SYSTEM OVERVIEW
The Developmental Disabilities (DD) Eligibility & Enrollment (E&E) team determines eligibility for a range of DD programs and services. This includes processing applications, assessments, and renewals that establish eligibility and level of care for Medicaid waivers and other DD supports. The team manages a high volume of work each month—including in-person and phone assessments, waiver renewals, and application processing—to ensure individuals can access services in a timely manner.
CHALLENGE
At the start of the project, the system carried a backlog of approximately 7,595 items across initial assessments, renewals, the eligibility mailbox, and online applications. For this project, a backlog item is defined as work that has remained incomplete for more than 30 days.
Because eligibility determinations are a required step before individuals can access certain DD services, prolonged backlogs can affect the timeliness of those determinations and delay vital services to eligible individuals. Reducing the backlog presented an opportunity to improve processing timelines, strengthen internal workflows, and better position the team to support ongoing and future demand.
IMPROVEMENT STRATEGIES
Because the team’s capacity to complete work is driven primarily by assessor and support staff availability, the following strategies were designed to protect, focus, and maximize the productivity of that critical workforce resource.
– Established clear daily performance expectations: Clear expectations were set for daily completion targets so staff could focus their time and effort on the highest-priority work each day. This improved visibility into progress, reduced uncertainty about priorities, and helped leaders balance effort across the team in real time.
– Implemented full-kit work practices: Work is being organized so cases are complete and ready before staff begin processing them. This reduced rework, delays, and unnecessary handoffs, allowing staff to spend more of their time completing work rather than tracking down missing information.
– Optimized workload distribution across the team: Work assignments were actively managed to prevent any single queue or role from becoming overloaded. This helped reduce bad multi-tasking and maintain steady flow across assessments, mailbox work, and applications, even as volume fluctuated.
– Transitioned renewals to phone-based assessments: Shifted all Aged & Disabled (AD) waiver renewals from in-person to phone assessments, enabling staff to complete more assessments per day by eliminating travel time, reducing scheduling delays, and allowing work to be completed more efficiently within the normal workday.
– Launched a self-scheduling pilot: Enabled assessors to manage their own calendars, reducing scheduling bottlenecks and improving day-to-day flow.
– Intelligently managed resource allocation: After clearing certain work queues, staff were proactively re-assigned to other work queues to support the areas with the highest volume.
– Strengthened weekly oversight: Used weekly system measures and huddles to track progress, identify barriers early, and make quick operational adjustments.
– Stabilized new work intake: Ensured new applications and renewals, including the December renewal surge, were processed as they arrived rather than added back into backlog.
RESULTS
– Cleared 100% of the original backlog, reducing total pending items from 7,595 to 0, even while absorbing all new incoming work.
– Assessments backlog eliminated, with combined in-person and phone assessments reduced from 5,022 to 0.
– Initial application backlog eliminated, with online applications reduced from 843 to 0 and maintained at current levels.
– Renewals and related processing stabilized, with remaining work now managed as part of normal operations rather than accumulating as backlog.
– New demand now processed in real time, including 3,235 new assessments since October.
These results were achieved without augmenting staffing resources. The DD Division concurrently actioned cost savings strategies estimated to save over $25 million in General Fund savings in the coming year, while ensuring individuals have access to DD services that improve customer outcomes.
