Health Services Delivery Reform: Building Better Health Through Innovative and Evidence-Based Health Technology Practices
To increase access to critical health, social, and self-sufficiency programs for residents through the innovative use of Video Interviewing.
Through collaboration with community partners, the County of San Diego, Health and Human Services Agency launched Video Interviewing in February 2010 as a means to improve customer service and enhance access to health coverage and food assistance, utilizing innovative technology to increase efficiency and provide timely services to our shared customers. Several problems existed prior to Video Interviewing pertaining to access to public assistance benefits:
- Serving Rural Areas of San Diego County: Staff providing mandated interviews at Outstation Clinics in rural areas of San Diego County would travel up to 40 miles roundtrip taking up to 90 minutes in travel time, often experiencing lost productivity due to client no-shows. Workers would complete a manual process in the field, then duplicate the process to enter information into the computer once back in the office.
- County Medical Services Intakes: Clients in rural areas had to travel up to 87 miles roundtrip to be evaluated for County Medical Services where outstation services were not available.
- CalFresh Outreach: Improvements were needed in order to streamline the application process to serve a high volume of CalFresh applicants from a Community Partner.
- Medi-Cal and CalFresh- Special Populations: Certain targeted hard to reach populations, such as customers residing in Battered Women’s Shelters and migrant farm workers, were hesitant to seek benefits in person.
Video Interviewing supports the County of San Diego’s Live Well, San Diego! initiative to build better health by improving systems delivery and increasing access to services. This project utilizes existing technology with limited one-time start up costs and minimal ongoing expenses which are mitigated by the reduction in mileage costs, as well as increased operational efficiencies, and customer benefits. Video Interviews are currently being conducted to evaluate for Medi-Cal, CalFresh, and County Medical Services programs.
Since program implementation, the County of San Diego has experienced cost savings through mileage reduction and staff productivity gains. Overall estimated annual savings after initial start up costs are $19,885 in gained efficiencies and 2,378 saved client miles for rural CMS applicants*. Savings have been calculated by increased productivity due to travel time, eliminated mileage costs for travel to outstation clinics, increased productivity during client no shows, and gained clerical efficiencies through eliminated mail process steps. This savings calculation continues to increase as expansion of Video Interviewing continues.
Clients benefit as they can apply for services in familiar surroundings, do not have to travel long distances to receive services, and on average are being approved the same day as the interview- up to 84% of the time at some locations. Taxpayers benefit as government is able to reduce costs to deliver services allowing more work time to serve other customers. Video Interviewing also reduces lobby congestion in the Family Resource Centers.
Following initial implementation, Video Interviewing has successfully expanded to all Regions in HHSA. Eight community partners have implemented Video Interviewing and additional partners are in planning stages. Clients are able to apply for multiple public assistance programs (Medi-Cal, CalFresh, and County Medical Services). As the network of participants expands, the potential for savings and improved access to services communities continues to grow. This project’s success is a reflection of engaged County/Community collaborations and a commitment to delivering cost effective services.
Video Interviewing has been recognized with a Digital Government Achievement Award (DGAA), a National Association of Counties (NACo) award for innovation in County government, the American Public Human Services Association (APHSA), and Harvard’s Ash Center Innovation in Government Bright Ideas award.
For more information on how to replicate this program in your operation, please contact Deanna Zotalis-Ferreira at Deanna.Zotalis@sdcounty.ca.gov or by phone at (760) 740-8807.
*As of FY2011-2012