadowing (observer)
Any
Varied to unique
Moderate to complex
actions
Data extracted from
automated system
Any
Any
Any

UNDERSTAND Business CULTURE

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Tool selection and criteria…
Tool
Duration
Frequency
Complexity
Timed with a stop watch –
(observer)
Short touch time (TT)
Very Repetitive
Simple to moderate
Self-timed by worker
(tracking sheets)
Medium to long TT
Repetitive to
unique
Simple to complex
Self-work sampling (15 minute
increments)
Medium to long TT
Varied to unique
Moderate to complex
actions
Job shadowing (observer)
Any
Varied to unique
Moderate to complex
actions
Data extracted from
automated system
Any
Any
Any

UNDERSTAND Business CULTURE

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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”
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Create tracking tool and train staff on usage…
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Identify sample size, participants & skill level…
Identify skill type
across sample
population
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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)
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Food and Nutrition Services
New Application Processing
(Touch Time per Task - Minutes)
114 Minutes of Total “ Average Touch
Time”
19 mins
ISSI Search
and
Registration
n=40
1 – 50 mins
14 mins
23 mins
16 mins
42 mins
NC FAST Search &
Registration
n=29
Keying Application in
NCF & Assigning
n=21
Updating
ISSI
n=50
Processing Application
n=37
1– 31 mins
1 – 58 mins
3 – 75 mins
3 – 90 mins
Data ranges for each step in FNS Application Processing
n = number of samples taken for a specific step
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Medical Assistance
New Application Processing
(Touch Time per Task - Minutes)
126 Minutes of Total “Average Touch
Time”
10 mins
18 mins
ISSI Search
and
Registration
n=40
NC FAST Search &
Registration
n=45
1 – 31 mins
1 – 97 mins
28 mins
Keying Application in
NCF & Assigning
n=21
1 – 112 mins
15 mins
55 mins
Updating
ISSI
n=50
Processing Application
n=37
3 – 51 mins
1 – 228 mins
Data ranges for each step in MA Application Processing
n = number of samples taken for a specific step
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Touch Time in MINUTES
Food & Nutrituion Changes *
Novice
n
Household Changes
Bilingual
Income Changes
Bilingual
Misc. Changes
Bilingual
Solid
n
Expert
n
28
27
28
38
21
9
15
4
73
3
23.3
20
Solid
32
Income
27
English
28
n
30
n
31
n
63
Expert
28
Misc.
30
n
48
n
23
TOTAL
Touch time by skill
Touch time by change type
Touch time Bilingual vs English
OVERALL TOTAL
Touch time
n (sample size)
Novice
n
Household
34
Bilingual
38
n
24
n
15
30
78
* 1 case incomplete
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Touch Time in MINUTES
Food & Nutrition Re-certifications *
Timely
Bilingual
Untimely
Bilingual
Late
Bilingual
Novice
n
Solid
n
Expert
n
41
55
37
62
42
41
11
4
3
1
36
49
45
50
42
41
44
7
1
12
33
25
33
38
15
6
27
1
Novice
40
Timely
46
Bilingual
47
n
190
n
60
n
74
Solid
49
Untimely
43
English
38
n
21
n
105
n
151
Expert
41
Late
31
n
14
n
60
TOTAL
Touch time by Skill
Touch time by Recert type
Bilingual vs English only
OVERALL TOTAL
Touch time
n (sample size)
41
225
* 17 cases incomplete
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Method of
Application
FNS
(Interview/Screen/Queue)
MA
(Interview/Screen/Queue)
FNS
(Processing)
MA
(Processing)
TOTAL
TOTAL
M/F/D
5 minutes
5 minutes
115 minutes
115 minutes
120 minutes
Face-to-face
45 minutes *
45 minutes *
75 minutes *
75 minutes *
120 minutes *
e-PASS
5 minutes *
5 minutes *
115 minutes *
115 minutes *
120 minutes *
*Estimates – Time study has not been conducted for these activities
Program
Screen/Queue
Re-Certification
Total
FNS
5 minutes
40 minutes
45 minutes
MA
5 minutes **
115 minutes **
120 minutes **
**Based on proposed process to manually close case in EIS and re-key as new streamlined application in NCF.
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FNS: New Application
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)
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FNS: Re-Certification
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)
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MA: New Application – NON MAGI
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)
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To Do List:
Program
Activity / Next Steps
FNS Changes
Determine times for…
1) Income
2) Household
3) Deductions
MA Changes
Determine times for…
1) English
2) Bilingual
MA Re-Certifications
Determine 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 First
Determine time for…
1) Client Application & Assessment
2) Case Management
Long Term Care
Determine time for…
1) Application process
1) Re-Certification
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Managing variability in processes…
Common Cause Variation
& Special Cause Variation
It’s important to understand the
amount of variability…
Reduce the amount of variability;
compress the upper and lower
control limit
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Developed a forecasting model
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Developed a forecasting model
Given the application
volume stated above, this
is the number of staff
needed to process claims
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Disciplined and pragmatic approach to determine capacity
40
Determining Time Standards
& Understanding Capacity
Phase 2
Capacity Model
41
Demonstration
42
Questions?
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Understanding how NC Fast
impacts County Workload
Timothy Scott
Trevor Thomason
Business Process Consultant
Business Process Consultant
Six Sigma Black Belt
Six Sigma Green Belt
timothy.scott@mecklenburgcountync.gov
704-363-5447
704-591-5007
Mecklenburg County
44
Thank you…
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