The Importance of Follow-up
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The Importance of Follow-up

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July 1, 2013

In early 2012, the Center funded six Benefits Enrollment Centers (BECs) to implement significant innovations to scale up benefits access work in their region and increase enrollment for underserved populations. Two of these grantees—AgeOptions (Cook County, IL) and the Georgia Legal Services Program (GLSP, GA)—specifically worked on creating robust systems for tracking and following up with clients to ensure they enrolled in, used, and retained the benefits for which they were eligible. Through critical partnerships with state adjudicating agencies, these grantees were able to better assist their clients who like many others try to access benefits but get lost or caught up in the process.

What did they do?

AgeOptions partnered with South Suburban Senior Services of Catholic Charities (SSSS/CC) and PLOWS Council on Aging to better serve low-income Medicare beneficiaries across suburban Cook County. In addition to strengthening their relationships with caseworkers and supervisors at the Illinois Department of Human Services (DHS, which administers SNAP, Medicaid, and the Medicare Savings Programs), PLOWS also received access to and utilized IMSA (DHS’s client lookup system) to check on their clients' application status. (SSSS/CC sought, but did not receive, access to IMSA during the grant period.)

The Georgia Legal Services Program developed a follow-up protocol that integrated benefits assistance with their legal services, ensuring a smooth, in-house process to help clients move from application assistance to appeals (when necessary). They also formed a relationship with their local eligibility determination agency, the Department of Family and Children’s Services (DFCS), to better understand why applications are denied or benefits are terminated.

While all clients were encouraged to report back to the BECs regarding any notifications they received from DHS and DFCS, the BECs also proactively tracked clients and contacted them to inquire about their enrollment status. Most follow-ups occurred within an average of 59 days, with 40% happening within one month.

AgeOptions and GLSP followed up with 1,606 clients during the one-year grant period. The assistance provided to these clients took many forms, but two areas predominated:

  • 847 clients received help in troubleshooting applications.
  • 775 clients received counseling and education on how to use the benefits.

Importantly, 12% of the follow-up clients reported significant changes in eligibility criteria (e.g., income, marital status, and household composition) that affected their benefits application.

What were the results?

Thanks to the robust procedures in place for following up with clients, AgeOptions and GLSP:

  • Helped these clients apply for and receive $2.9 million in benefits.
  • Increased the value of benefits received by an average of $4,100 per person (or 31% more than the client would otherwise have received with only a single contact).

Both grantees cited their experiences with local adjudicating agencies as providing tremendous insight into the barriers to enrollment for their clients. There was recognition that while progress was made, still much work needs to be done to improve the procedures and ease with which clients move through the system.

AgeOptions and its community partners have said that their increased understanding of the inner-workings of the South Suburban DHS office has equipped them with the tools needed to further stimulate change at DHS. At the same time, they recognize that, “The project helped stimulate some change but much more work needs to be done. As the adage says, Rome was not built in a day!”

GLSP has developed a 16-point list of systemic issues that clients face in obtaining benefits. This list has been presented to the Commissioner of the Department of Community Health and the Medicaid Re-design Committee helping to re-design Medicaid eligibility and re-determination procedures.

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