Improving Social Services, Privacy and Project Management Top 2008 Watch List

Innovative attempts to cut program costs and improve services draw attention from observers.

by / December 28, 2008

Most of the projects highlighted here were selected because they involved strategies many state and local governments are still deciding whether or not to try. Industry observers are watching for the success or failure of the Indiana Family and Social Services Administration's (FSSA) attempt to outsource food stamp eligibility. All states are seeking ways to cut Medicaid costs, making Tennessee's Medicaid fraud analytics process critical to watch. Most state and local governments are investigating best practices for redacting Social Security numbers from online public documents. The Richmond (Va.) Police Department's (RPD) crime-predicting system will certainly lead to clones elsewhere if it further reduces crime, and the District of Columbia's "stock portfolio" approach to IT project management is already making waves.

A Step Ahead of Crime

During 2008, many government IT observers took special notice of an analytics-based tool for predicting crimes that the RPD developed.

The system, which gives police a color-coded map showing where crime is likely to be most intense, features a new function for 2008 that classifies the crime it measures into six categories -- burglary, robbery, auto theft, theft from auto, violent crime and other larceny.

"If you're predicting increased robbery activity versus auto theft or a burglary, we have different tactics to prevent those types of crimes," said Stephen Hollifield, information systems manager for the RPD.

Hollifield uses SPSS Predictive Enterprise Services to run the analytics. The system tries to improve its accuracy each week by automatically creating a new crime-predicting algorithm and testing it against the one used the previous week. Hollifield calls this the "champion-challenger" process. At the end of each week, the analytics tool uses the crime information collected to create a new "challenger" algorithm; the existing algorithm is the "champion." The analytics system applies the challenger algorithm to crime records from the past five years, and it tests how accurate the challenger would have been at predicting the crimes that actually happened. If the challenger algorithm would have been more accurate than the champion algorithm, then the challenger becomes the new champion algorithm. If not, the champion predicts crime for another week.

The RPD introduced the project in 2006, and in one year, murders dropped 32 percent, rapes went down 20 percent, robberies decreased 3 percent, aggravated assaults and burglaries dropped 18 percent and auto thefts fell 13 percent. Observers are waiting to see if the system's new functionality -- performing the same analytics on six, narrower categories of crime - drops the crime rate further.

Indiana Overhaul

State IT departments that are considering whether or not to consolidate and outsource welfare eligibility processes are watching how the strategy works for the FSSA. The agency has slowly rolled out its program -- outsourced to IBM and its partners -- across the state, enabling any caseworker answering the phone to handle all clients' issues, no matter who they are. In the past, clients often had to wait and call back if their assigned caseworkers were unavailable.

The project aims to accelerate the eligibility filing process, but that goal has been slow in reaching fruition. In the early stages of the rollout, which started in November 2007, the automation slowed processes in the participating pilot counties. In June 2008, the U.S. Department of Agriculture's Food and Nutrition Service (FNS) sent FSSA Secretary Mitch Roob a letter of concern because of the project's troubles.

"Indiana's most recent monthly reports indicate a decline in the timeliness of application processing that has occurred in the pilot region since the transition to the modernized service delivery model," said the letter from Ollice Holden, regional administrator of the FNS.

The automation program was deployed in 59 of Indiana's 92 counties. Before the rollout, participating counties approved 85 percent of benefits applications within 30 days of receiving them. With the new system, those

counties approved less than 50 percent of benefits applications within 30 days, according to the FNS. Most of those applications were approved within 60 days, however, which Roob said is Indiana's maximum acceptable time limit from the FNS.

The FNS letter found its way to the press in August, but at the time Roob cautioned Government Technology that projects often experience difficulties like that during the transition phase.

However, as of early October, the FSSA's welfare automation project had improved its numbers dramatically. The FNS's latest figures show a jump to 91.5 percent success rate in the agency's 30-day window for approving food stamps, which is well above the national average. Citizens also found reaching a caseworker easier than before, said Lauren Auld, FSSA director of media relations.

"Over the past four weeks, less than 6 percent of individuals calling the service center abandon their calls, compared to slightly more than 11 percent in the previous month," Auld said in late September. If the FSSA's modernization results continue to improve, look for imitations from other states.

Prescription IT

As private companies determine that that health insurance benefits are too costly to offer their employees, the demands on Medicaid are increasing. It's now the largest budget item in many states and accounts for 22 percent of total state spending, according to the National Governors Association (NGA).

Several states use IT strategies to cut Medicaid costs. One example is Tennessee, which detects and tracks a form of Medicaid fraud that was previously invisible. This is due to recent legislation that forces Tennessee pharmacies to report all their prescription drug sales to a centralized database. TennCare, the state's Medicaid program, can tap its e-prescribing system into that database, said David Beshara, pharmacy director of TennCare.

Before the legislation, the e-prescribing system only forced pharmacies to report prescription drug sales paid for by Medicaid. This loophole aided fraud. An unscrupulous patient could visit several doctors' offices and collect prescriptions from all of them, which the patient then charged to Medicaid. However, pharmacies didn't report drug sales that weren't paid for by Medicaid, even when Medicaid paid for the doctor visits that generated the prescriptions. Sometimes, patients would pay for doctor visits with Medicaid to get drug prescriptions that they purchased at the pharmacy without Medicaid money and then sold to addicts.

TennCare can now spot this fraud using the state's centralized prescription drug transaction database. All purchases are now recorded for TennCare, which can run analytics on drugs purchased with private money that may correlate with Medicaid-paid doctor visits. If this Medicaid cost-cutting strategy produces savings, look for similar strategies in other states.

Dash to Redact

State and local governments are scrambling to redact Social Security numbers (SSN) from online public documents, such as Uniform Commercial Code (UCC) documents and tax liens. Naturally concerns about identity theft are driving these efforts. Many states are looking at the California Secretary of State's office and its effort as a possible template for future projects.

In 2008, California finished combing through 2 million UCC forms, a process that involved examining millions more pages because often UCC documents are several pages. The agency hired Kindred Partners to redact the SSNs.

The project's most significant challenge was deciding whether to redact only part of the SSNs or all nine digits, said Nicole Winger, deputy secretary of state for communications at the California Secretary of State's office. Many title companies insisted that knowing the last four digits of SSNs makes narrowing down UCC research much easier.

Before the agency hired a vendor, it crossed out by hand all but the last four digits. However, some observers pointed out that tech-savvy identity thieves could use an algorithm to decipher the

entire SSN if they had the last four digits and the person's birth date.

"Our agency's decision was to err on the side of security. If someone has a court order [for the last four digits] or wants to take it up on an individual basis, we can take it from there," Winger said.

Many states are finding vendors to pursue similar projects.

Taking Stock

Finding the most effective way to manage IT projects is an endless quest for state and local agencies. However, Vivek Kundra, CTO of the District of Columbia, believes he may have done just that. Kundra manages his technology projects like a stock portfolio, treating each IT project like a publicly traded stock. The approach received much attention during state and local government IT events in 2008.

He has five "fund managers," each of whom focuses on one of five aspects of government - education, public safety, health care, government operations and economic development. Kundra and Mayor Adrian Fenty then decide what projects to hold, buy and sell. "In your personal life, would you continue investing in a stock that you knew was tanking? Unfortunately in the public sector, we allow that to happen," Kundra said.

The stock portfolio approach has already saved millions of dollars, according to Kundra. He slashed $3 million in spending by eliminating a redundant project in the D.C. Public Schools. The district also saved $4.6 million when Kundra sank an enterprise intranet initiative after he noticed the city already had a parallel project.

Though Kundra's rough-and-tumble Wall Street management approach was successful, he said it initially prompted backlash from employees.

"We moved from a culture that was built around feelings, relationships, who you knew, and making sure we were protecting jobs rather than the interest of the public and taxpayer dollars, to a culture in which we focused on results, accountability, and making sure we got the most out of the investments we made. That created a lot of friction," Kundra said.

The stock portfolio management approach also helps Kundra when he's forced to fire an employee. The stock portfolio approach gives him a detailed paper trail to support the termination. "It allows you to monitor people and performance on a daily basis rather than on an annual basis," Kundra explained.


Andy Opsahl

Andy Opsahl is a former writer and features editor for Government Technology magazine.