In addition to the organizational changes that took place within Customer Service Centers and by the creation of the CMU and Customer Call Centers, the development of a Community Partner Network (CPN) marks the other key component of the new organizational structure under ACCESS Florida. State officials envisioned community partners as being supplemental access points for clients to apply for benefits in comfortable, convenient settings. The CPN was not a part of the pilot in the SunCoast Region, and it continues to be a evolving entity with new partners being added to the list on an ongoing basis. In this section, we present an overview of the CPN, including the roles of partners and the types of organizations that joined the network. We then describe the communication between DCF and partner organizations, as well as how partners were recruited, trained, and monitored. Finally, we identify some variations in community partners across Florida and changes in the network that emerged over time.
Overview of the Community Partner Network
The CPN was developed to increase the number of places individuals can go to apply for benefits, as DCF was closing Customer Service Centers. Since its inception in 2005, the CPN has grown to include a diverse range of agencies and organizations, including social service agencies, county health departments, housing authorities, hospitals, faith-based organizations, aging resource centers, homeless service providers, one-stop workforce centers, food banks, aging councils, early childhood centers, migrant service providers, independent living facilities, libraries, domestic violence centers, and nursing homes. Most partners are not-for-profit organizations, although some public entities and private organizations also participate. While a small number of partners are statewide organizations, the vast majority are unique to specific districts or regions of Florida.
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Community partners vary according to the scope of services they offer as well as the scope of clients they serve under ACCESS Florida. Partners can provide such services as access to a computer to complete the electronic application, access to fax and photocopying machines, and, in some cases, have staff available to provide technical assistance in completing applications. In joining the network, partners agree to provide one of four service levels, summarized in Table III.4. It is important to note that partners do not have authority to screen for eligibility or determine eligibility; this authority remains with DCF.
Many community partners provide ACCESS services only to their customer base, however narrowly defined it may be. For many of these partners, it is not practical to have an open-door policy for any potential DCF client. For instance, some partners are located in hospital settings where they work to enroll uninsured low-income patients in Medicaid (as well as any other programs for which these uninsured patients may be eligible). The physical location of these in-hospital offices make it impossible or impractical to offer an open-door policy. Other examples of partners that serve specific populations include assisted living facilities for seniors and organizations that provide in-home services to disabled clients. The decision about whom to provide services to is ultimately up to the community partner. Table III.4. Service Levels of Community Partner Network
Service Level Services Provided
Partner Paper application pick-up point
Bronze Partner-level services plus access to computers with the electronic application, and access to telephone to call DCF Customer Call Center
Silver Bronze-level services plus access to printer to print application summary from the electronic application Gold Silver-level services plus access to fax machine to submit
application for benefits and/or other required
documentation, access to copy machine to photocopy documentation, staff who verify identity of applicant, and provide assistance in completing the electronic
applicationa
aGold partner organizations include health providers that have a signed agreement with DCF to fund outposted intake/processing specialists who work on site, an arrangement that preceded ACCESS Florida.
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One way to gauge the degree to which partners serve the general public is to examine how many organizations have agreed to be listed as a partner on the DCF website. Figure III.4 shows, for each partner level, the number of partners listed on DCF’s website and the total number of registered partners with the state.22 Among those 2,495 partners registered
with the agency in September 2006, approximately 37 percent (935 partners) agreed to be listed on the state’s website. The fact that a partner does not wish to be advertised on the website does not necessarily mean it will only serve its own constituency, nor does it mean that it refuses to be listed in any public location, such as in an ACCESS Florida brochure in a Customer Service Center’s lobby. Still, it does suggest that most outside organizations are opting out of public notice.
Most partners (67 percent) have agreed to offer Gold-level services and assistance with application activities. The other partners promote self-directed activities to clients; 16 percent serve as a pick-up site for paper applications (Partner), and 14 percent grant clients access to computers and telephones (Bronze). Very few partners offer Silver-level services. Figure III.4. Number of Community Partners by Service Level, September 2006
0 500 1,000 1,500 2,000 2,500 3,000
Partner Bronze Silver Gold Total
Web listed partners Other partners
392 339
84
1,680
2,495
Source: MPR Tabulations of Florida Department of Children and Families data.
22 The estimates in Figure III.4 are imprecise for several reasons. First, there is a lag between when a partner joins the partner network and when the website listing is compiled by the state. Second, organizations included on the website may still be difficult or impractical for most potential clients to reach. Finally, service levels reflect the level at which an organization enrolled with DCF and does not necessarily reflect actual services provided.
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Recruiting Community Partners
DCF used a range of strategies to recruit community organizations to join the CPN. Areas where Customer Service Centers had closed were considered high priority and received special attention. Initially, district officials and local supervisors assumed responsibility for growing the network. Eventually, they designated “partner liaisons” a district-level position and charged them with ongoing recruitment efforts. Initial recruitment efforts focused on organizations that had ongoing or prior collaborations with the agency, many of which had previously provided application assistance to their constituents. Additional candidate organizations were identified by DCF staff. State staff sent letters of invitation to these organizations that gave a brief overview of ACCESS Florida, and offered to come to their headquarters to discuss the partnership. In addition, DCF staff sponsored community forums on the proposed partnership and spoke at local community meetings. As the CPN grew, partners provided DCF staff with referrals to other potential partners.
Motivations for Joining the CPN
Local organizations identified two primary reasons for joining the CPN. First, most partner staff noted that they decided to collaborate with DCF because ACCESS Florida fit naturally into their organization’s mission to help needy populations. Some groups, such as churches, saw the network as a way to better serve the local area. One librarian remarked that becoming a partner was “an opportunity to serve the community; the library is not just for books.” DCF staff agreed that entities sharing a similar mission were generally eager and willing to join the network. In fact, many organizations that became formal partners had already been helping their own clients apply for benefits. One main difference for some is that now they can help clients apply on site using a computer.
Second, some partners cited financial incentives as a reason for joining the network. For example, hospitals and other medical providers can get reimbursed for services if they help clients get enrolled in Medicaid. Other partners—especially not-for-profits—admitted that nominal financial compensation through fee agreements will help pay overhead expenses (fee agreements are discussed later in this chapter). In addition, food banks explained that helping clients apply for food stamp benefits helps decrease the demand for emergency food items, which could then be allocated to other in-need, non-FSP clients.
Reservations about Joining the CPN
Some organizations were reluctant to join the partner network. While some joined in spite of their reluctance, others declined. Partners and DCF staff offered several reasons why. Common concerns were that becoming a partner would place an additional burden on an organization’s staff, diverting them from their regular duties, or that space limitations could not handle an influx of clients. Some organizations objected because they thought DCF was asking outside organizations to do its job. A few potential partners worried they did not have the appropriate policy background or technical expertise to serve clients effectively, or were reluctant to handle confidential information. Finally, some potential partner organizations declined to join the CPN when they realized that the financial compensation would be minimal or nonexistent.
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In attempting to persuade reluctant organizations to join the network, DCF staff stressed that each partner was free to decide the level of service (Partner, Bronze, Silver, Gold) they would provide and to limit services to their own constituency. They also emphasized that the goal was to recruit multiple partners in the same geographic area so that no single partner would be overburdened. DCF emphasized that partners were viewed as supplements to Customer Service Centers, not replacements; Customer Service Centers would still handle eligibility determination. Some groups then agreed to sign up as long as they would only serve their own clients, and/or would offer a lower level of services. Some potential partners, including groups that had successfully worked with DCF in the past, declined to participate because of concerns that they would not be able to limit their level of service in real-world settings. For example, partner staff would feel compelled to assist DCF clients who struggled with the electronic application even though their service level did not require them to provide this level of service. Sometimes districts were able to offer fee agreements as an incentive, but these were limited due to budget restrictions.
DCF staff reported that some partners actively dropped out of the network and others remained in the network but effectively dropped out by not promoting the services or making them visible and accessible. Data on the number and type of organizations that actively or passively dropped out of the network is not available. However, DCF staff reported that the number of dropouts is relatively small and that, in general, the organizations that do drop out tend to be organizations that serve a broad population, including many who are ineligible for DCF services. For instance, while some libraries felt compelled to provide services to the public, others felt too understaffed to assist DCF clients without detracting from their core services.
Communication and Other Support from DCF
This section describes the relationship between the community partners and DCF. In particular, we describe the means of communication between the organizations and the types of financial and in-kind support that DCF provided to partners.
Means of Communication
Community partners have two primary mechanisms for communicating with DCF staff—through a designated partner liaison, and through contacts with Customer Service Centers. Partners also can contact a call center if they have general questions, although it seems that most partner staff typically do so to check on the status of a client’s application (no information is available as to what degree partners utilize the ARU as compared with speaking to a live agent). Initially, districts identified individuals within the agency, to assist with recruiting community partners and serving as a point of contact, while continuing with many of their regular job responsibilities. The state eventually realized that it was important to have staff in these district-level “liaison” positions full-time. Each liaison may be assigned to multiple counties depending on the geographic area within each of the 14 districts/region, and so far most have been hired internally within DCF.
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As these positions became more formalized, communication with the partners became more consistent. One important function of the liaison is to be an ongoing resource for partners to answer any questions they may have about policies or procedures. Partner liaisons notify organizations of procedural changes or updates, typically via e-mail broadcasts. One district developed a newsletter for partners that reinforce procedures, present commonly-asked questions and answers, and spotlights different organizations so that partners can become familiar with other resources in their community. Liaisons also visit the partners in person on a monthly or quarterly basis to replenish supplies (for example, paper applications or ACCESS Florida brochures) and address any questions or concerns. Due to time constraints, some areas of the state limit face-to-face visits to partners with fee agreements or very active gold partners, although liaisons will visit in- person if an organization makes a special request. The expectation of the frequency of liaison visits to community partner sites is a performance standard in the annual performance appraisals of all liaisons.
Several liaisons have made efforts to facilitate communication among partners. For example, one liaison established a listserv to disseminate information and to allow organizations to ask each other questions. In January 2006, the coordinator and liaisons in the SunCoast Region began sponsoring partner forums, which originally served as recruiting forums. At these semi-annual meetings, which last about two hours, liaisons share information about upcoming policy or procedural changes, such as a new feature of the electronic application. There is also a question-and-answer session, and partners have an opportunity to share experiences, concerns, and best practice strategies with each other. Other districts hold annual partner meetings where they invite all partners to a full-day session of information sharing and networking between partner organizations and DCF leaders.
Most communication between partner and Customer Service Centers has been relatively informal. In rare cases, a partner or DCF staff member indicated that DCF had appointed a worker to handle all inquiries from community partners. Mostly, traditional communication with Customer Service Centers was limited to former colleagues (some partner staff used to be DCF caseworkers or supervisors), or to the contact that the organization used before modernization and the CPN (for example, a contact at the Medicaid office for a medical provider). By design, partners are expected to rely on communication with their liaison or a call center agent.
In-kind and Financial Support
Aside from training, DCF provides in-kind and financial compensation to some partners. Because DCF had a surplus of computers after some Customer Service Centers upgraded their equipment and/or downsized staff, the agency was able to provide computers to many partner organizations. Partners use the computers to give clients access to the electronic application. Some partners also received printers, fax machines, copiers and, in at least one case, furniture from DCF. Another district provided short-term capacity- building funds that partners can use to obtain Internet service, or make the lobby more customer-friendly. Some areas limit funding agreements to organizations that will offer
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“something extra” to DCF clients, such as a nursing home willing to let the general public use its computers and fax machine.
Several districts offer ongoing funding to a small number of partners through formal fee agreements. The maximum that most organizations can receive is $60 per day of service delivery, or about $1,200 per month. DCF headquarters leaves it up to the districts to determine if they want to offer funding to partners. In most cases, the decision to utilize fee agreements hinges on available funds, and as such most organizations do not have such an arrangement with DCF because its funding is limited. For example, the SunCoast Region had agreements with about seven percent of its partners as of summer 2006. Another district had agreements with about 24 percent, and another with 3 percent, according to staff reports. Appendix F includes examples of the standard and fee agreements between DCF and community partners.
Typically, district officials elect to offer fee agreements in areas that are underserved by Customer Service Centers, other partners, or both. They also require that partners operate at the Gold level of service. Specific compensation may be determined by hours of operation (those with evening or weekend hours would get paid more), the number of clients served, and the amount of other community partner sites in a given location. Most districts will entertain fee agreements for any type of organization. However, two districts have elected to use fee agreements only with Workforce Investment Boards.23 A few
districts mentioned setting aside agreements only for those organizations that are hesitant to join the CPN. If an organization is enthusiastic about becoming a partner, it may not need a financial incentive to participate.
Training Community Partners
Individual district offices, not DCF headquarters, are responsible for designing and delivering training to organizations in their respective CPNs.24 After joining the CPN, the
expectation is that outside organizations receive training on ACCESS Florida; liaisons ensure that partners receive this training. The majority of partner staff reported receiving training, although, in some cases, the training did not take place until several months after the partner organization became part of the network. Some of these lags in training were likely related to a vacant liaison position, and delays in converting partner liaisons to full-time positions.
The content and format of trainings remained fairly consistent across the state. Sessions either took place on site at a partner organization exclusively for their staff, or group training for multiple partners at a central location like the closest DCF office. Training focused on the electronic application and consisted of hands-on practice and/or a
23 For example, one district was in the process of establishing an interagency agreement with a total of 13 one-stop centers. These centers will become “Gold Plus” partners. The “Plus” means that, in addition to providing all services associated with a Gold-level partner, they will ensure that a staff person is always available to help applicants who want to access DCF services.
24 In spring 2006, one office developed a training guide in PowerPoint that headquarters was planning to modify for other districts to use.
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walk-through of the electronic screens using a PowerPoint presentation. Other topics included an overview of DCF programs and the history of ACCESS Florida, an explanation of the partners’ role versus DCF’s role, the Health Insurance Portability and Accountability Act (HIPAA) regulations and client confidentiality, and a question-and-answer session. Organizations also usually received guides or instruction sheets that cover the important policies and procedures under ACCESS Florida, as well as the liaison’s contact information. Training lasted anywhere from one hour to half a day, depending on the size of the group.25