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Eligibility Screening and Initial Application to Social Services System
Business Model and System Design
OCTOBER 1996
Pacific Management and Research Associates
____________________________________ 1721 Second Street, Suite 203
Sacramento, California 95814
(916) 448-9038
PMRA
Eligibility Screening and Initial Application to Social Services System Business Model and System Alternatives
Presented To:
Oregon Pathways Clackamas County Department of Human Services 1024 Main Street Oregon City, OR 97045 (503) 650-3567 Voice / (503) 655-8677 FAX
Presented By:
Pacific Management and Research Associates 1721 Second Street, Suite 203 Sacramento, California 95814 (916) 448-9038 Voice / (916) 448-6848 FAX / (916) 448-5376 BBS
October 8, 1996
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Letter of Transmittal
The Oregon Department of Human Resources and Clackamas County are pleased to release this technical feasibility study for Oregon Pathways. This venture was part of a project intended to test concepts for the integration of social services. Simply put, our goal was to make it easier for people who need services to get them and to redirect resources now used for client processing to more direct services.
An impressive group of managers responsible for service delivery in Clackamas County came together for an intensive eighteen months of problem solving and research. The agencies represented included the Oregon State Employment Department, North Clackamas School District, Social Security Administration, Adult and Family Services, and Clackamas Department of Human Services. The Clackamas County Department of Human Services includes Public Health, Social Services, Mental Health, Housing Authority, Community Development, Community Corrections, Employment Training and Business Services (JTPA). All the agencies committed to this effort recognized that existing accountability, eligibility screening and data collection were necessary for direct service funding to continue. However, they were also committed to working together to reduce unnecessary duplication and to use technology to collaboratively redesign the
way people access services. This redesign initiative was holistic. It focused on the entire service milieu without regard to program definition or jurisdictional control. We believe that the Oregon Pathways initiative will demonstrate how the delivery of government services can be dramatically improved. Pacific Management and Research Associates responded to our challenge to develop a technical feasibility study. Their task was to evaluate and describe technical alternatives, provide design specifications for required software and hardware, estimate the costs of development and implementation and conduct a cost analysis. The work of Fred Best, Bob Herguth, Cy Welch and Bernadette Dawson has been exemplary. The Oregon Pathways Project has been on a fast tract since its inception. PMRA kept up the pace and, through this report, have positioned us to begin the reengineering process. This report clearly shows that implementation of Oregon Pathways is feasible, and that it will be cost effective. What the report cannot impart is the unprecedented demonstration of camaraderie, coordination and cooperation that resulted from this initiative. Nor can it fully capture how the magic of information technology can aid and empower people. With great pleasure, we present the Business Model and System Alternatives for Oregon Pathways.
Project Managers: Jono Hildner, Clackamas County Department of Human Services Gary Potter, State of Oregon Department of Human Resources Michele Wallace, State of Oregon, Adult and Family Services Project Coordinator: Deborah Helgerson, Clackamas Department of Human Services
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Oregon Pathways Steering Groups
Design Team
Tim Carman Deputy Superintendent North Clackamas School District
Gary DiCenzo Director Housing Authority and Community Development
Terry Gassaway Director Clackamas County Community Corrections
Barbara Gasuen Assistant Director Oregon City Office, Employment Department
Deborah Helgerson Project Coordinator Pathways Project
Jono Hildner Director Department of Human Services
Ron Lajoy Assistant Director Mental Health and Clinical Services
John Mullin Director Clackamas County Social Services
Gary Potter Project Coordinator Pioneer Center of Adult and Family Services
Dell Smith Director Employment, Training and Business Services
Guy Super District Manager Social Security Administration
Tom Troxel Director Public Health
Michele Wallace District Manager Adult and Family Service, Clackamas District
Jan Wolfe Facilitator Olympic Performance, Inc.
Detail Team
Lennie Bjornsen Director Office of Children and Families
Diane Chown Employer Relations Oregon City Office, Employment Service
Diane Gissel Office Specialist I Clackamas County Social Services
Deborah Helgerson Project Coordinator Pathways Project
Barbara Hopson Administrative Analyst Public Health
Patty Huntley Program Manager Clackamas County Social Service
Tim Kopet Supervising Psychologist Mental Health
Nancy Latini Director North Clackamas County School District
Michael Lee Services Coordinator Employment, Training and Business Services
John Margaronis Assistant Administrator State Department of Human Resources
Sue Manning Service Representative Oregon City Office, Employment Service
Roger Martin Service Coordinator Employment, Training and Business Services
Karin Morey Parole and Probation Clackamas County Community Corrections
Jon Pierce Human Resources Specialist, Adult and Family Services
Anita Pixley Services Supervisor Clackamas County Housing Authority
Will Reinhart Operations Manager Adult and Family Services
Yolanda Stewart Social Security Liaison Clackamas County Social Services
Technical Team
Deborah Helgerson Project Coordinator Pathways Project
Jono Hildner Director Department of Human Services
Ward Kent Assistant Director of Data Processing, Department of Human Resources
Grant Norlin LAN Administrator Employment, Training and Business Services
Wilson Orso Systems Analyst, State Job Training Partnership Administration
Kelly Otto Information Systems Liaison, Oregon City Employment Department
Gary Potter Project Coordinator Pioneer Center of Adult and Family Services
Ros Samnang Project Leader, Service Integration, Department of Human Resources
Ed Seufert Systems Administrator Clackamas County Information Services
Terry Souza Oregon Employment Department
Pacific Management and Research Associates
Fred Best President
Bernadette Dawson Vice President
Robert Herguth Systems Analyst
Cyrus Welch Senior Programmer
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Acknowledgments
Appreciation is expressed to the following people for their generous advice, assistance and information: his paper was prepared with advice and information from many people. Pacific Management and Research Associates appreciates the assistance provided so generously from the following persons.
Lennie Bjornsen, Office of Children and Families Tim Carman, Ph.D. North Clackamas School District Diane Chown, Oregon City Employment Department Jan Cox, Clackamas County Department of Human Services Terry Gassaway, Clackamas County Community Corrections Gary DiCenzo, Housing Authority ands Community Development Diane Gissel, Clackamas County Social Services Barbara Gasuen, Oregon City Office-Employment Department Tammie Fisher, Employment, Training and Business Services Ward Kent, Adult and Family Services, Clackamas Branch Mary K. Holder, Clackamas County Department of Human Services Barbara Hopson, Public Health Patty Huntley, Clackamas County Social Services Tim Kopet, Ph.D., Mental Health Ron Lajoy, Ph.D., Mental Health Nancy Latini, Ph.D., North Clackamas County School District Michael Lee, Employment Training and Business Service Gloria Lewton, Clackamas County Department of Human Services John Margaronis, State Department of Human Resources Sue Manning, Oregon City Employment Department
Roger Martin, Employment Training and Business Services Karin Morey, Clackamas County Community Corrections John Mullin, Clackamas County Social Services Grant Norlin, Employment, Training and Business Services Kelly Otto, Oregon Employment Department Pam Peterson, Clackamas County Department of Human Services Toni Peterson, Department of Human Resources Jon Pierce, Adult and Family Services, Clackamas Branch Anita L. Pixley, Clackamas County Housing Authority Will Reinhart, Adult and Family Services, Clackamas Branch Ros Samnang, Oregon Department of Human Resources Ed Seufert, Clackamas County Information Services Linda Slama, Clackamas County Department of Human Services Dell Smith, Employment, Training and Business Services Terry Souza, Oregon Employment Department Yolanda Stewart, Clackamas County Social Services Guy Super, U.S. Department of Health and Human Services Tom Troxel, Clackamas County Public Health Jan Wolfe, Olympic Performance, Inc.
The contents of this paper do not necessarily reflect the views of any of these individuals or the agencies they represent
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Table of Contents
COVER SHEETS
Letter of Transmittal ........................................................................................................ i
Oregon Pathways Steering Groups .............................................................................. iii
Acknowledgments ......................................................................................................... iv
Table of Contents ........................................................................................................... v
1. INTRODUCTION AND BACKGROUND ............................................................... 1
1. History ......................................................................................................................... 1
2. Pathways to the Future .............................................................................................. 3 The Social Forces Behind Pathways ............................................................................................................ 3 Linkage to Other Policy Initiatives ................................................................................................................ 4
3. Preview of Report ....................................................................................................... 5
2. BUSINESS MODEL AND SYSTEM OVERVIEW .................................................. 7
1. Problem Statement ..................................................................................................... 7
2. Mission and Objectives .............................................................................................. 8 Mission Statement ........................................................................................................................................ 8 Operational Objectives ................................................................................................................................. 8
3. Overview of Proposed System ................................................................................ 10
4. Linking System Goals and Functions ..................................................................... 13
3. EVALUATION OF ALTERNATIVES ................................................................... 21
1. Evaluation Criteria .................................................................................................... 21
2. Parameters of the Pathways System ....................................................................... 22
3. Isolation of Alternative Approaches ........................................................................ 23 Defining Issues ........................................................................................................................................... 23 Generation of Alternatives .......................................................................................................................... 25 Definition of Components ........................................................................................................................... 26 Assumptions and Undefined Conditions ..................................................................................................... 27
4. Review and Evaluation of Alternatives ................................................................... 28 Alternative 1: Central Processing and Data Storage .................................................................................. 29 Alternative 2: Central Processing and No Data Storage ............................................................................. 31 Alternative 3: Central Eligibility Screening and Data Storage with Remote Referral Processing ................ 34 Alternative 4: Central Eligibility Screening, Remote Referral Processing and No Data Storage................. 36 Alternative 5: Remote Eligibility with Central Referral Processing and Data Storage ................................. 39 Alternative 6: Remote Eligibility Screening, Central Referral Processing and No Data Storage ................. 41 Alternative 7: Remote Eligibility Screening and Referral Processing with Central Data Storage ................ 44 Alternative 8: Remote Eligibility Screening and Referral Processing with No Data Storage ....................... 46 Alternative 9: Agency-Based Eligibility Screening with Central Referral Processing and Data Storage ..... 49 Alternative 10: Agency-Based Eligibility Screening, Central Referral Processing and No Data Storage .... 51 Alternative 11: Agency-Based Eligibility Screening, Remote Referral Processing, and Data Storage ....... 54 Alternative 12: Agency-Based Eligibility Screening, Remote Referral Processing, and No Data Storage .. 57
5. Comparative Evaluation of Alternatives ................................................................. 60
4. TEST OF PROTOTYPE ....................................................................................... 63
1. Potential for “User Friendliness” ............................................................................ 63 Initial Access Screens ................................................................................................................................ 63 Entry of Client ID Information ..................................................................................................................... 65 Get Best Source Data and Eligibility Screening .......................................................................................... 66
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Review Programs for Which Client is Eligible ............................................................................................. 68 Process New Client or Exit ......................................................................................................................... 69
2. Implications for System Design ............................................................................... 69
5. COST ANALYSIS ................................................................................................ 71
1. Framework for Cost Analysis .................................................................................. 71
2. Costs of Implementation and Maintenance ............................................................ 72 Costs of Development and Implementation ................................................................................................ 73 Maintenance Costs ..................................................................................................................................... 73
3. Economic Benefits ................................................................................................... 75 Return on Investment ................................................................................................................................. 75 Lower Processing Costs ............................................................................................................................. 76 Reduced Paper Forms and Records .......................................................................................................... 84
4. Break Even Analysis ................................................................................................ 86
5. Replication Costs ..................................................................................................... 87
6. SYSTEM DESIGN ............................................................................................... 89
1. Design Parameters ................................................................................................... 89
2. Alternative Designs .................................................................................................. 90 Discussion of Alternatives .......................................................................................................................... 91
3. Design Specification ................................................................................................ 98 Scope of Design ....................................................................................................................................... 100 System Narrative ...................................................................................................................................... 100 Definition of Components ......................................................................................................................... 102 Module Design Narrative .......................................................................................................................... 106 Standards and Conventions ..................................................................................................................... 116 Menu Specification ................................................................................................................................... 118 Input Specifications .................................................................................................................................. 118 Output Specifications ............................................................................................................................... 118 Technical Specifications ........................................................................................................................... 119
4. System Controls ..................................................................................................... 122 User Input ................................................................................................................................................. 122 Disaster Recovery .................................................................................................................................... 122 Security .................................................................................................................................................... 123 Privacy...................................................................................................................................................... 124
7. MILESTONES FOR IMPLEMENTATION .......................................................... 129
1. Overview and Timetable ......................................................................................... 129
2. Elaboration of Tasks and Milestones .................................................................... 131 Planning and Review ................................................................................................................................ 131 System Development ............................................................................................................................... 132 Installation and Training ........................................................................................................................... 138 Management and Accounting ................................................................................................................... 140
3. Project Integration and Prioritization .................................................................... 140 Prerequisite Analysis ................................................................................................................................ 140
8. APPENDICES .................................................................................................... 143
A1. Principles and Objectives of Oregon Pathways ................................................. 144
A2. Detailed List of Pathways Goals and Objectives ............................................... 145
A3. System Outputs .................................................................................................... 151
A4. Summary of System Functions ........................................................................... 156
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A5. Oregon Pathways Agencies and Programs ....................................................... 157
A6. Privacy Protection Agreement ............................................................................ 159
A7. Eligibility Screening Flowcharts ......................................................................... 162
A8. Data Matrices ........................................................................................................ 183
9. TABLE OF EXHIBITS ....................................................................................... 195
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Chapter 1
Introduction and Background This report presents a technical plan for the development and
implementation of an integrated eligibility screening system; the first component of the Oregon Pathways initiative. The report presents goals and objectives of the system, evaluates practical alternatives, and presents a design, cost justification and implementation plan.
The Oregon Pathways initiative strives to change the way public
agencies deliver services to clients. Oregon Pathways is applying
cross-agency collaboration, information technology and service
integration to improve the quality and efficiency of service delivery.
This chapter provides a history of the Pathways initiative, summarizes the social and policy context of the project, and previews the overall contents of this report.
1. History
Oregon Pathways is the result of a multi-year state-local collaboration to improve the efficiency and accessibility of human services.
The first stages of this initiative began in 1991, with a state program that awarded grants to local government for planning innovative approaches to service integration. Clackamas County applied for and received one of these grants for the purpose of developing an interactive service information and referral (I&R) system. After completing this project, Clackamas County received a second grant to improve access to services by streamlining eligibility determination.
In late 1993, Clackamas County established a staff for Pathways, then worked with state and federal agencies to setup a “Design Team” composed of chief executives from twelve human service agencies. Over the next several months, this team engaged in weekly meetings to explore “how to design and implement an automated system to integrate access to the total spectrum of services supporting the self-sufficiency of families.”
By mid-1994, these meetings resulted in agreements on the principles and approaches for creating a common access eligibility screening system, and established common understanding and
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cooperative working relations among Participating Agencies (Appendix 1).
During the second half of 1994, the Design Team began focusing attention toward implementation preparation. A “Detail Team“ was setup to review and specify detail about agency inner-workings related to Pathways. Among other things, this Detail Team identified the privacy concerns and procedures, existing agency equipment and resources, data and procedures needed to integrate eligibility screening for Participating Agencies. During this time, the Design Team made arrangements to procure technical planning support and establish a “Technical Team” to guide systems design. The fourth team, the User Team, was organized in the second half of 1995 to integrate feedback about the Pathways concept from the standpoint of line staff and managers.
Oregon Pathways has moved forward through a highly participatory, multi-tiered planning process. As noted above, this process was anchored in four planning teams:
Design Team. The vision of the Oregon Pathways initiative is guided by the Design Team. This team consists of agency heads from county, state and federal service providers. It provides the conceptual foundation for the Oregon Pathways initiative.
Detail Team. Detail team members provide practical information, through research and experience, from their respective agencies to fill in and develop the foundation laid by the design team.
Technical Team. Technical team members bring the information technology resources and experience necessary to guide the design, development, and implementation of Oregon Pathways information systems.
UserTeam. User team members provide feedback on system software revisions, formulate staff training plans, and ensure that information about staff interactions with the system are fed back into the development process.
During the first half of 1995, these teams worked to produce the technical blueprint for Oregon Pathways that is summarized in this report (see page iii for the membership of these teams).
Pathways represents a ground breaking effort to use open participation and technology to reduce the confusion, inefficiency and polarization that confounds efforts to improve and operationalize cross-agency cooperation. Its sustained success and forward motion can be attributed to three key factors. First, the process through which Pathways was conceived and developed has been open, meticulously balanced, and inclusive. It has involved all major human resource agencies and levels of
Oregon Pathways has moved forward through a highly participatory, multi-tiered planning process.
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staff in a process that has continually fostered trust and buy-in among participants. Second, it has been favored with agency decision makers who understand the potential of information technology and are willing to seek new solutions to improving government services, and are prepared to take risks to pursue that purpose. Third, Pathways has focused on using participatory planning and technology to increase communications and ease the task of developing functional service integration. It has not sought to change, consolidate, or control participating agencies. Rather, it has sought to create personal and electronic linkages at the service level that allow clients, staff and agency managers to freely share resources and coordinate services.
2. Pathways to the Future
Oregon Pathways is concept that strives to re-engineer processes that directly affect the way services are provided to clients. It reflects the changing conditions and needs of our society and inter-links with other important policy innovations.
The Social Forces Behind Pathways
Oregon Pathways reflects changes that are restructuring all aspects of our lives and society, and altering the fundamental assumptions that guide our human services.
American society is well into the process of moving from a manufacturing-based “industrial era” to a technology and service-based “information era”.
Among the changes that are emerging from this transition, four seem to be well established. First, our production processes are moving increasingly to commodities and services that are customized to individual needs. Second, information technology is allowing our economic and social institutions to become increasingly decentralized. Third, the ways we organize our society are becoming less bureaucratic and more fluid. Fourth, productive equipment and resources are becoming increasingly accessible for direct individual use (Exhibit 1.1).
Exhibit 1.1
INFORMATION ERA TRENDS
The services and products of the future - whether they be privately or publicly generated - will be increasingly client-centered.
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Individualized Products and Services
Computer Assisted Design and Manufacturing (CAD/CAM)
Small Batch Production Runs and Flexible Manufacturing
Direct Access Technology
Non-Traditional Education, Individual Study
Individual Service Strategies Decentralization
Telecommuting
“Virtual Organization” or “Hollow Corporation”
Schools without Walls
Front-Line Decision Making
Open Access Information Services (Internet, AOL, Prodigy) Flexible Organization
Out-Sourcing or Sub-Contracting
Project-Oriented Organization or ”Adhocracy”
Temporary Placement Agencies or Renting Employees
Corporate “Downsizing” or ”Rightsizing”
Increased Self-Employment
“Just-in-Time” Inventory
Leasing Versus Ownership Personal Capitalization
Miniaturization and Transportability (Microchips, Cellular Phones)
Common Access Technology (ATMs, TV Courses, Video Tapes)
Economic Affordability of Equipment (PCs, VCRs, Laser Printers)
Electronic Money and Credit (Credit Cards, Training Vouchers)
Among the implications of these four trends, one stands out. We are moving away from an era where individuals gathered around centrally located resources - schools, factories, hospitals - that were based upon the need to organize clients and workers around heavy equipment. In its place, we are moving into an era where equipment, resources and services are clustered around the individual. The services and products of the future - whether they be privately or publicly generated - will be increasingly client-centered.
Pathways represents a ground-breaking initiative to integrate government services to meet individual needs, and to empower individuals with the information and choices needed to access the services that best meet their needs.
Linkage to Other Policy Initiatives
Government agencies at all levels are focusing increasingly on the issues of improving quality and individualization of services, enhancing access and personal choice, increasing cross-agency collaboration and service integration, and applying outcome oriented accountability.
Oregon has been at the forefront of many of these initiatives. At the state and local level, Oregon has been a pacesetter in implementing federal reforms, and has been the originator of a number of policy innovations (Exhibit 1.2).
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Quality and Individualization of Services
Oregon Transition, Referral, Client Self-Sufficiency System (TRCS)
The Oregon Option
DOL Displaced Worker Training Accounts Access and Personal Choice
Clackamas County Prism Information and Referral System
Distributed Oregon on-line Public Health Information (DOLPHIN)
Employment Service Kiosks
Faces and Hermisten Projects
Telecommunication Information Infrastructure Assistance Program Cross-Agency Collaboration and Service Integration
Federal Department of Labor “One-Stop Shopping” Initiatives
America 2000 Education Reforms
Human Resource Investment Councils (HRICs)
Oregon Service Integration Grants
Shared Information Systems (SIS) Process Automation
Oregon ACCESS Forms Automation Project Outcome Oriented Accountability
National Performance Review (NPR)
Oregon Benchmarks
Most notably, state and local governments within Oregon have been at the forefront of harnessing information technology as a tool for empowering citizens to access and choose public services that meet individual needs.
As Oregon Pathways progresses from concept to reality, it will complement and inter-link with other efforts to re-engineer government.
3. Preview of Report
The purpose of this report is to outline a design for the initial phase of the Pathways initiative, which focuses on integrated eligibility screening across public service providers in Clackamas County. The proposed system has been designed for Clackamas County with the intention that the proven design may be implemented throughout Oregon.
The report will have seven chapters:
[1] Introduction and Background. This chapter provides background on the history and pertinence of Pathways.
[2] Business Model and System Overview. Chapter 2 specifies the objectives and functions of Pathways.
Exhibit 1.2
PUBLIC INITIATIVES THAT CAN BE LINKED TO PATHWAYS
As Oregon Pathways progresses from concept to reality, it will complement and inter-link with other efforts to re-engineer government.
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[3] Evaluation of Alternatives. This chapter describes and evaluates alternative approaches to implementing path-ways.
[4] Test of Prototype Chapter 4 describes the nature and results of a functional test of the Pathways concept.
[5] Cost Analysis. This chapter specifies the costs of implementing and maintaining Pathways relative to the current system of agency-based eligibility screening.
[6] System Design. This chapter provides the design for development of the Oregon Pathways system.
[7] Milestones for Implementation. The final chapter outlines a timetable and sequence of activities for implementation of the first phase of Pathways.
Appendices are attached to the end of this report to provide more background and elaboration of selected sections and a table of exhibits is provided for your convenience.
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Chapter 2
Business Model and System Overview
This chapter specifies the goals and objectives of the Oregon Pathways initiative, and outlines prospective functions for the proposed system.
The purpose of this chapter is to specify goals and functions for
the Oregon Pathways initiative to integrate eligibility screening across public service providers in Clackamas County. The proposed system has been designed for Clackamas County with the intention that the proven design may be implemented across Oregon.
This chapter focuses on the business model that will be supported by the Oregon Pathways information system. It has four sections:
Problem Statement
Mission and Goals
Overview of Proposed System
Linking System Goals and Functions
These sections provided the conceptual foundation for identifying alternative approaches and for the development of an operational model and testable prototype.
1. Problem Statement
From the perspective of a client, finding and receiving human services in Oregon is a confusing and tiring process. Each agency has multiple programs, each with its own intake and eligibility requirements, appointment schedules, case backlogs, and verification requirements. The client must struggle through each redundant process until the agency’s requirements are met and services can be delivered. The door that the client walks through first is likely to be the agency that the client accesses services from, for better or worse.
From the standpoint of a public human service provider, the view is not any better. The agency must navigate a maze of
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crisscrossing and sometimes conflicting federal, state, and local intake, eligibility, and verification guidelines before services can be delivered. The result is slow, ineffective, inefficient service delivery as well as increased error rates, increased costs, and potential system abuses.
2. Mission and Objectives
The Oregon Pathways initiative has developed out of several years of inter-agency discussion among the social service agencies of Clackamas County and the State of Oregon (Appendix 5). The following sections on the Mission Statement and Oregon Pathways goals and objectives have evolved from these inter-agency discussions.
Mission Statement
The Oregon Pathways System will use information technology and cross-agency coordination to streamline application and eligibility screening processes, shift staff from “paperwork” to client service, provide information about services available from different agencies, and empower clients to choose and combine services to effectively meet their specific needs.
Operational Objectives
Over time, the Pathways initiative has evolved to reflect seven major goals:
Increase Client Access to services
Improve Program Services and Impacts
Protect Privacy and Personal Rights
Increase Efficiency and Cost Effectiveness
Support Planning and Coordination of Services
Sustain Public Support and Agency Buy-In
Utilize Replicable Processes
These seven goals summarize a variety of more specific purposes (Exhibit 2.1). A more detailed summary of goals and objectives is provided in Appendix 2.
The Oregon Pathways System will streamline application and eligibility screening processes, and empower clients to choose and combine services to effectively meet their specific needs.
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[1] Increase Client Access to Services [a] Provide Universal Access to Variety of Services and Agencies
[b] Empower Clients with Self-Directed Access and Choice
[c] Support Client Choice of Services
[d] Simplify Intake and Needs Assessment
[e] Streamline Eligibility Screening and Verification
[2] Improve Program Services and Impacts [a] Use Processes that Foster Client Self-Reliance
[b] Eliminate Unneeded “Paperwork” and Reduce Administrative Activities
[c] Integrate Services from Multiple Agencies to Holistically Service Client Needs
[d] Increase Staff Time for Direct Client Service and Interaction
[e] Improve Staff Morale and Performance
[f] Emphasize Results and Outcomes
[3] Protect Privacy and Personal Rights [a] Allow Clients to Review, Correct and Update Eligibility Data
[b] Provide Full Disclosure of Client Rights and Responsibilities
[c] Ensure Security Against Inappropriate Use of Client Data
[d] Allow Client Options for Deleting Unneeded Self-Reported Eligibility Data
[e] Allow Clients to Access Services without the Use of Pathways
[4] Increase Efficiency and Cost-Effectiveness [a] Decrease Unnecessary Data Collection
[b] Streamline the Collection and Updating of Client Data
[c] Eliminate Duplicate Eligibility Determination and Verification
[d] Improve Client Placement and Targeting of Services
[5] Support Planning and Coordination of Services [a] Remove Barriers to Cooperation Among Programs and Agencies
[b] Foster Cross-Agency Forums and Discussion
[c] Support Functional Cross-Agency Referral and Case Management
[d] Link to Other Related Initiatives
[e] Document and Assess Service Outcomes
[f] Share and Update Data Among Multiple Agencies and MIS
[g] Improve Accessibility and Quality of Data for Planning
[6] Sustain Public Support and Agency Buy-In [a] Demonstrate Potential for Major System Change
[b] Involve All Stakeholders in Development
[c] Make System Easy-to-Understand and Use
[d] Document Service Outcomes (Link to Oregon Benchmarks)
[e] Maintain the Integrity of Existing Programs and Services
[7] Utilize Replicable Processes [a] Use Transferable Technologies and Processes
[b] Ensure Usability in Varied Technological and Organizational Settings
[c] Maintain Acceptable Startup and Maintenance Costs
Exhibit 2.1
OPERATIONAL OBJECTIVES FOR OREGON PATHWAYS
This exhibit summarizes goals for the Pathways System that have been developed through a multi-year planning process.
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3. Overview of Proposed System
The Oregon Pathways system will use information technology to increase access to services and streamline intake processes. The system will provide clients with multi-site universal access, simultaneous eligibility screening for multiple programs, cross-agency information and choice concerning available services, and electronic application and referral to client-selected programs. Foremost, Pathways will simultaneously determine client eligibility for multiple programs and provide clients with information and choices concerning the services they are eligible to receive. This system will maximize return on resources by placing clients within services that have the best chance of producing positive outcomes, producing cost savings that allow the realignment of staff responsibilities to client service, and establish a technical foundation for cross-agency case management.
Initially, Pathways will provide universal access to the varied social services provided by the following federal, state and local public agencies:
Adult and Family Services
Community Corrections
Community Development
Employment Department (Employment Service)
Employment, Training and Business Services (JTPA)
Housing Authority
Mental Health
North Clackamas School District
Public Health
Social Security Administration
Social Services
These agencies are also listed in Appendix 5. Clients can obtain service information and determine their eligibility for services at the site of any Participating Agency (Exhibit 2.2).
Pathways will maximize return on resources by placing clients with services that have the best chance of pro-ducing positive outcomes.
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Clients seek service from any Participating Agencies.
All Participating Agencies provide entrance points that give clients access to a comprehensive array of services: Community Corrections Public Health Employment
Department School District Employment Training (JTPA,
Etc.) Social Security
Housing Authority Social Services Mental Health
Agency staff meet with clients to discuss needs, use the Pathways computer system to identify potential services, and determine client willingness to use existing data to assess their eligibility for services.
Agency staff use the Pathways system to find services to meet the specific needs and eligibility status of clients: Retrieve, verify, review and update
client data needed for eligibility screening
Simultaneously determine client eligibility for multiple programs
Assist clients to select services that meet their individual needs
Electronically transfer applications to selected programs
Provide client with referral information Reduce waiting period for services
The Client has the option of obtaining a list of programs and services, and applying through the existing paper based application process at each agency. Client is given general information
about prospective programs and services
Client applies for services at each agency through the traditional paper application process
Applications are processed
Applications are processed, eligibility determined and services delivered to clients.
Exhibit 2.2
HOW PATHWAYS DELIVERS SERVICES
Pathways simplifies and streamlines client access to services by providing an overview of available programs, electronically screening for eligibility, automating initial application creation, expediting referrals and reducing the waiting time for services.
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During the initial phase of operation, agency staff work with clients to determine their needs and the types of services they are seeking.
1
Clients and staff will work together to use a user-friendly query system to identify and describe potential services. This same system can also determine client eligibility for all services provided by every Participating Agency, or for services specified to be of particular interest to clients.
2
To determine eligibility for services, clients must give permission to use eligibility data that currently exists within Best Source agency databases (e.g. age, ID numbers, educational background, employment history, date of birth, property ownership, disabilities, income).
3
This permission is given when clients read and sign a statement that allows the Oregon Pathways system to access existing client data that is pertinent to eligibility determination, and authorizes Participating Agencies to store and exchange data on the clients’ behalf. This statement also specifies limits on use of this data and client rights concerning privacy and review.
Clients not wishing to give permission to access data from their records may directly apply for services at agency sites.
If clients give permission to access eligibility-related data, Pathways immediately accesses pre-existing data, works with clients to enter or update missing or outdated data,
4
then uses a computerized system to simultaneously determine client eligibility for a variety of services provided by multiple agencies. All these tasks are efficiently completed during the client’s first visit.
In cases where clients are not eligible for a specific service, Pathways will provide an “eligibility audit” specifying the reasons for ineligibility. If ineligibility is based on incorrect data, options will be provided to make adjustments and reassess eligibility.
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If clients are ineligible for desired services or decide not to use any services, they have the right to delete all new information entered during the eligibility screening process.
In cases where clients are eligible, they are given a choice of the services they wish to use. This is done by giving clients a printout with information about the services for which they are
1
Ultimately, the Pathways system will provide a kiosk option that allows clients to directly access information about services, determine their own eligibility for programs, and initiate electronic applications and self-referrals. 2
Clients can choose one of two approaches for finding services. In the first approach, agency staff work with clients to review potential programs and select services that best meet their needs, then Pathways efficiently determines whether clients appear eligible for the selected services. In the second approach, agency staff use the Pathways system to determine all services for which clients appear eligible, then Pathways provides information so that clients can select the services that best meet their needs. 3
Best source data refers to sources of data that have been identified as having verified pieces of client eligibility data. 4
Data that is newly entered, updated or changed due to a challenge from clients will be electronically flagged for verification. Verification will include date of verification, type of documentation, and agency/staff verifying data. 5
The specifics of the “eligibility audit” and remote eligibility data updating process will be designed and refined in response to field testing. It is envisioned that Pathways will provide a number of alternative processes which allow clients and staff to balance the goal of efficiency with the goal providing clients with a choice of available services.
If clients give permission to access eligibility-related data, Pathways immediately accesses pre-existing data, then simultaneously determines client eligibility for a variety of services provided by multiple agencies.
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qualified, and referral instructions for services provided by other agencies. Agency staff will also counsel clients as needed.
At this point, clients will specify the services they wish to access. Clients will then contact selected service providers for final processing and eligibility verification. This process will be streamlined by the electronic transfer of referral notices to designated agencies along with pertinent pre-existing and newly entered data. This transferred data will be incorporated into either a computer screen or paper printout of service applications that can be completed by applicants. These applications will be forwarded by telecommunications to specified Participating Agencies. At some point, “digitized signatures” may be used to further expedite the application process. Currently, the design calls for the storage of data indicating at what agency the release can be found. After this universal intake, clients may visit, phone or correspond with agencies providing desired services.
Newly entered data, eligibility determinations, and referrals will be transferred to the agencies providing services selected by clients. Agencies receiving this data will use it in accord with the their existing guidelines concerning applications, eligibility verification and client rights.
It is expected that this process will greatly reduce the cost, effort and time required to apply for services, determine and verify eligibility, and initiate service delivery.
4. Linking System Goals and Functions
Design and selection of technical components for Pathways requires an explicit statement of the practical functions that must be performed if the system is to meet specified goals.
Exhibit 2.3 provides a detailed linkage of functions to Pathways goals. This list was developed by linking specific functions to each goal and sub-goal. Specific functions - many of which are linked to more than one goal or sub-goal - were then classified into five global functions:
User Interface and Security. These functions entail screens and other devices which allow users to interact with the system. An important part of the interface are a variety of security functions.
Data Entry, Storage and Retrieval. These functions deal with the entry, storage and retrieval of data to and from a variety of storage devices.
Data Processing. These functions deal with a wide array of procedures that transform data (e.g. listing, sorting, filtering, translating, and calculating).
Operational design and selection of tech-nical components for Pathways requires an explicit statement of the practical functions that must be per-formed if the system is to meet specified goals.
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Data Transfer. These functions employ a variety of approaches to move data from one location to another.
Policies and Procedures.
This listing of specific and global functions has been reviewed and edited to remove duplicate listings of functions (Exhibit 2.4).