Inter-Departmental Correspondence

Human Services Agency



May 19, 2004


June 8, 2004



Honorable Board of Supervisors



Maureen D. Borland, Director, Human Services Agency


Glen H. Brooks, Jr., Director, Central Region



Human Services Agency Health Insurance TeleCenter Update



Accept this report providing an update on the San Mateo County Human Services Agency (HSA) Health Insurance TeleCenter (HIT).



In July, 2003, the Board approved a recommendation by HSA to centralize ongoing Medi-Cal cases in a call center environment. A model was needed which would accommodate the needs of a growing number of employed recipients and not decrease the level of customer service. The TeleCenter was a solution to increasing caseloads and regulatory mandates with no equivalent allocation increase. An innovative and streamlined approach was called for and a call center model was identified as the best solution.



The TeleCenter was implemented on November 10, 2003 with 23,000 ongoing Medi-Cal cases. Procedures were put into place designed to handle virtually all eligibility issues via mail or by telephone. The TeleCenter currently receives over 8,000 telephone calls per month; processes approximately 1,800 renewals and 500 status reports per month; and handles over 1,000 pieces of mail and computer documents daily. TeleCenter staff are committed to a high standard of excellence, which is reflected by a 95% efficiency rate. This efficiency rate is based on a goal of answering 80% of the telephone calls within 30 seconds or less. Current statistics reflect that TeleCenter staff answer 95% of the calls within 30 seconds or less, with an average of nine seconds response delay. The TeleCenter has been successful in achieving the anticipated outcomes as follows:



Increased response time to customer telephone calls. Currently the average response time to customers' telephone calls, as noted above, varies between 9 and 18 seconds.


Improved quality of service. Recipients are helped by the first available staff rather than waiting for a specific Benefits Analyst to assist them.


Consistency of information given to customers through the Voice Response Unit system.


Timely completion of redeterminations and status reports.


Immediate identification of staff training needs through a call monitoring process.


Consistent, on-going staff training by the onsite coach trainer.


Consistency of processes and procedures.


The TeleCenter, in a short time, has proven to be successful and has benefited both HSA and Medi-Cal customers, resulting in the decision to expand services to Non-Assistance Food Stamp recipients. Effective May 17, 2004, approximately 1,500 on-going Non-Assistance Food Stamp cases were relocated from the regional offices to the TeleCenter. By telephoning the 800 number, recipients are now able to address issues related to their Food Stamps. Future enhancements to the TeleCenter include systems upgrades and enhanced system capacity to accommodate additional programs and potential non-San Mateo County caseloads. HSA will continue to evaluate the efficiencies of the TeleCenter to ensure the needs of employed recipients are met; customer service is provided at a high level; regulatory requirements continue to be met; and significant cost savings are realized.


Vision Alignment

The continued operation of HIT will keep the commitment of responsive, effective and collaborative government and goal number 3: Government decisions are based on careful consideration of future impact, rather than temporary relief or immediate gain.


Fiscal Impact

There are no additional costs nor Net County Costs associated with the acceptance of this report.