A Case Study Of How To Reinvent A Government Agency

Tom Suehs through his great leadership skills reinvented a government agency that can serve as a lesson for others. As Melissa Maynard, Stateline Staff Writer reports:

Two years ago the Texas Health and Human Services Commission was the worst state agency in the country at performing a straightforward task: giving food stamp applicants a yes or no within 30 days in normal cases and 7 days for emergency cases.

In 2009, Tom Suehs, who had served as deputy executive director at the Commission since 2003 became head of the state’s largest agency. Suehs also hired Stanley Stewart, a technocrat from Michigan, who had implemented an IT system in Michigan similar to the system Texas was struggling to make a transition to, known as TIERS. Suehs and Stewart took some key steps as leaders to turn things around at the Texas Health and Human Services Commission. Before discussing those key steps it is important to understand the way things were in 2009 at the Texas Health and Human Services Commission and the way they are today.

The Way Things Once Were

The most visible changes to address the backlog can be seen in the 316 eligibility offices scattered around Texas. When the backlog was at its worst, the atmosphere in these offices was palpably angry, as confused and frustrated applicants sometimes waited for hours, only be told to come back again another day.

Nora Sanchez’s experience was common. When her request to recertify herself and her kids for food stamps failed to go through, there was no warning, she says. “They didn’t send me anything,” she says. “I didn’t receive anything about whether I was pending or if I needed papers. Nothing.” When she went to the office in May of 2009 to ask about her status, she was told she would have to wait because they were still “entering Januarys and Februarys.” She called her caseworker twice a week, and never once got through. She always left messages but her calls were never returned. Sanchez says she made weekly trips to the office, waiting from two to five hours each time. And when she finally got to the front of the line, they just instructed her to wait for her letter to come in the mail.

The frustration was intense on the workers’ side, too. The eligibility system was operating on two different IT systems — neither of which worked very well, as a state audit notes. The legacy IT system, known as SAVERR, was no longer meeting the state’s needs. “It was cutting-edge when the microwave was cutting edge,” one worker joked. The legislature first approved the new system, TIERS, in 1999, but its development and implementation was plagued by glitches and delays. Often, employees were trained on the system by people who did not know how to use it themselves.

In the meantime, operating in two systems created cracks for clients to fall through. A client who had been approved for benefits and then moved to another town might not continue to show up as eligible. Online applications could be received but had to be manually typed into TIERS, which often operated at glacial speeds because of inadequate server capacity. Print-outs, paper applications and hand-written receipts provided the only paper trail whenever there were discrepancies, which was often. As Sandra Dillett recalls, “Somebody had to go and re-look at all the paper receipts to figure out what happened.”

New Leadership Brings New Results

Walk into an eligibility office today, and chances are you’ll be greeted pleasantly and asked about the reason for the visit. If you just need to pick up a food stamps application, the greeter will hand you one without having to wait. He or she can also answer simple questions right away.

If your case requires a more intensive response from agency staff, the greeter will push a button informing a new office management system called the “Nemo Q” why you are here. The system will assess how many workers are currently working in various roles and filter your case to the right person and place in line in order to maximize efficiency. The easier your problem, the faster the system will push you through, ensuring that the office doesn’t become clogged. While you wait, you’ll be able to take a seat in a clean, bright office and track your expected wait time on a large monitor. There’s a good chance that you’ll be able to complete an interview the same day, while you’re there, rather than scheduling a time to come back in the future.

The back-room improvements that Texas has made will have an impact on your visit as well, whether you’re aware of it or not. Fixing the programming glitches in TIERS and overseeing its successful statewide roll-out may be Stewart’s most important contribution to Texas’ turnaround. The new system makes it easier for workers to do their jobs. And customers no longer have to wait around while the system loads a new page or a worker tries to decipher the reason for error messages.

Just as importantly, it has improved the state’s ability to track its performance all the way down to the frontline worker level. It is what allows Stewart to pull reports every morning and pinpoint late cases. He follows up with the offices in question to troubleshoot.

Stewart also helped the state overcome other weaknesses in its technological infrastructure that were leading to customer-service problems. Finally, there is adequate server capacity and enough phone lines to handle incoming and outgoing calls. Before, busy signals were pervasive. Workers would have to wait for phone lines to open up before they could return phone calls when clients left messages.

In June, the federal government gave Texas a $6 million performance bonus for dramatically improving its payment error rate, moving it into the tier of “best” states for 2010. Characteristically, Suehs shared the reward with his employees. It was a powerful morale booster. Employees who received strong performance evaluations during 2010 got a bonus equal to about 4.5 percent of their annual salary.

One of the lasting lessons from Texas’ experience may be to not forget about the basics. While some of Suehs’ solutions were complex and expensive — system-wide process improvements, big IT investments, increases in staffing — other, equally critical remedies were surprisingly simple. Listening to employees. Keeping offices clean. Recognizing successes. “It’s just Management 101,” says Suehs. “Getting that employee to feel good about themselves, and making sure they know what their job is.”

Key steps that Sueh’s and Stewart took in turning around performance at the Texas Health and Human Services Commission were:

1) Listening to Employees – Suehs made dozens of visits to eligibility offices and talked with workers at all levels about how their jobs were going and what he could do to help them. He solicited email input about how to fix the problems and personally read thousands of responses.

2) Challenging Employees In A Fun Way – Suehs also worked at rebuilding morale among the workers. At the height of the backlog, Suehs asked the various eligibility offices to compete against each other in the “Commissioner’s Challenge,” a contest to see which offices could provide the best customer service by processing applications quickly and accurately. Suehs promised to personally grill a nice meal for the winners. It may sound like a summer-camp strategy, but numerous people interviewed for Melissa Maynard’s article pointed to the competition as a turning point that helped cultivate a team atmosphere and boost staff spirits.

3) Bringing In Outside Help – At first, Stewart, who was retired, worried about how Suehs’ decision to give czar-like authority over the food stamp program to an “old black guy from Michigan” who comes highly recommended by the federal government would go over in Texas. As it turned out, Stewart’s outsider status lent him the credibility he needed to make major changes.

4) Utilizing Technology – Computer technology has improved the state’s ability to track its performance all the way down to the frontline worker level. It is what allows Stewart to pull reports every morning and pinpoint late cases. He follows up with the offices in question to troubleshoot.

5) Establishing Performance Goals – Stewart is clear about his goal: He wants Texas to be the top state in the country for on-time processing. “We’re going for 100 percent,” Stewart says. He’s getting close. Each day, Stewart reviews a detailed explanation of every delinquent case and follows up on the ones that trouble him.

Government agencies can be reinvented. Tom Suehs and Stanley Stewart exemplify the kind of leadership we need in government. What do you think about the successful turnaround of the Texas Health and Human Services Commission?