neighboring District 10 at minimal additional cost to the study. District 10 is also an urban district with a relatively high Hispanic/Latino population and a high proportion of elderly households, and unlike many other districts, it did not experience any closure of Customer Service Centers under ACCESS Florida. Focus groups were not conducted in District 10.
Within each district, we worked with a district liaison to identify Customer Service Centers and community partners to visit. The process was one of intentional selection, opting to visit offices and partners that represent a mix of circumstances facing clients and workers. We visited a total of 10 Customer Service Centers and 17 community partners, or an average of 2.5 Customer Service Centers and 4.3 partners per district. We also conducted
Table I.2. Characteristics of Florida DCF Districts, Including Those Selected for Staff Interviews and Client Focus Groups
District Major Cities Staff Interview Mode Client Focus Groups Conducted Number of Counties in District Percent of Total Population Rural Percent of Total Population Hispanic/ Latino Total FSP Households July 2005 (1,000s) Percent of FSP Households with Elderly Community Partners per 1000 FSP Households Number of Counties without Customer Service Centersa District Has Call Centerb 1 Pensacola 4 19.1 3.1 18.3 15.4 5 2 2 Tallahassee 14 38.8 3.1 26.9 17.3 6 7
3 Gainesville In-Person Yes 11 52.2 4.9 24.7 16.4 5 4
4 Jacksonville 5 12.2 3.8 36.4 15.1 4 0 Yes 7 Orlando 4 5.7 14.8 61.3 19.4 4 0
8 Naples, Fort Myers In-Person Yes 5 12.6 12.7 18.8 22.7 3 1
9 Palm Beach 1 1.7 12.4 27.9 24.0 3 0
10 Ft. Lauderdale In-Person 1 0.1 16.7 50.9 25.1 2 0 11 Miami In-Person Yes 2 0.9 55.9 179.2 44.1 1 0 Yes 12 Daytona Phone 2 11.8 6.4 18.0 17.5 4 0
13 Rural 5 35.4 5.2 26.8 19.9 5 0
14 Rural Phone 3 23.3 11.0 27.6 18.2 10 1
15 Vero Beach 4 10.7 8.4 14.2 19.3 5 0
SunCoast Tampa, St. Petersburg Phone 6 5.7 10.0 101.0 19.2 7 0 Yes
DCF Districts participating in site visits or phone interviews indicated in bold type.
aReflects March 2006.
bIn-person interviews were conducted at three Customer Call Centers, even when other interviews in that district were conducted via phone or when other data were
not collected from that district. Interviews were conducted at the Jacksonville Customer Call Center in December 2005 as part of the planning phase for this study; at the SunCoast Customer Call Center in July 2006; and at the Miami Customer Call Center in August 2006.
14
I: Introduction
phone interviews in an additional four Customer Service Centers and six community partners in three of these districts.9 These phone interviews were conducted after the in-
person site visits were complete.
To supplement the data collected from these four districts with data from other parts of the state, we conducted phone interviews with staff in three other DCF districts. The districts selected for phone interviews include:
• SunCoast Region. The SunCoast Region was selected in large part because district staff played a central role in designing ACCESS Florida changes. As a result, its staff could provide insight into the development and implementation of the modernization changes.
• District 12. District 12 was selected to get additional perspectives from a mid- sized district (similar to District 8).
• District 14. District 14 was selected to get additional perspectives from a rural district (similar to District 3).
As with the in-person interviews, phone interviews were conducted at Customer Service Centers and community partners that were intentionally selected to generate a mix of circumstances. We interviewed district administrators in each of these districts, as well as staff from at total of four Customer Service Centers and six partners.
Limitations of Research Design
The study was designed to collect comprehensive data on DCF’s experiences with modernization; thus, it is intended to document changes made under ACCESS Florida and to examine how costs, client access and staff satisfaction may have been affected by these changes. The research design has three important limitations.
First, our methodology lacks a reliable comparison group for estimating impacts. Because ACCESS Florida was implemented consistently and simultaneously across the state, there were no non-ACCESS Florida districts to use as comparison to conclude that modernization caused observed changes to the number of applications received, the number of participants, or other outcomes. Examining how outcomes changed from periods before ACCESS Florida implementation helps inform our understanding of potential impacts, but we cannot control for other, concurrent changes that could also affect key outcomes. Moreover, our understanding of the pre-ACCESS Florida policy environment is based primarily on interviews conducted after ACCESS Florida was implemented. Thus, our knowledge of how key procedures changed, as well as our understanding of staff and client impressions before ACCESS Florida, are all subject to recall errors. While it is still valuable
15
I: Introduction
to examine changes in outcomes, as well as reported changes in procedures and impressions, caution should be used in interpreting the findings.
The second limitation is that the study is not a cost-benefit analysis. While we identify potentially positive and negative aspects of modernization in general and ACCESS Florida in particular, the study was not designed to quantify the associated costs and benefits.
Finally, the study reflects ACCESS Florida as it existed over a short period of time early in its implementation. While modernization changes had been in effect in Florida for almost a year and a half when the study was conducted, some aspects had not been fully implemented, and DCF was making ongoing modifications to other aspects. Many of the modifications made by DCF were made in reaction to what it perceived as positive or negative aspects of ACCESS Florida. As a result, it is likely that some of the positive and/or negative aspects identified through this study may have changed substantially after our data collection was complete.
Organization of the Report
This report is designed to systematically discuss the individual changes made under ACCESS Florida. Chapter II summarizes the changes as seen from a typical FSP client’s perspective. Chapter II can be used as a quick-reference of the changes, all of which are discussed in greater detail in subsequent chapters.
Each of Chapters III through V covers one of the three broad types of changes made under ACCESS Florida. Chapter III discusses organizational changes made at DCF and the community partner network; Chapter IV discusses policy and procedural changes made for the FSP; and Chapter V discusses the technology employed as part of ACCESS Florida. These chapters describe the changes made, but do not discuss staff and client impressions of the changes and do not examine how those changes may affect key outcomes of interest.
Chapter VI provides an analysis of the potential effects of ACCESS Florida. The chapter examines four key outcomes: (1) client access and client satisfaction, (2) FSP benefit payment accuracy, (3) processing efficiency and administrative costs, and (4) staff satisfaction. For each outcome, we systematically describe how different modernization changes could affect that outcome, whether available statistics provide any evidence that the changes do affect that outcome, and what staff and clients said about the effect of the changes on that outcome.
The report concludes with Chapter VII, a discussion of the lessons that other states can draw from Florida’s experiences with modernization. We begin with a discussion of what other states can learn from Florida’s efforts to design and implement ACCESS Florida. We also examine what states can learn from the challenges and successes that Florida experienced in using technology. Finally, we summarize ACCESS Florida’s key implications for operating costs and client access.
A Glossary, at the beginning of this report, provides definitions of the various ACCESS Florida related terminology discussed throughout this report.
C
H A P T E RI I
T
H EA C C E S S F
L O R I D AM
O D E LF
R O MT
H EC
L I E N T’
SP
E R S P E C T I V Eost aspects of service delivery for the FSP and other programs have been affected by ACCESS Florida. While some of the changes may be evident to the client, many other changes are not obvious. Indeed, the relationship between the client and DCF is functionally very different after modernization.
While the goal of this study was to describe all of the administrative changes implemented to alter the services provided to DCF clients, it is useful to begin by describing how the actual services provided to clients have changed. In this chapter, we describe, from the client’s perspective, how applying for and receiving benefits is different under ACCESS Florida from under the former caseworker model.
Table II.1 lists all of the ACCESS Florida changes that would be apparent to an FSP client. The table shows changes in the way clients obtain and complete applications, are interviewed for eligibility, verify the information in their applications, are deemed eligible and maintain their cases over time. Table II.1 also shows which specific changes made by DCF (and discussed in Chapters III, IV and V) are most influential for the client.
Overall, the two changes under ACCESS Florida that are most apparent to clients are the new reliance on technology and the shift away from the caseworker model. Clients notice signs of technology immediately upon entering a DCF Customer Service Center. The lobbies are outfitted with banks of computers where clients apply for benefits. A DCF staff member in the lobby typically will greet the applicants and encourage them to use the computers. Clients notice the shift away from the caseworker model as they move through the eligibility determination process. The person who conducts their initial interview will not be the same person who may contact them with follow-up questions or to complete a longer interview. And if the clients wish to check the status of their application or have other questions, they call a toll-free customer service number rather than their caseworker, as they would have in the past.
Table II.1. Summary of ACCESS Florida Changes From the FSP Client Perspective
Relevant DCF Changes Activity Caseworker Model ACCESS Florida Organization (Chapter III)
Policy/ Procedure
(Chapter IV) Technology (Chapter V)
Obtaining and Completing Applications
Obtaining Application Paper Request for Assistance forms available primarily at DCF Customer Service Centers, but also at other locations.
On-line applications available from any computer with an Internet connection; paper applications can be obtained at DCF Customer Service Centers, but are not promoted; clients can use computers at “community partner” organizations; some Customer Service Centers are closed. Mode of Completion Paper Request for Assistance forms were
completed by hand, and a computer- generated Common Application Form was signed following eligibility interview.
Most applications completed and signed electronically, before any interview. Application Assistance Interviewing clerk and/or caseworker can
provide some assistance and/or interpretation of questions during initial intake interview; other organizations in community may provide application assistance.
Meeter-greeter or computer helper in DCF lobby can provide assistance for clients applying from Customer Service Centers; some community partners may provide some assistance; web application requires questions to be answered before initial intake interview.
Submitting Applications Most applicants submit paper Request for Assistance in person at DCF Customer Service Centers; applicants can also mail or fax applications.
Most applications are completed and submitted electronically; many applicants complete the application on computers in DCF Customer Service Centers; many others submit applications via Internet from home computers or from community partner computers.
Assigning Application
Date Application date determined as the date the signed Request for Assistance was received by the Customer Service Center
Application date determined as the date that the on-line application is signed electronically.
Table II.1 (continued)
Relevant DCF Changes Activity Caseworker Model ACCESS Florida Organization (Chapter III)
Policy/ Procedure
(Chapter IV) Technology (Chapter V) Checking status of
application
Client calls caseworker. Client calls toll-free DCF phone number to check status through Automated Response Unit or a call agent at the Customer Call Center.
Eligibility Interviews
Number of interviews All applicants participate in pre-eligibility
interview and full eligibility interview. All applicants participate in abbreviated intake interview; less than ten percent of applicants also must participate in a longer “red track” eligibility interview. There is no pre-eligibility interview.
Notification of interview Client receives letter notifying them of date and time for interview; clients can call to reschedule or request hardship exemption.
Clients applying in person receive
abbreviated interview the same day; clients applying via Internet receive a letter notifying them of date and time for
interview, and clients can call to reschedule or request a hardship exemption; a red track interview, if necessary, is scheduled during the abbreviated interview.
Timing of interview Occurs within 14 days of receipt of Request
for Assistance. Abbreviated interview typically occurs the same day as the application if submitted in person, within 7 days if submitted over Internet; red track interview, if necessary, occurs within 7 days.
Duration of interview Pre-eligibility interview lasts 10 minutes; full
eligibility interview lasts 1 hour. No pre-eligibility interview; Abbreviated interview lasts 7 to 15 minutes; red track interview lasts 45 minutes.
Expedited service
Table II.1 (continued)
Relevant DCF Changes Activity Caseworker Model ACCESS Florida Organization (Chapter III)
Policy/ Procedure
(Chapter IV) Technology (Chapter V) Location of interview For most applicants, interview occurs in
person at DCF Customer Service Center.
For applicants that apply in-person, abbreviated interview typically occurs in person; for applicants that apply via Internet, abbreviated interview typically occurs over the phone; most red-track interviews occur over the phone. Hardship exemptions Clients can be exempt from the in-person
interview if traveling to DCF Customer Service Center poses a hardship; few clients received hardship exemptions.
In most of the state, hardship exemptions are substantially more frequent, but the policy remains unchanged from the caseworker model; in two locations in state, FNS requirement that all applicants conduct interview in person is waived.
Verification Procedures
Documentation required for application
Documentation required for most income, expenses and assets.
Client statement accepted for age and household composition, many expenses and assets, and some income.
Notification of documentation requirement
Clients receive written notification of documentation requirements along with letter notifying them of interview date; some additional requirements may be identified during eligibility interview.
Clients applying in person receive written notification of documentation requirements after abbreviated interview is complete; clients interviewed via phone receive written notification of documentation requirements via mail.
Procedures for submitting documentation
Clients bring documentation to Customer Service Center; wait to see caseworker or leave documentation with front desk clerk; may need to wait for DCF staff to make copies of some documents; (documents also can be mailed or faxed).
Clients bring documentation to Customer Service Center; make own copies if needed using copier in lobby; attach cover slip and leave documentation in drop box in lobby; no interaction with DCF staff necessary; (documents also can be mailed or faxed).
Table II.1 (continued)
Relevant DCF Changes Activity Caseworker Model ACCESS Florida Organization (Chapter III)
Policy/ Procedure
(Chapter IV) Technology (Chapter V)
Eligibility Determination
When eligibility is determined
Within 30 days of application (typically processing time was close to 30 days).
Within 30 days of application (during July – September 2006, average processing time was 20 days).
Who determines eligibility Eligibility is determined by the caseworker who conducted the interview.
Eligibility is determined by a processing specialist, who is different from the person who conducted the client’s abbreviated interview (but is likely the same individual who conducted the red track interview if a red track interview occurred).
Recertification
Application and Interviews Client must complete application and participate in an eligibility interview at every recertification period.
In-person interviews waived for all clients at recertification. Some elderly and disabled clients have “passive recertification,” allowing them to complete paperwork without any interview.
Case Maintenance
General case questions Clients call caseworker to ask general questions about case.
Clients call DCF toll-free number to ask a call agent at the Customer Call Center general questions about case. Where changes are
reported
Client informs caseworker of changes. Client can report changes on-line. Client can report changes to the Customer Call Center via fax or phone; clients can access phone and fax from DCF Customer Service Center lobby.
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II: The ACCESS Florida Model From The Client’s Perspective