San Joaquin County Eliminates Lobby Wait Time

Challenges

Every day, up to 2,000 clients visit the San Joaquin County HSA. However, the agency was using an inefficient manual process to manage client appointments and walk-ins, leaving thousands of people waiting in line for up to four hours to apply for aid, meet with a caseworker, or simply drop off documents.

Complicated check ins.

To check in, clients either used in-house phones to call a worker directly or relied on lobby workers to call or physically notify caseworkers when they arrived.

Long wait times.

There was no escalation process for clients when they could not track down a caseworker. Clients could be left waiting in the crowded lobby for hours, frustrated.

Impact on compliance.

Many clients left the agency without seeing a caseworker, which threatened the agency’s ability to administer emergency benefits within the required 72 hours.

No insights for leadership.

The manual system had no reporting mechanism to help supervisors and managers determine why clients were waiting in the lobby or how many clients left the agency unseen.

Solution

In 2008, San Joaquin County HSA became the first county in California to implement Compass® Appointments and Compass® Appointments Kiosk for Medi-Cal (California’s Medicaid program), CalFresh (California’s Supplemental Nutrition Assistance Program), and Welfare to Work (CalWORKs) for many reasons. The agency could take advantage of scheduling functionality that was not available in largescale or consortium-based systems and the technical infrastructure was easy to manage and configure. Northwoods’ expertise in human services, specifically in eligibility, was also a big selling point.

To ensure clients are quickly routed to the right location within the agency, San Joaquin County HSA installed self-service kiosks in the lobby, allowing clients to check themselves in for scheduled or walk-in appointments. Two of the kiosks are dedicated to clients checking in for pre-scheduled appointments. Another kiosk solely allows clients to drop off documents without waiting in additional lines. The fourth kiosk is used for fingerprinting and Electronic Benefit Transfer (EBT).

Once a client checks in, Compass Appointments sends an electronic notification to the caseworker. If the worker does not respond, an escalation process is activated. “The best part of Compass Appointments is that the client can check in and it sends a message to the worker. If that person never responds, that message can escalate to the appropriate people. The idea that the system escalates the client’s need without the client having to escalate it is probably one of the greatest benefits for us,” said Kevin Stamper, Intake Program Manager.

To further boost productivity, the agency created a no-show unit to handle clients who miss appointments. This enabled caseworkers to trade a CalFresh or CalWORKs no-show, which requires a face-to-face meeting, with a Medi-Cal case, which does not require face-to-face interaction. Caseworkers can still process cases without wasting an appointment slot. This flexibility helps ensure clients receive necessary benefits and the agency meets mandated compliance requirements and emergency timeframes.

Results

Clients get the benefits they need more quickly, while the agency fully utilizes resources. The tool also minimizes worker and client frustration and positions San Joaquin County HSA to handle current and future challenges.

Keeping up with curveballs.

The passage of ACA caused an influx of clients eligible for Medi-Cal. ACA also caused an increase in applications for CalFresh, because most clients eligible for medical assistance are also eligible for nutrition assistance. Eligibility workers used pre-determined appointment slots to handle this influx of intakes.

Same-day processing for new applicants.

By watching the flow of clients through Compass Appointments, Intake Program Manager Kevin Stamper was able to adjust the appointment schedule to minimize no-shows and allow the agency to serve new clients within hours.

Insight into operations.

Supervisors and managers have a complete view of all appointments. Reports available through Compass Appointments also help management track and determine staffing needs, evaluate compliance with state and federal mandates, and determine if cases are being correctly distributed.