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Title:

Human Services Decision Support

System

Category:

Data and Knowledge Management

State: Michigan

Contact Information: Jim Hogan

Information Officer

Michigan Department of Technology, Management and Budget 235 South Grand Ave

Lansing, Mi 48933 517-373-6702

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Executive Summary: Human Services Decision Support System.

Michigan places a high emphasis on value based decision making and outcome based reporting. These are critical management tools for modifying programs based on metrics and for providing the public with accountability measures on how state government is performing. Michigan’s mature data and knowledge management practices are key enablers for these two measures. Michigan is using our enterprise data warehouse (EDW) to provide both real-time data and dashboard reporting tools for this purpose. This is an innovative approach to using the EDW and underscores our on-going maturation in the use of data to improve the operations of state government.

For years, Michigan’s EDW has served as the informational backbone for most of the State’s large agencies, becoming more and more valuable in helping state government better serve citizens, improve operational efficiencies, and contain costs. What began in the mid-1990s as a technological tool to monitor Medicaid claims has evolved in 2011 into a large repository of historical data and an enterprise solution with more than 10,000 users across 20 state agencies. In 2010 Michigan has expanded its use of the data to measure the effectiveness of programs and provide policy leaders with

information and knowledge to make adjustments in the operation of specific programs. Further, the metrics collected at the agency level are being used in the aggregate to develop enterprise dashboard reporting for critical state programs. These performance-based reports are made available to the public by way of Michigan’s “dashboard report.”

In 2010 an EDW predictive analytics and dashboard reporting capability was developed for the Michigan Department of Human Services (DHS) that serves as an important demonstration of how smart data usage can improve operations, better serve citizens, and provide a more transparent reporting capability. For the first time, more than 1,000 county managers in 115 DHS offices across the state use enterprise data distributed to their desktop to make decisions locally and produce metrics specific to their county and caseload – decisions that better target services to their local communities and

beneficiaries.

The Bridges Information Management Mart (BRIMM) extracts caseload information nightly from the DHS eligibility determination and benefit issuance system (known as Bridges), and Michigan’s children services systems. This localized data is then used by management in the assignment of caseloads, and to build and maintain dashboard reports and outcome measurement reports specific to each county office. This allows management to measure employee performance and client outcomes on a daily basis.

BRIMM has helped DHS County managers move from a reactive mode to a proactive, forward-looking mode. In so doing, DHS has dramatically improved caseworker productivity, management productivity, and – perhaps most importantly – citizen

wellbeing by making data-driven decisions locally and quickly. BRIMM vividly illustrates the evolution of the EDW in Michigan – a major agency using data prospectively to positively affect outcomes and improve the operations of state government.

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C. Description

Business problem. The Michigan Department of Human Services lacked a decision support system at the local office level for caseworkers and supervisors to better manage caseload and provide timely services to clients. There was also no localized reporting solution that could generate daily metrics or aggregate outcome measures at the county level. Absent a strategic data and knowledge management solution, local decision making and reporting would continue to be performed by the Lansing Michigan central office. This adds time to caseload determinations, misaligns caseload and worker ratios, and offers limited flexibility in receiving timely and localized reports or providing accurate local data for state-wide reporting.

Solution. In 2010, the DHS teamed with the Department of Technology, Management and Budget (DTMB) and the State’s vendor partner, Ingenix, to leverage the enterprise data warehouse to build a county-level decision support system. This is the first time Michigan has localized data from the warehouse to improve daily decision

making at the field offices. The decision support system is called the Bridges Information Management Mart (BRIMM) and was launched statewide in September 2010. Development of local data requirements and reporting needs began 6 months prior. The launch was preceded by 60 days of fine-tuning and end-user training. The solution has two major components: Caseload management and dashboard reporting.

 Caseload management – Caseload data from multiple agencies is downloaded from the enterprise data warehouse to each of the local offices on a nightly basis. Updated information from multiple sources, compiled into relational tables

specific to a region, yields multiple operational efficiencies to both case workers and the supervisors managing caseload distribution, including:

 Determination of monthly benefits is being done 75% faster by

caseworkers since all the data they need can be found at one source.

 Multiple benefit programs associated with a family can be assigned to one caseworker rather than assigning one caseworker for each benefit

program.

 Travel and time efficiencies have been gained by assigning workers to cases within a set geographic area.

 Dashboard reporting – Management at the local counties can access

standardized dashboard reports with up-to-date statistics and trend data. This same dashboard utility includes the use of business intelligence software to help users build ad hoc reports using drop down menu options and a “query by

example” feature. These standardized dashboard reports are “rolled-up’ for all of Michigan’s 83 counties to produce a state-wide dashboard on Michigan’s

progress in delivering assistive and protective services to Michigan citizens.

Michigan has a mature data and knowledge management governance structure in place that leverages both technology and data stewardship best practices. Specific elements

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of this governance structure ensure that projects like BRIMM can be delivered on a fast-track development schedule. Specific solution elements include:

Technology

 Teradata data warehouse. This 7.11 Terabyte repository holds information across 474 datasets and 18,000 tables, collected over 15 years.

 Data encryption and security logging provide secure and auditable transaction monitoring

 Flexible options for updating the enterprise data warehouse from parent applications before transferring data to local offices include data loads and extraction by Windows servers through OLEDB; Teradata utilities for data load / unload; Oracle transparent gateway servers for both production and development systems to send or receive Oracle data

 Data validation process - Teradata utilities report number of rows loaded or unloaded, rows in error and the type of error, rows accepted or rejected

Data stewardship

 Internal subject matter experts to interpret and validate the data.

 Access to Ingenix contract staffs to provide enhanced analytics and to assist in the development of complex queries.

 Data governance protocols that include data sharing agreements between agencies, reviewed by the state Attorney General Office, to ensure that

personably identifiable information is kept secured on a “need-to-know” basis, while aggregated data is made available for program measurement.

D. SIGNIFICANCE

One of the significant values of an enterprise approach to data and knowledge management is the provision of specific strategies and tools to help accelerate the deployment of agency solutions. The BRIMM application was deployed in less than 12 months because several steps in the planning and initiation phase of the project were permanently in place with Michigan’s enterprise approach. Decisions about

development tools, data extraction and validation processes are complete, as are planning steps regarding data sharing agreements, data access and security.

These process enablers allowed the BRIMM decision support system to quickly begin providing business solutions (caseload management and dashboard reporting) that improve operations for local DHS offices. These same solutions reaffirm the strong alignment between Michigan and national CIO priorities including:

Shared services - DHS county staffs have access to common shared software business analytic tools that are identical in all 83 counties. Prior to the BRIMM application, data downloads would have been initiated locally, and analyzed using different tools (Excel, Access, SAS etc.). Employees transferring to new counties would need to re-learn homegrown solutions.

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Governance – Data sharing agreements allow cross-agency access to data.

Data and information management – Case workers have access to client data spanning multiple systems at their finger-tips. Common data indexing enabled by technology hastens response time for client – worker interactions.

Business Intelligence and analytics – The enterprise data warehouse supports multiple tools. The BRIMM project leverages SAP Business Objects to build canned reports and caseload statistics.

The NASCIO priority strategies are a good benchmark for evaluating how technology solutions improve the operation of state government. In the past 12 months, the BRIMM decision support system has improved local management of human services offices in the following ways:

Worker efficiency. Each caseworker begins his or her morning with a caseload assignment roster. Every name on the sheet must be visited or phoned for verification of information (job searching, changes in income levels, change in family medical composition etc.). Caseworkers are able to complete more follow-up per day since all case history and demographic information are available online in one place. Prior to BRIMM, this would require compiling information from both printed and electronic sources.

Management efficiency. Supervisors can look at workload distribution across their county workers including indicators on the complexity of cases. This allows for day-to-day adjustments in caseload assignments to better balance workload and output.

Measurement. Public facing reports can be generated locally and in real-time. Many community organizations are interested in county statistics (Medicaid, day care, cash assistance, out-of-home placements etc.). Historically, this information would take weeks to be processed and returned to a local office. Now, the

reports are available daily at the local level.

E. Benefits

Michigan has a uniform data and knowledge management process overseen by our enterprise data warehouse team. This disciplined team approach to data analytics allows for an agile response to business problems needing quick resolution. In 2010, the warehouse team partnered with the Department of Human Services’ data

management unit to develop an intuitive dashboard analysis and reporting application that could be used at every county field office to help workers better manage caseload and to provide reporting capabilities locally versus centrally. One primary business driver was climbing caseloads for intake workers (Caseload ratio was 200:1 in 2004 and grew to 600:1 in 2010). Leadership wanted tools that would reduce administrative

workload and help workers better manage growing caseloads. This was a key need given the states inability to hire additional workers with on-going budgetary shortfalls in Michigan, and the importance of providing beneficiaries with the proper services. The solution that was developed is a desktop based dashboard case management

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application that provides role based tools for caseworkers and management. The business logic used to develop both the predictive reporting tools and the dashboard reports are transferrable to any state using analytic and reporting software tools. Primary benefit measures include:

Caseworker productivity has improved with the deployment of the following tools:

 Client demographic information spanning all assistance programs can be found in one place – eliminating the need to pull client information from multiple data sources.

 Client benefit summary information spanning multiple programs allows case workers to accelerate the benefit redetermination process. This tool helps DHS meet our federally mandated standard of promptness and avoid federal

sanctions. DHS time studies indicate that determination of monthly benefits can be done 50% faster for each individual case.

 Mobile worker – DHS is migrating to a service delivery model whereby

caseworkers work remotely or share “hoteling” space with other tenants. This application runs on a client desktop with updated information downloaded each morning. There is no need to be connected to a host system.

Management productivity has improved with the deployment of the following tools:

Smart distribution of caseload assignments. -- Geo-spatial data is accessed via a web service call to our enterprise-wide Bing maps solution. This technology helps management distribute cases to workers in tighter geographic areas – thus reducing travel time between appointments.

External reporting – Each county director must testify to the local county DHS board or must present to the local legislative caucus. This solution allows county specific data to be compiled in reports within minutes. Prior to this solution, each county director had to request local data reports to be produced from the Lansing central office – often requiring ten day lead time.

Productivity measurement – Caseload assignments, difficulty of caseloads and completion metrics allow local managers to modify caseload assignments to better balance workload between workers, both junior and senior level workers.

Companion caseload assignments – Those DHS clients receiving assistance from multiple sources (social security supplemental benefits and state assistance benefits) are given one case-worker to work with vs. multiple caseworkers.

Citizen well-being is positively impacted with these process improvements;

Streamlined case management – Clients deal with one caseworker representing multiple programs instead of multiple caseworkers.

Simplified re-determination – Clients need one visit (phone call) from a caseworker because all relevant information is available to the caseworker.

Expanded eligibility opportunities – Data tools allows managers to identify categories of beneficiaries – such as children with disabilities or children with

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special nutritional needs that may be eligible for supplemental benefits that wouldn’t be apparent without comparing caseload data.

Host system performance is improved by distributing input / output to local systems;

 Prior to BRIMM, client look-up functions executed on the parent “Bridges” system would consume memory with extensive queries of historical data.

 Localized data on the desktop allows for case history queries to run using local PC memory, rather than consuming main system memory and slowing down the system for other users state-wide. This has reduced help desk tickets specific to slow performance by 60% since implementation.

The project has the added benefit of collecting performance metrics locally that are rolled-up into state-wide totals. Michigan is maintaining a report card on indicators of well-being for Michigan citizens that are published as part of the Governor’s dashboard website. The BRIMM decision support tool produces a monthly “green book” report of statistics that mirrors data maintained in the Federal “green book” report on assistive services programs. http://www.michigan.gov/dhs/0,1607,7-124-5458-204912--,00.html

The BRIMM decision support system is a low cost solution that provides data

management teams residing within different state agencies (or in states looking for a transferrable solution) with a model that is repeatable. The core business processes are very similar across government programs. These elements include:

1. Distributed workforce statewide with regional data needs.

2. Mobile workforce with a need to download relevant caseload information (be it assistive caseload, licensing caseload, permitting caseload, inspection caseload etc.)

3. Configurable menu driven analytic tools that are formula-based and can provide alternatives for caseload distribution.

4. Integration of geo-spatial data with caseload information to develop “smart grids” of appointment based visits to minimize travel time.

5. Standard dash board reports that can be generated from a menu-driven interface that can be shared with internal and external stakeholders.

6. Regional based reports that can be aggregated by the central office for state-wide reporting as part of Michigan’s web-based public facing “report card”.

The BRIMM application was developed using a cross functional team that included 1 project manager, 4 state staffs and 2 Ingenix contractors. Staffing costs totaled $400,000 for the six months development time. Our enterprise licenses negated the need for further software investment. This six month project has improved worker output and abated the need for DHS to hire additional staffs - helping DHS avoid millions in annual staffing costs (annual weighted cost per FTE = $70,000). This

success story is now being told to other state agencies. Michigan’s goal is to repeat this process for other state agencies with similar business needs and further evolve our enterprise data warehouse solution to a value-based predictive tool set with robust dashboard reporting capabilities.

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