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					Mecklenburg County’s Interoperable System


   Mecklenburg County, North Carolina


  A County Developed
 Interoperable System
                                                       JANUARY 20, 2009




      Presented by:
      Richard W. “Jake” Jacobsen, Jr., Executive in Residence
      Institute for Social Capital
      University of North Carolina at Charlotte (UNCC)
                                                                          1
    Mecklenburg County, North Carolina System
     Mecklenburg County’s Interoperable

• Land mass is 546 square miles. Its
  county seat is Charlotte.

•    2008 City Population       695,995
•    2008 County Population     902,803
•    MSA                        1.7 mil.
•    100-mile                   6.9 mil.

• 1st most educated workforce
• 1st America’s most livable
  communities

• Cost of living below national average
• City, County and State AAA bond
  rating
                                           www.charlottechamber.com
                                                               2
The Competitors
 Mecklenburg County’s Interoperable System

County Services funded through property taxes,
federal and state revenue, local sales taxes, fees
and other sources are provided to meet the
community's priorities as defined by the Board of
County Commissioners.
    −   Board of Commissioners
    −   Elections
    −   Sheriff, Courts, and Jails
    −   Taxes
    −   Property and Real Estate
    −   Environment
    −   Park & Recreation
    −   Building Code
    −   Employment
    −   Charlotte-Mecklenburg Schools
    −   Central Piedmont Community College
    −   Social Services, Health, Mental Health,
        Indigent Hospitalization, Vital Records      3
 Mecklenburg Social Services
Department ofCounty’s Interoperable System




  August 4, 1919: The Mecklenburg Board of County
  Commissioners and the Board of Education organized the
  County’s Department of Public Welfare.
      The department was located in the Charlotte City Hall.
       The staff included the superintendent, Mr. Lucius H.
       Ranson and a secretary. The budget for the first fiscal
       year was $2,239.76.
                                                                 4
   Mecklenburg Social Services
  Department ofCounty’s Interoperable System

• 1921: NC General Assembly enacts first Welfare Law, proscribing
  the duties of the Superintendent, including:
      Care & supervision of the poor, and
       administration of the poor funds
      Monitor the condition of persons discharged
       from hospitals for the insane and other State
       institutions
      Oversight of all prisoners in the County on
       parole and probation (adult and juvenile)
      Oversight of all dependent and delinquent
       children, especially those on parole or
       probation
      Promote wholesome recreation in the             Lucius H. Ranson,
       County and enforce laws regulating              Superintendent of
       commercial amusement                              Public Welfare
      Assist the State board in finding employment
       for the unemployed
      Creation of a 3-member Black Advisory Board to study welfare
       problems of Blacks and assist the County in serving them       5
 Mecklenburg Social Services
Department ofCounty’s Interoperable System

 Currently, North Carolina General Statutes 108A-14:
 Act as an agent for the Social Services Commission
 and the NC Department of Health and Human
 Services to:
   • Administer programs of public assistance,
   • Investigate reports of child abuse and neglect and take
     appropriate actions to protect children at risk, and
   • Investigate reports of abuse,
     neglect and exploitation of
     disabled adults and take
     appropriate actions to protect
     these individuals.



                                                               6
      “DSS, THEY WILL DO ANYTHING”
  Mecklenburg County’s Interoperable System

            QUESTION: WHO PROVIDES
            MASS CARE & SHELTERING?
To:         The NCDIRECT Mailing List
Sent:       Wednesday, June 06, 2007
From:       A DSS Director              Reply:    Wednesday,
                                                  June 06, 2007
Subject:    DSS Requirement to
            Provide Mass Care?          From:     An Old Time
                                                  DSS Director
Can anyone point me to the              “it is under the same
legislation and/or policy that          legislation that basically
MANDATES DSS to be the agency           reads….
that provides Mass Care and
Sheltering in a disaster?               Let’s get DSS, they will do
                                        anything – unclaimed dead
I can’t find it.                        people fall under that one
                                        too.”
                                                                     7
   Mecklenburg County’s Interoperable System

Services provided by the Mecklenburg           •   Food Stamps
County Department of Social Services:          •   Fraud Investigations
  • Community Resources                        •   Graphic Services
  • Adult Medicaid, State /County Special      •   Human Resources Liaisons
    Assistance, and Food Stamps                •   Information Services
  • Adult Social Work                          •   Just1Call
  • Bilingual and Special Needs                •   Low Income Energy Assistance
  • Child Welfare District Operations:         •   Mecklenburg Transportation System
    Intake, Investigations, Family             •   NC Health Choice
    Intervention and Permanency Planning       •   Organizational Development
  • Child Welfare Non-District Operations:     •   Refugee Assistance
    Intake/After Hours/Conflict of             •   Senior Nutrition
    Interest/ Facilities, Sex Abuse, Nursing   •   Transportation Scheduling Call Center
    Unit, Interstate Requests, Foster Care,    •   Work First
    Court Ordered Visits and Adoption          •   Work First Employment Services
  • Citizens Information and Referral Call
    Center
  • Community Resources Office
  • Compliance and Quality Assurance
  • Contracts Administration                        45 different
  • Customer Service Group Call Center
  • Facilities Services
  • Family & Children’s Medicaid
                                                    businesses!
  • Finance/Accounting
  • First Floor Service and Information                                              8
 Mecklenburg Social Services
Department ofCounty’s Interoperable System

      Public Assistance Caseloads
          FOOD & NUTRITION SERVICES:
          November 2008: 39,971 cases
          (11.6% increase since November 2007)


          MEDICAID & NC HEALTH CHOICE:
          November 2008: 87,685 cases
          (12.4% % increase since November 2007)


          UNDUPLICATED CUSTOMERS:
          November 2008: 155,071 customers
          (11.2% % increase since November 2007)
                                                   9
  Mecklenburg Social Services
 Department ofCounty’s Interoperable System


• Approximately 17.16% of Mecklenburg County residents
  were receiving public assistance in November 2008.
  This includes 38.2% of children and 9.9% of adults
  residing in Mecklenburg County.




                                                         10
 Mecklenburg Social Services
Department ofCounty’s Interoperable System

                DSS Call Centers
• The DSS Call Centers answered 602,664 calls, or
  an average of just over 50,000 calls per month
  from July 2007 through June 2008.
  – This resulted in 157,003 transactions completed by the
    Call Centers, or an average of over 13,000 transactions
    (customer address changes, etc) per month.




                                                              11
  Mecklenburg County’s Interoperable System


Since the late 1980's
                                 Improved
Mecklenburg County
                                  service
has aggressively                  delivery to
pursued automation                customers
within Health and
                                 Improved
Human Services with
                                  staff
these specific                    productivity
benefits in mind.
                                 Improved
                                  management
                                  competence

                                            12
     DSS Wide Area Network
Mecklenburg County’s Interoperable System
                                 ITS
                               EFUNDS
                                                                                Wide Area Network and Data Links                                    Child and
                                                                                                                                                                                                   Access
                                                                                                                                               Adolescent Services                             1 Site, 1 ESD staff
  Internet                                                                                                                                         at Latrobe
                                                                                                                                                   1 ESD Case Worker                      After Hours Support
                                              Charlotte Mecklenburg                                        Health Department                                                                  3 Sites, 3 YFS staff
                                               Police Department                                               Southeast
                              T1                         1 Sites                                                                              NMLI 100Mbps                     Central Piedmont Community College
      8 T1s                                       1 YFS Social Workers                                       1 Site, 13 HD
                                                                                                                                                                                               1 Site, 1 ESD Staff
 1.544Mbps each                                                                                             Administration
                                                                                                                                               Mental Health,
                                                                                                                                                Community                              Child Care Resources, Inc.
                                   Fiber 10Mbps                            Biddle Point                                                          Services                                  1 Site, 1 CCRI Staff (DSS)
                                                                               CCRI
                                                                                                                     Fiber 100Mbps
Charlotte Mecklenburg                                                      Mercy South                                                                                                            Job Link
                                       9.6 Multi-Drop Lines                                                          (single-mode)
  Government Center                                                         Mercy Vail                                                    Fiber 100Mbps                                       2 sites, 2 ESD Staff
***************************                                                 North Park                                                     (multi-mode)            ISDNs
       Mainframe                                                          Mainframe Only                                                                          128 kbps                   Senior Nutrition
                                                                                                                                                                    each               21 Sites, 21 SFA Site Coordinators
          ****
                                                  NMLI
    All City/County                           Wireless B(100Mbs)                                                                                                                      Community Social Workers
                                                        ack Up (11
        Networks                                                   Mbs)                            The Wallace H. Kuralt Centre                                                          7 Sites, 8 SFA Social Workers

    NTCMGC2 (285)                      T1                                                                                                                                             Charlotte Housing Authority
                                                   Charlotte East                                                 Fiber
                                                                                                        Network Servers (Computers):                                                       3 Sites, 16 CHA Workers
                                                                                                        (multi-mode)
                                                                                                AFD1 (417); DSS1 (130); EVAL1(5); MED1 (123);
                                                    Network Server                                 SFA1 (115); DSSTAPE; DSSZEN; GWDSS;
                                                     (Computers):                                              DSSWINFRAME1;
                                                     YFSCPS1 (72)                          NTDSS1; NTDSS2; NTDSSAPP1; NTDSSAPP2; NTDSSWEB1;                                                          ACS (Curtis)
    56Kbps          56Kbps                                                                                                                                                                      1 Site, 9 ESD Contract Staff
                                                                                                         NTDSSSQL3; DSS-MS-DC01;
                                                                                                                NTDSSTERM1
                                                                                                                                                                                              Carolina's HealthCare
                                                                                                                                                                           5 T1s
                                                           T1                                                                                                           1.544 Mbps
                                                                                                                                                                                                    Systems
      AOC              ITS                                                                                                                                                                            8 Clinical Sites,
                                                                                                                                                                           each                    19 Medicaid/ESD Staff

   State Government                                  Fiber 1Gbps                                                                                                                                  ESD Orientation
             at                                      (multi-mode)                                                                                                                                    1 Site, 2 ESD Staff
          Raleigh                                                                                                                                                        Citrix
                                            Fiber 100Mbps                                                                                                                                     Presbyterian Hospital
 ***************************                                                                                                                                           WinFrame                    1 Site, 2 Medicaid Staff
                                            (single-mode)
     Mainframe only
                                                                                                  Crisis Assistance                                                9.6                             Transportation
                                                                                                   7 CAM, 1 Fraud, 1 ESD,
                                                                                                                                                                Syncronet                            1 Site, 30 SFA Staff
                                            Bob Walton Plaza                                                                         Analogue Modem
                                                                                                                                      (pcAnywhere)
            56Kbps
                                      Network Server (Computers): (80)                                                                                  Analogue Modem
                                            DSSHOTSPARE (0)


          Charlotte                                                                                                                                                            WIC
        Mecklenburg                                                                                                                  After Hours Support                      Health
    Board of Education
                                                                                       County and Courts Office                         2 Sites, 2 YFS Staff                  Dept.
     **********************                                                                     Building                                                                                                    ISD PC
     Central Piedmont                                                                                                                                                                                   2 Sites, 2 ISD Staff
    Community College                                                                   Network Server (Computers):
     **********************                                                                     YFS1 (285)
       Mainframe only                                                                                                                                            Carolina HealthCare
                                                                                                                                                                Systems Main Hospital
                                                                                                                                                                                                                         13
                                        Ennett/Heptig November 13,2003
                                                                                               NTDSSSQL4
                                                                                                                                                                       HBOC Program
                                        sfa1\sys\tech\home\profile\visio\wan-dss.vsd
Mecklenburg County’s Interoperable System

 To improve case management software
     systems, Mecklenburg County’s
 Department of Social Services partnered
with the County’s Information Services &
Technology Department (IST) to develop
an Integrated Social Services Information
                 (ISSI).




                                            14
Mecklenburg County’s Interoperable System

           ISSI Background
• ISSI is a full featured case management
  system developed by IST for the Department of
  Social Services.
• ISSI was developed as a collaborative effort
  between DSS Supervisors, ISD, IST, and most
  importantly front line staff.
• ISSI has replaced 4 legacy applications.
     – Fraud
     – AIMS (Automated Income Maintenance System)
     – SAMII (Services for Adults Management
       Information)
     – CWII (Child Welfare II)


                                                    15
   Mecklenburg County’s Interoperable System

                                                                   DSS – Suite
                               MIT
                          Mecklenburg
                          Interviewing
                               Tool
                           (Eligibility)
                                                                  of Integrated
             Front                                                Applications
             Desk             ASWS               ISSI
                                            Integrated Social
                                           Services Information

  Appoint-                                                          Just1Call
                Worker
   ments
                Assign-
                 ment




                     Worker          MealBytes        TransWeb
                     Notify



The integrated applications suite includes the Front Desk Registration
System (FDRS), the Mecklenburg Interviewing Tool (MIT), MealBytes,
TransWeb, Just1Call, and the pinnacle of our automation efforts, the
                                                                       16
Integrated Social Services Information System (ISSI).
Mecklenburg County’s Interoperable System

             ISSI Implementation

  • Fraud:               November 2002
  • Adult Social Work:   November 2003
  • Adult Medicaid:      March 2004
  • Economic Services:   June 2004
  • Child Welfare:       July 2007



                                         17
Mecklenburg County’s Interoperable System

           ISSI – Current Usage

    • Classic ISSI and ISSI-Child
      Welfare have over 1,100 users at
      Mecklenburg County.
    • ISSI-Child Welfare is also being
      used in Buncombe County.
    • ISSI can be run on a users desktop
      or remotely via Terminal Server.



                                           18
Mecklenburg County’s Interoperable System

               Benefits of ISSI
 • ISSI provides total integration for the main
   service areas at DSS.
 • Data is entered once and is available to all
   service areas that use ISSI
 • ISSI provides a holistic view of DSS Clients
 • Workers can view information on line and are
   not as dependent on the physical folder
 • Without ISSI the creation of the Call Center
   would not have been possible

                                                  19
Mecklenburg County’s Interoperable System

           Classic ISSI Costs

  • More than 50 DSS and IST staff were
    involved in the development of
    Classic ISSI

  • Took over 4 years to develop

  • Cost was $6 million




                                          20
   Mecklenburg County’s Interoperable System

            ROI Figures for Classic ISSI
  (From the Estimated Return on Investment for ISSI
compiled by the Office of Planning and Evaluation at DSS)
                  Division            Annual Benefits

         Fraud Investigations          $160,709

         Adult Medicaid                $374,568

         Economic Services Division    $619,278

         Adult Social Work Services     $84,061

         Central Services               $2,564


         Information Services           $8,038
         Division


                            Total:    $1,249,218        21
Mecklenburg County’s Interoperable System

              ISSI – CW Costs
• More than 40 DSS and IST staff were involved
  in the development of ISSI – Child Welfare

• Took 3 years to develop

• Cost was $2.6 million

• 8 contractors

• 22 County Staff




                                                 22
Mecklenburg County’s Interoperable System

           ROI – ISSI Child Welfare
(From the ROI - Labor and Benefit Study completed by the
     IST Project Management Division/BPM Group)

                  Division      Annual Benefits

            Intake               $583,295.43

            PPL and Adoptions    $395,750.15

            Investigations       $344,634.17

            Record Room           $20,048.90

            System Downtime       $10,008.00

            Data Integrity        $2,494.52

                       Total:   $1,356,231.18
                                                           23
Mecklenburg County’s Interoperable System

        ISSI-CW Intangible Benefits
    • Shared Common Database
    • Improved Service
    • Newer and Better Technology
    • Standard for future Application
      Development
    • Easier to Deploy
    • Easier to provide remote access




                                        24
Mecklenburg County’s Interoperable System

     ISSI – CW Project Expectations
   • Accommodate federal benchmarks where
     possible
   • Include the Intake Referral form
   • Have a history of investigations
   • Include elements of MRS (Multiple
     Response System Tracking)
   • Incorporate necessary Structured Decision
     Making Language/Data Elements




                                                 25
Mecklenburg County’s Interoperable System

          ISSI – CW Interfaces
  • Upload to the state for Day Sheets
  • Export data for upload to the County
    Finance System for Adoption Assistance and
    Foster Care Board Payments.




                                                 26
Mecklenburg County’s Interoperable System

         ISSI–CW and How We Did It…
• Project manager from IST and a Customer Sponsor from
  Both Counties
• Management Team with representatives from both counties
• Design Team made up of supervisors and end users from
  both counties
• System Architect and development team with resources
  from both counties
• Contract staff provided expertise and supplemented
  existing IT staff
• Data Base Administrator and a Technical Services Project
  Manager
• Utilized teleconferencing tools for meetings between the
  two counties
• Utilized web based code sharing tools
• Vendor developed computer based training (CBT)
• Very importantly - We followed our System Development
  Life Cycle throughout all phases of the project          27
     Mecklenburg County’s Interoperable System

        Automation…                              Automation…
    In July 1994 DSS had:                    In July 2007 DSS has:
•   40 dumb terminals, no PCs, no        •   a fully integrated case management
    networks,                                system w/ CWS being added in 8/07
    no file servers, no E-mail, and no   •   1,099 FTEs
    voice mail 1,200 FTEs                •   4 major sites and over 50 satellite
•   $54 million budget                       offices within Mecklenburg County
•   2 major business sites               •   1,423 desktop PCs and 198 laptops
•   State planned to add 297             •   72 County owned network printers
    terminals;                           •   60 IKON Multifunction devices
•   DSS planned to add 278               •   226 desktop printers
    personal computers
                                         •   15 custom developed software
                                             applications programmed by IST
                                         •   $79 million budget
                                         •   35 custom applications by ISD
                                         •   1,093 voicemail boxes
                                         •   6 Call Centers (CIR, CSG, MTS, CPS,
                                             ESD Managed Care, and APS)         28
 Mecklenburg County’s Interoperable System

      Automation… Today, DSS Has Gone From:
• coax cabling, to Arcnet, to Ethernet, to wireless LANS and
  WANS…. From hard wired PCs to air cards… from Daytimers,
  to automated calendars, to PDAs, to Blackberries….. From
  Index Cards…. to siloed systems…. to full blown integrated
  Case Management systems.
• no nets…. to Internets…. to Intranets ….to Extra Nets. From
  calendar hunting for Conference Room... to automated
  reservations…
• FoxBase, to Fox Pro, to Visual Basic, to .Net
• SYSM (Mainframe E-mail), to GroupWise, to Outlook…
• modems, to microwaves, to fiber…..
• being completely tethered… to partially un-tethered…. and
  soon to be completely un-tethered through teleworking and
  mobility.                                                29
Mecklenburg County’s Interoperable System

               Terminal Server




  It is the blue blades!
                                       30
Mecklenburg County’s Interoperable System
                     Department of Social Services
                           Remote Workers
                                                                                                                              CMGC


  DSS (Kuralt)
                                                                                               Firewall




                                                                                    0 U nk
                                                                      k




                                                                                           s
                                                                  Lin




                                                                                       se r
                                                                                 500 B Li
                                                                E
                                                             tro rs
                                                          M e se




                                                                                  30M
                               Terminal Server         B 0U
      ISSI Application
                                                    0 M 120
           Server                                10
                                    1GB Link
                         1G
                           B
                           Lin
                               k




                                                                      Internet                       700 KB Link
                                                                Internet                               1 User
                                                                                           1.5
                                                                                                 MB
                                                                                               1 U Link
                               Router                                                             se r




                                                                                     1. 1 U
                                                                                       5
                                                                                         M se r
                                                                                                                                  Air Card




                                                                                          B
   Future
                                                                                            Li
                                                                                               nk
                                                                                                                Cable Modem




 untethering
                                                                                                          DSL


                                                                                                                                         31
                                                                                                                               DSS Remote Worker
    K. Hahn 7/2/07
 Mecklenburg County’s Interoperable System

    Integrated Social Services Information (ISSI)
              Child Welfare August 2007
• Web-based Child Welfare system
• Designed in collaboration with
  Buncombe County, leveraging
  best practices from each county
• Integration of agency data
  through a shared common
  database
• Improved coordination of services
• Future worker mobility
• Framework for future
  development
• State-mandated tools
                                                    32
Mecklenburg County’s Interoperable System

   Impact of ISSI (BEFORE)
• Separate databases for:
  – Economic Services Division (AIMS)
  – Adult Medicaid (AIMS)
  – Adult Social Work Services (SAMI)
  – Fraud
  – Youth and Family Services (CWS)




                                        33
Mecklenburg County’s Interoperable System

     Impact of ISSI (NOW)
  • One database that includes:
    – Economic Services Division
    – Adult Medicaid
    – Adult Social Work Services
    – Fraud
    – Youth and Family Services
  • Sophisticated, state-of-the art system
  • .Dot Net, teleworking and mobility


                                             34
Mecklenburg County’s Interoperable System

• There is no production downtime!
• All Letters and Forms can be faxed or emailed from
  your desk!
• Forms will be preformatted for window envelopes
• Narratives have Spell Check, BOLD, ITALIC, and
  Underline capabilities
     – You can view/sort Narratives from newest to
       oldest or by other criteria while you are
       typing in a current narrative



                                                   35
Mecklenburg County’s Interoperable System

• Narratives will not be lost should you need to
  exit the screen (to answer a phone call, etc.)
• You will be able to bookmark screens in ISSI
  much the same way you mark a favorites on the
  internet
• ISSI will keep track of your MRU (Most Recently
  Used) cases
     – ISSI will send automatic notification
       (alerts) of significant changes, to all
       associated workers


                                                   36
Mecklenburg County’s Interoperable System




             ISSI-CW Design Team       37
Mecklenburg County’s Interoperable System




                 FUTURE
  • Voice over Internet Protocol (VoIP)
  • Imaging
  • Virtual Office
  • Virtual People
  • RepRap
                                          38
Mecklenburg County’s Interoperable System


“There is nothing
more difficult to carry
out, nor more
doubtful of success,
nor more dangerous
to handle, than to
initiate a new order
of things.”
- Niccolò Machiavelli
                                       39
Mecklenburg County’s Interoperable System


   Mecklenburg County, North Carolina


  A County Developed
 Interoperable System
                                                       JANUARY 20, 2009




      Presented by:
      Richard W. “Jake” Jacobsen, Jr., Executive in Residence
      Institute for Social Capital
      University of North Carolina at Charlotte (UNCC)
                                                                          40

				
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