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					New Jersey Department of Labor
Unemployment Insurance Modernization Project
Business Process Conceptual Design

April 2003
Executive Summary
                                                                Executive Summary…


Why Modernize UI?
New Jersey demographics are changing rapidly - tides within the
workforce employer base are shifting and substantial numbers of New
Jersey‟s current workforce are “baby-boomers”, including a huge number
of the agency‟s own employees. This shift in demographics is also
shifting customer service needs. These needs are substantially different
from the last State UI modernization effort (mid -1980s).
Impacted by the counter-cyclical effects of the first major economic
downturn in over a decade, the agency is currently suffering with a
substantially increased workload, an increasingly frustrated staff, and
greater employer and claimant demands.
The US congress, through the Reed Act has provided substantial funds to
the States (including New Jersey), to streamline and modernize their
Unemployment Insurance services.
                                                                Executive Summary…


Why Modernize UI? (cont.)
The UI Division recognizes the need and possesses the commitment (and
the funding) to improve UI customer service by combining industry best
practices, redesigning workflow effectively and efficiently, and by updating
supporting technology.
In recent years, legacy systems and associated business processes,
some of which are more than two decades old, have been updated with
patchwork ingenuity. However, investments in replacement infrastructure
were cost-prohibitive, so these systems have sadly fallen far behind in
their ability to serve today‟s workload demands and customer
expectations. As a result, all stakeholders suffer.
                                                                                                                Executive Summary…


     Why This Approach?
     A basic business tenet is that systems must support business processes.
     So, before a modern UI system is designed and built, the Division has
     taken the critical step of reviewing and redesigning its business
     processes.
     Leadership has also recognized that the best approach to developing
     business processes requires a collaborative effort – input from across the
     UI Division (from front-line staff through to senior managers) and from its
     customers (claimants, employers and partner agencies).
                                                      k                        e
                                                   in                      fin                    Do
This deliverable is part of a                    Th                     De
                                                   Analysis
                                                   Analysis                    Design
                                                                               Design                  Plan
                                                                                                       Plan
series of tasks that leads to
a strategic plan for
                                  UI Process     Review current state   Design business       Detail all requirements   Implementation
modernization of UI               Review         ID gaps with vision
                                                                        processes
                                                                        Design architecture
                                                                                              Get approval for new
                                                                                              system design
                                                                                                                        RFPs


services:                         Managing
                                                 Review initiatives     Manage project        Plan delivery              Manage the
                                                 Planning               Review                Plan migration            change
                                  the Program    Agree controls
                                                                        interdependencies
                                                                                              Consider change needs

                                                 Detailed work plan     Business process      Requirements
                                                                        conceptual design
                                  Deliverables   Baseline description   Technical architecture Strategic plan plan
                                                                                               Draft strategic
                                                                        Interface document     Strategic plan


                                                 Nov 2002 –                Feb – May               May – July
                                                  Feb 2003                   2003                    2003
                                                                                             Executive Summary…


Successful Projects Start With a Vision!
The Business Process Conceptual Design sets out both a framework and
blueprint for UI Modernization…



                                                Vision
               Framework                     Objectives and
                                             Measurements

                                               Principles

                                               Enablers
  Blueprint
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 * The technology and systems blueprint will be addressed in the technical architecture phase.
                                                                 Executive Summary…


Our Vision for UI Modernization
We will deliver revolutionized unemployment insurance services, while
maintaining the integrity of the Trust Fund
At each point of customer contact, we will provide a fair, friendly and high
quality service to every member of the workforce community
   For claimants, we will help them to focus on reemployment by
    making the claims process timely, efficient, and informative. We will
    also help them to access related government services by improving
    referrals from UI, in partnership with the workforce community
   For employers, we will simplify correspondence and improve our
    responsiveness. We will treat employers as partners in the provision
    of unemployment insurance
   For staff, we will empower them to deliver superior service by
    ensuring a stable work environment, creating equal opportunities for
    career growth and providing appropriate tools and training to do the
    job. We will treat our employees with the same professionalism and
    respect they are expected to share with every UI customer.
                                                                  Executive Summary…


The Vision, Objectives and Business Design
Principles Set the Framework for UI Modernization
The phrases highlighted in red (in the vision) illustrate the need to:
   Maintain the integrity of the trust fund
   Provide timely and efficient services
   Work as a partner to other workforce services (Disability, Workforce
    New Jersey, etc.)
   Improve responsiveness to customer (whether claimant, employer, or
    internal agency) needs
   Provide superior customer service
   Provide an environment where our employees can succeed


    These and the business design principles together provide the
    boundaries and guidelines for future UI Modernization projects
                                                                                                                    Executive Summary…


Creating the Blueprint: Where Did We Start?
With a framework established, we needed to create a blueprint to
describe the UI of the future.
We started with the acknowledgement that certain processes are
necessary to delivering UI services, both today and in the future. These
processes include:            Selected
                                                                                    Organization and Culture

                             Interfacing
                              Agencies                                Core Process        Entry

                                                                                                               Adjudication

   Claim intake             One Stop partners
                                                                                          Intake               Determination




                                                                                                                               Inquiry / Triage
                                                                        Prevent




                                                      Investigation
                                                                      overpayment
    Adjudication
                             Workforce New Jersey
                                                                                       Continued
                                                                                             Triage
                                                                                       certification           Determination
                             TDI

   Certification                                                                    Lower-Authority                Re-
                                                                                                               determination
                             Dept of Human Services
                                                                                       Appeal (AT)

   Appeals                                                                          Higher-Authority
                             Attorney General
                                                                                      Appeal (BoR)

   Payments                 Employer Accounts
                                                                                     Financial management
                                                                                    Performance management

   Controls                 Bank
                                                                                Operations / process management
                                                                                      System management

                             Treasury                                           Business and Technical Enablers



Revolutionizing UI is not about replacing these processes but rather
making them more efficient, timely and, in parallel, enabling our staff
               to provide superior customer service
                                                                                                                                                 Executive Summary…


         Creating the Blueprint: Changes
                                                              Providing multiple means for
                                                              customers to communicate with us
 Enabling customers to self                                   in real-time (phone, internet, in
 serve wherever possible                                      person) and for us to communicate
                                                              with our customers                                   Establishing a triage
                                                                                                                   function that enables a
                                                                             Organization and Culture
                                                                                                                   quick assessment of a
                            Selected
                           Interfacing                                                                             customer’s needs and
                            Agencies                              Core Process
Enabling UI staff to                                                                Entry
                                                                                                                   linking him/her to the
view and work with a       One Stop partners
                                                                                                      Adjudication
                                                                                                                   service that they need
claimant’s or                                                                           Intake             Determination




                                                                                                                           Inquiry / Triage
                                                                      Prevent
employer’s full case       Workforce New Jersey
                                                    Investigation   overpayment
                                                                                      Continued
information easily                                                                         Triage
                                                                                     certification         Determination
                                                                                                                                              Allowing
                           TDI
(everything from                                                                   Lower-Authority              Re-                           claimants and
claims to appeals          Dept of Human Services
                                                                                     Appeal (AT)           determination
                                                                                                                                              employers to
information)                                                                       Higher-Authority                                           update specific
                           Attorney General
                                                                                    Appeal (BoR)
                                                                                                                                              information (e.g.
  Improving                Employer Accounts
                                                                                   Financial management
                                                                                                                                              address, etc.)
  coordination                                                                    Performance management
                                                                                                                                              depending on the
                                                                              Operations / process management
  between UI partners      Bank
                                                                                    System management                                         claim processing
  through                  Treasury                                           Business and Technical Enablers                                 step
  phone/internet web
  links                                                                                               Enabling claimants
                                                                                                      and employers to
Enabling claimants and employers to                                                                   access (by phone or
interact with UI on a 24 hour, 7 day a week                                                           internet) their own
basis                                                                                                 case information
                                                                                                                                                              Executive Summary…


           Creating the Blueprint: Changes (Cont.)
                                                                                                                          Providing meaningful
                            Providing UI staff with the                                                                   training and career paths
                            ability to create their own                                                                   better to enable our
                            reports                                                                                       workforce
Preventing improper
payments or                      Selected
                                                                                       Organization and Culture

overpayments by                 Interfacing
                                                                                                                                                     Linking performance
                                                                         Core Process
performing systematic            Agencies                                                    Entry                                                   throughout the agency
cross checks at
                                                                                                                  Adjudication                       - from Division
                                One Stop partners

multiple points in the
                                                                                             Intake               Determination                      objectives & measures




                                                                                                                                  Inquiry / Triage
                                                                           Prevent
                                                         Investigation
life of a claim (at claim       Workforce New Jersey                     overpayment                                                                 to PARs
                                                                                           Continued
                                                                                                Triage            Determination
entry, certification,           TDI
                                                                                          certification

etc.)                                                                                   Lower-Authority                Re-
                                                                                                                                                            Create a channel
                                                                                          Appeal (AT)             determination
                                Dept of Human Services
                                                                                                                                                            for comments
   Enabling what if                                  Higher-Authority                                                                                       that enables all
   analysis on process          Attorney General
                                                       Appeal (BoR)
                                                                                                                                                            staff to propose
   changes before               Employer Accounts
                                                     Financial management
                                                                                                                                                            process / policy
   they are                                        Performance management
                                                                                                                                                            improvements
   implemented –
                                                Operations / process management
                                Bank
                                                      System management                                                                                     and a and
   understanding the            Treasury        Business and Technical Enablers                                                                             feedback loop to
   ramifications of                                                                                                                                         inform them of
   decisions early                                                      Providing different                                                                 the results
        Showing all UI staff the end-to-end                             payment options:
        process, where their roles fit in, and                          direct deposit and
        how their efforts contribute to overall                         debit cards
        success
                                                                 Executive Summary…


Making It Happen
Continued contribution from all members of UI is key; the business
redesign workshops and interviews involved over 120 UI stakeholders,
from front-line staff to senior managers and included union
representatives.


These modernized UI conceptual business processes have been
  designed by the people who will live through the change and
              provide these services in the future


The time is right, funding is available and the motivation is there to create
a revolutionary new UI for New Jersey.
We hope that you will enjoy reading the rest of this document to see in
detail how NJ UI will fulfill its vision.
Contents
                                                                                                  Contents…


Contents of the Business Process Conceptual Design
Executive Summary                                                                                     2
Contents                                                                                             18
Introduction: This Document Is the Framework and Blueprint for UI Modernization                      21
Our Approach: Facilitating UI to Develop Your Own Framework and Blueprint                            25
Articulating the Vision in Terms of Objectives and Measurements                                      33
    UI Modernization Objectives, as Redefined in April „03                                          39
Business Design Principles to Guide Future Operations and Change Projects                            43
    Design Principles for Our External Customers, Internal Customers and for Agency Excellence      47
    Elaborating on Key Design Principles                                                            50
Our Blueprint for Revolutionized Unemployment Insurance Services                                     61
    Introduction                                                                                    63
    Simplified, Efficient, Responsive Processes                                                     66
    –      Triage and Inquiry                                                                        67
    –      Intake and Adjudication                                                                   85
    –      Continued Claims and Payments                                                             99
    –      Preventing Overpayments                                                                  112
    –      Investigating Overpayments                                                               123
    –      Appeals                                                                                  137
    –      Policy and Procedures                                                                    153
    –      Financial Processes                                                                      170
    –      Internal Controls                                                                        189
                                                                       Contents…


Contents (cont.)
   Simplified, Efficient, Responsive Processes (Cont.)
    –    Process Enablers                                               192
    –    New and Changed External Process Interfaces                    204
    –    Process Differences, by Benefit Program                        211
   Real-time Information to Transform Management Responsiveness        217
   Creating the Right Environment: Organization and Culture Changes    224
Building the Momentum for Change                                        236
   What UI Modernization Means to Our Stakeholders                     238
   Our Inclusive Approach has Supported Our Change Objectives          244
Next Steps                                                              249
                                                                          Contents…


Contents (cont.)
Appendices:
   Appendix A: Customer Focus Group Reports
   Appendix B: Process Scenarios
   Appendix C: Best Practices Crosswalk
   Appendix D: Management Information Example
   Appendix E: Detailed Implementation Ideas
   Appendix F: Policy and Procedure Impacts
   Appendix G: Cross-walk With RFP Requirements
   Appendix H: Cross-walk With Business & Systems Characteristics List
   Appendix I: Cross-walk With Parallel Initiatives
    Introduction: This
    Business Process
 Conceptual Design is the
Framework & Blueprint for
     UI Modernization
                                                                                             Purpose and Audience…


Why a Conceptual Business Process Design?
Situation
NJDOL Division of Unemployment Insurance has received federal Reed Act money and made the
commitment to spend some of this money modernizing its business processes and IT systems for UI.
Challenge
The core IT system supporting NJDOL was built in 1975 with the last major upgrade in 1984. The
associated business processes have not had a major review since 1984. The existing UI functions and
associated IT systems are not operating efficiently nor providing the level of customer service needed.

Answer
The Division of UI needs to redesign its business processes before it designs its new IT system. This
deliverable, the Business Process Conceptual Design, and the process undertaken to create it will provide
both the framework for action and a blueprint that articulates the envisioned end-state. Both also contribute to
the change process (already started within the agency) that is needed to ensure project success.




                                 Design principles           A high level blueprint
  Articulate the vision in                                                                      Building the
                                    guide future             articulates and confirms
 terms of objectives and                                                                       momentum for
                                  operations and              the vision, objectives
      measurements                                                                               change
                                  change projects             and design principles
                                                                                                        Purpose and Audience…


    This Design Document Provides Both a Framework
    and Blueprint for UI Modernization…


                                                                                                     Articulate the vision in
                                                 Vision                                             terms of objectives and
             Framework                        Objectives and                                             measurements
                                              Measurements

                                                Principles

                                                Enablers                                              Design principles
 Blueprint
                                                                                                    guide future operations
                                        ces



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                                                                                                    articulates and confirms
                                                                                                     the vision, objectives
* The technology and systems blueprint will be addressed in the technical architecture phase.
                                                                                                     and design principles
                          Begin the change process

                                                                                                    Building the momentum
                                                                                                           for change
                                                                                                                               Purpose and Audience…


       As Such, It Is a Firm Foundation on Which to Build
       Detailed Plans
       This Conceptual Business Process Design sets out a framework for action and a strategic blueprint for the
       delivery of UI services in the medium term future.
       This design will be the foundation from which the UI Modernization team – in partnership with experts from all
       relevant parts of the organization – will develop the Technical Architecture and the Strategic Implementation Plan.
       The Strategic Implementation Plan (due in July 2003) will set out the timetable for both design and
       implementation projects.

                                               High level plan, UI Modernization Nov 2002 – July 2003

                                                                        nk                     e
Our primary audiences are:                                       Th
                                                                    i                      fin                    Do
                                                                                        De
• Senior Management, Income Security                               Analysis
                                                                   Analysis                    Design
                                                                                               Design                  Plan
                                                                                                                       Plan

• Subject Matter Experts across UI
                                                  UI Process     Review current state   Design business       Detail all requirements   Implementation
• UI Modernization core team                      Review         ID gaps with vision
                                                                                        processes
                                                                                                              Get approval for new      RFPs
                                                                                        Design architecture   system design
• IT specialists in DIT, OIT and UI Systems
                                                                 Review initiatives     Manage project        Plan delivery              Manage the
   Management                                     Managing       Planning               Review                Plan migration            change
                                                  the Program    Agree controls
                                                                                        interdependencies
                                                                                                              Consider change needs
• Managers and experts within interfacing
                                                                                        Business process
  organizations – our workforce partners                         Detailed work plan     conceptual design     Requirements
                                                  Deliverables   Baseline description   Technical architecture Strategic plan plan
                                                                                                               Draft strategic
                                                                                        Interface document     Strategic plan


                                                                 Nov 2002 –                Feb – May               May – July
                                                                  Feb 2003                   2003                    2003
Our Approach: Facilitating
 UI to Develop Your Own
Framework and Blueprint
                                                                                                      Approach…


Scope of the Business Process Conceptual Design
In this, the Business Processes Conceptual Design phase of the project, the team was chartered to develop:
    A detailed description of the reengineered Division of UI processes and the workflow for these processes.
     Beyond the core functions (e.g. Claim intake), these new processes needed to accommodate the
     following list of UI benefit programs:
     –    Unemployment insurance
               Standard, in-state benefits
               Interstate unemployment insurance
               Combined wage claims
               UCFE (prior federal employees seeking unemployment benefits)
               UCX (prior US military employees seeking unemployment benefits)
               All extensions
     –    Disability During Unemployment
     –    Additional Benefits during Training
     –    Self-Employment Assistance
     –    Disaster Unemployment Assistance
     –    Trade Re-adjustment Act assistance


    This description also needed to validate and update the Business and Systems Characteristics and
     Systems Initiatives that are currently underway. These were incorporated into the business design
     principles for UI Modernization, in a session with the UI Modernization Project Team.
                                                                                                       Approach…


State Guidelines for the Approach to the Business
Process Conceptual Design
As part of the RFP, the State provided approach parameters for this effort:
•   Work closely with the project manager and the subject matter experts
•   Ensure that each business function is addressed in the reengineered processes and meets the objectives of
    the Division for a seamless and integrated service
•   Employ an efficient combination of document reviews, interviewing, process observation, and collaborative
    group discussion (focus groups) in order to analyze current business processes and identify and develop the
    reengineered business processes, workflow, and interfaces.
•   Interview and conduct focus groups to obtain input from external customers (including claimants, employers
    and employer agents)
We also added a framework of principles to control project delivery throughout UI Modernization:

•   Manage change as a core project theme, recognizing that our employees are central to successful change
•   The UI Modernization Project will not threaten the job security of our employees
•   Throughout the design and delivery of new processes and system tools, we must maintain the integrity of
    services - benefits, system, data, trust fund
•   All new processes and systems must be flexible and easy to change – for example, changes required by
    new legislation
•   The Department of Labor does not want to outsource support of any resulting system(s) to a vendor – and
    we must plan accordingly
•   Achieve UI Modernization within reasonable costs
                                                                                                          Approach…


    Our Methodology: Build and Iterate
     The methodology – particularly applied in workshops - to build out the new conceptual business processes
     emphasizes best practices used many large government projects…



VisionThe view of the
          future

             Ideas                                                                     Technical
                Key points from                                                       Architecture
                the Vision


                                   Principles                            Business Processes
                                          Key points
                                          affirmed by the
                                          Project Team


                                                            Objectives
                                                                Focused
                                                                principles


                                                                                 Measurements
                                                                                    Determining
                                                                                    objective
                                                                                    fulfillment
                                                                                                          Approach…


Our Methodology: Build and Iterate (cont.)
   Vision –The team started by developing the Vision (in our Kickoff workshops – Late November, 2002).
    The vision defines the future UI by describing, in broad terms, the key attributes and stakeholder
    characteristics for our claimants, employers, and employees.
   Key Ideas - Using the vision and the external and internal interviews, we identified key ideas. These
    included:
    –    Revolutionary Customer Service
    –    Partnership with the Workforce Community
    –    A Stable Work Environment
    –    Professionalism and Respect to our customers and fellow employees
   Principles - The key ideas were further refined to identify the underlying principles (principles being an
    affirmation of a key idea at a greater level of detail). An example:
    –     Make the customer experience easy, efficient and informed – so that each customer can make the
         right choices for themselves (e.g., access, payment and correspondence methods)
    These principles helped to direct and define the business processes
   Objectives and Measurements - Through follow-up sessions, the vision and principles were used to
    identify the key objectives and their corresponding measurements. The objectives (based on the
    Principles) provide the actions needed to achieve the vision. An example of one of our objectives and its
    corresponding measurement is:
    –    Objective: Deliver timely seamless service without sacrificing quality
         •     Measurement: Identify the average number of handoffs when processing an initial claim


This methodology builds an integrated approach: from where we are going (the vision)
        to determining that the process and project is a success (measurements)
                                                                                          Approach…


Business Process Conceptual Design Schedule

February (2003)               March (2003)                         April (2003)

       Customer Interviews         Expert Workshops                    Partner Interviews



                                  Intake to adjudication                 Other DOL partners
        Claimants            


                                  Continued claims, appeals, and         Federal DOL
        Employers            
                                  inquiry                                 representatives
        Employer agents
                                 Control of benefit payments            CWA
        Claimant advocates
                                 Financial processes                    Other partner
                                                                          agencies
                                 Policy and procedures
                                 One Stops/Workforce New
                                  Jersey
                                 Organization and Culture
                                 Management Information
                                 Consolidation and
                                  communication approaches
                                                                                                       Approach…


Breakdown of the Schedule: Interviews & Workshops
 Customer Interviews
Before starting the redesign workshops, the project team met with NJDOL UI customers to gain a better
understanding of their needs and issues with the existing processes, recognizing existing process steps that
work well, and identifying any additional quick wins. Claimant information was gathered through interviews and
focus groups help at One Stop centers. Employer and employer agent information was developed from a
series of focus groups. We also met with claimant advocates to better understand the customer experience
during the appeals processes.

 Expert Workshops

Expert workshops have been the heart of this redesign phase. Our approach was to enable UI staff to redesign
the future UI through a collaborative and informed process. Representatives in each of these eight sessions
included front line staff through to senior UI managers as well as other DOL experts. Each workshop
discussed and developed new processes in an open forum, where participation and free discussion was
encouraged. Each session started with a review of the vision, moved on to the identification of key principles
and finished with the development of future process steps. Further iteration on the detailed process steps was
developed using scenarios.

 Partner Interviews

After the completion of the conceptual process redesign workshops, we met with key partner agencies to
review potential changes to the way we work with them. These sessions helped us to confirm process
interface changes, given the new UI processes. In addition, we met with two key stakeholders with no
„process‟ interface – namely the CWA (Communication Workers of America) and officials from the Federal
Department of Labor – to ensure that we continue to solicit their advice and support.
                                                                                                         Approach…


Key Benefits of Our Approach
Over the past 11 weeks, we have found that
    Identifying customer needs early, before the workshops, allowed non-front-line UI representatives to
     better understand the processes from both the customer and front-line worker‟s perspectives
    Focused workshop sessions on a particular component of the overall process (e.g. One Stops) – allowed
     participants to focus on a specific set of functions and not get overwhelmed by the enormity of the entire
     UI process
    Participation from a broad spectrum of UI functional groups in each workshop provided “out of the box”
     comments and ideas, allowing people to hear, listen, and learn from people across the spectrum of UI
     functions
    Participation from a broad range of employees in differing roles provided the ability to hear how a process
     might work from a multitude of different perspectives
    Participation from over 120 UI personnel provided the ability to get a broad perspective of a process
     (everyone has a chance to contribute to the answer), to arrive at a solution designed by the organization
     (not by a small team or by the consultants), and to start the mindset change needed by UI to successfully
     implement the solution
    Having the members of the team focus on informed facilitation and note-taking allowed the UI members
     of the Team and the workshop participants to focus on designing the new processes
    Quick documentation and communication – getting results out quickly to other affected parties – provided
     the ability to keep everyone engaged and maintained project momentum
    Identifying “quick wins” got people excited about the possibility that things might change now. Not all
     process improvements need to wait until the completion of the project before they are acted upon. Some
     of these initiatives were started before the end of the project




Please note that, throughout this document, we refer to UI staff as „representatives‟ rather than agents. We use
this generic term to avoid any confusion with the current „claims agent‟ role.
Articulating the Vision in
Terms of Objectives and
     Measurements
                                                                                    Vision, objectives & measurements…


   Articulating the Vision in Terms of Objectives and
   Measurements

   The Division of UI needs to redesign its business processes before it designs its new IT system. This
   deliverable, the Business Process Conceptual Design, and the process undertaken to create it will provide
   both the framework for action and a blueprint that articulates the envisioned end-state. Both also contribute to
   the change process (already started within the agency) needed to ensure project success.




                                    Design principles           A high level blueprint
     Articulate the vision in                                                                      Building the
                                       guide future             articulates and confirms
    terms of objectives and                                                                       momentum for
                                     operations and              the vision, objectives
         measurements                                                                               change
                                     change projects             and design principles




The vision statement               Objectives &                  Objectives &                  Objectives &
 for unemployment                  measures for                  measures for                  measures for
      insurance                 external customers            internal customers            agency excellence
                                                                                                      Vision, objectives & measurements…


         Vision, Objectives and Measurements Provide Clear
         Endpoint for Us to Target

The UI Modernization vision expresses
our desired end-state for the initiative.                                              Our objectives and measurements
                                                                                       provide specific targets to aim for, that
                                                                                       should together deliver the vision.


                                                                                       The objectives also fit with the
                                                                                       Department of Labor’s overarching
                                                                                       goals.
                                               Vision
              Framework                     Objectives and
                                            Measurements

                                              Principles

                                              Enablers
 Blueprint
                                        s



                                                 UI organization
                                     ace
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                                                                                  Te
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* The technology and systems blueprint will be addressed in the technical architecture phase.
                                                                                Vision, objectives & measurements…


Our Vision for Modernized Unemployment Insurance
We will deliver revolutionized       unemployment insurance services, while maintaining the
integrity of the Trust Fund:

At each point of customer contact, we will provide a fair,   friendly and high quality service to
every member of the workforce community.

For claimants, we will help them to focus on reemployment by making the claims process timely, efficient
and informative. We will also help them to access related government services by improving referrals from UI,
in partnership with the workforce community.

For employers, we will simplify correspondence and improve our responsiveness. We will treat
employers as partners in the provision of unemployment insurance.

For staff, we will empower them to deliver superior service by ensuring a stable work environment, creating
equal opportunities for career growth and providing appropriate tools and training to do the job. We will treat
our employees with the same professionalism and respect they are expected to share with every UI customer.
                                                                                                                                Vision, objectives & measurements…


        Objectives and Measurements
        Objectives and their associated measurements are key components of a successful project framework. These
        are not established in one session but created through an iterative process that last through project
        implementation. In most cases, objectives are fully defined during the strategic design phase (now) and
        measurements in the requirements definition phase (so that the project team(s) have a clear understanding of
        the expectations). Measurements can also be honed through the project testing phase.
        Developing objectives and measurements for UI Modernization:
                    As a function of creating the vision (late November), we created the first view of the project‟s objectives
                     and measurements
                    We have revisited the objectives and measurements following the Conceptual Business Process Design
                     – results on the following slides
                    We will continue to refine the objectives and measurements through to the end of July:
                     –               At completion of the Technical Architecture – possibly to add objectives and to iterate further on the
                                     defined objectives and measurements
                     –               During strategic planning – objectives will be fully defined and we will make the measurements more
                                     specific (but not finalized)
                    When RFPs are developed, objectives and measurements must be fully defined, and the agency must be
                     confident that they represent exactly the targets we want to achieve

                                               Vision
       Framework                            Objectives and                                       Objectives are the targets
                                            Measurements
                                                                                                 for the vision
                                              Principles
                                              Enablers
Blueprint
                                        s



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                                                                              Vision, objectives & measurements…


UI Modernization Objectives, as defined in November
2002
Customer objectives (claimant and employer)
    Ensure that claimants are aware of reemployment and other related services as early as possible
    Ensure that process transfers between specialized units are seamless to the customer
    Allow customers to self-serve wherever feasible
    Improve responsiveness to employer and claimant inquiries
    Meet our customers‟ expectations on making services accessible



Objectives for excellence
•    Exceed the Federal timeliness targets but not as the expense of high quality, fair decision-making
•    Achieve efficiency improvements through specialization
•    Strive to ensure we communicate clearly on all occasions, with all stakeholders
•    Be able to support initiatives led by our workforce partners through close co-operation and data-sharing


Staff objectives
•    Ensure that our staff have the knowledge, tools and support necessary to deliver the best service they
     can
                                                                             Vision, objectives & measurements…


UI Modernization Objectives, as redefined in April 03
Objectives for external customers (claimant and employer)
1.   Ensure that claimants are aware of reemployment and other related services as early as possible
2.   Deliver timely, seamless service without sacrificing quality
3.   Provide superior customer service

Objectives for excellence
4.   Be able to support initiatives led by our workforce partners through close co-operation and data-sharing


Objectives for internal customers (staff)
5.   Ensure that our staff have the knowledge, tools and support necessary to deliver the best service they
     can
                                                                            Vision, objectives & measurements…


Objectives and Possible Measurements (4/03)
Objective 1:
Ensure that claimants are aware of reemployment and other related services as early as possible
Possible Measurements:
    Number of times people transferred from UI to our workforce partners within various key timeframes
    Number of people that
     –    activated their OSOS pended records (web)
     –    used scan card in One Stop Center
    Number of events per claimant


Objective 2:
Deliver timely and seamless service without sacrificing quality
Possible Measures:
    Timely – Federal Standards for transaction times
    Seamless transfers
     –    Number of handoffs obvious to the customer
     –    Amount of time between steps
    Quality – QPI measures
                                                                    Vision, objectives & measurements…


Objectives and Possible Measurements (4/03)
Objective 3:
Provide superior customer service
Possible Measurements:
    Percentage of self-serve
    Time on inquiries
    Surveys of customer satisfaction and trends in services used
    Reduction in wait time
    Number of contacts per customer
    Number of employees requiring retraining
    Number of repeated steps or rework
    Number of appeals that are really inquiries
                                                                         Vision, objectives & measurements…


Objectives and Possible Measurements (4/03)
Objective 4:
Be able to support initiatives led by our workforce partners through close co-operation and data-
sharing
Possible Measurements:
    Number of file sharing incidents
    Number of IT problem tickets open relate to file transfers
    Number of duplications of same element data entries
    Violations of service level agreements
    Numbers of complaints from partners
    Number of partner surveys
    Work related injuries
Objective 5:
Ensure that our staff have the knowledge, tools and support necessary to deliver superior service
Possible Measurements:
    Number of days absent and staff turnover
    Skill assessment surveys and follow-up of results of training
    Frequency of retraining
    Gap between the time training is requested and delivered
    Number of resolutions of calls to the help desk
    Trend in type of grievances filed
    Customer service survey feedback
   Business Design
      Principles
   to Guide Future
Operations and Change
       Projects
                                                                                          Business design principles…


Principles to Guide Future Operations and Change
Projects

The Division of UI needs to redesign its business processes before it designs its new IT system. This
deliverable, the Business Process Conceptual Design, and the process undertaken to create it will provide
both the framework for action and a blueprint that articulates the envisioned end-state. Both also contribute to
the change process (already started within the agency) needed to ensure project success.




                                 Design principles           A high level blueprint
  Articulate the vision in                                                                      Building the
                                    guide future             articulates and confirms
 terms of objectives and                                                                       momentum for
                                  operations and              the vision, objectives
      measurements                                                                               change
                                  change projects             and design principles




 Business design                                             Explaining key
                             The business design
principles to guide                                       principles that came
                                  principles
   future activity                                        out of the workshops
                                                                                                         Business design principles…


           Business Design Principles Support UI Modernization
           Objectives

                                               Vision                                             The design principles
              Framework                     Objectives and                                        support UI Modernization
                                            Measurements                                          objectives and can
                                              Principles
                                                                                                  therefore be categorized
                                                                                                  to support the different
                                              Enablers                                            groups of objectives
 Blueprint
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                                                                                                      Internal customers

* The technology and systems blueprint will be addressed in the technical architecture phase.
                                                                                                       (staff & managers)




                                                                                                      Agency excellence
                                                                                                     Business design principles…


         Business Design Principles Provide a Guiding
         Framework
                                                  Vision
              Framework                        Objectives and
                                               Measurements

                                                 Principles

                                                 Enablers
 Blueprint
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* The technology and systems blueprint will be addressed in the technical architecture phase.


                               The business design principles provide a guiding framework for
                                  The UI Modernization blueprint
                                  How we deliver services going forward
                                  Future design, development and delivery of change initiatives across UI


           The business design principles should inform every aspect of future service delivery. They will
                 be a constant reference point in the detailed design of UI Modernization projects
                                                                                         Business design principles…


Design Principles for Our External Customers
   Our customers are our claimants, New Jersey employers, our partners and NJDOL staff – and we will
    treat them all with respect. (See diagram below as illustration).
   Treat customers as people, not numbers… after all, it could be you on the other end
   Make the customer experience easy, efficient and informed – so that each customer can make the right
    choices for them (e.g., access, payment and correspondence methods)
   Communicate clearly, in a way the customer will understand – including the language they understand
    wherever possible
   UI is a gateway to reemployment services: educate customers about workforce services throughout the
    process and transfer them quickly and seamlessly, via effective collaboration with workforce partners
   Minimize cost barriers to customer access (e.g., with a local phone number per One Stop)
   Encourage remote self-service (via phone, web or email), while preserving in-person service for those
    who need it
   Ensure there are sufficient public access terminals to enable remote self-service for all constituencies
   Achieve a high-quality determination or decision as soon as possible
   Customers have the right not to participate in UI processes (e.g., drop out of an appeal / stop certifying)
    but must be informed of the implications
   Where insufficient information is available to make a firm decision, our default position is to pay benefits
   Customers will be able to access a holistic UI electronic case file remotely
   Streamline communications using modern tools and encourage customers to use the same tools,
    particularly employers
                                                                                        Business design principles…


Design Principles for Our Internal Customers
   Our staff is central to successful change
   Make the Division of UI a fulfilling place to work
   Ensure that staff have the tools and training they need to succeed
   Communicate: listen and give customers and staff the information and assistance they need - in a way
    they‟ll understand
   Automate the repetitive tasks, thereby freeing up staff to help our customers
   Ensure the physical environment is conducive to staff productivity
   Managers and all staff should be held accountable for realistic performance targets which are sensitive to
    variation
   Where needed, redirect inquiries to the right person to resolve a problem, first time
                                                                                      Business design principles…


Design Principles for Agency Excellence
    Maintain equally the integrity of systems, processes and finances
    Apply rules fairly and consistently and maintain regard for due process
    Prevent incorrect payments, before they happen
    Get it right first time, reducing rework
    Continuous improvement is a mainstay to ongoing success – and we‟ve all got a role in achieving it
    Optimize staff resources by balancing workload across the state
    Align activities and performance with annually-reviewed strategic goals / objectives, and measure
     performance against objectives


Technical excellence (sub-set):
    There is one system and uniform, easy to access data
    Use tools effectively to enable performance management, development and policy improvement
    Use workflow and case management to optimize end-to-end case processing
    Get accurate data from the start – and reuse it to avoid redundancy
                                                                                       Business design principles…


ELABORATING ON KEY DESIGN PRINCIPLES
    Some of the principles listed above evolved during the workshop sessions. In the following pages we
    provide further detail on these principles. They are:


   A focus on customer service – broken down into a number of principles:
    –    Treat customers as people, not numbers… after all, it could be you on the other end
    –    Make the customer experience easy, efficient and informed – so that each customer can make the
         right choices for them (e.g., access, payment and correspondence methods)
    –    Encourage remote self-service (via phone, web or email), while preserving in-person service for
         those who need it
    –    Achieve a high-quality determination or decision as soon as possible
    –    Where insufficient information is available to make a firm decision, our default position is to pay
         benefits
   Customers will be able to access a holistic UI electronic case file remotely
   Encourage remote self-service (via phone, web or email)
   UI as the gateway to reemployment services
   Our staff is central to successful change
   Getting it right first time, reducing rework
   Continuous improvement is a mainstay to ongoing success
   There is one system and uniform, easy to access data
                                                                                       Business design principles…


A Focus on Customer Service
What is it? A focus on customer service is a value to which UI Modernization aspires. Achieving great
customer service means that every aspect of the agency is aligned to deliver services that our customers
(claimants, employers, staff, partners) recognize and appreciate.
A focus on customer service therefore includes (but is not limited to):
      Providing a fast, friendly and personalized service
      Listening, showing empathy for our customers and resolving their needs – whether they are
       employers, claimants or others
     Redirect to the right person, first time
      Respecting our customers – and our staff
      Ensuring our end-to-end processes are designed, managed and delivered from a customer-centric
       perspective – for example, not failing our customers because „our system is down‟
      Provide clear, easy to understand information via all channels – IVR, web, paper and in-person
Purpose? To improve both the UI customer experience and UI as a place to work.
What will it look like? See overleaf for the results of a workshop brainstorm on this topic – some of these
ideas were translated into the customer service related principles on the previous slide. Note also that
agency sees every aspect of the business contributing to delivering a great service.
                                                                                             Business design principles…


A Focus on Customer Service: Workshop Brainstorm
    The comments below are the result of a brainstorm conducted in workshop 8 of the business process
    conceptual design. They show desirable characteristics of a focus on customer service, not a full definition.

       Satisfied customers                                       Strive to act the way we want to be treated
        –     Smiling faces                                        –     Knowledgeable, friendly, efficient
                                                                         assistance
        –     Earned trust and respect from customers
                                                                   –     Good communications
        –     Positive public opinion
                                                                   –     Provide follow up
        –     Able to resolve problems quickly and
              accurately                                           –     Customer gets benefit of the doubt
        –     Exceed expectations                                  –     Genuine concern
       Good information quickly                                   –     Treat people with respect
        –     Correct and consistent information                   –     Provide sense of security
        –     Fast & accurate                                     Minimal handoffs
        –     No waiting time                                      –     Minimize handoffs
        –     Clear understanding of the need                      –     No complex phone trees
        –     Easy access – remote in particular                  Others
       Personalized service                                       –     Reflection of positive work environment
        –     Customer is the only person that matters             –     (Trend of ever improving service – can‟t
                                                                         continually keep “ratcheting up the bar”,
              •     Treat each need and person                           set it at the right level)
                    individually
                                                                   –     Customer confidence that the system will
              •     Anticipate customer‟s needs                          work
        –     Take the time to listen
        –     Consider the audience and their abilities
                                                                                           Business design principles…


A Focus on Customer Service: Workshop Brainstorm
(cont.)
                                                                                             We
                                                                                            shoul
                                                                                              d
                                                                                            enable
Also needed:
   Cross-training of staff                                                                Employee
   Smooth and integrated (IT) services                                                     positive
    –     Integrated picture of the customer
    –     Integrated processes
   The right environment to enable people to focus on customer service                    Customer
                                                                                            positive
Issues:
   Setting the desired level of service
   Managing the expectations of the customers – customers‟ expectations are high: we are benchmarked
    with services provided by the private sector
Summary:
   We are in a customer service business (externally and internally)
   Providing good customer service will make all of our jobs easier
   Front line staff attitudes and the right tools are key to the organization‟s success
   Must provide advice and options to customers so they can make the right choices for them
                                                                                          Business design principles…


Customers Will Be Able to Access a Holistic UI
Electronic Case File Remotely
What is it? The ability of the customer (claimant or employer) to access claim-specific information via the web
or phone.
This will enable the claimant to:
   Identify the status of their claim, or previous claim (including appeals, approved training or even
    investigations into the claim)
   Review information used to make the determination (e.g., see the wages and weeks information)
   Make informed decisions and understand their next steps better (e.g., by using a „pre-monetary‟ calculator)
   See the available benefits and to assess the impact of deductions or garnishments
It will enable the employer to:
   Review live and historical claims against the company, including information used to make determinations
   Review charges, with an explanation of the impact on the employer‟s experience rating (to be requested
    from Employer Accounts)
Purpose? To enable our customers to understand the status of their claims. This achieves the following
benefits:
   More of our clients can self-serve, at times convenient to them and without queuing for assistance
   The Division of UI and partners will also be able to see the entire customer history (exact length of history
    stored to be determined, owing to cost/benefit implications – e.g., 3/10/15 years?)
   The volume of simple inquiries and issues will reduce (such as change of address), thereby freeing up
    staff to concentrate on those customers with more complex needs
[Greater access will need to be accompanied by a feedback mechanism, so that customers can voice
satisfaction/issues/requests more easily – thereby allow faster continuous improvement].
                                                                                         Business design principles…


Encourage Remote Self Service
What is it? A key principle for UI Modernization is that customers should be able to self-serve wherever
feasible. In practical terms, this means that customers will access information 24/7 as well as conducting
major interactions with the agency at any time, including:
   Research a question and find an answer
   Access their electronic case files via the phone and via the web. Customers will be able to view all
    case information
   Change key information (e.g., address)
   Start the claim process (file a new claim or re-open an existing claim)
   Certify for continued claims
   Protest a determination or decision, and file an appeal
   Make a complaint or provide positive feedback
Purpose? To enable our customers to interact with the agency at times convenient to them, achieving three
significant benefits:
   Enable our customers to access information at any time
   The volume of simple inquiries and issues will reduce (such as change of address), thereby freeing
    staff up to concentrate on those customers with more complex needs
   Reduced repetitiveness of some UI roles – thereby making the work more interesting




      To ensure customers adopt the self-serve option as far as possible, all services should be
                       designed and tested from the customer perspective
                                                                                           Business design principles…


UI As the Gateway to Reemployment Services
What is it? UI is often the first contact many customers have with government workforce services; we also
understand that – for the majority of our customers – the final outcome should be a new job. We will facilitate
our customers to achieve this outcome by transferring customers and information to our workforce partners
quickly and effectively.
Purpose? UI should become an effective access point to all workforce services, recognizing that
unemployment benefits should be transitional, rather than an end point. While putting these transfers in place,
UI will still remain focused on delivering the agency‟s core services.

What will it look like? The Division of UI will:
    Provide claimants with workforce information at appropriate times at UI access points (on phone, web
     and hard copy)
     –     e.g., play reemployment services information when/if claimants are on hold
     –     e.g., integrate access to the UI website with those of our workforce partners
    Where requested by workforce partners, transfer customers from UI at key stages of the claim lifecycle
     (so they can be targeted for services). The preferred forms of transfer are:
     1.    Immediate and seamless transfer (e.g., phone transfer to waiting Workforce representative)
     2.    Immediate scheduling for an appointment
     3.    Assist the customer by making the appointment on his/her behalf
    Make UI databases accessible for our workforce partners to query, again so that they can target services
     at appropriate sub-sections of the UI population
    There is even the possibility, in time, of linking UI information with information from other agencies
     (through common databases, etc) to see an even more complete picture of the customer.
                                                                                        Business design principles…


Our Staff Is Central to Successful Change
What is it? Placing staff at the heart of modernizing Unemployment Insurance services by recognizing that
technology, processes and management are all enablers: our staff delivers the service.
Purpose? The changes described in this modernization blueprint will only be effective if they are informed
and embraced by our staff.
What will it look like? The discussion on organization and culture changes to support the business process
redesign has only just begun. However, some of the ideas include:


In terms of participating in the modernization process:
   Ongoing involvement in all the planning steps of UI Modernization and the resulting projects
   Ongoing communication about change events, plans and how to get involved in UI Modernization


In terms of culture change:
   Making jobs more interesting
   Putting more responsibility in the hands of front-line personnel
   Reviewing training, development and career paths, including a new dedicated team within the Division to
    focus on UI-specific training
   Encouraging cross-training and easier promotions across functional units
   Investigating how to reduce stress in front-line roles
   Continuing the review of the physical environments within which people work
   Early assessment of the impact of new technologies on peoples‟ day-to-day jobs
   Tying performance reviews to outcomes
   Ensuring we publicize modernization changes and events as they happen – to all staff
                                                                                           Business design principles…


Getting It Right First Time!
What is it? The principle of getting it right first time forces us to focus on making accurate, high quality
determinations as early as possible
Purpose? An explicit focus on getting it right first time will mean that obstacles to delivering the best
determination possible are addressed first. As we increase the percentage of time we get it right first time,
rework will reduce, thereby freeing up time to focus on more value-added activities.


What will it look like?
   Accurate wage data transfers
   Accurate identity validation up front
   Gathering accurate eligibility information, once only
   Encouraging faster correspondence via modern methods such as email (and file transfer for large
    employers)
   By using workflow capability, preventing work from moving on to the next step until completed correctly
    in the current step
   Performance management activities focused on the front-end of the process
   Proactive system checks done early and through-out the life of the claim looking for problem situations
    that if resolved quickly and early will prevent overpayments and rework
                                                                                         Business design principles…


Continuous Improvement Is a Mainstay of Ongoing
Success
What is it? Continuous improvement is the recognition that any one single initiative won‟t deliver
fundamental performance improvements. Improvement is a continuous process, requiring the participation
of everyone in the organization.


Purpose? To make sure we are relentlessly focused on providing our customers with the best service we
possibly can.


What will it look like?
At an organizational level
   All parts of the organization will have performance targets, that support overall agency objectives
   Mechanisms to enable everyone to propose process and policy improvements, at any time
   Continuous analysis of current policies, procedures and performance to identify improvement
    opportunities
   A small team dedicated to performance improvement, working as internal consultants to managers
    across the State


At a personal level
   An ongoing commitment to developing everyone‟s skills - through training and career development
   Constant opportunities to get involved in improvement ideas
   Personal performance targets that tie directly to agency objectives
                                                                                         Business design principles…


One System and Uniform, Easy to Access, Data
What is it? A single, shared system for all UI services – where data is only entered once, stored in one
place, modified in one place and accessed many times.


Purpose?
The principle of a single system means minimizing interfaces and in doing so removing the many difficulties
that arise from transferring information between systems.
Uniform data means (a) storing data in one place, (b) modifying it in one place and (c) controlling edits to
data so that it is as „clean‟ – and therefore as reliable - as possible.
Both of these measures will maximize consistency and minimize data-entry rework – thereby helping to
reduce customer frustration, make data querying easier... And more!


What will it look like?
   Single data repository with controlled fields
   Single system, multiple modules (as far as possible)
   Interfaces that maximize data transfer
   Single sign on
   Reduce need for staff to know multiple systems and modules
   Easier to train staff – system will have common, intuitive logic found in many modern applications
   Our Blueprint for
    Revolutionized
Unemployment Insurance
       Services
                                                                                                 Introduction to our blueprint…


         Our Blueprint for Revolutionized UI Services


        The Division of UI needs to redesign its business processes before it designs its new IT system. This
        deliverable, the Business Process Conceptual Design, and the process undertaken to create it will provide
        both the framework for action and a blueprint that articulates the envisioned end-state. Both also contribute to
        the change process (already started within the agency) needed to ensure project success.




                                         Design principles           A high level blueprint
           Articulate the vision in                                                                     Building the
                                            guide future             articulates and confirms
          terms of objectives and                                                                      momentum for
                                          operations and              the vision, objectives
               measurements                                                                              change
                                          change projects             and design principles




   Redesigned               Underpinning                                      Management                  Create the right
                                                     Effective
   processes:               business and                                 information: lynchpin             environment:
                                                     process
simplified, efficient,        technical                                      of continuous               organization and
                                                    interfaces
   responsive                 enablers                                       improvement                  culture change
                                                                                                               Introduction to our blueprint…


           Introduction to Our Blueprint
                                                                                  The high-level blueprint presents a snapshot of the
                                                                                  overall processes, outputs, and interfaces that will
                                                                                  exist in the future UI organization. The diagram on
                                                                                  the following page includes:
                                                                                      The core UI process, from the initial filing of a
                                                                                       claim – or intake – through to all possible
                                                                                       process outputs
                                                                                      The processes used during the life of a claim
                                                                                       (e.g. investigation and triage)
                                                                                      The management activities that support the
                                                                                       delivery of excellence, and
                                               Vision                                 A selection of interfacing agencies.
              Framework                     Objectives and                        Following the high-level blueprint is a separate
                                            Measurements                          diagram that highlights a number of the key
                                                                                  messages and reinforces the key concepts
                                              Principles
                                                                                  discussed earlier.
                                              Enablers
 Blueprint
                                        s



                                                 UI organization
                                     ace
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      us




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* The technology and systems blueprint will be addressed in the technical architecture phase.
                                                                                        Introduction to our blueprint…


  Core Processes of UI Modernization
                                                       Organization and Culture
 Selected
Interfacing
 Agencies                                Core Process
                                                              Entry

                                                                                  Adjudication
One Stop partners
                                                              Intake              Determination




                                                                                                     Inquiry / Triage
                         Investigation
                                           Prevent
Workforce New Jersey                     overpayment
                                                            Continued
                                                                 Triage
                                                           certification          Determination
TDI

                                                         Lower- Authority              Re-
                                                           Appeal (AT)            determination
Dept of Human Services



                                                         Higher- Authority
Attorney General
                                                          Appeal (BoR)

                                                        Financial management
Employer Accounts
                                                       Performance management
                                                  Operations / process management
Bank
                                                         System management

Treasury                                           Business and Technical Enablers
Interfaces are expanded to                                                                              Introduction to our blueprint…
include additional partners

             Introduction to Our Blueprint: Key Points
                                                                                                Our core business of
                                                              Organization and Culture
       Selected                                                                                  providing benefits
      Interfacing                                                                                 does not change
       Agencies
                 Overpayments  Core Process
                                                                     Entry
                  are identified
                      ASAP                                                               Adjudication
       One Stop partners
                                                                     Intake              Determination




                                                                                                             Inquiry / Triage
                                Investigation


                                                  Prevent
       Workforce New Jersey                     overpayment
                                                                   Continued
                                                                       Triage
                                                                  certification          Determination
       TDI

                                                                Lower- Authority              Re-
                                                                  Appeal (AT)            determination
       Dept of Human Services

                                                                                                                                  Triage
                                                                Higher- Authority                                                  and
       Attorney General
                                                                 Appeal (BoR)                                                    inquiry
     All business                                                                                                                  are
                                                               Financial management                                             available
    processes are
       Employer Accounts
   underpinned by                                             Performance management                                            at every
        efficient                                                                                                                  step
                                                         Operations / process management
   management of
       Bank
                                                                System management
   every portion of
     the business                                        Business and Technical Enablers
       Treasury
                                                                                      Introduction to our blueprint…


SIMPLIFIED, EFFICIENT, RESPONSIVE PROCESSES
The processes covered here are the core processes that enable effective and efficient delivery of benefits:
   Triage and Inquiry

   Intake and Adjudication

   Continued Claims

   Preventing Overpayments

   Appeals

   Policy and Procedures – Developing, Communicating, Monitoring & Remedial Action

   Financial Processes

   Internal Controls
TRIAGE AND INQUIRY PROCESS
                                                                                                         Triage . . .



Introduction to Triage and Inquiry
   Triage is a function that will:
    –     Be immediately accessible via local cost phone numbers, the web, or a one-stop triage
          representative (or “greeter”)
    –     Route customers quickly and efficiently to the services they need, whether those services be
          provided by the Division of UI or one of its partners
    –     Route customers with more complex inquiries or needs to a customer service representative
    –     Allow customers to get answers to straight-forward questions on their own, quickly
    (Please see section on Business Enablers for further information)



                                       Self service
                                                                                             ices
                      Automated directory & information provision                     UI serv
                                    (phone/web)
                                    Basic triage
                                                                                     Workforce
                       Agent assesses need quickly and directs to
                                                                                   partner service
                                  appropriate service
                                      Assisted triage                               Exit (if in
                                                                                               quiry
                  Agent invests time to understand whole need – for                  complete
                         customers requiring a guiding hand                                      )
                                                                                                        Triage . . .



Introduction to Triage and Inquiry (cont.)
   This section presents the new triage process for claimants and employers, in the following order:
    –    Claimant Triage
         •     High-level view of the process: inputs and outputs
         •     Process map
                 -   Summary of what‟s new
                 -   Detailed explanatory notes
         •     Underlying business principles


    –    Employer Triage
         •     High-level view of the process: inputs and outputs
         •     Process map
                 -   Summary of what‟s new
                 -   Detailed explanatory notes
         •     Underlying business principles


   Please note that the process maps included in this section are not intended to present the full, exhaustive
    list of possible outputs from the system.
                                                                                                                                                                       Triage . . .



              Claimant Triage – High-Level View of the Process




       INPUTS                                                                                                                                                  OUTPUTS

•   Current or potential claimant
    contacts to:
                                                                                                                                              •   Claimant or potential
                                                                                                                                                  claimants questions are
     • File a claim or appeal                                                                                                                     answered
     • Ask a question (e.g. am I    Claimant Triage Process
                                                                                                                                              •   Appointment is scheduled
        eligible?)                   Claimant Triage, Conceptual Process Diagram v0.2
                                                                                                                                                  (e.g. for fact finding)
     • Check claim status
                                               Customer                      Triage function                               Division of UI



                                                                                                                                              •
                                            (claimant, other)     (Joint UI-workforce partners service)



                                                                                                                                                  Self-service options
     • Certify continued claim
                                                                                                3. Address simple
                                                                    2. Present menu                                 5. File a claim
                                                                                                    question(s)
                                            1. Make contact             of options
                                                                      (basic triage)


                                                                                                                                                  accomplished (e.g. address
     • Schedule an appointment
                                                                                                                           6. Certify for
                                                                                                                         continued weeks
                                                                   4. Assisted triage



                                                                                                                                                  changes)
                                                                 (for complex needs)




     • Make a repayment
                                                                                                                     7. Schedule for
                                                                                 9. Transfer for                    (re) adjudication




                                                                                                                                              •
                                                                               immediate non-UI
                                                                              specialist assistance


                                                                                                                             8. Manage debt
                                                                                                                                                  Seamlessly and directly
     • Access reemployment                                                                                                                        routed to the appropriate UI
        services                                                                                                                                  process
     • Change key info (e.g.                                                                                                                  •   Routed to a Partner Service
        address)                                                                                                                              •   Etc.
     • Etc.
                                                                                                                     Triage . . .



     Claimant triage: What’s New

Claimant Triage, Conceptual Process Diagram

            Customer                                Triage function                               Division of UI
         (claimant, other)               (Joint UI-workforce partners service)



                                                                                           5. File a claim
                                    1      2. Present menu      2      3. Address simple
                                                                           question(s)
         1. Make contact                       of options
                                             (basic triage)
                                                                                                  6. Certify for
                                                                                                continued weeks
                                                                     4
                                          4. Assisted triage        10. Change key
                                    3   (for complex needs)           information           7. Schedule for
                                                                                           (re) adjudication


                                                        9. Transfer for
                                                      immediate non-UI
                                                5    specialist assistance                          8. Manage debt

                                6



 Please note that this process map does not include all possible outputs from the employer triage and inquiry process.
                                                                                                         Triage . . .



Claimant triage: What’s New (cont.)
    • Where possible, claimants will be able to interact with the agency in their own language
    Menu of options will be akin to the IVR entry point, but will provide access to a broader range of services
1   (including UI, DI and workforce partner services). Triage services will cover UI and DDU.
       Early, initial assessment of customer needs
       Access to self-service options (see 6 below)
       Access via a local phone number, web or One-Stop greeter
       Access to other Partner services (Workforce New Jersey)
       Through the IVR or web, be able to change your own information without an agent
       Triage representation will include representatives from our workforce partners as well as UI
2
       Triage representative to answer questions about any/all workforce services and direct customers to
        the appropriate service
       Up-to-date, searchable lists of “Frequently Asked Questions” (FAQs) and their answers (in person,
        web and possibly phone)
       Disability during unemployment triage will be integrated into the same service
       Representative assisted counseling and support, newly available via IVR and possibly also web
3       system
       Easy and fast routing to key UI activities: claim filing, continued claim certification, adjudication
4       scheduling, appeal filing and debt collection – via any of the entry channels (web, phone, One Stop)
       (In time) Seamless transfer to specialist services within and outside of the Division of UI
5
       Triage will also provide easy access to self-service options: including the FAQs described above,
6       change of address, review of electronic case file (ECF) contents – such as continued claim filing
        schedule, status of claim, etc.
                                                                                                           Triage . . .



Claimant Triage: Explanation and Enablers
1   Process: Make contact: claimant and other customers can enter the UI system via a single phone, web
    access point (extending the concept of One-Stop to phone and web) or by visiting a One Stop. The new
    phone and web service will be jointly provided by UI and our workforce partners.
    UI Modernization also has a stated aim that 95%+ of all claimants should use either phone or web, so
    that resources can be freed up to assist those who need hands-on help.
    Technology: A key enabler is a local phone number for access to Triage, UI and partner (e.g. workforce
    services. Integrate web and phone service – e.g., „get representative to call me‟ button in web
    applications, and information on phone queue wait times provided on website. Also PIN security.
2   Process: Present menu of options (basic triage) – either on phone, web or in-person. Intent is to provide
    a fast initial assessment of customer need and provide customers with an understanding of and access
    to the broad range of available UI and workforce partner services.
    Triage and IVR phone trees will cover all UI and DDU benefits.
    Self-help options should be prominent, enabling many to access information easily without agent
    intervention (e.g., change address, understand the certification requirements, etc.)
    Basic triage must not become a bottleneck to accessing services behind this „single front end‟
    Transfer to specialist services. These services should be joined as seamlessly as possible. Preferred
    methods for transfer: (a) immediate transfer to available service provider, (b) automatic scheduling of
    appointments on behalf of these customers, (c) for least seamless services, triage representative should
    arrange the appointment(s) on behalf of the customer, (d) internet links to partner services.
    (Note: Basic triage currently exists in segments of the UI organization, in the “greeter” function in one-
    stops and the initial phone tree).
    Technology: Voice response IVR software will allow customers to state what their need is and the IVR
    will route to the appropriate service area. Internet will provide links to appropriate services (within or
    outside of UI)
                                                                                                        Triage . . .



Claimant Triage: Explanations and Enablers (cont.)
3    Process: Address simple questions (self help). Customers are directed to the FAQ component of the
     phone or internet applications. Customers are encouraged to find the answer and if unable to do so, link
     to the agent assisted triage (at any point in the process customers can link to the agent assisted triage
     component).
     Technology: From phone inquiries, voice response software will allow people to ask simple questions
     and route to the associated FAQ answers, On the internet, the system will provide links from questions
     to the associated FAQ answers. Where appropriate both the phone and internet will route customers to
     needed services
4    Process: Agent assisted triage – for the minority with greatest needs, for questions unanswered by
     FAQs, or for customers who opt for assisted triage. Customers are connected to triage representatives
     (on the phone, a “chat room” - instant messenger or a phone number( to call) if on the web, or in person
     at a One Stop). Triage representatives will assist with needs and direct the customer to any or all
     services.
               Triage representation will include representatives from our workforce partners as well as UI
               Triage representative role is complex, requiring knowledge of a wide range of government
                services. It should be highly valued in the organization, so as to encourage experienced,
                skilled staff to serve as triage representatives.
     Technology: Chat Room, or instant messenger for those using the web




The following process steps are the major transfers within the UI system…The principles shown here apply
equally to customers needing to access the whole range of UI services: disability insurance, customer
complaints, appeal filing, etc.
                                                                                                              Triage . . .



Claimant Triage: Explanations and Enablers (cont.)
5   Process: File a claim or appeal. For people who want to move directly to filing a new claim, re-opening
    an existing claim, or filing an appeal, they should be able to do so quickly, without struggling to navigate a
    tree of options (phone, web)
    The customer‟s preferred method of notification will be solicited at the point of first claim filing – and will
    be recorded as part of their electronic case file.
    (See Intake to Adjudication and Appeals Process sections for further information)
    Technology: Security: If the caller opts for a transaction from triage (claim entry, etc.), SSN and PIN
    number are required, and the system performs identity validation in the background. (When a claimant
    first chooses to select a transaction – primarily to file a claim – they will need to establish their PIN
    number. This option will be made available from triage, with both self-service and assisted options
    provided.)
    Audit Trail: The system records and time-date stamps all transactions in the audit trail
    Cross-matches: As a claimant enters information (phone or web), the system performs cross checks
    against specific databases. The system flags issues and routes to UI representative or professional
    investigator through the workflow module
6   Process: Certifying for continued weeks. A large proportion of callers will need to certify and so again
    should be able to do so quickly, without struggling to navigate a tree of options
         Assumption: all certifications in future will be either telephone or web based (minimal mail) and web
         certification will be acknowledged via email.
    (See continued claims process for further information)
    Technology: See above (step 5)
                                                                                                       Triage . . .



Claimant Triage: Explanations and Enablers (cont.)
7    Process: Schedule for re-determination. If a claimant has had their benefits suspended for one of many
     reasons, they will be able to quickly self-schedule for adjudication or re-determination
     Technology: Enablers for this step include the automated scheduling and workflow systems
8    Process: Debt management. Customers needing to contact collections should again be clearly directed
     to the right service area
     Technology: See above (step 5)
9    Process: Transfers to non-UI services should ideally be as seamless as those within UI. These transfers
     are outside the scope of UI Modernization. The Division will collaborate with these partners to achieve
     best results
     Technology: Early phases of UI Modernization will provide phone numbers and links to partner services
     (e.g. Employment Services). Later phases will provide more integration between partners and might
     involve automated scheduling, data transfers, coordinated workflows
10   Process: Claimants will be able to access their electronic case file information and make changes to key
     information - for example, address - without having to speak to an agent (unless they wish to do so).
     Technology: Electronic case file, IVR, web access
                                                                                                             Triage . . .



Claimant Triage: Business Design Principles
   Immediate routing for services, based on simple but comprehensive menu of options
   Filter out claims with issues early and handle these rapidly
   Be akin to a real “one stop”
   Provide a reassuring environment that acknowledges the emotional aspects of the process
   Make access free and immediate
   Responsiveness – quick answers
   Provide a choice of access method
   Address customer needs quickly
   Minimize in-person contact / service (but make it available to those who need it)
   Triage co-presented with Employment Services/other partners
   Client-friendly service
   Facilitate self-service
   Claimants should be able to change all key information (e.g. address) info
   Enable customer informed choice regarding accessing UI representatives (e.g. provide actual wait times
    via web application and IVR)
   UI representatives should see all key info, all claim information, all tracking info – with appropriate limits
    on access (e.g. draft AT decisions, medical info)
   UI representatives should be trained on how to use key information (e.g. Address)
   UI should ensure there is sufficient queuing capacity to handle the volume of customers
                                                                                                                                                                   Triage . . .



              Employer Triage – High-Level View of the Process




      INPUTS                                                                                                                                                OUTPUTS


•   Employer contacts to:                                                                                                                   •   Employer’s questions are
     • Alert UI to an issue                                                                                                                     answered
     • Check claim / appeal status   Employer Triage Process                                                                                •   Appointment is scheduled
     • Schedule an appointment                                                                                                                  (e.g. for fact finding)
     • File an appeal                                                                                                                       •
                                       Employer entry, Conceptual Process Diagram v0.2

                                                 Employer
                                                                              Triage function
                                                                     (Joint UI-Fiscal partners service)
                                                                                                                           Division of UI       Self-service options
     • Change key info (address)                                                                                                                accomplished (e.g. changing
                                                                                                 5. Address simple
                                                                     2. Present menu                 question(s)
                                              1. Make contact            of options
                                                                       (basic triage)
                                                                                                                        7. Protest a
                                                                                                                           charge




     • Protest a charge                                             3. Assisted triage
                                                                  (for complex needs)
                                                                                                 6. Make a refund                               an address)
     • Etc.
                                                                                  4. Transfer for
                                                                                immediate non-UI
                                                                               specialist assistance


                                                                                                                     8. Log an appeal
                                                                                                                                            •   Seamlessly and directly
                                                                                                                                                routed to the appropriate
                                                                                                                                                partners, including:
                                                                                                                                                  • Treasury
                                                                                                                                                  • Employer accounts
                                                                                                                                            •   Etc.
                                                                                                           Triage . . .



  Employer Triage: What’s New




                                  1                    2




                                3
                                                              4




Please note that this process map does not include all possible outputs from the employer triage and inquiry process.
                                                                                                            Triage . . .



Employer Triage: What’s New (cont.)
    Menu of options will be similar to the IVR entry point, but will provide access to Division of UI and
    


1   Employer Accounts services
       Early, initial assessment of employer needs
       Access to self-help options
       Access via integrated UI – Employer Accounts IVR system (with possible later joint representation in
        the triage representative function)
       Connections to Partner services (where applicable)
       Disability during unemployment triage will be integrated into the same service
    This service will probably make use of the Treasury employer PIN security already established.
       Triage representative to answer simple, quick questions about UI and Employer Accounts services
2
       Up-to-date, searchable lists of “Frequently Asked Questions” and their answers (web, and possibly
        phone)
       Agent assisted counseling and support, newly available via IVR and possibly also web system
3
       Easy and fast routing to key UI activities for employers (e.g. protesting of charges, appeal filing), via
4       any of the entry channels
       Seamless transfer to specialist services within and outside of the Division of UI
                                                                                                         Triage . . .



Employer Triage: Explanations and Enablers
1   Process: Make contact. To „triage‟ employer tax inquiries and direct them to the appropriate specialists
    via a single entry point., UI operations should co-present its employer services with Employer Accounts
    (and possibly Treasury, should they so choose) as closely as possible.
    At the start, this should include effective integration of the Employer Accounts and UI IVR systems and
    appropriate links on each agency‟s website (Note: Employer Accounts uses the My New Jersey portal as
    the access point.)
    As a later, optional phase, employer triage should be jointly resourced by Employer Accounts and UI
    staff, accessed by a single phone number.
    Technology: A key enabler is the effective integration of the UI and Employer Accounts IVR systems –
    and appropriate web links from UI to Employer Accounts and vice versa. Also employer authentication,
    using PKI or PINs.
2   Process: Present menu of options (basic triage) – either on phone or web. Do a fast initial assessment
    of employer needs
         Self-help options should be prominent, enabling many to access information easily without
         intervention (e.g., change address, see UI activity against the employer, see tax rate). Effective
         routing to partners or co-presentation of information will be critical.
               Change of primary address will need to be done via Employer Accounts or Treasury, change
               of secondary addresses (e.g., address where UI notifications or tax returns are sent) may be
               done via UI or Employer Accounts web page.
               Employer authentication: this will require use of a PIN number, which is likely to be the PIN
               selected by Revenue and identified on the WR30.
         Basic triage must not become a bottleneck to accessing services behind this „single front end‟
    Technology: Again, effective integration of UI and Employer Accounts IVR and web will be important.
    An additional enabler is an IVR system with underpinning voice response software
                                                                                                       Triage . . .



Employer Triage: Explanations and Enablers (cont.)
3    Process: Assisted triage – for employers with complex needs. These customers to be filtered off from
     main triage „system‟ for advice on potential service needs
     This may eventually be resourced by Employer Accounts and UI staff jointly
     Technology: Assisted triage will be facilitated by a workflow system, and instant messenger for those via
     the web.
4    Process: Transfer for immediate non-UI assistance. This idea has so far only been discussed within UI.
     As a result, we do not yet know how transfers to Treasury and Employer Accounts would work.
     Technology:Assisted triage will be facilitated by workflow and automated scheduling systems.
5    Process: Address questions. Simple questions are handled through FAQs by the employer (whether on
     the phone or internet. For questions unanswered by FAQ or if opting out, the employer will connect to a
     Triage representative by way of a phone connection, a “chat room” - instant messenger or a phone
     number( to call) if on the web, or in person at a One Stop).
     Technology: Voice response software will allow people to ask questions which are routed to either
     FAQs answers or to a triage representative (depending on the amount of self help used by the
     employer). On the web, the employer would use FAQ screens for self help. The system provides
     instant messenger for those questions unanswered by FAQs answers or where the employer has opted
     for personalized assistance.
6, 7 – example employer reasons for contacting UI
                                                                                                       Triage . . .



Employer Triage: Explanations and Enablers (cont.)
6   Process: Protest a charge. An employer may wish to protest a current or potential UI claim charge as the
    charge is hitting his/her company. These calls would be either be directed to a UI representative to log
    and to schedule a fact-finding.
    Charging decisions will be fed automatically to Employer Accounts to inform experience rating.
    Employers will be informed that this transfer of information has occurred, so they do not unnecessarily
    contact Employer Accounts.
    Technology: Enablers include a workflow system, and integrated Employer Accounts-UI web and IVR
7   Process: Log an appeal. Appeals will be possible by phone, web and letter.
    Technology: A key enabler for phone appeals is voice-to-text software that converts a spoken message
    to a written appeal. Likewise the employer can file an appeal through the internet. The workflow system
    will route the appeal once received (by any channel) to the appropriate appeals staff
                                                                                                              Triage . . .



Employer Triage: Business Design Principles
   Immediate routing for services
   Make access free and immediate
   Responsiveness – quick answers
   Provide a choice of access method
   Address customer needs quickly
   Minimize in-person contact / service (but make it available to those who need it)
   Client-friendly service
   Facilitate self-service
   Employers should be able to make auto changes to profile, ideally through Revenue, but should be able
    to view profile via UI
    –     View: claims against company, scheduled calls & hearings, etc.
   UI representatives should see all key information (e.g. addresses), all claim information, all tracking
    information – with appropriate limits on access (e.g. draft AT decisions, medical info)
   UI representatives should be trained on how to use key information (e.g. address)
INTAKE AND ADJUDICATION PROCESS
                                                                                     Intake and Adjudication . . .



Introduction to Intake and Adjudication
   This section presents the new intake and adjudication processes, in the following order:
    –    Intake and Adjudication
         •     High-level view of the process: inputs and outputs
         •     Process map
               -     Summary of what‟s new
               -     Detailed explanatory notes
         •     Underlying business principles
                                                                                                                                                                             Intake and Adjudication . . .

              Intake and Adjudication – High-Level View of the
              Process




       INPUTS                                                                                                                                                                         OUTPUTS

                                    Intake and Adjudication
•   Claimant:                                                                                                                                                        •   Claimant:
                                            Process
     • Decision to file a claim                                                                                                                                           • Receive determination
     • Provide information                                                                                                                                                   (and information on
                                     Intake and Adjudication, Conceptual Process Diagram, v0.2

                                              Claimant                                          Division of UI                                  Employer




•                                                                                                                                                                            next steps)
                                                                                                                                                  2. For lay-offs,
                                                                                                                                               employer may send



    Employer:
                                                                             3. Enter                                                          in case information
                                               1. Select to file a
                                                                            identifying                                                                early
                                                     claim
                                                                           information




                                                                                                                                                                     •
                                                                                                       4. Validate          5. Assess for
                                                                                                       claimant's           non-qualifying




     • Provide information                                                                                                                                               Employer:
                                                                                                         identity               facts
                                                                             6. Gather
                                                   7. Provide
                                                                             remaining
                                                    eligibility
                                                                         information from
                                                  information                                         Agent assistance NOT needed
                                                                              claimant




                                                                                                                                                                          • Receive determination
                                                                     Agent assistance needed




        (separation, etc.)
                                                                            9. Can an
                                                                           immediate                                          8. Automated
                                                                          determination          No                           determination
                                                                           be made?




     • Mass layoffs: provision of                                                                                                                                            (and information on
                                                                                            10. Schedule
                                                                                             fact-finding

                                                  11. Provide                                                   13. Review case                  12. Provide
                                                     further                                                    information prior                  eligibility
                                                  information                                                        to appt                     information




        separation information at                                              Yes
                                                                                          14. Conduct fact
                                                                                               finding
                                                                                                                                                                             next steps)
                                                                                                                                                                          • Receive non-charging
                                                                                                                          16. Notify of
                                                                                             15. Make                                            17. Receive
                                                                                                                        determination &
                                                                                           determination                                        determination



        time of layoff
                                                                                                                           next steps

                                                  18. Receive
                                                 determination

                                                                                                                               19. Notify
                                                                                                                                               20. Receive non-



                                                                                                                                                                             determination
                                                                                                                            employer of non-
                                                                                                                                                   charging
                                                                                                                               charging
                                                                                                                                                determination
                                                                                                                             determination
Intake and Adjudication: What’s New
  Intake and Adjudication, Conceptual Process Diagram, v0.2                                                                            Intake and
                                                                                                                                     Adjudication . . .

         Claimant                                           Division of UI                                       Employer
                                                                                                                  2. For lay-offs,
                                                                                                           1   employer may send
                                        3. Enter                                                               in case information
          1. Select to file a
                                       identifying                                                                     early
                claim
                                      information                               2
                                                                  4. Validate           5. Assess for
                                                                  claimant's            non-qualifying
                                                                    identity                facts
                                        6. Gather
              7. Provide
                                        remaining
               eligibility
                                    information from
             information                                         Agent assistance NOT needed
                                         claimant

                                                     3
                                Agent assistance needed
                                                                                    4
                                       9. Can an
                                      immediate                                           8. Automated
                                     determination          No                            determination
                                      be made?



                                                       10. Schedule
                                                        fact-finding

             11. Provide                                                   13. Review case                       12. Provide
                further                                                    information prior                       eligibility
             information                                                        to appt                          information

                                                     14. Conduct fact
                                                          finding
                                          Yes

                                                                                5
                                                                                      16. Notify of
                                                         15. Make                                                17. Receive
                                                                                    determination &
                                                       determination                                            determination
                                                                                       next steps

             18. Receive
            determination

                                                                                           19. Notify
                                                                                                               20. Receive non-
                                                                                        employer of non-
                                                                                                                   charging
                                                                                           charging
                                                                                                                determination
                                                                                         determination
                                                                                          Intake and Adjudication . . .



Intake and Adjudication: What’s New
       Where possible, claimants will be able to interact with the agency in their own language
       In the case of mass layoffs, the Division of UI will encourage and enable employers to identify
1       individuals that were laid off, and provide non-monetary information (in advance via electronic
        means). This will reduce administrative elements of the response team‟s work.
       Employers have also requested the opportunity to review wage record (WR30) information, post-
        submission to confirm the right data was entered.
       This information is stored in the system, and retrieved when one of these individuals files a claim
       At the stage of identity verification and eligibility validation, additional systems cross-checks will be
        performed. If and when a flag is raised, an investigation will be triggered and an automatic notification
2       can be sent to the claimant alerting them of the investigation. (See Preventing Overpayments for
        additional detail)
       The key change here is the filtering off of claims that do not need UI representative intervention.
        These claims are filed via phone or web (only). At the point where the claimant has entered all
3       information the CRM component of the system will either create a Electronic Case File for the
        Claimant or append an existing file.
       Automated determination is a key element of processing claims-without-agents.
4
       All notification (of claimants and employers) will be generated automatically – with a preference being
5       for electronic communication methods.
       As noted in the Triage and Inquiry Process, the customer‟s preferred method of notification will be
        solicited at the point of entering the system for the first time (intake) – and will be recorded as part of
        their electronic case file. Employers‟ preferred contact methods will also be recorded in their
        electronic case file.
       Employers (and claimants, where possible) will be encouraged to provide information electronically to
        the Division of UI – whether via email or web forms.
       All subsequent actions on a claim update the employer‟s and claimant‟s Electronic Case Files
                                                                                           Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
1   Process: Potential claimants will be able to select to file a new claim (or re-open one) via the telephone
    or web. If a potential claimant is in a One Stop facility, he/she may receive help filing their claim via either
    of these methods – paper claims will not be accepted. Instead, claimants that are not able to self-serve
    will be assisted. These representatives (using the web) will work with claimant to enter their information
    and file a claim on their behalf. Submission of other claim information – for example, medical certification
    – will continue to be accepted on paper. (It should be noted that NJDOL will maintain the ability to create
    and process paper claims as a business continuity option.)
    Technology: Voice recognition, voice-to-text software
2   Process: Employers conducting temporary or mass lay-offs will be enabled to submit non-monetary
    information electronically and in bulk to the Department, along with details of the employees affected.
    This information will be used to create a „template‟ claim for those employees, which will be stored (in the
    new UI system) until such time as they file a claim. The resulting claims process will be faster and more
    consistent for those affected by lay-offs. It will also reduce administrative elements of the response
    team‟s work, allowing them to focus on providing other assistance.
    Employers have also requested the ability to review wage record (WR30) information post-submission,
    as an extra guarantee that the information has been transferred correctly. [This request to be discussed
    with Employer Accounts].
    Technology: Ability to capture, store, and incorporate monetary and non-monetary information
    submitted early in the case of mass-layoffs; workflow system. These inputs either create or append the
    Electronic Case File for the Claimant.
3   Process: Enter identifying information. The claimant will be asked to select or enter his/her SSN and
    other identifying information.
         Degree of identity information desired has not been defined (e.g., do we want to continue to allow
         claimants to file initial claims before SSN has been validated? Do we want to require additional
         identifying information?)
    Technology: Voice recognition, voice-to-text software, ability to capture and store incomplete information
                                                                                          Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
4   Process: Validate claimant‟s identity. As soon as the social security number is entered, the system will
    run cross-checks to assess if that social security number is valid – running checks against a Federal
    SSN database and against the INS SAVE system. (See Preventing Overpayments Section for details on
    other ongoing cross-checks.)
         If a cross-check raises a serious potential problem with the claim, notification will be sent to a
         professional investigator to investigate the claim before any payment is made. The claim process
         will continue. Claimants will be notified that an investigation is ongoing (to deter ineligible claimants)
    Technology: Automatic notification system, workflow, validation cross-checks (both real-time and batch)
5   Process: Assess for non-qualifying facts. The underlying principle is that as much information as
    possible to inform the claim should be provided via up front system feeds. So, in parallel to identity
    verification, the system will run cross-checks to assess if that social security number has any potential
    disqualifying factors attached to it (e.g., if it is registered on a company‟s new hire or employee list). (See
    preventing overpayments for details.)
         Again, if a cross-check raises a serious potential problem with the claim, notification will be sent to
         a professional investigator to investigate the claim before any payment is made, and a notice will be
         generated to the claimant. Exactly what should be sent to a professional investigator and what
         could be handled by a skilled claims representative is to be defined.
    Technology: Automatic notification system, workflow, validation cross-checks, creation or update to the
    claimant‟s Electronic Case File (CRM).
                                                                                        Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
6   Process: Gather remaining information from the client. Where further information is required, the
    claimant will be asked questions through a series of automated prompts.
         Information requested should include interaction preferences: what language would you prefer to
         work in? what address (postal or email) would you like as your preferred address for the
         Department of Labor?
         Information gathering from points 2 to 6 must be as accurate as possible. Use should be made of
         tools and techniques to ensure accurate data collection – e.g., O*NET connector, automatic
         translation of address into county code etc
    Technology: Enablers include the O*NET connector, validation software, voice recognition, voice-to-text
    software. A CRM solution includes many features that will allow for basic customer data verification
    including the creation of the Electronic Case File
7   Process: Provide eligibility information. Claimant provides information required for step 6.
    Technology: None required.
8   Process: Unassisted claims or claims-without-agents. Wherever a claim can be determined without fact-
    finding (i.e.., in the case of single-party issues), an automated determination can be made. These claims-
    without-agents are vanilla claims for which all information can be captured by the system without needing
    human intervention.
    Key assumption for phone filing: a voice recognition system must be able to collect address information
    accurately. Based on this assumption, the team estimated that approximately 60 - 70% of claims might
    qualify as unassisted.
    Technology: Voice recognition, voice-to-text software, customer relationship management system
    (Electronic Case File), workflow system
                                                                                            Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
9    Process: Assisted claims: Where (a) the system determines, by type of information outstanding (e.g.,
     reason for separation), that the claim requires human intervention or (b) a claimant opts to work with a
     representative, the claim should be routed immediately to the next available representative.
     The representative will assess the eligibility problem and resolve it if possible (in some cases, because
     the system will transfer all claims that might have issues, no real issue will be found. In this situation, the
     NJDOL rep will cross-check the information flagged by the system, add extra detail as needed, and
     complete the application with the help of the claimant).
     Where a determination cannot be made immediately – I.e., all two-party issues - the representative will
     schedule a fact-finding as soon as possible.
     When a claimant is filing outside of business hours (expanded to span 7am to 7pm), he/she should be
     given a choice to (a) phone the agency within 2 days (in business hours) and then be routed immediately
     to a representative or (b) have a representative call him/her the next day
     Technology: Workflow system, customer relationship management system (Electronic Case File)
10   Process: Schedule fact-finding. The representative will schedule a detailed fact-finding interview as soon
     as possible. The relevant employer(s) will receive notice and a request for the requisite information – via
     the medium that employer has requested on its profile (email / internet / hard copy).
     Fact-findings are scheduled as soon as possible. The agency will ensure that its workload is not the
     major factor in delaying fact-finding interviews.
     Technology: Automated scheduling through the workflow system, expert system (to identify required
     information and generate requests for this information)
                                                                                           Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
11   Process: Claimant provides eligibility information. The claimant may be asked to supplement his/her
     basic claim information with details on bonus, pension, wages/weeks etc. As it arrives that information
     must be appended immediately to the appropriate electronic case file (I.e., imaged, if on paper).
     Technology: Internet eligibility screens, Workflow, customer relationship management system
     (Electronic Case File) – eligibility information, imaging capability (if documentation sent in by claimant or
     employer)
12   Process: Employer provides eligibility information. The employer may be asked to provide information on
     the specific claim – for example with details on bonus, pension, wages/weeks, reason for separation etc.
     Employers will be strongly encouraged to provide this information via electronic means (e.g. via email, or
     a web form). As it arrives that information must also be appended immediately to the appropriate
     electronic case file.
     Technology: Internet eligibility screens, Workflow, customer relationship management system
     (Electronic Case File) – eligibility information, imaging (if documentation sent in by claimant or employer)
                                                                                          Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
13   Process: Review case information prior to fact-finding appointment. Shortly before the appointment, the
     examiner reviews all claim information pertaining to the issues at hand. The system will store the flagged
     issues as well as any comments from the representative who scheduled the meeting. Any information
     sent in by either the claimant or his/her employers is accessible on the case file.
          In some cases, an eligibility determination may be possible without full fact-finding (if both parties
          have sent in information and it agrees – e.g., on the reason for separation). In this situation, the
          examiner should be able to make a determination immediately and cancel the appointments. The
          examiner will build this review into their workload.
     Technology: Customer relationship management system (Electronic Case File) – review comments,
     workflow, automated scheduling, imaging (if documentation sent in by claimant or employer)
14   Process: Conduct fact-finding. The examiner conducts fact-finding interviews with the claimant and
     employer(s) to determine eligibility. All information gathered during fact-finding is entered into the case
     file (including the fact-finding statement). Based on the information and prior steps, the examiner may
     take an affidavit or schedule a next step that allows employers to respond to requests for information.
     Technology: Fact finding via email, instant messenger, or internet screens, Imaging (if documentation
     sent in by claimant or employer), Customer relationship management system (Electronic Case File) for
     fact finding information
                                                                                       Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
15   Process: Make determination. Based on the information available, the examiner must make a
     determination. As well as allowing examiners to view standard reasons for denial/approval, the system
     will allow examiners to add free text reasons.
     Technology: Customer relationship management system (Electronic Case File) for determination
     information
16   Process: Notify of determination and next steps. Notification is generated automatically.
     Technology: Workflow and automated notification system (email, posted mail), Customer relationship
     management system (Electronic Case File) for next steps
17   Process: Employer notification – by method and to address specified in the key information (e.g.
     address)
     Technology: Workflow and automated notification system (email, posted mail), Customer relationship
     management system (Electronic Case File) for employer notification dates and particulars
18   Process: Claimant notification – by method and to address specified in the key information. Next steps
     (dependent on determination) should include information on certification, appeal rights, reemployment
     assistance, and inquiries.
     Technology: Workflow and automated notification system, Customer relationship management system
     (Electronic Case File) for claimant notification dates and particulars
                                                                                     Intake and Adjudication . . .



Intake and Adjudication: Explanation and Enablers
(cont.)
19   Process: Notify employer(s) of non-charging determination.
     Requires fuller analysis. Issues include:
          Should non-charging be elevated to the importance of claims adjudication? What would be the
          impact on the Trust Fund and workload?
          Should non-charging work be integrated into the claims workload or separated out? If separated out
          (a) would non-charging determinations simply need to be done before first payment? (b) would a
          parallel stream create extra set of correspondence for claimants and employers?
          Should non-charging remain an employer-triggered process
     Technology: Workflow, automated notification system (email, postal mail), Customer relationship
     management system (Electronic Case File) for employer case file determination information
                                                                                        Intake and Adjudication . . .



Intake and Adjudication: Business Design Principles
Principles for customers
    Quick filing
    Provide a choice of access methods
    90% + of our claimants will file via internet or phone – freeing up time to assist others who need more
     assistance
Principles for employers
    Allow employers to pro-actively send qualifying information to agency
    Enable e-communication with employers
Principles for the agency
    Maintain a customer-focus
    Eliminate as much paperwork as possible
    Best management of wage data
    Claims-without-agents where possible
    Must follow due process
    Balance workload across state – optimizing staff and office utilization
    Share information with other functional groups efficiently
    Get it right the first time
CONTINUED CLAIMS AND PAYMENTS
                                                                           Continued Claims and Payment . . .



Introduction to Continued Claims and Payments
   This section presents the new continued claims and payments process, in the following order:
    –    Continued Claims and Payments
         •     High-level view of the process: inputs and outputs
         •     Process map
               -    Summary of what‟s new
               -    Detailed explanatory notes
         •     Underlying business principles




   Note: the terms “suspend” and “suspended claim” are used in this section to emphasize a key difference
    of the new continued claims process – that claims will not be “pended” indefinitely. The goal is for
    suspended claims to be addressed immediately for in-business-hour certification attempts or within 48-
    hours for out-of-business-hour certification attempts where the claimant has chosen to contact the
    agency. (See process map and detailed explanatory notes for further clarification.)
                                                                                                                                                                                      Continued Claims and Payment . . .


                Continued Claims and Payment – High-Level View of
                the Process




       INPUTS                                                                                                                                                                                           OUTPUTS

                                         Continued Claims and                                                                                                                         •
• Claimant contacts Division to                                                                                                                                                           Payment
    certify                                Payment Process                                                                                                                            •   Claimant notified (of
•   Claimant contacts UI after initial    Continued Claims: Conceptual Process Diagram                                                                                                    successful, suspended, or
                                                                                                                                                                                          denied certification)
                                                    Claimant                                       Division of Unemployment Insurance

    claim has been filed                         1. Contact UI
                                                                           2. Validate identity                                      4. Validate




                                                                                                                                                                                      •
                                                                           and access profile                                         eligibility




•
                                                                                                                      Flagged, or



    Claimant contacts UI after                                                                                                                                                            Claimant reminded if fails to
                                                                                                                                                      Preferred
                                                                                                                     non-preferred
                                                                                                                                                      answers
                                                                               3. Route for                            answers
                                                                              preventative             9. Suspend                                                   5. Approve
                                                                              investigation          certification and                                            continued claim
                                                                                                      notify claimant                                               (automatic)




    continued claim has been                     23. Contact UI,
                                                    after cert
                                                   suspended
                                                                              17. Notify and
                                                                             provide contact
                                                                                 options
                                                                                         After bus. hrs            In bus. hrs

                                                                                                                                          10.
                                                                                                                                      Immediately
                                                                                                                                     route to agent
                                                                                                                                                                                          contact UI after certification
    suspended                                                                                                                                                                             was suspended
                                                   18. Select
                                                preferred option                                                                      11. Identify if
                                                                                                                                       one or two
                                                                   19. Claimant         21. UI to           22. Allocate               party issue
                                                                                                                                                        One-party
                                                                    to initiate          initiate           as workload




                                                                                                                                                                                      •
                                                                                                                                                         issue
                                                                     contact            contact                 item
                                                                              Call within 48 hrs



                                                                                                                                                                                          Routing to adjudication
                                                                                                                           Two-party issue
                                                                   No call within
                                                                      48 hrs                              15. Schedule             Don't              12. Assess if
                                                                                                           fact finding            know             claimant eligible
                                                                     20. Send
                                                                     reminder
                                                                    (automatic)                                                                  No                 Yes




                                                   7. Receive
                                                                                                          16. Route to
                                                                                                          adjudication
                                                                                                                                  13. Determine
                                                                                                                                  ineligible (part/
                                                                                                                                       whole)
                                                                                                                                                                  6. Make payment
                                                                                                                                                                     (automatic)
                                                                                                                                                                                          process
                                                                                                                                                                                      •
                                                    payment




                                                                                                                                                                                          Routing for preventative
                                                                                                                                                             8. Notify claimant &
                                                                                                                                      14. Deny              update claimant profile
                                                                                                                                                                 (automatic)




                                                                                                                                                                                          investigation
                                                                                                                                                                                      •   Routed to an agent
  Continued Claims & Payment:
Continued Claims: Conceptual Process Diagram                                 What’s New                                                                  Continued
                                                                                                                                                          Claims
                                                                                                                                                           and
            Claimant                                           Division of Unemployment Insurance                                                        Payment
                                                                                                                                                            ...
                                        2. Validate identity                                       4. Validate
         1. Contact UI
                                        and access profile                                          eligibility

                                                                                  Flagged, or
                                                                                                                   Preferred
                                                                                 non-preferred
                                   1        3. Route for
                                                                 4                 answers
                                                                                                                   answers
                                           preventative            9. Suspend
                                           investigation         certification and                                         5. Approve continued
                                                                  notify claimant                                            claim (automatic)

                                                  After bus. hrs                     In bus. hrs
                                                                                                                         Agent
         23. Contact UI,                                                                                                corrects
                                                                                                                         errors
            after cert
          suspended              7                                                            5          10.
                                         17. Notify and                                              Immediately
                                         provide contact                                            route to agent
                                            options
    8      18. Select
        preferred option                                                                            11. Identify if
                                                                                                     one or two
                                                                                                     party issue
                           9    19. Claimant
                                 to initiate
                                                     21. UI to
                                                      initiate                                6                       One-party
                                                                                                                       issue
                                  contact            contact
                                          Call within 48 hrs
                                                                                       Two-party issue
                                No call within
                                   48 hrs                            15. Schedule              Don't                12. Assess if
                                                                      fact finding             know               claimant eligible
                           10    20. Send
                                 reminder
                                (automatic)                                                                  No                Yes
                                                                                              13. Determine
                                                                     16. Route to
                                                                     adjudication
                                                                                              ineligible (part/        2     6. Make payment
                                                                                                                                (automatic)
                                                                                                  whole)

           7. Receive
            payment

                                                                                                                            8. Notify claimant &
                                                                 22. Establish                      14. Deny               update claimant profile
                                                                 overpayment                                                    (automatic)          3
                                                                                 Continued Claims and Payment . . .



Continued Claims and Payment: New and Enhanced
Functionality
       At the stage of identity verification and eligibility validation, additional systems cross-checks will be
1       performed. If and when a flag is raised, an investigation is triggered and an automatic notification is
        sent to the claimant alerting them of the investigation. (See Preventing Overpayments for additional
        detail)

2      Automatic payments are facilitated by the additional of direct deposit and/or UI debit cards as
        payment options. (A full cost/benefit analysis will determine the option(s) selected)

3      Automatic notification is provided to the claimant at the end of the certification process via the means
        selected by the claimant during intake.
       If any issues are encountered during certification, a claimant is notified that the claim has been
4       suspended and what the precise ramifications of the claim suspension. In business hours (7 AM to 7
        PM), the claims are routed directly to an agent (or provided the opportunity to resolve the issues by
        conversing with a UI representative via instant messenger technology).

5      Claimants calling during business hours will be immediately routed to a representative, who will be
        able to determine whether the claimant is eligible, whether fact finding is required, or whether the
        claimant should be paid immediately.
       The speed with which certification issues can be resolved depends on whether there are multiple-
6       party issues. The process has been altered to streamline the resolution of single-party issues, and
        allow for the best allocation of adjudication resources for other issues.
       Claimants will be immediately notified if their certification attempt made out-of-business hours (7 PM
7       to 7 AM) is suspended and provided their next step options.
       Claimants are able to select their preferred option for resolution of any issues encountered during
8       certification.
                                                                                Continued Claims and Payment . . .



Continued Claims and Payment: New and Enhanced
Functionality (cont.)
        If issues are encountered during out-of-business hour certification, claimants will be provided the
9        option of calling NJDOL UI during business hours and being routed directly to someone who will
         access their electronic case file and resolve the issue (or they can re-access the certification web
         site) – or they can choose to have NJDOL call them back.

10      Claimants who fail to contact the agency within the agreed amount of time will be issued one
         automatic reminder via the means selected at intake. After this reminder, NJDOL UI will not
         proactively follow up.
        The benefit of this process step has not been fully investigated.
                                                                               Continued Claims and Payment . . .



Continued Claims and Payment: Explanation and
Enablers
1   Process: Claimants will contact NJDOL UI to certify via phone, web, or in-person in a One Stop. (The
    stated aim is that at least 95% of all claimants use either phone or web, so that resources can be freed
    up in One Stops to assist those who need hands-on help).
    Technology: No additional enablers required.
2   Process: Validate identity and access profile. Claimants will provide identifying information (likely SSN
    and pin number) so UI representative can verify identity and access claimant electronic case file.
         Identity validation process has not been defined.
    Technology: Workflow, potentially additional identify validation crosschecks.
3   Process: Route for preventative investigation. Where a cross-check flags a potentially serious eligibility
    issue, notification is sent to a professional investigator to trigger an investigation. (See Preventing
    Overpayments for additional information).
         Not confirmed how this will work when in parallel with certification process
    Technology: Automatic notification
4   Process: Validate eligibility – using a pre-established set of questions, validate claimant eligibility for
    continued benefits. A large majority of certifications should be conducted on the phone or over the web
    (even if representative assistance is needed).
         Idea: provide reemployment services information when claimants are waiting.
    Technology: Workflow
                                                                               Continued Claims and Payment . . .



Continued Claims and Payment: Explanation and
Enablers (cont.)
Steps 5-8 represent the certification process for issue-free claims where the preferred answers are provided

5    Process: If the claimant has provided the preferred answers to the eligibility validation questions (step
     4), they are automatically approved and routed for payment
     Technology: Workflow
6    Process: Make payment. The claimant‟s payment is automatically approved by the system, and
     generated via the mechanism they selected at the initial claims process.
     The payment options that will be available to claimants (and may be used to offset refunds) may include
     direct deposit, UI debit card and check, but may be limited to two options as debit cards and checks meet
     the same customer need – payments for those without bank accounts.
     Technology: Workflow system
7    Process: Receive payment. The claimant receives payment via the payment mechanism they selected.
     In some cases he/she may be notified that the payment has been allocated against a refund owed.
     Technology: None.
8    Process: Notification to claimant is generated automatically. This notification should include the amount
     of the payment, the date, the next certification date and options, and information on how to access
     reemployment services, and other workforce services as appropriate.
           Note: it was suggested that the certification frequency should remain 2 weeks, but the new system
           will be flexible enough to handle different certification schedules.
     Technology: Automatic notification system, workflow
                                                                                  Continued Claims and Payment . . .



Continued Claims and Payment: Explanation and
Enablers (cont.)
Steps 9-16 represent the certification process when issues are present, and certification occurs during
business hours (7 AM to 7 PM)
9     Process: Suspend certification. If a claimant provides “non-preferred answers” to the eligibility questions,
      he/ she will be provided the opportunity to confirm his/her answer choice (to minimize possibility that
      information was improperly entered). If he/she confirms the non-preferred answer, the certification is
      “suspended” and he/she will be notified.
      Within standard business hours, this claim will be immediately routed to a UI representative (step 10);
      outside of business hours, they will be notified and provided with their contact options (step 17) and what
      that means.
      Technology: Workflow
10    Process: Immediately route to representative.If a claim is suspended during business hours (step 9) or if
      a claimant selects the option of contacting the agency at step 19, the claimant will be routed directly to an
      appropriate UI representative.
      If a representative is able to clarify a claimant‟s questions or correct an error, the claimant can be routed
      back to the automated, claims-without-agents continued claims process (step 5).
      For suspended certification during business hours, a claimant certifying by phone will be transferred to
      the appropriate representative. Claimants certifying via the web during business hours could be provided
      the option of using a “instant messenger” system whereby the representative could interview them in
      real-time, via the web.
           Note: if a claimant web certifying chose not to use the instant messenger option, they would be
           routed to step 17 whereby they would be able to elect that a UI representative call them back.
      Technology: Workflow, call routing, instant messenger
                                                                                  Continued Claims and Payment . . .



Continued Claims and Payment: Explanation and
Enablers (cont.)
11   Process: The UI representative will decide whether the certification “problem” is a one or a two party
     issue. If a two party issue (i.e. an issue involving the employer), the fact finding is scheduled as soon as
     possible (step 15). If a single party issue, the UI representative would immediately address the
     certification issue (step 12).
     Technology: Automated scheduling, expert system, workflow
12   Process: One party issue – assess if eligible. The UI representative proceeds to determine whether the
     claimant is eligible, enters the result in the system, and proceeds to step 13 (ineligible) or 5 (eligible).
          Note: the workload impact of the „assisted certification‟ model as described here is unknown.
     Technology: Expert system, workflow
13   Process: Determine as ineligible. If the claimant failed to meet the certification criteria, he/she is
     identified as being ineligible by the representative, who immediately enters the result in the system.
     Technology: Workflow
14   Process: Deny. If ineligible, the claimant is denied benefits and immediately notified (see step 8). If there
     has been an overpayment, the claim will set up for overpayment (step 22).
     Technology: Workflow, automatic notification system
15   Process: Schedule fact-finding. If the claimant‟s certification issue is identified as a two-party issue (i.e.,
     it involves the employer for any reason), the representative must schedule a fact-finding as soon as
     possible – while maintaining due process – and provide the claimant with “next step” information.
     Technology: Automated scheduling, workflow, automated notification
16   Process: Route to adjudication. The case then re-enters the adjudication process.
     Technology: Workflow
                                                                                 Continued Claims and Payment . . .



Continued Claims and Payment: Explanation and
Enablers (cont.)
Steps 17-22 represent the certification process when issues are present, and certification occurs outside of
business hours (7 AM to 7 PM). (These process steps are relevant only for web and phone certification – as in-
person certification will be naturally limited to business hours.)
17   Process: If the claimant encounters a problem (when attempting to certify for benefits outside business
     hours, the claimant is informed of his/her options: (1) to contact NJDOL UI again during business hours
     (via local number, or by re-accessing the web site) (step 19), or (2) request that the agency calls him/her
     back the next day (step 21).
     Technology: Enablers include the workflow system and case management.
18   Process: Claimant selects preferred option (claimant or agency initiated follow-up).
     Technology: None.
19   Process: Claimant to initiate contact. If claimant selects to call UI, he/she is directed do so within a given
     time period (The time period discussed within the workshops was 48 hours, however this merits further
     analysis.) in order to be routed directly to a representative, who is able to easily access the record of
     their attempted certification and quickly address any remaining issues. If the web is the preferred method
     of certification, a claimant can re-access the certification web site.
     The claim then rejoins the „issue arises with certification – in business hours‟ process (step 10).
     Technology: Workflow.
                                                                               Continued Claims and Payment . . .



Continued Claims and Payment: Explanation and
Enablers (cont.)
20   Process: Send reminder. If claimant does not contact within 48 hours (or the default time frame), the
     system will automatically generate and send a letter or email stating that the claim will not be reopened
     until the claimant takes further actions.
          [Note: the process by which claimants reenter system after the lag period elapsed was not
          discussed]
     Technology: Automated notification, workflow system
21   Process: If claimant chooses to have UI call him/her, the claimant confirms their preferred contact details
     (provided during the initial claims process) and provides their preferred contact dates and times. These
     are routed to the next available UI representative
     Technology: Workflow system
22   Process: Establish overpayment. If there has been an overpayment, the claim will be routed to
     Collections.
     Technology: Workflow system
                                                                                Continued Claims and Payment . . .



Continued Claims and Payment: Business Design
Principles
   Contact to certify by phone or web (95%), other 5% certify manually or on paper
   At each certification, amount of payment per week and remaining balance will be provided through the
    case file
   Allow 48 hour “fix period” before sending out letter informing didn‟t certify correctly
   If call is received within business hours, customers should be able to get through in less than 5 minutes
   Extend business hours, to no more than 12 hours / 5 days
   Enable claimants to reconfirm certification answers
   Full tracking / audit trail; including where representative changes claimant responses for certification
   Claimant option of card vs. auto payment vs. check
   Different certification models (to be enabled on same system, e.g. DDU)
   “Workflow” transfers actions (and tracks progress) across all units in UI
   If certification issues arise out-of-hours, workflow creates call-back assignments OR leave action to
    claimant to get resolved
   Assume someone manages workload queues across resources
   Customers should be able to find out status of claim via IVR (e.g. is issued x resolved?)
   As much as practical, get real time data
   Perform cross-match during continued claims as often as cross-match data is updated and available
PREVENTING OVERPAYMENTS
                                                                                Preventing Overpayments . . .



Introduction to Preventing Overpayments Process
   Preventing Overpayments Process
    –    This section presents the new preventing overpayments process, in the following order:
         •    Diagram depicting the relationship of the Preventing Overpayments process to the Intake and
              Adjudication and Continued Claims processes
         •    High-level view of the process: inputs and outputs
         •    Process map
              -     Summary of what‟s new
              -     Detailed explanatory notes
         •    Underlying business principles


   Note: the Preventing Overpayments Process applies both to new and to continued claims.
                                                                                                                    Preventing Overpayments . . .



      Introduction: Relationship to Other Processes

       Intake & Adjudication Process – SNAPSHOT




                                                                                                               The preventing
                                                                                                                overpayments
                                                                                                               process occurs
                                                                                                              concurrently with
                                                                                                                these process
Continued Claims: Conceptual Process Diagram
 Continued Claims & Payment Process                               – SNAPSHOT
                                                                                                                    steps
         Claimant                                 Division of Unemployment Insurance


                           2. Validate identity                                          4. Validate
       1. Contact UI
                           and access profile                                             eligibility

                                                                       Flagged, or
                                                                                                        Preferred
                                                                      non-preferred
                                                                                                        answers
                               3. Route for                             answers
                              preventative               9. Suspend
                                                                                                               5. Approve continued
                              investigation            certification and
                                                                                                                 claim (automatic)
                                                        notify claimant
                                      After bus. hrs                       In bus. hrs
                                                                                                             Agent
       23. Contact UI,                                                                                      corrects
                                                                                                                                                                         Preventing Overpayments . . .

               Preventing Overpayments – High-Level View of the
               Process

      INPUTS                                                                                                                                                                        OUTPUTS

Verify identity
• Social security number, address
• Other security identifier
• Citizenship status (INS)                                                                                                                                        • Ineligible claims identified and
• Homeland security cross-match                  Preventing                                                                                                           denied before and after first
• Employee addresses                        Overpayments Process                                                                                                      payment
Verify qualifying information                                                                                                                                           • Denial notification, to
• Cross-matches: New hire, state             Preventing fraud and overpayments: conceptual process diagram
                                                                                                                                                                           include rights information
   vendor, corporate officer, current                    Claimant

                                                                       Core process steps: intake
                                                                       or continued claims
                                                                                                                  Agency


                                                                                                                             4a. Continue with
                                                                                                                                                   Employer

                                                                                                                                                                           and other workforce
                                                                                                                                 intake and


   claimant, Dept of Corrections, death
                                                   1a.Choose to file
                                                       a claim                                                              adjudication process




                                                    1b.Choose to
                                                                           2.Validate
                                                                            eligibility
                                                                                                     3. Cross-
                                                                                                    check flag?
                                                                                                                                                                           service information
   certificates, bankruptcy                                                                                                                                       •
                                                       certify                                                                4b. Continue with
                                                                                                                              continued claims



                                                                                                                                                                      Investigation
                                                                                     6. Routed to                                  process
                                                                                                             5. UI agent
                                                                                       BPC for
                                                                                                            handles issue
                                                                                     investigation




Collate available eligibility information
                                                      8. Provide                        7. BPC                                                       8. Provide
                                                     information                     investigates                                                   information




• Pension information
                                                                         10. Resolve as             9. Resolve as
                                                                            ineligible                 eligible




                                                     14. Receive           11. Notify                  12. Send for
                                                                                                                            13. Process
                                                                                                          criminal




• Wage records
                                                     notification          claimant                                          collection
                                                                                                       investigation




• Separation information (if provided)
• Social security wage data
• Cross-matches: state tax, child
   support, workers‟ compensation,
   special (injury) compensation
• Outstanding debt (intra- or interstate)
• ECF history (incl. previous claim data)
                                                                                                                    Preventing Overpayments . . .

 Preventing Overpayments: What’s New
Preventing fraud and overpayments: conceptual process diagram

                                                                                                                                  Outside
         Claimant                                                Agency                                           Employer
                                                                                                                                  agency
                            Core process steps: intake
                            or continued claims
        1a.Choose to file                                                      2
            a claim          1                                                                4. Continue with
                                 2.Validate              3. Cross-        All claims        intake or continued
                                  eligibility            check flag                           claims process

         1b.Choose to
            certify

                                       5. Routed to
                                 3       UI agent
                                                                         UI agent resolves issue


                             UI agent cannot resolve issue

                                       6. Routed to
    4     15. Receive                  professional                                                               15. Receive
          notification               investigator and                                                             notification
                                     send notification


                                                                                                                    8. Provide
           8. Provide                7. Professional
                                                                                                                   information
          information                 investigates
                                                                                                                                    8. Provide
                                                                9. Benefits                                                        information
                                                                  allowed
                                       10. Benefits
                                         denied




                               11. Send            12. Send for
                                                                              13. Process
          14. Receive         notification       possible criminal                                                14. Receive
                                                                               collection
          notification        (automatic)          investigation                                                  notification


                                                         If two-party issue, or where employer will be credited
                                                                                         Preventing Overpayments . . .



Preventing Overpayments: New and Enhanced
Functionality
       The emphasis on preventing overpayments is new for NJDOL UI. The benefits of preventing
        overpayments reduces the number of possible issues and narrows the focus to those issues truly
        requiring attention
       Preventing overpayments, as well as investigations will become even more integrated with day-to-day
        UI operations.

1      The number and type of cross-checks done early in the process will be expanded, and will be done
        on the most recent data available (real-time data may not be available).

2      If a cross-check flag is raised, the process of filing a claim or certifying will continue


       Flagged cross-checks will be addressed by appropriately trained UI representatives, to quickly
3       resolve basic issues, and determine those issues that require handling by a professional investigator.
        Appropriately trained representatives should be able to resolve issues concerning such things as
        incorrect addresses and names. If the UI representative is able to handle the issue, they will do so
        and allow the claimant to continue filing their initial claim or certifying their continued claim. If they
        cannot address the issue, they will route it (via workflow) to a professional investigator for additional
        investigation. The claim filing process will continue even while an investigation is ongoing also.
       Claimants may be notified about an investigation as early as possible. This notification will be
        generated automatically and will acknowledge all previous communications from NJ DOL UI and
4       explain the nature of the inquiry. (This is expected to have a significant deterrent effect on ineligible
        claimants.)
                                                                                     Preventing Overpayments . . .



Preventing Overpayments: Explanation and Enablers
1   Process: When a claimant chooses to file a new claim (or reopen an existing claim), he/she will be able
    to do so via phone or web – and will have the choice to file unassisted (a claim-without-agents), or with
    the assistance of a UI representative. (See triage, intake-to-adjudication, and continued claims
    processes for details)
    Technology: No additional enablers required.
2   Process: Validate eligibility. This is a key step of the claim filing process, done behind the scenes. Upon
    entry of a social security number (SSN), the system will cross-check that SSN and other claimant
    information against a range of other government databases to
         Verify the identity of the claimant
         Identify whether the claimant qualifies for UI (gathering information required for any UI program at
         this stage)
         Gather available eligibility information (new hire cross-match, immigrant status, etc.)
    The preventing overpayments inputs and outputs diagram (presented earlier – with the large arrows)
    depicts the full list of potential cross-matches. Any cross-checks must be done against the latest version
    of the databases possible.
    Technology: New technology enablers include up-to-date databases of information against which the
    SSN of every claimant can be run, workflow, (validation crosschecks), CRM system (electronic case file),
    and intelligent systems
                                                                                        Preventing Overpayments . . .



Preventing Overpayments: Explanation and Enablers
(cont.)
3   Process: If a cross-check result is positive during intake or certification, the case will be transferred to a
    UI-claims-skilled representative for investigation/resolution. (The claimant will be notified that an
    investigation has been initiated, and this notification will acknowledge any previous communications sent
    to the claimant.)
    Procedures will be needed to define:
         Which cross-match issues should be directed immediately to a professional investigator? (It is likely
         that these will be the more serious issues.)
         Which cross-match issues should be directed immediately to a UI-skilled resource? (These may
         include questions about claimant key data: name, date of birth, social security number, address,
         and possibly others)
         (Note: the workshop participants discussed a different process whereby the expert system would
         identify those issues that required full investigation and that some cross-flag issues would be
         directly routed to a professional investigator.)
    The process steps in the case of a positive cross-match for each data source should take into account
    factors such as the reliability and sensitivity of the data source.
    Technology: Workflow systems, automatic notification, CRM system (electronic case file)
4   Process: Continue with initial claim (or certification process). Unless an appropriately trained UI
    representative interacts with the claimant to resolve a cross-flag issue, the initial investigation process
    will continue parallel to the claim filing or certifying, and be transparent to the claimant (See the intake to
    adjudication and continued claims processes for details).
    Technology: No additional technology enablers required.
                                                                                         Preventing Overpayments . . .



Preventing Overpayments: Explanation and Enablers
(cont.)
5   Process: Routed to UI representative. Flagged cross-match issues are routed directly to an available
    and appropriately trained representative for resolution.
         If the representative is able to resolve the issue, the claimant is returned to the initial claim filing
         process. (Representatives will likely be able to address incorrect SSN, name spelling, address
         problems, etc)
               [Note: workshop did not determine if this would mean transferring claimants back to the IVR]
         If the representative identifies that the issue is potentially more complex or serious, he/she will be
         able to send it to a professional investigator for further investigation and return the claimant back to
         the initial claim filing process
    Technology: Workflow, expert system, CRM system (electronic case file)
6   Process: Routed to professional investigator for investigation. The “flagged” cross-matches that cannot
    be resolved simply by a UI representative should be automatically included into the workload for
    investigations. Because they will need to be investigated before the first payment is made (for optimal
    results), these work items should also be flagged with a deadline date.
    Technology: Workflow, CRM system (electronic case file)
7   Process: Professional investigator investigates. The detailed investigation process is not yet developed
    [as of 4/23 – we are meeting with BPC to review and redesign the investigations process]. For all
    investigations pertaining to an initial claim, an automatic reminder should be set „a few days‟ before the
    first payment deadline – reminding the representative to review the possibility of suspending the claim‟s
    eligibility for further investigation (and also as a reminder of the work item!) (The investigation process is
    briefly discussed in the following section of this document.)
    Technology: Likely to include expert system, automatic scheduling and notification
                                                                                         Preventing Overpayments . . .



Preventing Overpayments: Explanation and Enablers
(cont.)
8    Process: Provide information. Claimants and employers will provide required information for
     investigation process (which remains to be defined).
     Technology: Workflow, CRM (electronic case file), potentially imaging solutions
9    Process: Resolve as eligible. If the investigation resolves that the claimant is eligible, the finding is
     logged and investigation closed.
     Technology: Workflow, CRM (electronic case file)
10   Process: Resolve as ineligible. If the claimant is found to be ineligible, the finding is logged on the
     system
     Technology: Workflow, CRM (electronic case file)
11   Process: Deny claim. Once the claim is formally denied…
          If before first payment, the claim is denied and the claimant notified (including all usual extra
          information) and provided next step information (e.g. how to file an appeal)
          If after first payment, the claim is denied, the claimant notified and the collection process
          automatically triggered (See financial processes section.)
     Claimant will receive appeal rights, employment services information etc in the same way as if
     determined ineligible in the usual way.
     Technology: Workflow, CRM (electronic case file), automated scheduling
12   Process: Send for potential criminal prosecution (where appropriate). This is likely to be an exceptional
     outcome of the preventing overpayments process.
     Technology: Workflow
                                                                                    Preventing Overpayments . . .



Preventing Overpayments: Explanation and Enablers
(cont.)
13   Process: Process collection. A collection process will be automatically triggered if a payment has been
     made prior to denial (See financial processes section for details)
     Technology: Workflow
14   Process: Claimant will be notified of any change of status to his/her claim, via the preferred method
     he/she indicated early in the process. Importantly, any notification sent to the claimant regarding an
     overpayment prevention investigation will acknowledge any previous communication from the Division.
     Technology: Automated notification, workflow, CRM (electronic case file)
                                                                                      Preventing Overpayments . . .



Preventing Overpayments: Business Design
Principles
   Preventing overpayments focuses on ensuring that only eligible claimants receive payment . However,
    the agency will err on the side of paying claims: only where there is sufficient evidence that the claim is
    invalid (or ineligible) will a claim be denied or payment stopped.
   The process steps in the case of a “flagged” cross-match for each data source should take into account
    factors such as the reliability and sensitivity of the data source.
INVESTIGATING OVERPAYMENTS
                                                                                   Investigating Overpayments . . .



Introduction
Contents
   This section presents the process-specific business design principles for investigating overpayments.


Note:
   Initially, the investigation process was planned for review by BPC in the Spring of 2003 as part of the
    BARTS II requirements. However, for completeness and at the request of the UI Director , we have
    scheduled an extra workshop session to cover investigations; this session falls outside the deadline for
    delivery of this deliverable to the Quality Review Board (April 25). We will include the redesigned process
    in the following iteration, allowing for review outside the formal cycle.
                                                                                    Investigating Overpayments . . .

Investigating Overpayments: Business Design
Principles
    Investigators should be responsible for - and enabled to – take an investigation from start to finish (including
     triggering the collections process)
    Claim agents and/or adjudicators may assume additional validation actions in response to cross-match
     flags
    Telephone fact-finding should be used where possible in investigations, recognizing the need at times for in-
     person fact-finding
    Ongoing training to keep up with patterns of fraud/overpayments
    Solution must meet all the general IT principles – flexible, scalable, reliable etc – and must be maintain-able
     internally
    Need to be able to auto-prioritize cases: where the claimant is currently claiming, allegations etc
    Need to link investigations cases (taken from BARTS or equivalent) to the full claim history stored on the full
     UI system
    Need flag to BPC when wage record is changed, for any cases under investigation
    Investigations process should include setting up refunds (collections)
    All correspondence should be electronic where possible
    It should be as easy as possible for our customers to send data into the agency (e.g., employers sending in
     B98 information)
Detailed principles
    Would like wages to be separated from other earnings on WR30 (outside UI control)
    Consider having return addresses on letters personalized to investigators – so information can be acted
     upon immediately (where email not appropriate)
    Need to become pro-active in response to potential IT vulnerabilities – maybe in partnership with OIT/DIT
    Correspondence during investigations should include a specific contact route for investigations queries
    Replacement system must overcome current constraints such as accurate FEINs and limited characters per
     field
                                                                                   Investigating Overpayments . . .



    Ideas and quick wins
    Use the new hire directory to trace people – as a debtor locator for wage garnishments (refunds) etc
    Provide Adobe Acrobat reader to collections team, so they can read the list of bankruptcies
    Have an annual amnesty on debt interest – thereby encouraging full payment of principles
    Have an outside company (e.g., a bank) present on identity theft and how to guard against it
    Present at employer seminars again, to remind them about BPC processes
    Improve the B98 form
     –    Date terminated not same as last day of work
                                                                                                                                                                       Investigating Overpayments . . .

              Investigating Overpayments – High-Level View of the
              Process

      INPUTS                                                                                                                                                                        OUTPUTS




                                                Investigating
                                            Overpayments Process

                                             Preventing fraud and overpayments: conceptual process diagram

                                                         Claimant                                                 Agency                           Employer



•   Referral during intake & adjudication          1a.Choose to file
                                                       a claim
                                                                       Core process steps: intake
                                                                       or continued claims                                   4a. Continue with
                                                                                                                                 intake and
                                                                                                                            adjudication process
                                                                                                                                                                  •   Collections process
                                                                                                                                                                  •
                                                                           2.Validate                3. Cross-



    process
                                                                            eligibility             check flag?

                                                    1b.Choose to
                                                       certify                                                                4b. Continue with
                                                                                                                              continued claims
                                                                                                                                                                      Criminal prosecution
•
                                                                                                                                   process




                                                                                                                                                                  •
                                                                                     6. Routed to
                                                                                                             5. UI agent
                                                                                       BPC for
                                                                                                            handles issue


    Allegation (hotline & other sources)                                                                                                                              Civil prosecution
                                                                                     investigation


                                                      8. Provide                        7. BPC                                                       8. Provide
                                                     information                     investigates                                                   information




•   Historical cross-matches                                             10. Resolve as
                                                                            ineligible
                                                                                                    9. Resolve as
                                                                                                       eligible
                                                                                                                                                                  •   Case closes
                                                     14. Receive           11. Notify                  12. Send for
                                                                                                                            13. Process
                                                     notification          claimant                       criminal
                                                                                                                             collection
                                                                                                       investigation
                                                                                                                             Investigating Overpayments . . .



Investigating Overpayments: What’s New
 Investigating fraud and overpayments: conceptual process diagram

                                          Agency                                                            Employer           Claimant


     1. Input or referral
                                      2. Send
                                    request for             1            electronic transfer
                                                                        (preferred) or paper
                                                                                                            3. Provide
                                                                                                           information
                                    information


        4. Receive
                                                     electronic transfer (preferred) or paper
       information

                                          2                             3                       4
      5. Enter data
                            6. Assign case          7. Collate case            8. Send case
    received on paper
                             automatically           file (centrally)         to investigator
       into system


                                                      11. Notify claimant&
     9. Review case          10. Validate &                                                                                     12. Provide
                                                      request evidence as
           file             test information                                                                                    information
                                                            needed

                                                          13. Receive
                                                          information

                                                                                                                                14. Claimant
                                                          15. Schedule
                                                           fact-finding
                                                                                                    within 30 days       5     requests fact-
                                                                                                                                   finding



                                                            16. Fact-
                                                             finding
                                                                                     6                                           16. Fact-
                                                                                                                                  finding


                                                7      17. Make decision
                                                        & set up refund



                                                           19. Send for                                                        20. Receive
                               18. Close case
                                                           prosecution                                                         notification
                                                                                     Investigating Overpayments . . .

Investigating Overpayments: New and Enhanced
Functionality
       Requests for information on potential overpayment and fraud cases will be sent out to employers
        electronically – and returned electronically - where possible. Large employers and employer agents
1       should be provided means of responding in bulk, rather than on a case-by-case basis – to increase
        the percentage of responses.
       Cases will be assigned to investigators automatically, based on a number of rules – for example, by
2
        skill-set / location / individuals‟ workloads.
       Case file collation will be a much faster process, as all information will be attached to the claimant
3       and employer electronic case files.
       Investigation cases will therefore be transferred to investigators electronically also. All investigators
4       will also have access to the core UI system remotely.
       Where a fact-finding is required, the claimant will be able to schedule the session him/her –self via
        the phone or web. They will also be able to do so through the triage function: the investigations fact-
5       finding schedule will be accessible to all. The agency may put parameters on the options available
        (e.g., within 3 weeks).
       The majority of fact-findings will be conducted via the phone, unless there is a specific reason why an
6       in-person interview is required.
       Investigators will be responsible for setting up refunds where that is the outcome of the investigation.
7       This will be a simpler process step, supported by the system. There will be NO rekeying.
                                                                                   Investigating Overpayments . . .
Investigating Overpayments: Explanation and
Enablers
1   Process: Input or referral. The triggers for the investigations process are (a) referrals from the
    preventative cross-matches run during initial claims and continued claims, (b) allegations – via the hotline
    or any other source and (c) „historical‟ cross-match results where recent claims history is reviewed for
    patterns.
    Technology: All triggers will be automatic, as a result of the cross-check edits component of the UI
    system.
2   Process: Send request for information. Where possible, this will be done electronically. An immediate
    request for confirmation and review of previously submitted information will be sent to the relevant
    employers. (This is currently the B98).
          Option: send out these requests in batch, to help employers manage their side of the workflow.
          This might be particularly helpful for large employers and employer agents
          Option: the format of information requests should be tailored by type of employer/employer agent.
          E.g., web form for single cases / accept bulk wage record information from larger companies?
          Option: co-ordinate correspondence sent, with that sent by UI/DI – so employers do not receive
          more than one request for the same information
    The request for information must be worded as simply as possible, to minimize employer queries.
    Technology: Email, secure file transfer, workflow, eforms, web, CRM (electronic case file)
3   Process: Send information. See 2, above
    Technology: See 2, above
4   Process: Receive information. Information received back from employers will be accepted directly into
    the system.
    Technology: See 2, above
5   Process: Enter data received on paper into the system. To continue to cater for less technical
    employers, where information is submitted on paper, this will need to be entered into the system using
    imaging software.
    Technology: Imaging, workflow, CRM (electronic case file)
                                                                                    Investigating Overpayments . . .
Investigating Overpayments: Explanation and
Enablers
6    Process: Assign case automatically. As soon as „B98‟ information has been received into the system, the
     case will be automatically assigned to an investigator. Assigning a case will take into account a number
     of factors, including workload of each investigator, their skills and their location.
     Technology: Workflow
7    Process: Collate case file (centrally). The investigations case file will contain some extra information to
     the standard claims file. It will also be stored on the system. Access to the investigations case file may
     need to be limited. The collation process will therefore become a validation of the electronic information.
     Technology: Workflow, CRM (electronic case file)

8    Process: Send case to an investigator. The case file will be transferred automatically to the investigator
     for action.
     Technology: Workflow, CRM (electronic case file)
9    Process: Review case file. The investigator will review the file and the actions needed. To avoid
     duplication, for example investigators cross-checking addresses, the case file will be online and key
     information updated in real-time.
     Technology: Workflow, CRM (electronic case files)
10   Process: Validate and test information. The key activities of an investigation will vary from case to case –
     may include interviewing employers, co-workers and research.
     Technology: Variable, CRM (electronic case file)
11   Process: Notify claimant and request evidence as needed. The claimant is presented with the evidence
     trail and is allowed 30 days to respond. Depending on the preferences of each claimant, he/she may be
     notified by email
     Technology: Imaging, workflow, CRM (electronic case file)
                                                                                     Investigating Overpayments . . .
Investigating Overpayments: Explanation and
Enablers
12   Process: Provide information (possible). The claimant may submit extra evidence to the investigator in
     the course of the investigation.
     Technology: email possible
13   Process: Receive information. The claimant will have the option of submitting extra evidence on paper or
     electronically.
     Technology: email, imaging, workflow, CRM (electronic case file)

14   Process: Claimant requests fact-finding. After notification, the claimant has thirty days to request a fact-
     finding.
     Technology: CRM (electronic case file)
15   Process: Schedule fact-finding. The claimant will be able to schedule the fact-finding interview him/her –
     self, via the phone or the web. Alternatively, he/she may do so through a triage representative who will
     also have access to the schedule(s). The agency may put parameters on the options available (e.g.,
     within 3 weeks).
     Technology: Workflow, scheduling software, IVR, web
16   Process: Fact-finding. The vast majority of fact-finding interviews will be held on the telephone, unless a
     specific reason for in-person interview is identified. Notes from the fact-finding should be entered directly
     into the system.
     Technology: Phone system, eforms, CRM (electronic case file), workflow
17   Process: Make decision and set up refund. The investigator will make his/her decision and enter that into
     the computer. The decision type will automatically trigger notification, the content of the letter to be sent
     and the next actions (e.g., set up a refund). Depending on the preferences of each claimant, he/she may
     be notified by email.
     The refund will be set up automatically from the decision. The investigator will be responsible and will be
     assisted supported by automated calculations and workflow. Once the refund is set-up, ownership will
     transfer to the Collections unit.
     Technology: Workflow, CRM (electronic case file)
                                                                                      Investigating Overpayments . . .
Investigating Overpayments: Explanation and
Enablers
18   Process: Close case. Where there is no case to answer, the case will be closed by the investigator and
     a history of the investigation maintained on the system.
     Technology: CRM (electronic case file), data warehouse
19   Process: Send for prosecution. Where a case of extensive fraud/overpayment is established, the case
     can be transferred to the Attorney General‟s office for further investigation (whether criminal or civil). The
     transfer will be in a format appropriate to the AG‟s office.
     Technology: CRM (electronic case file)
20   Process: Receive notification. The claimant will receive notice of the outcome of the investigation, by
     his/her preferred communications method.
     Technology: N/A
                                                                                            Investigating Overpayments . . .



    Current Challenges to Investigations
     Incorrect addresses for employers and claimants
     Volume of B98s returned by employers is low
     Information returned by employers is often incorrect. They fill out the B98 poorly. E.g.,
      –    Wrong pay weeks
      –    Wrong SSN
      –    Incorrectly show when the money was earned (often show when money paid, not earned)
     System is not flexible in understanding names (e.g., search for Reilly and if someone is called O‟Reilly,
      doesn‟t come up)
     No verification in BARTS on correct address or social security number
     Can‟t expunge history – e.g., if someone has suffered identity theft
     Don‟t know if we are picking up on tell-tale signs of identity theft (patterns etc)
     Employer responses are only submitted on paper currently
     Employers can‟t send batch returns
     Staff can‟t correct data entry problems in real time – all batch processing in the BARTS system
     Incomplete case information (files) provided to the field investigators – such as payroll, case assembly -
      meaning they conduct their own preparation (rework)
     Field investigators don‟t have online access to full case history – only the BARTS extract, which covers a
      maximum of four quarters. There is no synchronization or link with the full claim history on LOOPS
     Common cases involve off the books employment, fictitious employers, imposters, corporate officer
      claiming and identity theft
     We don‟t yet fully understand the new Federal standards (and the new regulation on equity and good
      conscience) and implications for what we focus on
                                                                                      Investigating Overpayments . . .



    Current Challenges to Investigations (Cont.)
    Investigators don‟t complete the process (don‟t set up refunds)
    BPC and all UI activity is low priority for employers but we rely on them for most of our information:
     responding to BPC is purely altruistic – no immediate return
    Employers are constantly calling regarding the B98 form, with a large number of basic questions being
     asked
Preventing overpayments
    Don‟t prepare for future threats, have forward thinking. For example, new technologies mean more and
     varied opportunities for prevention and for types of fraud. Not doing anything about them
    Adjudication centers aren‟t responsive to BPC referrals
Debt management, collections
    Don‟t have full information on the history behind debts we have to collect. Difficult to respond to customer
     concerns.
    Knowing about bankruptcies in order to trigger appropriate action; proof of claim, suspension of collection
     activities
    Political intervention undermining debt decisions
    Don‟t use many collections methods used in wider industry…. E.g.,
     –    Cold calling (legal issues?)
     –    Pro-active debt collection through agencies (may require legislation as they demand a % of the
          principle)
    Don‟t allow credit card payments of debts
    Don‟t allow „direct debit‟ style payment of debts by claimants
APPEALS
                                                                               Appeals . . .



Introduction to Appeals
   This section presents the new appeals processes, in the following order:
    –    Appeals Tribunal
         •     High-level view of the process: inputs and outputs
         •     Process map
               -     Summary of what‟s new
               -     Detailed explanatory notes
    –    Board of Review
         •     High-level view of the process: inputs and outputs
         •     Process map
               -     Summary of what‟s new
               -     Detailed explanatory notes
    –    Underlying business principles
                                                                                                                                                                              Appeals . . .



             AT Appeals – High-Level View of the Process




      INPUTS                                                                                                                                                            OUTPUTS


• Party requests                                                                                                                                        • All parties notified and
    reconsideration           AT Appeals Process                                                                                                            provided information
•   Any party (or party‟s                                                                                                                               •   Routed to UI for:
    advocate) requests case   AT Appeals: Conceptual Process Diagram

                                    Appealing Party                Division of Unemployment Insurance
                                                                                                                                 Other Interested
                                                                                                                                     Parties
                                                                                                                                                             • Re-determination
    information                                                                                                                                              • Re-adjudication
                                       1. Requests         2. UI review of                                       3. Re-
                                     reconsideration       determination                                   determination by UI



                                        5. Receive                                                                                     5. Receive
                                      notification &     4. Case pre-review                                                          notification &




                                                                                                                                                             • Notification of
                                       information                                                                                    information
                                                                                   6. Provide (access
                                                                                         to) case
                                                                                      information if
                                                                                        requested
                                                            8. Schedule
                                                               hearing
                                    7. Party/Advocate                                                                              7. Party/Advocate
                                    requests case info                                                                             requests case info




                                                                                                                                                                decision to originating
                                                          9. Hold hearing          10. Make decision




                                                          12. Automated           13. Remand back to        11. UI automated
                                                            notification          UI for re-adjudication        next steps



                                                                   Appeals Tribunal jurisdiction
                                                                                                                                                                Adjudication Center
                                                                                                                             Appeals . . .



      AT Appeals: What’s New
AT Appeals: Conceptual Process Diagram
                                                                                                                Other Interested
      Appealing Party                          Division of Unemployment Insurance
                                                                                                                    Parties

        1. Requests
                          1         2. UI review of                                           3. Re-
      reconsideration               determination                                       determination by UI



         5. Receive                                                                                                  5. Receive
       notification &             4. Case pre-review                                                               notification &
        information                                                                                                 information
                                                            6. Provide (access
                                                                  to) case
                                                               information if
                                                                 requested
                                     8. Schedule                                    2
                                        hearing
     7. Party/Advocate
     requests case info
                                                       3                                                         7. Party/Advocate
                                                                                                                 requests case info


                                   9. Hold hearing          10. Make decision

                              4

                                   12. Automated           13. Remand back to            11. UI automated
                                     notification          UI for re-adjudication            next steps

                                                                                                            5
                                            Appeals Tribunal jurisdiction
                                                                                                        Appeals . . .



AT Appeals: New and Enhanced Functionality
*      All steps that involve a change to the claim, customer or employer information update the Electronic
        Case File
       An online case law library will be made available to all parties within and external to the agency
       Parties will be able to request a reconsideration via phone, taking advantage of voice-to-text software
1       (as well as via the web or by mail – as currently)
       Case information will be stored on the system and therefore will be easily accessible to AT staff and
2       also to parties via their electronic case files, for example to see the status of an appeal
       Parties will be able to submit preferred hearing dates via the phone or web
3
       Hearing times can be scheduled automatically, requiring only approval from AT
       Scheduling will need to accommodate class action and other multiple-party hearings

4      Potential for some decision-support modules to support hearings

       Automatic application of the decision by the UI system, entered by the Appeals Examiner. This
5       removes the need for cases to be referred back to adjudication centers for re-entry into the UI
        system. The next step(s) of the process will be triggered automatically. (For example, setting up a
        claimant‟s skeleton refund and including the requirement to contact UI Debt Management in the
        notification letter to the claimant).
                                                                                                         Appeals . . .



AT Appeals: Explanation and Enablers
1   Process: Parties will be able to request a reconsideration (and initiate an appeal) by email/web form, fax,
    letter or telephone with detailed reason and information about (a) when NOT available for hearings and
    (b) language preferences … as well as key data – name, address etc.
    Customers should be made fully aware of the steps taken following a request for reconsideration:
    namely, that the agency will take the opportunity to review the determination before sending the case
    through to the Appeals Tribunal.
    Technology: Voice-to-text software to enable phone requests for appeal to be transcribed. Workflow
    system to transfer the work item to Appeals Tribunal, ECF for updates
2   Process: UI review of determination. To avoid unnecessary workload at the Appeals Tribunal, the agency
    will consistently conduct a reconsideration of the determination made, before the Appeals Tribunal begins
    case preparation. This will filter out appeals caused by agency error or late submission of salient
    information. For development purposes, this review will, where possible, be conducted by the same
    office/unit that provided the original determination but not by the same adjudicator.
    Technology: Workflow will send the review task to the appropriate office. The electronic case file (ECF)
    will include all information used in the fact-finding as well as any other information that was submitted
    after the determination date.
3   Process: Re-determination by UI. Where the determination has been reviewed and the original
    determination changed, a re-determination will be applied by the Division of UI. All appropriate parties will
    be automatically notified of the re-determination. It will be the parties‟ responsibility to appeal a re-
    determination.
    Where there is no re-determination, the responsible adjudication center will immediately file an appeal on
    behalf of the party that protested the determination.
    Technology: Automatic notification of parties following a re-determination. ECF for updates
                                                                                                         Appeals . . .



AT Appeals: Explanation and Enablers (cont.)
4   Process: Case pre-review and notification of parties. If the agency reconfirms the original determination,
    the appeal is submitted formally to the Appeal Tribunal. The pre-review unit of the Tribunal then prepares
    the case and identifies and notifies all interested parties that the appeal has been received by the
    Tribunal.
    Technology: Automatic notification of parties and workflow to transfer the appeal. ECF for updates
5   Process: Parties receive notification and information. Information sent includes confirmation of receipt of
    appeal, verbatim copy of the appeal filing (including reasons), appeal rights information and – for current
    claimants – instructions on how to continue claiming. The docket number of the appeal should also be
    included so that parties can track the appeal‟s status via their ECFs.
    [This combines what is currently two separate packages – one from the AT and one from the adjudication
    center – into a single mailing]
         Option: allow claimants the option of whether to continue to claim during appeal
         Option: provide hearing date at this stage? May require a policy change
    Technology: Automatic notification (and details of package sent stored on ECF for all parties)
6   Process: If appropriate, case information can be attached to the electronic case files of the parties
    involved in the appeal. This will require allocation of security „tags‟ to case information to differentiate
    access. Where access to case information via ECF is not possible or desirable, the Appeals Tribunal will
    be able to collate materials requested under a subpoena quickly as all information will be stored on the
    system
    Technology: Electronic case file, integrated phone and web systems
7   Process: To prepare for the hearing, parties may request / subpoena case information. At any time, they
    should be able to access their electronic case files to identify salient information about their appeal –
    e.g., hearing date, status etc (using the docket number to identify the right appeal). If they wish to access
    this information via a representative, this option will also be available
    Technology: Electronic case file, integrated phone and web systems
                                                                                                           Appeals . . .



AT Appeals: Explanation and Enablers (cont.)
8    Process: Scheduling the appeal hearing. With early notification of appeal, parties will be given the option
     of submitting preferred dates for the hearing. If they choose to submit preferred dates, that information
     will be automatically submitted into the automated scheduling system.
     The Tribunal will maintain the flexibility to schedule hearings as far in advance as deemed appropriate.
     The scheduling system will be able to recommend dates meeting the defined parameters, for approval by
     an AT agent. Notification of all parties can then be sent out automatically, once the pre-review team has
     approved the date and time of the hearing (based on all parameters, including time required etc).
     Technology: Automatic scheduling and notification of parties, then workflow to transfer the case
     information to the appropriate Appeals Examiner
9    Process: Hold hearing. All hearings will be digitally recorded and then attached to the appropriate
     electronic case files. (The AT has an existing target to conduct 95% of all hearings by telephone).
     There is potential for application of some decision-support modules for Appeals Examiners – for
     example, prompting appropriate questions as per lead case recommendations.
     In the long-term, the AT may also consider use of video- and web- conferencing technologies to
     complement telephone hearings.
     Technology: Digital recording, ECF and workflow.
10   Process: Decision is made after the hearing, based solely on evidence provided at that forum. Decision
     is entered directly into the system by the Appeals Examiner either (a) typed in or (b) via voice-recognition
     software. The Appeals Examiner, supported by an easy-to-use monetary calculation tool, will also be
     responsible for entering monetary parameters and approving a monetary re-determination, if appropriate.
     Some cases may also require more than a single hearing.
     Technology: Voice-recognition software, expert monetary system and ECF.
                                                                                                          Appeals . . .



AT Appeals: Explanation and Enablers (cont.)
11   Process: Once the decision is made, the system will automatically trigger the required agency actions
     (authorized by the Deputy) in response to the decision parameters entered by the Appeals Examiner.
     These actions will be in „suspend‟ for two days to allow a senior adjudication examiner to view the
     decision and actions, before the actions are triggered.
     Automated actions following an AT decision
                  may include payment / set-up of a refund / benefit non-charging credit and associated
                  notifications on behalf of the Deputy
                  will include automatic notification to the originating adjudication center that the decision has
                  affirmed, modified or reversed the determination, for training purposes
     Technology: ECF, expert system, workflow.
12   Process: The AT‟s notification of decision will be automatically generated, once the examiner has
     confirmed the decision in the system. Parties will receive notifications via their preferred methods (with
     an automatic alternative method triggered if an email is returned as undeliverable). Decision should be
     shown at top of first page, with explanation following (rather than at the end of several pages). Package
     sent should include next steps instructions to each party, dependent on the situation.
                  Option: where AT notification and agency notifications are required at the same time – for
                  example, when a refund is established automatically – these could be sent together, saving
                  on mailing costs
     Technology: ECF, automatic notification, workflow.
13   Process: Remand back to UI. In cases where the Appeals Tribunal decides that the appeal was caused
     by agency omission, or that the case requires further investigation, it can be remanded back to UI. The
     remand will trigger immediate inclusion of the work item in the appropriate office‟s work queue.
     Technology: Voice-recognition software, ECF and workflow
*    A case may be withdrawn, vacated or dismissed for many reasons. These outcomes are not shown on
     the conceptual design only for simplicity.
                                                                                                                                                                          Appeals . . .



            BoR Appeals – High-Level View of the Process




     INPUTS                                                                                                                                                          OUTPUTS

• Party appeals to Board of                                                                                                                          • All parties notified
  Review (becomes appellant)                                                                                                                         • All parties provided
                                                                                                                                                         information (if needed)
                               BoR Appeals Process
                                                                                                                                                     •   Routed to UI for:
                                Board of Review Appeals: Conceptual Process Diagram

                                     Appealing Party                               Division of UI
                                                                                                                                Other Interested
                                                                                                                                    Parties                • Re-determination
                                                                                                                                                     •
                                      1. Rejects AT
                                                           2. File with Board of




                                                                                                                                                         Remanded back to
                                      decision and
                                                                  Review
                                         appeals


                                                            3. Send notice to
                                                            interested parties
                                      4. Receive and                                                                              4. Receive and
                                    review information                                                                          review information




                                                                                                                                                         Appeals Tribunal
                                                          5. Make decision and
                                                                 notify



                                                                                            7. Automated
                                                              6. Automated                redetermination &
                                                              notification of                notification
                                                                 decision


                                                         Board of Review jurisdiction     9. Remand back      8. UI automated
                                                                                             to Appeals          next steps
                                                                                               Tribunal
                                                                                                                    Appeals . . .



         BoR Appeals: New and Enhanced Functionality

Board of Review Appeals: Conceptual Process Diagram

                                                                                                      Other Interested
   Appealing Party                                    Division of UI
                                                                                                          Parties

     1. Rejects AT
                             2. File with Board of
     decision and       1           Review
        appeals


                               3. Send notice to
                               interested parties
     4. Receive and                                                                                     4. Receive and
   review information                                                                                 review information
                                                     2
                               5. Make decision




                                6. Automated               3
                                notification of
                                   decision

                                                                                4
                            Board of Review jurisdiction       9. Remand back       8. UI automated
                                                                  to Appeals           next steps
                                                                    Tribunal
                                                                                                             Appeals . . .



BoR Appeals: New and Enhanced Functionality
          All steps that involve a change to the claim, customer or employer information update the Electronic
           Case File

1         Parties will be able to initiate a Board of Review appeal via email, fax, Internet, and via the phone
           using voice-to-text software. (Note: the extent to which phone filing and the use of digital signatures
           for appeals are constrained by law or policy must be clarified.)
          Workflow will enable draft decisions to be circulated for review or it can be done on a virtual
2          discussion board, centrally
          All case information will be stored on the UI system and will be accessible to the Board
          Automatic application of the decision by the UI system, entered by the Board Member. This removes
3          the need for cases to be referred back to adjudication centers for re-entry into the UI system – and
           therefore speeds up notification of parties
          Transfer of a case back to NJDOL UI or to the Appeals Tribunal will be automatic and will
4          automatically trigger the next step of the process

    Note: Much of the functionality described above is, or is expected to be, delivered in ACES.
                                                                                                          Appeals . . .



BoR Appeals: Explanation and Enablers
1   Process: Parties will be able to initiate a BoR appeal by email, fax, letter, internet or telephone
    Technology: Voice-to-text software to enable phone requests for appeal to be transcribed. Workflow
    system to transfer the work item to Appeals Tribunal
2   Process: File with Board of Review. The case is automatically transferred to the Board‟s jurisdiction. The
    Board then allocates the case to an Appellate Specialist.
    (Appellate Specialists are also responsible for
         Dissemination of any precedent-making case law
         Management of multi-party and „lead‟ cases)
    Technology: Workflow and security controls (to change the access rights as jurisdiction transfers)
3   Process: Board sends notice of receipt of appeal to all interested parties via their preferred
    correspondence method (indicated at earlier appeal stage or before).
    Technology: Automatic notification The electronic case file (ECF) will include all information used in the
    fact-finding as well as any other information that was submitted after the determination date.
4   Process: Notice of receipt package should include rights information, transcript of reason(s) for the
    appeal, (instructions on continued certification for the claimant) etc.
    Technology: Automatic notification of parties
                                                                                                         Appeals . . .



BoR Appeals: Explanation and Enablers (cont)
5   Process: The process steps to make a decision can involve:
         Review of the appeal by a specialist, who prepares a written statement/ draft decision
         Review of the written statement/draft decision by Board members
         Discussion of the case at a weekly Board meeting
         A hearing (If a hearing is scheduled, then the system automatically is updated and sends
         notification)
         Board approval of the draft decision
    Workflow will transfer cases around the Board, with flags for action. Elapsed time should also be shown.
    All workload must be visible to the Secretary.
    Technology: Workflow, a virtual discussion board to facilitate remote review and approval of cases,
    digital recording for hearings.
6   Process: Automated notification of Board decision to all parties, including reasons for decision. This
    should be easy to understand and include a copy of the applicable section of the UI law, to inform parties
    who may not appreciate that they have appealed without real legal grounds.
    Conceptually, the re-determination itself will be conducted by the UI-owned system in response to
    parameters entered by the Board. The re-determination will include automatic notification of the parties.
    Technology: Automatic notification of parties of the decision, via method preferred by the parties
                                                                                                       Appeals . . .



BoR Appeals: Explanation and Enablers (cont)
8   Process: The next steps for UI will be triggered automatically as appropriate – including payment / set-
    up of a refund / benefit non-charging credit / notification (for all).
    Technology: ECF, automatic notification, workflow.
9   Process: In cases where the Board of Review decides that the higher authority appeal was caused by
    an error at the Appeals Tribunal, the remand back to the AT will trigger immediate inclusion of the work
    item in the Tribunal‟s work queue.
    Technology: Voice-recognition software, ECF and workflow
                                                                                                      Appeals . . .



Appeals Processes: Business Design Principles
   95% of AT hearings by phone [AT-defined target]
   Different tracking and actions for Leading Cases
   Build in ability to use tracking for training and MI (e.g. number of appeals based on decisions per
    adjudicator, per adjudication center and so on)
POLICY AND PROCEDURES
                                                                                         Policy and procedures . . .



Introduction to this section
Contents
This section presents the new policy and procedures processes, in the following order:


    Developing and communicating procedures
     –     High-level view of the process: inputs and outputs
     –     Summary of what‟s new: annotated process map
     –     Process map with detailed explanatory notes
     –     Underlying business principles


    Monitoring procedures & remedial action
     –     High-level view of the process: inputs and outputs
     –     Summary of what‟s new: annotated process map
     –     Process map with detailed explanatory notes
     –     Underlying business principles


    Developing and communicating policy – discussion
                                                                                                                                                                     Policy and procedures . . .



               High-level view of Developing & Communicating
               Procedures: Inputs and Outputs



       INPUTS                                                                                                                                                              OUTPUTS

•   Internal agency initiative                                                                                                                             • New/updated procedure
                                         Developing &
•   External stakeholder initiative                                                                                                                            posted on internal website
•   Legislative mandate
                                        Communicating                                                                                                      •   Synopsis emailed to all
                                      Procedures Process
•   Feedback from front-line staff                                                                                                                             impacted staff
                                      Board of Review Appeals: Conceptual Process Diagram

                                           Appealing Party                               Division of UI
                                                                                                                                      Other Interested
                                                                                                                                          Parties
                                                                                                                                                           •   Implemented
                                            1. Rejects AT
                                            decision and
                                               appeals




                                            4. Receive and
                                                                 2. File with Board of
                                                                        Review


                                                                  3. Send notice to
                                                                  interested parties
                                                                                                                                        4. Receive and
                                                                                                                                                               technical/operational
                                                                                                                                                               changes to enable the
                                          review information                                                                          review information
                                                                5. Make decision and
                                                                       notify



                                                                                                  7. Automated
                                                                    6. Automated                redetermination &




                                                                                                                                                               new procedure
                                                                    notification of                notification
                                                                       decision


                                                               Board of Review jurisdiction     9. Remand back      8. UI automated
                                                                                                   to Appeals          next steps




                                                                                                                                                           •
                                                                                                     Tribunal




                                                                                                                                                               Defined compliance
                                                                                                                                                               measures and monitoring
                                                                                                                                                               plan
                                                                                                                          Policy and procedures . . .


What’s New: Developing & Communicating Procedures
 Policy and procedure development: Conceptual Process Diagram
    Legislative & policy
                                        Bureau of P,S&S                                                    Rest of Agency
        community

       1. Good idea or       3. Funnelled to
                                                                                                    2. Good idea
          mandate            Bureau of PP&S


                            4. Triage: prioritize
                                                         5. Initial analysis of
                             changes, test vs.
                                                          operations impact
                                 objectives

                                                    1      6. Gather initial
      6. Provide position                                                                        6. Initial feasibility
                                                              input from
             input                                                                                       input
                                                          interested parties


                              7. Consolidate             8. Draft procedure
                                 analysis                  & roll-out plan

                                               Iterate
                                             if needed
                                                         2
                                                             9. Input from
           9. Input                                                                                    9. Input
                                                          interested parties


                                                          10. Circulate for
                                                             clearance
                                                                                           3         11. Develop
                                                                                                   implementation
                                                            (comment)                               plan in parallel


                                                         12. Approve new /
                               13. Distribute                                                  17. Make systems / op'l
                                                              changed
                                 synopsis                                                       changes acc to plan
                                                             procedure


                                                                       16. Conduct
                                                                                      5
                                             15. Run Help Desk         information               16. Attend training
                                                                     meetings / training
                                                4
                                                                                                   14. Hold staff
                                                                                                 meeting to discuss
                                                                                          Policy and procedures . . .



What’s New: Developing & Communicating Procedures
       Stakeholders across the Department will be able to view and post comments and questions about
1       first draft procedures on a virtual discussion board
       Stakeholders across the Department will be able to view and post comments and questions about
2       second draft procedures on a virtual discussion board. [For some policies, the timescales will be too
        tight before implementation to do this effectively. However, the aim to allow for proper consultation
        wherever possible].
       Systems and operations implementation projects triggered by policy or procedure change will be
3       formally recognized as projects and subject to project controls and reporting
       A policy and procedure help desk will respond to questions from the field about appropriate courses of
4       action in difficult circumstances
       For significant changes, the policy and procedures group will run information / training sessions
5       across the State
                                                                                            Policy and procedures . . .



Explanation and Enablers: Developing and
Communicating Procedures
1   Process: New policies and procedures (or changes) can be initiated outside the agency by any
    stakeholder. Legislative mandates in particular.
    Technology: Virtual suggestions box on the Departmental website
2   Process: New policies and procedures (or changes) can be initiated easily inside the agency from any
    source. The workshop suggested encouraging recommendations from the field through a well-advertised
    virtual suggestions box or similar.
    Technology: Virtual suggestions box on the internal website
3   Process: All ideas with a potential procedural implication should be directed to and logged by the Bureau
    Technology: Database to manage the list of items for review
4   Process: Policy/procedural ideas should be managed as a portfolio – with the most important ones
    prioritized. Factors used to determine priority should include contribution to the agency‟s strategic
    objectives and legislative backing
    Technology: Database to manage the list of items for review
5   Process: The policy and procedures group will conduct an initial analysis of the proposed change on
    operations – creating a „straw model‟ for later comments to build upon. The initial analysis should cover
    process, organization, technology, data implications. At this stage, the group will also identify all affected
    parties.
    Technology: Data warehouse and “What if” analysis of policy/procedure impacts
                                                                                            Policy and procedures . . .



Explanation and Enablers: Developing and
Communicating Procedures
6    Process: An initial round of consultation will be conducted via an online message-board or discussion
     function, so that all comments are available for review by all interested parties. Key agency functions will
     be required to assess the feasibility and impact of the change from their perspective (applications /
     network / technical architecture / adjudication etc). As appropriate, external stakeholder input will also be
     solicited at this stage
     Technology: Virtual discussion board and/or communication capability (email) or web posting to get
     comments on the draft
7    Process: The policy and procedure group will consolidate the input – identifying and resolving significant
     overlaps and gaps.
     Technology: Database to manage and consolidate inputs
8    Process: The group will then develop the draft procedure, success measures and monitoring plan. A first
     cut implementation plan should also be developed: depending on the subject, the responsibility for
     developing the plan may lie outside the policy and procedures group (although they will continue to
     input).
     Technology: Database to manage the development process and actions
9    Process:The second round of input on the draft procedure will again be facilitated by an online
     discussion function – and be time boxed.
     Technology: Virtual discussion board
10   Process: Clearance will require different levels of approval dependent on the scope of the change. To
     facilitate faster approvals, workflow can be used to prompt actions.
     Technology: Workflow process to manage approvals
                                                                                         Policy and procedures . . .



Explanation and Enablers: Developing and
Communicating Procedures
11   Process: In parallel with formal sign off (and even before) the agency teams listed in the draft plan will
     be augmenting and improving the implementation plan for the new procedure. Where a procedure
     requires more activity than development and communication to the field, it will be deemed a project – and
     subject to project lifecycle and controls.
     Technology: Possibly project planning software
12   Process: For all but the most contentious of issues, approval should be delegated to an appropriate
     manager, for example, the Head of the Bureau.
     Technology: Workflow process to manage approvals
13   Process: All procedure changes will be communicated to the field through an easy-to-understand
     synopsis, emailed to all appropriate staff. The email will contain a link to the full text of the new
     procedure. Additionally, business rules/expert system guides will be updated to reflect the new approach.
     The synopsis will include an explanation of why the change is being made (beyond „required by State
     legislature‟ or similar) and an explanation of how the change will help to achieve agency objectives
     Technology: Virtual discussion board and/or communication capability (email) or web posting, rules
     engine, expert system software
14   Process: Agency managers will be held accountable for their staff understanding and following
     procedure. All staff will be encouraged to provide feedback on the success or challenges of any change,
     so that adjustments can be made
     Technology: Virtual discussion board, management information (to enable managers to assess impacts)
15   Process: a policy/procedure help-desk will respond to any member of staff questions about correct
     policy/procedure at any time during business hours. The help-desk should be staffed by respected,
     experienced people who will need to understand both the policy/procedure and the operational context.
     Technology: Helpdesk phone number, database to log issues and help identify patterns
                                                                                           Policy and procedures . . .



Explanation and Enablers: Developing and
Communicating Procedures
16   Process: For larger changes, the policy and procedures group will be even more pro-active in
     communicating the change, potentially including meetings/training across the State as well as providing
     assistance to managers in explaining the implications to staff.
     Technology: N/A
17   Process: Operational and technology changes to make the policy/procedure change work should be
     implemented in parallel, as part of the same project.
     Technology: See step 13

* Ideally, all procedure development will be done before a policy comes into place; however, this is not always
possible - for example, the recent TUC-A experience. In these cases, the faster distribution methods should
assist in rapid action. Key recommendations included here – such as a project approach to implementation –
should always be followed, whatever the timescales.
                                                                                           Policy and procedures . . .



Developing & Communicating Procedures, Process-
Specific Business Design Principles
All policy & procedures
   Policy and procedures are a pillar of ongoing operations performance management and improvement
   Policies and procedures should always support agency objectives and compliance must be monitored, to
    provide a level baseline for performance improvement
   Policy and procedures team(s) should work as consultants to UI operations, with a focus on maintaining
    and enhancing performance
   Treat policies and procedures in a hierarchy (1) legislative mandates, (2) non-mandated policies with
    significant operational impact (3) others
Developing policy and procedures
   Where possible, all affected parties should be consulted – with a reciprocal duty to provide comments
    rapidly
   Legislatively-mandated policy changes can be implemented with less consultation activity
   Project management lifecycle and tools should be used to manage the development and implementation
    of new procedures (in particular, for co-ordination when technical and other operational changes must be
    delivered in parallel)
   All new procedures should be assessed by a „User Needs Assessment Group‟
   Final approval should be delegated for most policies/procedures, and should always be within 3 days
   Monitoring compliance to new policies and procedures should be a shared responsibility between
    operations managers and the central group; the monitoring plan should be developed alongside the
    procedure
Communicating policy and procedures
   Provide front-line staff with salient information – such as a „quick hit‟ synopsis - don‟t overwhelm them
    with too much detail. Also make clear the reasons and sources for new policies and procedures
   Easy-to-access central repository of policies and procedures should be available for all
                                                                                                                                                                    Policy and procedures . . .



             High-level view of Monitoring Procedures and
             Remedial Action: Inputs and Outputs



      INPUTS                                                                                                                                                              OUTPUTS

• Scheduled effectiveness                                                                                                                                 • Increased training on the
    assessment                   Monitoring Procedures                                                                                                        procedure
•   Feedback on new procedures
                                  and Remedial Action                                                                                                     •   Clarified communications
                                        Process
    from the field
                                  Policy and procedure monitoring & remedial action: Conceptual Process Diagram
                                                                                                                                                          •   Revision(s) to the
                                        Legislative, policy
                                           community
                                                                         Bureau of P,S&S

                                                                1. Scheduled
                                                                effectiveness
                                                                                                                          Rest of Agency
                                                                                                                                                              procedure and re-
                                                                                                                                                              issuance
                                                                assessment


                                                                                                                                        If issue
                                           2. Feedback on     6. Trigger success                               3. Feedback on
                                                                                      If widespread problem                         can be resolved
                                              procedure          assessment                                       procedure
                                                                                                                                     by operations



                                                                                                              4. Local resolution      5. Regional
                                                              7. Assess success
                                                                                                                   of issue         resolution of issue


                                                                                    8. Link back to
                                                                                         policy
                                                                                   (re)development
                                                              9. Define remedial
                                                               action options &
                                                                  measures


                                                              10. Agree actions                               11. Agree remedial
                                                               with operations                                     actions &
                                                                    mgmt                                           measures



                                                                                   12. Implement                13. Implement
                                                                                       actions                      actions
                                                                                                           Policy and procedures . . .



What’s New: Monitoring Procedures & Remedial
Action
  Policy and procedure monitoring & remedial action: Conceptual Process Diagram

     Legislative, policy
                                         Bureau of P,S&S                                          Rest of Agency
        community

                               1. Scheduled       1
                               effectiveness
                               assessment
                                                                                 2
                                                                                                               If issue
        2. Feedback on       6. Trigger success                                       3. Feedback on
                                                         If widespread problem                             can be resolved
           procedure             assessment                                              procedure
                                                                                                            by operations



                                                                                     4. Local resolution       5. Regional
                           3 7. Assess success                                            of issue          resolution of issue


                                                       8. Link back to
                                                            policy
                                                      (re)development
                             9. Define remedial
                              action options &
                                 measures


                             10. Agree actions                                       11. Agree remedial
                              with operations                                             actions &
                                   mgmt                                                   measures



                                                      12. Implement                    13. Implement
                                                          actions                          actions
                                                                                       Policy and procedures . . .



What’s New: Monitoring Procedures & Remedial
Action
1      A monitoring plan for new policies and procedures will be developed before implementation

       Stakeholders across the Department will be encouraged to view and post feedback on the impact of
2       new policies and procedures on a virtual discussion board

       A formal review will assess the success of policies and procedures and identify improvement actions,
3       which may include training, further communications, revisiting sections of policies/procedures and
        further research
                                                                                           Policy and procedures . . .



Explanation and Enablers: Monitoring Procedures and
Remedial Action (cont.)
1     Process: Operations managers are responsible for the successful implementation of policies and
      procedures. To support that effort, success/effectiveness assessments by the central policy and
      procedures group will be scheduled as part of the monitoring plan drafted in parallel with the
      policy/procedure. They will be conducted as early as practicable to identify if the measure is having the
      desired effect and contribution to overall objectives.
      Technology: Data warehouse and query tools, for performance analysis
2     Process: Feedback on the impact of any new/changed procedure from external stakeholders may
      trigger a success assessment.
      Technology: Virtual suggestions box on the Departmental website
3     Process: Feedback on the impact of any new/changed procedure from within the agency may trigger a
      success assessment
      Technology: Virtual suggestions box on the internal website
4/5   Process: Internal feedback on policy and procedure may highlight operational issues in a particular area,
      such as incorrect application of a new policy: these should be addressed at the appropriate level – local
      or regional.
      Technology: Virtual suggestions box on the internal website
6     Process: Success assessments will be triggered by automatic reminders from the workflow system
      Technology: Workflow, Data warehouse and query tools, for performance analysis
                                                                                           Policy and procedures . . .



Explanation and Enablers: Monitoring Procedures and
Remedial Action (cont.)
7     Process: Assess success: operations managers are responsible for the effective implementation of
      policy and procedure. To support their efforts, the policy and procedures group may conduct an impact
      assessment of the implemented change, as defined in the monitoring plan. This may involve data
      analysis, site visits and gathering input from Operations staff and managers to understand what‟s
      happening on the ground. The scale of the monitoring activity will depend on the complexity of the
      procedure(s) implemented – but will always rely on spot checking.
      Technology: Data warehouse and query tools, for performance analysis
8     Process: For serious „failures‟ there may be a need to return immediately to the drafting stage to revise
      the policy/procedure.
      Technology: Data warehouse and “What if” analysis of policy/procedure impacts
9     Process: Success assessment will include pro-active recommendations to resolve the performance
      issues identified (if any) as well as success measures for the recommended actions.
      Technology: Data warehouse and query tools, for performance analysis
10/   Process: Actions will be jointly agreed by the policy and procedures group and operations management.
11
      Technology: Workflow to facilitate the approvals process
12/   Process: Actions to ensure the policy / procedure achieves its objectives may be required by all areas of
13        the agency.
      Technology: N/A
                                                                                        Policy and procedures . . .



Monitoring Procedures & Remedial Action, Process-
Specific Business Design Principles
All policy & procedures
   Policy and procedures are a pillar of ongoing operations performance management and improvement
   Policies and procedures should always support agency objectives and compliance must be monitored, to
    provide a level baseline for performance improvement
   Policy and procedures team(s) should work as consultants to UI operations, with a focus on maintaining
    and enhancing performance
   Treat policies and procedures in a hierarchy (1) legislative mandates, (2) new/changed policies with
    significant operational impact (3) others
Monitoring
   Ensuring policies and procedures are followed is important to creating a baseline for performance
    improvements
   Policies and procedures should be reviewed as early as practicable for success
   Managers should be held responsible for communicating and enforcing policies and procedures; staff
    should be held accountable for applying policies and procedures
   A central group can spot-check compliance to procedures and help managers improve compliance – but
    should not be held responsible for delivering it
Remedial action
   Policy and procedures team(s) should work as consultants to UI operations, with a focus on maintaining
    and enhancing performance
   Policy and procedures should be measured in terms of
     –    contribution to overall agency objectives
     –    communication – was it implemented well?
                                                                                         Policy and procedures . . .



A Note on Policy Development…
High-level policy development is outside the scope of agency operations and is therefore not discussed in
detail in this document.
Policy development is unlikely to involve formalized consultation of agency staff in the same way as for
procedures. However, dissemination of policy can take advantage of many of the mechanisms discussed in
this chapter for procedures. For example:
    Same communication methods can be used – email groups; internal website post board
    Same policy –operations managers group could jointly review implementation
FINANCIAL PROCESSES
                                                                                           Financial Processes . . .



Financial Processes Underpin All Benefit Programs
Financial processes underpin the effective delivery of unemployment and disability benefits. Accurate financial
management is a MUST for the future integrity of the service.
This section addresses the following financial processes:
    Payments
    Federal Income Tax
    Collections
    Garnishments
    Check Reconciliation
    Reconciliation/Variation/Reporting
    Employer Credit
    Audit Trail
    Offsets
    Waivers
    Write-Offs


Note: this section was developed during a few short, intense break-out sessions. Some ideas were raised that
were not sufficiently discussed to be listed as principles. Rather than losing these ideas, however, they are
retained in the chapter as options and questions – to be investigated more fully in detailed design.
                                                                Financial Processes . . .



The Scope of Financial Processes for UI
Modernization

                        Reconciliation / variation reporting

          FIT

        Off-sets
                                                Receivables
        Waivers         Payables
                                                 (Employer
                         (benefit
       Write-offs                              Accounts – out
                      payments out)
                                                  of scope)
     Garnishments
     Disbursement
     reconciliation

                       Collections

                      Employer Credit

                         AUDIT TRAIL
                                                                                           Financial Processes . . .



Overall Principles
 Several key principles emerged during the course of the Financial Processes sessions. They are:
     Ensure responsible fiscal management
     There must be a single source of financial information
     UI should be viewed as a benefit system and as an insurance program
     Maintain integrity of the financial system as part of the overall system
     System date, transaction date, and effective date are recorded for all activities, and are underpinned by
      clear timing rules
     Every transaction stands alone, is given a transaction number, and is never overwritten
     Standard accounting principles must be applied (Generally Accepted Accounting Principles)
     All transactions should be viewable from a detail and summary (or „roll-up‟) perspective
     Employer Accounts should automatically flag employer issues to UI
     System and processes should be flexible enough to change payment interval relatively easily
                                                                                              Financial Processes . . .



Payments
Definition
    Payment (of claim) = Charges (inclusive of general fund charges) to Employer - Deductions
Principles
    System will cover standard benefit payments model. Also, may need to accommodate
     –       TRA health benefit coverage (IRS should be providing this service in the long term)
     –       DUA payments
    Must ensure that sufficient audit trail is in place for Electronic Fund Transfer (EFT) payments to enable
     criminal prosecutions
     –       This may attract the need for special tools for investigation


Option for how this should work in the future and first-cut implementation issues
    Checks
     –       Option A weekly benefit checks
             •     Issues are postage costs (although covered by USDOL), managing check stock
             •     Pros – Find bad addresses more rapidly
             •     Cons – level of effort, stolen checks, cash flow, cost of re-deposits (Increased frequency of
                   payment  increased processing costs)
     –       Option B bi-weekly benefit checks – as currently done
             •     Least upheaval from current approach
     –       System and processes should be flexible enough to change payment interval relatively easily
     –       Check format - No tear on the MICR line, combined instructions and check, more room for
             messages, plain language, clear readable instructions
                                                                                          Financial Processes . . .



Payments (cont.)
•   Direct Deposit
    –    Requirements for EFT
         •     ABA Routing Number
         •     Bank Account Number
         •     Checking or Savings Account
         •     Assumption: pre-notification of route to recipient‟s account not needed
    –    Issue: currently fraud prosecutions rely on the signature endorsing a check as the evidence trail.
         This will be lost in a pure epayment model
         •     IDEA: Send out form – or obtain from internet – for signature guarantee from bank as another
               downstream fraud prevention measure?
    –    Issue: claimants may forget the benefit amounts they are receiving, because it is no longer in „black
         and white‟ in front of them
         •     IDEA: When sending next certification reminder, provide latest deposit information?
   Lump sum for claimants facing a fixed lay-off period?
    –    A simpler model, that would reduce the administrative burden for this subset of claims
   UI debit cards
    –    Idea is to assess and potentially copy the model used by Welfare, based on the assumption that a
         significant proportion of UI claimants do not hold bank accounts
    –    Issue: will the Bank issue cards, or will that become a DOL responsibility?
                                                                                                   Financial Processes . . .



Payments (cont.)
Underlying principles
    Reimbursement checks will be managed wholly within DOL, with Treasury oversight via the daily
     reconciliation report. (This is being implemented in Spring 2003).
     –     On returned checks
           •     Write re-deposit on back of check (send claimant instructions)
           •     Scan in re-deposit instead of re-keying (reason code must be captured)
     –     Treasury extends the date
     –     Send replacement check (idea: show “void after 90 days on check”)
    When applicable, an overpayment automatically sets up and pays an underpayment
    On underpayments, withhold FIT
    Online, self-service viewing and printing of 1099
     –     Issue: will a mail or email verification notice still be required for every claimant?
     –     Note: this has proved very popular in other states…
    Stop payments
     –     Journal entry back to UC fund required
All new payment options require significant further investigation and a full cost/benefit analysis
    What are the costs of each option and combination?
    Procurement strategy?
                                                                                          Financial Processes . . .



Federal Income Tax (FIT)
How this should work in the future and what’s needed
   On phone or internet, claimant elects to make deduction and system deducts electronically
   Use internet or phone to allow claimant to change withholding status
   Automatically deduct FIT on “make-up” payments if FIT elected
   Tax Liability: UI personnel must explain clearly that FIT withholding cannot be returned to claimant. Tax
    contributions are immediately turned over to the IRS. The claimant has the opportunity to recover these
    funds (in whole or part) when they file their annual income tax form(s)
Option
   Carryover question on deduction on new claims
                                                                                           Financial Processes . . .



Collections – of Overpayments
Principles
    Agreements on payments should be logged and tracked on system
    Principal and fees must be paid in full
    Customers can choose payment method: credit cards should be accepted
    Debtors can overpay, but not underpay (according to month-by-month schedule)
    Automatic flag of defaults (like missed payments) based on business rules
    Where customers call and make alternative payback schedule arrangements, UI representative needs to
     explain that the arrangement will require renewal every 6 months in order to avoid a judgment filing -
     which will grab UI benefit payments, state tax / homestead/soil refunds
    No interest is charged until account file is in judgment
    Automatically generate monthly bills or send link to secure website for information
    Put all relevant data on a single screen for refund situations
    Have a user-friendly system - no code language
    Obtain link with Federal criminal prosecution system to learn when claimant makes refund payment to
     Federal probation office (This link is in place with state probation office.)
                                                                                                   Financial Processes . . .



   Collections – Summary Map
Processing collections: conceptual process diagram

               Debtor Customer                                           Agency


                                               Overpayment         Payment         Monthly bill
                                               determination       schedule           cycle
                                                  made             generated       established

                                 Customer
                                  notified



                                                Advise on          Payment
      Customer contacts Agency                                                      Monthly bill
                                               options and         schedule
         to change schedule                                                        cycle revised
                                              agree schedule       generated
                                 Customer
                                  notified



                                                                   Automatic
       Customer makes                            System
                                                                 confirmation of
          payment                                updated
                                                                    receipt
                                 Customer
                                  notified

                                                                 Access State
                                                                 refunds, incl
                                             Customer does not       tax
                                             make payment acc
                                                to schedule

                                                                 File civil case

                                 Customer
                                  notified
                                                                                          Financial Processes . . .



Collections – of Overpayments
How this should work in the future and what’s needed
   Any change of address needs to update claimant information
   Should be able to contact claimant by phone
   Interface UI to DI for address information, plus use DMV, new hire file, US and NJ Income tax
   Cross-match to other agency data bases
   Link claimant‟s debts to future UI benefits in one history
    –    All debt information should be accessible (and viewable in a summary roll-up format), in the same
         way as information on outgoing payments
Issues
   Where should system of record be located?
   Withdraw money owed from direct deposit accounts?
   At what point should debt be written off, but data retained in case person „resurfaces‟ and opportunity to
    collect balance exists?
   Policy issue: currently BPC can capture full amount of benefit check for collections – even when there is
    an existing UI-claimant agreement. As a result, the claimant may become eligible for welfare. The policy
    implications of this should be studied.
    –    Option: continue with agreed payment schedule, if customer is making payments regularly?
                                                                                            Financial Processes . . .



Child Support Garnishments
Principles
    All data should be attached to the electronic case file and therefore viewable to UI and to the claimant,
     potentially including the court order
    All adjustments should take account of garnishments and other offsets.
     –       System should be able to garnish even if set up as an underpayment
    Must build in systems assurance checks (duplication, omission)
    Need timing rules – to ensure that system & effective (processing) date are the same
    All data should be viewable at detailed and summary levels – and roll-up must work!
    Maintain system and data integrity
    Exception processes are needed (e.g., refunds)
    Must be compatible with TDI
How this should work in the future and what’s needed
    Child support is the primary driver
    Need a daily list of garnishments, by program - recapped in a weekly summary (roll-up)
    Automatically recalculate garnishment when weekly benefit changes
    End product must be useable by DHS
Future process
    File transfer between UI and ASCES system; amounts are reconciled (QC)
    Sent to DHS who confirms the totals and provides instructions to DOL regarding total and breakdown by
     county
    DOL wires funds to the New Jersey Administrative Office of the Courts
    Money wired to judiciaries (in and out of state) – on information received from the Dept. of Human
     Services
                                                                                          Financial Processes . . .



Child Support Garnishments (cont.)
Issues/constraints
   Set-up of garnishment is reliant on correct court order
   The structure is fixed … report is sent to DHS, and then wired to the New Jersey Administrative Office of
    the Courts
   Limitations on amount that can be garnished – need to be built in as business rules
   No ability to recall wires after payment is made
                                                                                               Financial Processes . . .



Disbursement Reconciliation
Principles
    System must allow for whatever mechanism UI and the claimants choose (direct deposit, debit card,
     checks, etc.)
    There should be daily reconciliation of charges to payments out and payments cashed
    Reconciliation should occur as money is disbursed and when checks are cashed
    Maintain ability to re-run checks and to be able to start mid-run
    Reconcile check stock daily
    TARGET: No unresolved reconciliation issues
How should this work in future
    On a daily basis, reconcile disbursements (charges to payments out)
    Reconcile as check goes out the door and when cashed (done at Treasury)
    All forms and checks should be generated directly from the system
    When receive a returned check, trigger bad address indicator so as to stop further checks to the address
Issues/constraints
    Reconciliation may not work when money is sent to the wrong bank account, to a closed bank account,
     when checks are sent to the wrong address, or checks are not cashed in a timely manner
     –       Permitting direct deposit as a transfer mechanisms increases the need for electronic reconciliation
             of distributions, but will make reconciliation easier and more accurate
     –       Reconciliation issues MUST be resolved.
    Deadline for honoring checks (i.e. time limit on receiving benefits paid while still eligible) is currently
     inconsistent across the agency. This is a legal/policy issue for quick resolution.
                                                                                               Financial Processes . . .



Disbursement Reconciliation - Reporting
Principles
    Charges to employers must reconcile to payments (enabling accurate experience rating)
    Refunds: cash collected must equal cash in system
    Standard accounting principles must be applied (Generally Accepted Accounting Principles)
    Timing is a major issue … capture effective & system dates
    Need to have an intelligent “snapshots” of accounts at a point in time
     –       But should include any later changes to that effective date data (prior to the cut off date) = later
             audit trail should highlight these items
     –       Should be available to employer accounts (will affect experience rating and B187 reports)
    Reconcile across UI and employer tax systems
    Capture system overrides in audit trail
                                                                                             Financial Processes . . .



Employer Credits
Principles
    Provide employers with the ability to view charging data, via Employer Accounts‟ portal, and other
     channels (via their electronic case files)
    Enable Employer Accounts to update experience rating (up or down) as soon as employer protest is
     upheld – or after notification and 10-day appeal period has elapsed (in real-time, or at least daily)
    Employer Accounts should automatically flag employer issues to UI and send information
Issues/constraints
    Policy question: should employers be credited when claimant checks were not cashed or were returned?
     –       Option: credit could be triggered when check is escheated back to the Fund?
     –       Option: set up as underpayment for a specific amount of time (20-day protest period, 2 year statue
             of limitations on employer)
             •    Note: establishing underpayments would need to be policed closely
             •    Related policy issue: revisit statute of limitations and consider making consistent for
                  employers and claimants
                                                                                               Financial Processes . . .



Offsets, Waivers and Write-offs
 Offsets
     Offsets are deductions from claimant benefit based on uncollected refunds
 Principles
     Benefits can only offset other benefits
     Same process as collections, but during a claim
     A waiver does not equal an official write-off
     Claimant refund might be spread over time, but employer credit hits immediately
     Variations (options): if claimant becomes permanently disabled or dies, eligible party can request waiver.
      Requires management approval
 Issues/constraints
     Must maintain hierarchy of what is impacted first (Issue: hierarchy should be clarified)
      –       Need collections policy clarified (see “Collections” page for further information)
 Waivers of offsets / write-offs
 Triggers
     Death, permanent disability
 Principles
     Do not revisit waivers
     No settlements
     Accurate & reconcilable
     Reports (summaries) needed for accounts
                                                                                           Financial Processes . . .



Write-offs (of Refund)
 Principles
     Write-offs only occur in refund
     Structure of refunds must support write-off process
     Treasury has final approval
      –       Must comply with Treasury requirements (circular as well as unspoken requirements)
              •    Detail of all records
              •    Example: separation principal/interest by program
      –       Therefore consider providing Treasury with system access
     Enable easy pulling of random samples requested as part of Treasury audit
      –       Automatic check of compliance?
      –       After Treasury approval of samples, write-off items can be removed from UI Financials. Ensure that
              there is an indicator in the system that there is a write-off (with effective date)
     Reduce receivables allowance for uncollected monies
 Issues/constraints
     After a waiver, what happens if the person re-files a claim. Are there conditions under which they can
      collect (i.e., not death / permanent disability)?
 Key Result
     Outstanding receivables that have never been approved for write-off may be resolved (with a one-time
      write-off)
      –       Issues: migration and aged debt recording
                                                                                            Financial Processes . . .



Financial Processes Enabler: Financial Audit Trail
     The fundamental underpinning enabler for accurate financial management is a comprehensive and
          reliable audit trail. The audit trail enabler is discussed elsewhere in this report and is reprised
                                 here to emphasize its importance to financial integrity.
 Principles
       Ability to trace each and every individual transaction (no whiteout!)
        –     Including system date, transaction date, identity of who made a change, what changed, reason for
              change
       Clear governance of who can make changes, approval structures, linking of information to claimant and
        employer, etc.
       Provide both a summary view, and the ability to drill-down
       Exception reporting as standard
       Control access to information and monitor (improper use of internal information for personal purposes)
       Offline and online balances must reconcile (allows early ID of problems)
       Must comply with Treasury requirements
       Need to be able to transfer data into Excel format for analysis
 Issues/constraints
       What are the records management, data capture, and retention rules that NJ applies to “online” records?
        –     These must be built into the design
        –     Should current standard of five years‟ accessible history (then archiving) continue?
        –     Should key data be available for longer than other ECF elements?
       Security
INTERNAL CONTROLS
                                                                                              Internal Controls . . .



Internal Controls: Design Principles
 Internal controls are a management function – and we need to decide the level of risk we are wiling to accept
 Audit trail and monitoring
 •    Strong audit trail : every transaction must be auditable, traceable
 •    One system, one data source for accounting and case management – makes system more transparent
      -     coordinated, reconcilable data
      -     claimant info rolled up into accounting information
      -     audit record of every single transaction
      -     ability to generate queries easily, as necessary
 •    Manual interventions may always be needed (if less so) so, when this done
      -     Ensure there is a strong audit trail of these changes
      -     Provide system guides and internal logic to show that if „a‟ changes, „b‟ must be altered too – to
            ensure consistency
 Access profiles
 •    should be based on future rights and responsibilities (more of them); some like payments will be sensitive
      and therefore limited
 •    Supervisors should be able to change the access profiles – within a range – for their teams
 •    A central system security function continues to be needed to oversee access
 •    Managers at all levels should use the tracking mechanism to cross-check at times – with adequate
      supervision, supported by system alerts
                                                                                               Internal Controls . . .



Internal Controls: Design Principles (cont.)
Payments
•   Ideally, the system‟s security and audit trail should be sufficient so that a single UI representative can be
    allowed to handle a claim, end to end? The management decision is the cost/benefit balance
    -      Potentially, there is no need to segregate claims taking from payment authorization with a strong
           audit trail
•   The system must therefore have a monitoring function which flags suspicious / fraud patterns
Access
•   Customer access must be secure, as private information will be held on it
•   Web entry into system – security must be equal to other entry points
PROCESS ENABLERS
                                                                                                    Enablers . . .



Underpinning Enablers for the New Processes
Introduction: In the following pages we describe the business and technology enablers for the new
processes. Enablers are tools or approaches that make possible the principles and objectives.


Business enablers                           Technology enablers
    Triage                                     CRM software
    Conducive workplace                        Electronic case file
    Training                                   Workflow
    Sufficient resources                       System cross-checks (expanded)
    Development                                Audit trail
    Performance management                     Automated notifications
    Self service                               Rules engine
    Online law and procedures library          Voice-to-text software
    Interpretation facility                    Intelligent systems
                                                Customer virtual suggestion box
                                                Internal virtual suggestion box
                                                Instant messenger / chat room
                                                Local phone numbers
                                                Unified database
                                                Integration of phone and web systems
                                                Data warehousing and query tools
                                                                                                        Enablers . . .



Business Enablers
This section specifically discusses the business enablers needed to support the new UI Modernization
processes. We describe enablers that are new (e.g. triage) and enablers that extend existing capabilities
(e.g. conducive workplace) – all of which were emphasized by workshop participants as crucial for UI
Modernization to succeed. We do not review existing enablers - such as effective management control,
vision etc – but assume that these will continue.
TRIAGE: Triage is the quick assessment of customer (claimant or employer) needs as they come into
contact with UI, so that they can be accurately assisted and and routed to services that will address these
needs. Triage may be a simple automated phone response, or where a customer has a more complex
need, a UI representative can help diagnose the problem and help the customer access the service(s)
he/she may need. Importantly, triage should apply to claimants who access the agency via phone, web or in-
person. Triage comes in three forms as shown in the diagram below.
As part of the triage capability, we will be able to transfer customers seamlessly and immediately to key
workforce partners via the phone or internet (Workforce New Jersey in the first phase, other services in later
stages)
                                                  Self service
                                                                                             ices
                                   Automated directory & information provision        UI serv
                                                 (phone/web)
                                                 Basic triage
                                                                                      Workforce
                                   Agent assesses need quickly and directs to
                                                                                    partner service
                                              appropriate service
                                                Assisted triage                     Exit (if in
                                                                                               quiry
                                Agent invests time to understand whole need – for    complete
                                       customers requiring a guiding hand                        )




CONDUCIVE WORKPLACE: For workers to provide the appropriate level of customer service in the new
UI, they need workplaces that enable them to perform their jobs. In some cases this involves reviewing
whether groups need to have some amount of isolation (e.g. adjudicators). In other situations, it means
having closer proximity to people providing other related services (e.g. triage at the One Stops). Providing
a conducive workplace also implies that our staff has the right tools, as discussed throughout the workshops.
The Division has already shown its commitment to a conducive workplace with its recent roll-out of new PCs.
                                                                                                          Enablers . . .



Business Enablers (cont.)
TRAINING: One of the key enablers needing extension is training and development. For UI Modernization
to work, the staff will need accurate, timely, measurable, refreshed, and cross -training. For accuracy, the
training has to take into account current process and procedures, reflect how a processes works, and how
the process fits into the entire UI workflow. For timeliness, the training needs to occur „just in time‟ (at the
point where the trainee is ready to use the new processes – not months before or after starting the job). For
measurable, the Division, trainee and supervisors need to know that the training was effective - and if not,
the causes for failure so that they can be remedied. For refresher training, trainers, supervisors and
trainees need to identify when retraining is needed (if for no other reason that the processes or procedures
have changed). As UI Modernization goes forward, UI employees will have opportunities to work in
positions with more responsibilities across DOL and require cross training to handle these responsibilities.
SUFFICIENT RESOURCES: The number of staff, skills sets and knowledge available to NJDOL UI has
decreased in recent years. The planned processes and system will help ease some of this workload but will
not in themselves resolve the resource issues that have come to light.
Sufficient resources means having the right number of people, with the right skills, at the right time and in the
right place. To achieve this, ideas have been discussed in the workshops around training (see above),
recruitment and retention, transition planning increasing the flexibility of career paths throughout the
Department of Labor (see below) and resource balancing across the field. These ideas need to be expanded
upon to ensure that sufficient resources are an enabler upon which UI Modernization can rely.
DEVELOPMENT: In parallel with training and flexible job assignments, NJDOL UI has made a commitment
to build meaningful career paths for staff and for those aiming for management. The career path should
include on-the-job training, mentoring and crucially it should ensure that people are exposed to many
aspects of the Division‟s work. Potentially, career paths may include time in our partner agencies too.
Ambitions discussed in the workshops were (a) to help retain staff and reduce frustration and (b) to ensure
staff is increasingly able to work across the organization.
Reviewing career paths for people currently working in One Stops, RCCs and Adjudication Centers are
agreed to be of particular importance because specialization here, while welcomed, has led to less exposure
to other functions.
                                                                                                             Enablers . . .



Business Enablers (cont.)
PERFORMANCE MANAGEMENT: Successful implementation of this blueprint does not mark the end of
process and performance enhancement. To succeed, the Division of UI has recognized the importance of
continuous improvement. Performance management, as the enabler for the principle of continuous
improvement, can be understood in two dimensions: personal and Division-wide.
At the personal level, the future holds an increased attention to
    Training (see above)
    Transparent performance measurement (everyone having the ability to review their own individual
     performance against normative measures and against group / team objectives)
    Everyone participating in recommending and delivering performance/process enhancements (tapping
     the wealth of expertise of all our staff)
In this way, staff will be able to see their contribution to Division objectives and will be provided training and
support quickly, where needed.
At the Division level, a group will be dedicated to monitoring policy, procedures and performance and
working with Operations managers to address problem areas. By acting as internal consultants to
Operations, this performance management group will keep focus on continuous performance improvement.


SELF SERVICE: Self service is rapidly becoming one of the predominant enablers in State government
(e.g. drivers license renewal through the internet) and in private industry (e.g. pouring your own soda at
Burger King).
For UI Modernization, self service means allowing our customers access to information - see the electronic
case file description later in this chapter - and providing customers with the tools to get their questions
answered, via the phone and internet. By achieving a high rate of self service, our front-line staff will be able
to concentrate on helping those customers that truly need assistance.
                                                                                                          Enablers . . .



Business Enablers (cont.)
ONLINE LAW & PROCEDURES LIBRARY: An easy-to-search online library of case law (leading cases in
particular) and of policy and procedures will be crucial to enable employees of the Division of UI to be able to
    Stay up-to-date in terms of changing case law
    Self-train
    Run easy cross-checks when dealing with an area of the business with which they may not be familiar


INTERPRETATION FACILITY: Where customers are not fluent in either English or Spanish, UI staff will
continue to need access to language interpretation services that can be used primarily for over-the-phone
and in-person situations but potentially also for web services.
                                                                                                        Enablers . . .



Technology Enablers
Introduction: This section reviews the technology enablers needed to support the business processes. In
this section we only describe technology enablers that are new (CRM, data warehousing, etc.) and those
enablers that extend existing capabilities (voice–to-text on the IVR system). The UI modernization effort will
continue to use and need a number of existing technology enablers including: IVR, database technology,
Wide Area Network (WAN), system monitoring software, etc.
The first of these new or extended enablers is Customer Relationship Management software
CUSTOMER RELATIONSHIP MANAGEMENT (CRM): CRM software is typically a packaged suite that will
allow the Division a more accurate and streamlined way to provide customer service. In most packages
CRM provides the capability to gather and access information about customers histories, preferences,
complaints, and other data so they can better understand what customers want now and anticipate what
customers will want in the future.
These features include:
    All customer data and history in one place (see electronic case file)
    Controlling the work flow (see workflow module)
    Auditing all transactions (see audit trail)
•    Faster response to customer inquiries
•    Increased efficiency through automation
•    Deeper understanding of customers
•    Increased service opportunities
•    Identifying customers groups and trends (see data warehousing and query)
•    Receiving customer feedback that leads to new and improved products or services
•    Obtaining information that can be shared with business partners.
                                                                                                       Enablers . . .



Technology Enablers (cont.)
ELECTRONIC CASE FILE (ECF): The ECF is a component of the Customer Relationship Management
system and holds in a single database, all pertinent information related to a claimant or a company.
Information is recorded on entry of initial claim and on any subsequent action. Case information is available
to the claimant and employer through phone access and the internet. All ECF information is available to UI
representatives. The ECF will also allow limited updates to profile information to the claimant and employer,
depending on the status of the claim.
Claimant information includes:
    Key information: Name, address, SSN (including preferences – e.g., preference for being contacted
     via email address over mailing address)
    Claim(s) information: All data related to a claim – benefit amount, when filed, where claim is in the
     process, fact finding, hearing information, certification dates, impacts of deductions and garnishments,
     repayment schedules, repayment balances, etc.
Employer information includes:
    Profile Information: Name Address, Federal ID number,
    Claim related information: Active and historical claims against that employer, associated contributions,
     relief of charges, claim-related fact findings and appeals information
                                                                                                              Enablers . . .



Technology Enablers (cont.)
WORKFLOW MODULE: As a separate piece of software or as a component module of the CRM, the
system will provide workflow capability, moving work items from person to person in „conveyor belt‟ style. It:
    Allows UI personnel to follow the process path of a claim (through the full process cycle)
    Enables UI personnel (and the customer, via the ECF) to view the status of the claim
    Enables UI personnel to identify the UI representative working on a particular aspect of the claim
    Enables scheduling of events (e.g., fact findings)
    Enables routing of activities (e.g., routing a claim to someone with a particular expertise, or reroute
     claim activities when someone is on vacation)
    Enables process reviews (by reviewing efforts needed to complete a process step)


EXPANDED SYSTEM CROSSCHECKS: To enable preventing overpayments, rework, and limit
opportunities of fraud at the initial claim entry and at various stages of the claim life cycle, the system will
perform periodic cross checks against relevant data. These checks will include:
    Verifying identity: SSN, INS, Homeland Security (?), and others
    Verifying qualifying information: inter-state new hire directory, Department of Corrections, UI current
     claims, etc.
    Eligibility impacts: wage data, child support garnishments
Problems are flagged as early as possible in the cycle and depending on the claim step will require action by
the claimant, adjudicator or by a professional investigator.
                                                                                                          Enablers . . .



Technology Enablers (cont.)
AUDIT TRAIL / CRADLE-TO-GRAVE TRACKING OF CLAIM: As part of the workflow ,CRM and UI
baseline components, the system will record an audit trail of all transactions. At a minimum, this audit trail
needs to capture the transaction author and time created. At a maximum, the audit trail might capture and
record the actions taken during an online session (e.g. the claimant looked at FAQs regarding claim
benefits, and then entered the initial claim screen).
AUTOMATIC, SYSTEM-GENERATED NOTIFICATIONS: The system will automatically generate the
following types of notifications:
    Online pop-up windows that remind the UI representative (or claimant, or employer) of a specific
     action, follow through, next step, or policy information
    Email or online notification that a claim has moved into their work queue and needs specific attention
     (this is tied to the workflow capability mentioned earlier)
    Email or postal mail notification – determination package, notice of appeal, etc
RULES ENGINE: In the UI system as in any other business application there is a requirement to separate
the business rules/logic from the rest of the system functions. A rules engine (by codifying these rules)
provides the opportunity for the rules to be reused by different system modules. This simplifies system
maintenance and more easily handles subsequent changes in the business logic
INTELLIGENT SYSTEM(S): This software because of its tie into the UI, workflow and specifically the rules
engine software knows when to create/pop-up notifications, directs the workflow, directs the UI
representative to likely next steps and flags certain problems for further actions.
VOICE-TO-TEXT SOFTWARE: This software (used on phone conversants) converts claimants‟ or
employers‟ voice responses (answers or questions) into a digital data format that is stored in the same
fashion as data entered through the internet. This enables the phone system to provide similar capabilities
as the internet.
                                                                                                         Enablers . . .



Technology Enablers (cont.)
CUSTOMER VIRTUAL SUGGESTION BOX: The virtual suggestion box is a online capability that allows
customers the ability to enter and provide feedback on the UI experience. This voluntary feature would be
available through the phone tree or internet site at the end of a transaction sequence. In a future phase, the
internet site could display a screen citing suggestions and subsequent follow-ups.
INTERNAL VIRTUAL SUGGESTION BOX: This tool will enable staff to provide continuous performance
improvements suggestions through a virtual suggestion box. Author can provide their name or remain
anonymous. Suggestions that are suggested will go on the supervisor and policy and procedure groups for
review and development. As part of the divisions communication plan, suggestions, implementations, and
authors will get recognized. The division has already committed to this enabler through the current “quick
wins” process
INSTANT MESSENGER / CHAT ROOM: The instant messenger/chat room capability is available to
customers specifically through the web. Using these technical capabilities, the customers could have a real-
time conversation (most probably around an inquiry) with a UI representative.
LOCAL PHONE NUMBER: Many of our clients spend excessive monies trying to connect with UI because
of long distance phone charges. Providing one local phone number per One Stop Center ( enabled by
voice-over-IP), would remove that cost from the customer at minimal extra cost to the division. Once
connected to the local line, the UI phone system would route the call to the next available representative
(wherever he/she is in New Jersey).
Interstate claimants only will be able to access NJDOL UI services via a 1-800 number.
UNIFIED DATABASE: A unified database is a single repository of all UI information. Today‟s system
architecture holds the same data in multiple data repositories making data reconciliation and problem
resolution difficult.
INTEGRATION OF PHONE AND WEB SYSTEMS: The integration of phone and web systems comes
through a number of other enablers (e.g. voice-to-text and unified database enabler). This integration
enables the Electronic Case File – providing a comprehensive view of the claimant or employer
                                                                                                       Enablers . . .



Technology Enablers (cont.)
DATA WAREHOUSING AND QUERY TOOLS: The data warehouse holds much of the same data that is
held in the production database. It is configured and optimized for real time data queries (these queries are
developed using discrete tools, specifically designed for real time reporting). Managers will use the data
warehouse and query tools to:
    Review system performance
    Produce Federal and State metric performance reports
    Review business policy, procedure and performance


CASE MANAGEMENT: See ECF
REAL-TIME SCHEDULING: See Workflow
IMMEDIATE OR REAL-TIME NOTIFICATION: See Automatic, System Generated Notifications
NEW AND CHANGED EXTERNAL PROCESS
INTERFACES
                                                                                          Process Interfaces . . .



New and Changed External Process Interfaces
    In this section we discuss new and changed process interfaces between the future UI functions and our
    partner agencies. An external, process interface is where one process step is conducted by one agency
    and further process steps are required by a partner agency.
This section will not review
A. Data interfaces (where data is transferred from or to UI for information or research purposes only, not
   supporting a process step) as these will be addressed as a component of the technical architecture. This
   includes cross-checks with other systems as well as requesting information from ICON etc.
B. Process interfaces with our core customers – employers and claimants (these are covered in the prior
   process section of this diagram)
C. Internal process „interfaces‟. As mentioned at the beginning of this document, UI Modernization covers
   all the following benefit programs. We do not treat transfers between these programs as interfaces, as
   they are internal.

     •     Unemployment insurance                     • Disability During Unemployment
           -     Standard, in-state benefits          • Additional Benefits during Training
           -     Interstate unemployment insurance    • Self-Employment Assistance
           -     Combined wage claims                 • Disaster Unemployment Assistance
           -     Extended benefits                    • Trade Re-adjustment Act assistance

     •     UCFE

     •     UCX
                                                                                                                                            Process Interfaces . . .



Process Interfaces: Partner Agencies Involved



                                                Attorney General                                                       One Stop group of partners


  Employer Accounts
                                            Core Process          Entry
                                                                                                                            Workforce New Jersey
                                                                                    Adjudication

                                                                  Intake            Determination




                                                                                                    Inquiry / Triage
                            Investigation      Prevent
                                             overpayment
                                                                Continued
                                                                    Triage
                                                               certification        Determination


                                                             Lower- Authority            Re-
Bank                                                           Appeal (AT)          determination


                                                             Higher- Authority
                                                              Appeal (BoR)

                                                            Financial management

                                                           Performance management                                           Temporary Disability Insurance
                                                      Operations / process management
 Treasury                                                    System management




                 County Courts
                                                                                 Dept of Human Services
                                                                                                                            Process Interfaces . . .



             New and Changed Process Interfaces

Interface name              Inward or   Purpose / description                                              UI process            External partner
                            Outward?                                                                       impacted              involved


Referral* to all One-       Out/In      Links will be available on the UI site to the web sites of our     Claimant              Workforce New
Stop services at point of               workforce partners. We will request the same for UI on their       Triage/Inquiry        Jersey & all One
inquiry, on web                         sites                                                                                    Stop partners
Referral to all One-Stop    Out         Customer can use FAQs for standard answers and/or get              Claimant              Workforce New
services at point of                    directions to the nearest One Stop office (from the customer‟s     Triage/Inquiry        Jersey & all One
inquiry, on telephone                   zip code). If the customer is placed on hold, they will hear a                           Stop partners
                                        recording detailing re-employment Services
Referral from One-Stop      In          To be confirmed with One Stop partners.                            Claimant              Workforce New
partners at point of                                                                                       Triage/Inquiry        Jersey & all One
inquiry                                                                                                                          Stop partners

Referral to all Workforce   Out         Standard UI notification will be modified to include information   Intake to             Workforce New
New Jersey services at                  on One-Stop services                                               Adjudication          Jersey & all One
point of denial                                                                                                                  Stop partners

Referral to all Workforce   Out         Standard UI notification will be modified to include information   Intake to             Workforce New
New Jersey services at                  on One-Stop services                                               Adjudication          Jersey & all One
point of claim invalidity                                                                                                        Stop partners

Referral to all Workforce   Out         Claim Submittal: In the new UI process, the letter with the        Intake to             Workforce New
New Jersey services at                  claimant‟s password and PIN for OSOS are sent out in the           Adjudication          Jersey & all One
notification of claim                   same package as the scan card                                                            Stop partners
submission


*In the long-term, our blueprint allows for modernized UI services to include a shared phone and web triage service with
our One-Stop partners (to mirror the in-person triage at some One Stop offices now). In the medium-term, however, our
focus will be on enabling improvements to transfers to and from our partners.
                                                                                                                              Process Interfaces . . .



              New and Changed Process Interfaces
Interface name            Inward or   Purpose / description                                                  UI process            External partner
                          Outward?                                                                           impacted              involved

Referral to Employer      Out/In      Integrated employer inquiry web site, providing links to               Employer              Employer
Accounts at point of                  Employer Accounts (and UI) online services.                            Triage/Inquiry        Accounts
inquiry, on web

Referral to Employer      Out         Integrated employer inquiry phone tree, which will transfer            Employer              Employer
Accounts at point of                  employers seamlessly to the appropriate unit for the type of           Triage/Inquiry        Accounts
inquiry, on phone                     question.

Referral from Employer    In          As needed, Employer Accounts staff to have ability to transfer         Employer              Employer
Accounts, on phone                    employers back to the integrated phone tree or directly to             Triage/Inquiry        Accounts
                                      specific UI units.

Transfer of new claims    In          All disability cases are filtered by State Plan and those              Intake and            TDI
from TDI to DDU/UI                    probably eligible for DDU will be automatically sent for intake        Adjudication
                                      and adjudication by the unit responsible for DDU.

Transfer of new claims    Out         Where a claimant‟s eligibility status changes, making him/her          Intake and            TDI
from DDU/UI to TDI                    potentially eligible for other disability benefits, the case will be   Adjudication
                                      transferred automatically to TDI.

Transfer of TDI appeals   In          The Appeals Tribunal and Board of Review handle all DI                 AT and BoR            TDI
                                      appeals. Where TDI agrees it is possible, these should be              appeals
                                      electronic transfers.

Application of TDI        Out         It will be possible to communicate DI appeal decisions                 AT and BoR            TDI
appeals decisions                     electronically from both the appeals authorities. TDI to confirm       appeals
                                      the preferred method.

TDI refunds and           In          The modernized UI service will continue to cover debt                  Collections / debt    TDI
changes to refunds                    management for all disability programs. Therefore, whenever            management
                                      a refund needs to be established or changed, that information
                                      should be fed automatically from the TDI system.
                                                                                                                          Process Interfaces . . .



              New and Changed Process Interfaces (cont.)
Interface name            Inward or   Purpose / description                                              UI process            External partner
                          Outward?                                                                       impacted              involved

Epayments                 Out         When UI moves to electronic funds transfer and direct deposit      Payment               Bank
                                      options for claimant payments, there will be a key process
                                      interface with the bank to approve and transfer funds.

Treasury audit of         Out         Treasury needs to reconcile the bank account daily                 Payment               Treasury
payment reconciliation                                                                                   reconciliation


Check replacement         Removed!    Treasury will not need to approve every replacement check;         Payment               Treasury
approval                              instead they will rely on daily bank account reconciliation to     (replacement
                                      flag anomalies. [Note: we anticipate the volume of check           checks)
                                      replacements to reduce considerably also].
Financial information     Out         Key transfer: Upload of information (totals and breakdowns) of     Payment               Budget &
                                      benefit payments paid, on a daily basis. Also a range of other                           Accounting
                                      information

Transfer of fraud cases   Out         When cases are ready for transfer to the AG‟s office, this can     Investigations        Attorney General
to Attorney General                   be done electronically, because in the vast majority of cases,
                                      all case materials will be stored on the system.

Child support             In          Automated submission from DHS‟ ACSES system to trigger a           Garnishments          Department of
garnishment request                   garnishment calculation and reconciliation (also automated         (financial process)   Human Services
                                      but cross-checked).

Child support             Out         Funds electronically transferred to the Administrative Office of   Garnishments          Administrative
garnishment payments                  the Courts                                                         (financial process)   Office of the
                                                                                                                               Courts
                                                                                                                          Process Interfaces . . .



               New and Changed Process Interfaces (cont.)
Interface name             Inward or   Purpose / description                                              UI process           External partner
                           Outward?                                                                       impacted             involved

ABT training institution   In          POSSIBLE: Potentially, training institutions that want to report   ABT continued        Training
reporting                              poor attendance at classes by an ABT recipient cannot do so        claims and           institutions
                                       over the web. This could be a simple additional web service.       payments
                                       [This idea was not discussed at a workshop – not yet
                                       approved].
TRA                        Out         POSSIBLE: Payments to health providers. New TRA                    TRA continued        IRS
                                       regulations now provide 65% coverage of health benefits for        claims and
                                       TRA recipients – to be administered initially by the state         payments
                                       agencies.
                                       IRS may need to access UI data to identify eligible claimants.
PROCESS DIFFERENCES, BY BENEFIT PROGRAM
                                                                                    Benefit program differences…



Ensuring the Blueprint Works for All Benefit Programs
The high-level processes described in the previous chapter are intended to cover the benefit programs
     described below:


1.   Unemployment insurance

     -    Standard, in-state benefits
     -    Interstate unemployment insurance
     -    Combined wage claims
     -    UCFE (prior federal employees seeking unemployment benefits)
     -    UCX (prior US military employees seeking unemployment benefits)
     -    All extensions
2.   Disability During Unemployment
3.   Additional Benefits during Training
4.   Self-Employment Assistance
5.   Disaster Unemployment Assistance
6.   Trade Re-adjustment Act assistance
                                                                                           Benefit program differences…



 All These Benefit Programs Share the Same
 Fundamental Processes…
                 In-state UI claims, TUC claims,    Collateral   Interstate   Disability during    SEA          ABT
                     UCX/UCFE claims, TRA            claims        claims     unemployment
               One Stop     RCC      Adjudication                                                 Workforce New Jersey
                                       Center

Intake
                                                                                                         
Adjudication
                                                                                                        
Continued
claim &
payments                                                                                                 
                                                                                                        
Preventing
overpayments


Correspondence
handling                                                                                                  
Inquiry
handling
                                                                                                        
Appeals
                                                                                                        
                                                                                                 Benefit program differences…



         However, Each Program Has Differences That Must
         Be Allowed for Within the High-level Blueprint
          Beyond the processes and enablers described earlier in this section, many benefit programs have different
          requirements – for example different eligibility measures - that will need to be taken into account. We include
          here a high-level checklist of the different requirements, to give a sense of the variations.
          All enablers discussed earlier will be available and used across ALL benefit programs, unless there is a
          specific legal or regulatory requirement not to do so.

Interstate, New       •   Interstate liable will in fact become closer to the standard model: 1-800 number for out-of-
Jersey liable             state claims will mean that claimants contact New Jersey directly, eliminating cases filed via
                          ICON
Interstate, New       •   Inform claimants of other States‟ internet applications or 1-800 numbers will be a part of
Jersey as agent           triage services (most states). ICON transmission functionality needed for states that do not
                          take their own claims. Paper IB1s are still required for all states for which we act as an agent.
Combined wage         •   Feed of new combined claims against New Jersey from ICON will continue to be dictated by
claims, New Jersey        the national program: overnight batch process, for foreseeable future.
liable
                      For cases file via ICON (MA and VI only)
                      •   Feed of new interstate claims against New Jersey from ICON will continue to be dictated by
                          the national program: overnight batch process, for foreseeable future.
                      •   All data sent through from ICON should be directly inserted into a „template‟ claim [currently
                          some has to be re-keyed in]
                      •   Need to enable faster and more accurate identification of Federal agency codes (for any
                          process)
Combined wage         •   Automated cross-check of available weeks and wages to request?
claims, New Jersey
as agent
                                                                                       Benefit program differences…



Benefit Program Differences (cont.)
UCX, UCFE           •   Speed and approach to cross-matches with the national databases will continue to be
                        dictated by the national programs. I.e., for UCX and UCFE claims, validating identity
                        will remain an overnight process, in the foreseeable future.
                    •   UCX: need ability to link copy of claimant‟s DD214 (proof of service) to the
                        electronic case file
                    •   UCFE: need ability to link copy of claimant‟s SF50 and/or paystubs
Disability during   •   Basis of eligibility is different. Employer coverage checks should be automatic.
unemployment
                    •   Financial calculations will be unique: DDU and UI benefits together can be worth
                        150% of standard UI benefits (neither benefit paying more than 100%). Impacts:
                          • Different basis for calculations
                          • Claimant case file should be able to reflect impact of DDU and UI claims on
                            the shared eligibility balance
                    •   Need the ability to attach medical approval to the claimant‟s electronic case file.
                        Currently, this is always provided as a hard copy form by a doctor and includes
                        his/her signature. This breaks down into the following information requirements:
                          •   The ability to enter physician and medical information including a prognosis date
                              through to which payments will be paid (see below).
                          • Listing of licensed physicians and status of licenses - suspended, revoked, etc.
                          • Listing of morbidity codes.
                          • Tracking of impartial examinations.
                    •   Different certification model: the claimant is deemed eligible until the prognosis date
                        provided by the doctor (to a maximum of eight weeks) or until an impartial exam
                        deems otherwise. At this point, the claim is re-adjudicated.
                                                                                     Benefit program differences…



Benefit Program Differences (cont.)
Additional        •   Continue to manage payments and continued claims certification for ABT. This
Benefits during       therefore requires a certification model that allows for change, to cover paper, phone
Training              and web certification
                  • Basis of eligibility is different
                  •   Benefit payment should extend only to the end of the training course, not a standard
                      period
                  •   Grant payment will not be associated with certification (separate payment to training
                      institution)
Self-Employment   •   SEA certification is (currently) mail-based only.
Assistance
                  • Basis of eligibility is different as are implications of receiving SEA (for example, no
                      longer eligible for UI or extensions)
                  •   Benefit payment amount is different.
Trade Re-         •   TRA claims will have a different basis of eligibility: based on an approved TRA list
Adjustment Act
                  •   Claims process will need to accommodate training approval and tracking
                  •   TRA accounting will need to accommodate health insurance payments (if short-term
                      responsibility does not transfer to the IRS)
Disaster          •   DUA eligibility will be based on pre-authorized location criteria
Unemployment
                  •   Benefit amounts will be different
Assistance
                  •   DUA procedures in particular are constantly evolving and must be easy to change
                      rapidly, to enable rapid response to a disaster
REAL-TIME INFORMATION TO TRANSFORM
MANAGEMENT RESPONSIVENESS
                                                                                              Management information…


Real-time, Accessible Management Information
Accurate, timely and meaningful management information (MI) will be a crucial enabler in the way we
manage unemployment insurance services in the future. We started to explore the impact and uses for
management information during the expert workshop sessions. This section outlines our early principles for
how MI should be used and for the design of MI tools.
The new IT system will collect and maintain an exhaustive audit trail of information, which can be used as a
platform for analysis to support all management functions. It will be possible for this information to be queried
easily by non-technical managers – in the creation of specific reports and real-time (on screen) views of
information.
The new tools will enable faster management action:
•   Evidence-based planning: we‟ll know what‟s achievable
•   Rapid identification and response when performance problems arise
•   Quicker identification of good practice – improvement trends will be more obvious
•   Transparent breakdown of workload – by region, office and even by person
Enhanced access to case information will also enable policy and operations modeling


                                                                   XXX solutions




                                    XXX solutions


                                                                              XXX solutions
                                                    Process XXX




         Illustrative only…
                                                                                       Management information…


Real-time MI Enables More Responsive Management
Management information will enable


Senior management to
              Deliver agency objectives
              Drive continuous improvement (process and procedure)
              Provide Federally required reports


Field managers to
              Manage their units (system, people, processes) against agency objectives
              Manage staff and their development
              Drive continuous improvement (process and procedure)


All staff to
              Understand and monitor their own contribution to performance
              View and feel part of the overall drive towards agency objectives
              Drive continuous improvement (process and procedure)


Management information will not be used to monitor the minutiae of or to micro-manage staff activity. Instead
the focus will be on identifying performance drivers and targeting training and development where most
needed.
                                                                                    Management information…


Real-time MI will enable Managers to do Many Things
Differently…
•   Use real-time staff performance information to provide pats on the back; target staff improvement
    actions (including mentoring & training), in support of the organization‟s needs
•   Identify training and customer service needs
•   Share data with staff real-time
•   Better determination of where problems lie and targeting of remedial actions
     •     E.g., identification of spelling errors that trigger system errors
•   Manage more proactively, in a more timely manner
•   Increase consistency across the agency (through sharing of same information)
•   Identify best practices and share with the rest of the organization
•   Plan resources and activities more accurately
•   Improve customer focus
•   Improve internal communications
                                                                                           Management information…


Our Business Design Principles for MI
The design principles below represent a first-cut list of management information needs. They are split into
principles (a) for how management information should be used in the future and (b) for the tools needed.
(a) Design principles for how MI is used
     MI should be a balance of qualitative and quantitative information
      –     Must include customer satisfaction as a key indicator
     Build in remedial action loop: MI is only valuable as a trigger to action
     Interpretation of MI will require training
     Management style and approach may be impacted – may need training on how to manage in new
      model?
    Overall performance measurement…
     Measure across whole process
     Balance emphasis on timeliness with concern about quality
     Generate outcome measurements
      –     Not just the immediate outcomes (average wait time), but about contribution to overall objectives
            (how are we doing against )
     Recognize the differences in claim types
      –     E.g., number of employers per claimant can vary significantly by region and by office (although this
            should reduce significantly when intake and adjudication workload is shared across the State)
     Balance the need to achieve overall performance targets with an understanding of local differences. In
      particular, look at trends in offices‟ performance – don‟t just compare different regions
                                                                                            Management information…


Our Business Design Principles for MI (cont.)
(a) Design principles for how MI is used (cont)
    Staff and people measurement…
     Measure contribution to agency objectives at all levels, from front-line staff upwards
      –    E.g., Allow front-line workers to compare their performance against their peers
     Enable each manager to
      –    Measure his/her office‟s performance against agency objectives
      –    Define extra performance metrics, for specific local issues
     Use information on staff performance carefully (mitigate the big brother aspects)
     Establish patterns and measure aberrations, - and collect the reasons for why there is an aberration
(b) Design principles for MI tools
     Reports should be accessible to people across the organization, making performance transparent within
      the Division of UI
     Allow for an “end-to-end” view of each claim and/or customer history
      –    E.g., How many contacts were made during the course of one claim?
     Relate all aspects of performance to get a holistic view (thereby taking into account the different
      constraints faced by different parts of the organization)
     Provide the ability to customize reports and views
     Flexible query capability
     Provide real-time information as far as possible
                                                                                           Management information…


Our Business Design Principles for MI (cont.)
   Include a proactive alert system that has built-in triggers to flag problems quickly
    –    for example, failure of a server should be flagged to managers of all services dependent on that
         server
   Enable timely query access to historical data, for trend and policy research
   Protect data fields from poor quality data entry
    –    E.g., Currently, people enter 9999 into LOOPS fields for a number of different reasons. Instead, we
         should ensure that each piece of information can be entered in an appropriate place (no „forcing‟ the
         system)
   Must move away from system codes and instead use meaningful names/labels
   Need for standard data naming conventions
   The new system must be able to capture and provide analysis on output and performance data, using a
    variety of workload data. The system should
    –    Capture performance data at the lowest level (cost center level as well as by claim)
    –    Measure workload items including, but not limited to, initial claims processes, weeks claimed etc.
    –    Be able to provide workload data for any new UI programs that may be enacted by the State or the
         federal government (e.g., TEUC)
    –    Provide for the ability to determine the length of various processes. (Eg. How long does it take to
         process an initial claim in the Vineland RCC? etc).
    –    Provide for the ability to budget workload data by cost center and measure performance against
         budget.
CREATING THE RIGHT ENVIRONMENT:
ORGANIZATION AND CULTURE CHALLENGES
We Must Address Organization & Culture Challenges
Addressing organizational and cultural challenges effectively is crucial to the success of UI
Modernization.
UI Modernization is being developed in a frustrating and sometimes stressful environment for UI employees that
presents clear opportunities for improvement. These are discussed in the baseline description document, and
include:
   Stressful, repetitive tasks in the One Stop and RCC offices
   Insufficient training beyond inductions
   Additional pressure on remaining staff following early retirement initiative


In addition, UI Modernization itself represents significant changes to future ways of working:
   Enhanced processes
   New system
   Modernized functions, such as preventative investigations for potential overpayments; performance
    management and potentially an in-house training service


The discussion on how the organization and culture of the Division of Unemployment Insurance should change
is just beginning. This chapter covers:
   Core UI functions of the future
   Principles for organization and culture
   Potential quick wins
   Next steps
                                                                                            Organization and culture…


Core Functions of the Future: Overview

  Intake      Adjudication            Claims-without-Agents                 Triage and Information

  Managing certification & payments                  Appeals Tribunal                     Board of Review

 Overpayment Prevention              Fraud / Overpayments Investigations                  Debt Management


            Research and Reporting*                Performance & Risk Management

                        Policies and Procedures Development


      Training and Personnel              Marketing & Communications*

      Management                 IT Support and Security*                Financial Accounting*



                                          MONITOR & IMPROVE
    DELIVERY functions                                                          SUPPORT functions
                                          functions

 * These functions are currently in full or in part provided outside of the Division of UI. They are included
 here for their importance to delivering UI services.
                                                                                           Organization and culture…


Core Functions: Description of New Functions
 The table below details new functions that we anticipate will be needed to deliver UI in the future model, as
 well as changes to some current functions. These changes are directly aimed at supporting the modernized
 processes and approach described earlier.

Claims-without-      One ambition for UI Modernization is that straightforward or „vanilla‟ claims can be
agents               submitted through the web or an automated phone system, avoiding the need for
                     claimants to queue for representative assistance wherever possible.
                     This new function will be responsible for ensuring that claims-without-agents are
                     processed efficiently and effectively – and that the service is available and useful to as
                     many claimants as possible.
Triage and           Services within triage and information will include:
information
                        managing entry into the UI system
                            – accessible phone tree
                            – website system and content management
                        „self-serve‟ information provision on phone system and web
                        representative-assisted triage at One Stop centers, on the phone and via web
                     Workforce New Jersey has committed to identifying how UI and Workforce New Jersey
                     can work together to provide this service jointly to our shared customer base.
Managing             There is a potential new, consolidated oversight role in managing all continued claims,
certification &      post-determination. To be investigated further.
payments
                                                                                          Organization and culture…


Core Functions: Description of New Functions (cont.)
Overpayment       The new preventative model as part of controlling benefit payments could logically be
prevention        separated out from traditional (post-event) investigations.
                  Further detail is required to understand how much prevention activity will best be
                  undertaken as part of the claim intake and adjudication process, or in a new
                  overpayment prevention function. The two functions will certainly need to become
                  interlinked further.
Performance and   To enable continuous improvement and inform management decision-making more
risk management   effectively, an enhanced central function is needed. This function will focus on
                  understanding the drivers of risk and performance and – working to Operations – help
                  improve every aspect of UI service delivery.
                  The performance and risk management function could contain elements of the current
                  QC, QA/Internal Audit, and BPC.
Training and      There will be a new in-house training function to address the need for UI-specific training
personnel         and development, both at point of hire and throughout employees‟ careers. This new
                  function will be formalizing the training roles already undertaken by some staff in BPS&S
                  and executive teams.
                  The personnel function will be a dedicated liaison with DOL personnel, responsible for
                  development paths, recruitment, retention and succession planning.
Marketing and     Communications directly with UI‟s customers – employers, claimants and staff (and our
communications    partners) – has been identified as a key area for improvement. The new function will
                     oversee communications during UI processes, and
                     deliver supporting communications services (extra communiqués etc).
IT support and    Note: the structure of IT services in the future will be defined in parallel with the technical
security          architecture.
                                                                                          Organization and culture…


Organization & Culture Business Design Principles
•   Consolidate services that customers do not physically access
      –     Option: physical consolidation (see next page for considerations)
      –     Option: virtual consolidation – work as a single unit while geographically dispersed
•   Co-locate services that customers do physically access with other workforce services, in locations
    convenient for the customer
•   Balance consolidation of back-end services with ability to manage the operations (see next page)
•   Effective resource allocation and values should inform organization structure
      –     Effective resource allocation can be measured by the productivity of the resource model
      –     The Division‟s cultural values should also be central to any organization decisions – for example,
            our organization should enable great customer service as well as make the organization a fulfilling
            place to work
•   Work to achieve a collaborative, matrix organization with service delivery as the primary function
•   Balance a flat organization model with the need for managers‟ span-of-control to be reasonable – I.e., not
    over-stretching managers
•   Separate „customer service‟ functions from „policing‟ functions, to balance customer service with
    preservation of Trust Fund
•   Operations management structure should reflect labor market regions, to remain close to local issues and
    local workforce partners
•   All benefit programs should be supported by the same management and tools, with less need to
    distinguish among them operationally
      –     Option: include as separate units, but under regional manager command
      –     Option: completely integrate with in-state UI (assumes that processes have been simplified through
            application of „expert systems‟)
      –     DDU should stay in its current position within DDI
                                                                                           Organization and culture…


Organization & Culture Business Design Principles
Some function-specific principles have also been defined:
•   Prevention of overpayments is everyone‟s responsibility – and should be worked into approaches and
    training. In particular, the claims intake, adjudication, claims-without-agents, certification and payment and
    overpayment prevention functions will be impacted by prevention activities.
•   Debt Management should be a centralized, separate function.
•   Appeals Tribunal and Board of Review both have autonomy in regard to the substance of their decisions,
    regardless of where organizationally positioned.
•   IT support in field should be generally-skilled to cover many support issues; however, they should have
    full support of and access to specialists who can resolve more complex issues (who would be based
    centrally)


Ideas for functional re-organization are still in development; the ideas above will continue to be tested.
                                                                                        Organization and culture…

         Balancing the Benefits of Consolidation and
         Dispersion Will Be an Ongoing Challenge

                                                                                     Dispersed
                                                                                     functions
         Consolidated
          functions

     Cost savings from synergies           In practice, few organizations    Enhanced understanding of the
  Improved alignment with corporate           are wholly centralized or                business
                  strategy                          decentralized           Rapid response to local demands
 Optimal utilization of scarce resources     – the fundamental issue is
                                                                            Enhanced customer satisfaction
          Economies of scale                        one of degree
                                                                              Minimum corporate overhead
Shared best practices & standardization
      Reduced operational risk                                                    Wider resource pool
        Improved career paths
     Minimum duplication of effort




            Getting the balance right between agency standards & control and business unit
                                    freedom is an ongoing challenge
                                                                                                      Organization and culture…


       Organization & Culture: Potential Quick Wins
        The workshop participants discussed a number of actions that could be started soon, to demonstrate the
        Division‟s commitment to addressing organizational and cultural issues:
               Begin providing a single point of contact for employer inquiries
        •       Begin training on what „empowerment‟ means and responsibility to identify barriers to service delivery,
                along with potential solutions, in particular for managers
        •       Provide a central point of contact for managers to direct „ silo barrier problems‟ for appropriate referral
                and tracking
        •       Begin cross-training exposure – potentially to include short-term placements and more information-
                sharing where technically possible now
        •       Begin planning for rewritten job descriptions with SMART* objectives and clear accountabilities – in
                particular ensuring that job descriptions reflect current requirements
        •       Train on how to manage with SMART objectives and accountabilities
        •       Develop tracking for the informal mentoring program to assess how to improve
        •       Begin thinking through how „case management‟ could work and training implications
        •       Develop a view of property leases vs. consolidation and co-location goals




* SMART: Specific, Measurable, Action-orientated, Realistic and Timed
                                                                                             Organization and culture…


Organization & Culture: Implementation Risks
The following risks have been identified, and should be addressed in the strategic plan phase:
•    Potential changes to job scopes, unit scopes, and the fit with DOP regulations
•    Ensuring Union representatives are continually involved
•    Ensuring the initiative is already delivering before the administration‟s term is over (so that it will continue)
•    Identifying the appropriate skill-sets for the future state
•    Addressing the perceived lack of mentoring and training; lack of cross-understanding of other functions
     and programs; culture of self-interest and not sharing information to protect jobs
•    Clarifying accountability and alignment to UI Modernization objectives
•    Change and fear as a barrier: consolidation over past few years – recent experience of change has not
     been good
•    Move towards specialization for quality and consistency (and costs)
•    Resourcing for the triage and inquiry function
•    Need to analyze best ways to introduce flexibility into the work day to cover a longer period of time (e.g.,
     workshops 2 and 8 discussed a 12 hour business day option that could be supported by multiple shifts)
•    Prevention of incorrect benefit payments – change in model, integration with claims processing
                                                                         Organization and culture…


Next Steps: Detailing Culture Change
An organization‟s culture acts
like a lens through which all
business plans,
communications, initiatives and
other messages are filtered and                             C
interpreted by employees.                                   U
While this phase of UI
                                       Agency               L
Modernization has focused                                   T
primarily on process change,           Strategy
the initiative has not lost sight of                        U
the importance of effecting                                 R
culture modernization as well.                              E                Business
                                                                              Results



                                                   Norms        Values
                                                       Assumptions
                                             “the way we do things round here”
                                                                                          Organization and culture…


Detailing Culture Change: Select the Best Levers
The next phase of organization and culture design will focus on the detailed changes that will re-energize and
focus the organization to deliver the objectives UI Modernization. In planning, it‟s worth remembering that the
elements that form a culture can be used as levers to change it, too.
This process will be as inclusive as the workshops that developed the rest of this blueprint.

                                      • How power is exercised
                                      • How leaders behave
                                      • What is understood by success
                                      • How careers develop
                                      • How people are rewarded

                                                People
                                                     C
                                                     U
                                                     L
                              Processes              T      Technology
      • How work and money flow                      U                  • How technology shapes jobs
      • How information is reported                  R                  • How technology can mobilize
      • How performance is managed                   E                  • How technology can empower
      • How the business is governed                                    • The influence of e-commerce
      • How quality is achieved            Organization
                                 • How the structure works
                                 • How the organization communicates
                                 • The influence of working environment
                                 • How alliances and partnerships work
                                 • How suppliers are treated
                                 • Working practices and SOPs
Building the Momentum
       for Change
                                                                                             Momentum for Change…


Building the Momentum for Change


The Division of UI needs to redesign its business processes before it designs its new IT system. This
deliverable, the Business Process Conceptual Design, and the process undertaken to create it will provide
both the framework for action and a blueprint that articulates the envisioned end-state. Both also contribute to
the change process (already started within the agency) needed to ensure project success.




                                 Design principles           A high level blueprint
  Articulate the vision in                                                                      Building the
                                    guide future             articulates and confirms
 terms of objectives and                                                                       momentum for
                                  operations and              the vision, objectives
      measurements                                                                               change
                                  change projects             and design principles




                                                                                            Our inclusive
                                                               What UI
                                                                                           approach has
                                                         Modernization means
                                                                                        supported our change
                                                         for our stakeholders
                                                                                             objectives
                                                           Momentum for Change…


WHAT UI MODERNIZATION MEANS TO OUR
STAKEHOLDERS




          Claimants                      Employers



                       What will UI
                      Modernization
                       mean to…?
         Staff

                                              Political
                                            stakeholders




                      Partner Agencies
                                                                                            Momentum for Change…


For Our Claimants…
Extract from the UI Modernization vision statement:
 For our claimants, we will help them to focus on reemployment by making the claims process timely,
 efficient and informative. We will also help them to access related government services by improving
                     referrals from UI, in partnership with the workforce community.
Example benefits for our claimants:
I have immediate access to the UI Division, by phone, on the Internet, or by visiting a One Stop Career Center,
with little or no waiting. I can even speak to a representative immediately if I so desire
The UI agency will treat me as a real person, with a sincere interest in my needs and questions
I will easily understand the initial claim-filing process and get my question answered by phone or by the
Internet. If necessary, I can speak to a knowledgeable and skilled representative who will show a sincere
interest in answering my questions or solving my problem
I can expect a prompt determination of my claim. If eligible, my claim will be paid promptly by my choice of
payment (check, direct deposit, or other expedient means)
If my claim is not allowed, I will promptly know the reasons why and be informed of my rights to request a
reconsideration of my claim or appeal the denial. I can use the phone, Internet or a paper form to file an
appeal.
My ongoing obligation to report to the agency my continued status can be quickly done by my choice of phone
or internet.
From the onset of my contact with the agency, I will get prompt assistance with the various services and
programs available that may allow me to become employed again as soon as possible
I have instant access to my claim status either by phone or internet – and will be able to view all and to change
some basic information in my own case file
I can expect to contact the agency via a local phone number (at local cost)
                                                                                                 Momentum for Change…


For Our Employers…
Extract from the UI Modernization vision statement:
 For our employers, we will simplify correspondence and improve our responsiveness. We will treat
                  employers as partners in the provision of unemployment insurance

Example benefits for our employers:
The agency is easily available by its website or phone and will answer any of my questions or inquiries
(providing my cumulative and individual claim status and history)
I will be able to view my company‟s unemployment insurance information – claims and charges – online, via a
secure internet site
I will have the opportunity to provide the agency with information about mass layoffs and those individuals who
may be affected in advance – making the process easier for me and for my employees
I will be able to participate better in UI fact-finding, because I will be able to leave a voicemail for an adjudicator
if he/she is out when I call
I will be able to take advantage of a range of correspondence methods, to make interaction with the Division of
UI faster
The agency staff with whom I engage will be fair, prompt, knowledgeable, and immediately available
I will be informed of my ongoing UI obligations and responsibilities (via the internet or phone)
I will be able to file an appeal by internet, phone or in writing – whichever is most convenient to me
                                                                                           Momentum for Change…


For Our Staff…
Extract from the UI Modernization vision statement:
For our staff, we will empower them to deliver superior service by ensuring a stable work environment,
 creating equal opportunities for career growth and providing appropriate tools and training to do the
   job. We will treat our employees with the same professionalism and respect they are expected to
                                     share with every UI customer.

Example benefits for our staff:
We have the ability to inform proposed and existing changes – and hear how my improvement ideas have
been acted upon
We have the means of communicating with each other effectively at all levels of the agency
We have a suite of tools that enable us to meet our customers‟ needs so that we can provide prompt and
efficient customer service
We have a common database and system that provides fully integrated information in real time about
employers and claimants
Our time is spent efficiently, doing those things that best meet our customer‟s needs
We are involved in preserving the integrity of the UI trust fund
We are able to avoid mistakes, redundancies, and re-work by means of the excellent tools at our disposal, the
training we receive, and our commitment to excellence
We have a dedicated training service that helps us to stay up-to-date on delivering UI services
There is a clear career path within the Department that we can aim for
                                                                                          Momentum for Change…


For Our Political Stakeholders…
Example benefits:
The UI agency is a “shining star” in the array of services offered by the New Jersey State Government
The State receives great feedback from individuals and citizen groups about the outstanding friendliness,
courtesy and prompt services offered by the men and women of the UI agency
The UI agency provides an increasingly important role in the economic health of our State and the financial
viability of our citizens
The Unemployment Trust Fund is well managed and the integrity of its resources is assured by the
attentiveness given by all employed to administer claims
The UI agency provides an increasing pivotal role in the economic development needs of a trained, qualified,
and accessible workforce for in-state employers
                                                                                         Momentum for Change…


For Our Partner Agencies…
Example benefits:
The UI agency is cooperative in providing timely information to other partners
The UI agency recognizes its essential role in the “team” by providing essential economic support and prompt
and efficient services to employers and those who are out of work through no fault of their own
We share a common database for individuals or organizations. This database is integrated, accessible, and
user friendly
The UI agency promptly cooperates with its partnering agencies (One Stops, Tax, Child Support)
The UI agency functions like a collaborative partner to serve the common needs of the customers we jointly
share
                                  Momentum for Change…


OUR INCLUSIVE APPROACH HAS SUPPORTED OUR
CHANGE OBJECTIVES
                                                                                          Momentum for Change…


We have taken an inclusive approach…
We have taken an inclusive approach to the creation of the business process conceptual design to ensure we
have taken advantage of the knowledge residing both within the organization and with our customers. Activities
have included:
Gathering insights from our customers
    Claimant focus groups and interviews
    Employer focus groups
    A legal services (claimant advocate) focus group
Reports from these sessions are attached as Appendix A.
Gathering insights from other States
    The team developed a best practice guide to innovative approaches taken by other State agencies in the
     provision of UI services
This report is attached as Appendix C.
Designing the framework and blueprint
    Eight guided workshop sessions involving over 120 people from across the Department of Labor and its
     partners (many in more than one session)
Summary slides from each workshop are available upon request.
Validating the framework and blueprint
    A final workshop session for 60+ people, communicated and validated the major changes implied by the
     business process conceptual design
    We solicited informal feedback on this report by key experts prior to submission
                                                                                                 Momentum for Change…


       …which itself has contributed to the change process
       The diagram below depicts the key stages in delivering change effectively in any organization. The approach
       taken to the business process conceptual design phase – in particular the inclusive nature of the workshops –
       has helped facilitate readiness for change for an important cross-section of the agency.


                       Build a compelling
                        case for change
                           Benefits                                                       The business
                                                      Engage change                   process conceptual
Drive the                                             leaders at every                 design workshops
program                                                    level                         have helped to
                                                                                      achieve a number of
                                                 Risk and                                critical change
    Speed             Outcome                                                          management goals
                                                complexity

   Design the                                          Win the
   business to                                      commitment
  deliver what‟s                                      of critical
    important          Sustainability               stakeholders



            Additionally, our approach has forced the pace of UI Modernization - giving the process extra
            energy and giving the Division the chance to deliver early wins and to prove it’s serious about
                                                       change
                                                                                                          Momentum for Change…


             However, we need to continue to lay the foundations
             for a successful transition
             We are still in the early phases of UI Modernization. We have started to build some excitement about future
             changes and need to maintain a steady momentum in building first awareness and then buy-in to the initiative.




Maintain buy-in during
the planning and                                                                                      Support change
                                                                                                      

detailed design
                                                                                                      agents
phases:
                                                                                                         Provide
                                                                                                          provide assistance
   Ensure the detailed                                                                                   in getting
    design addresses                                                                                      messages out
    concerns of front-line
    staff                                                                                                Provide tools
   Prioritize changes                                                                                   Ensure there’s
    with biggest impacts                                                                                  something to talk
    on day-to-day work                                                                                    about!
   When planning, build
    in time for user
    assessment of
    projects and
    deliverables
                                                                                                Momentum for Change…


Some ideas for ongoing change management
   Assess status and effectiveness to date of current change management activities
   Develop a formal Change Management Plan
    –    Identify and train „change champions‟ who already have a following
    –    Provide change champions with appropriate training and guidance, potentially incorporating these
         accountabilities into their job descriptions and objectives
    –    Emphasize continued involvement of all stakeholders at all levels
    –    Emphasize articulation to all stakeholders how UI Modernization will affect them through
         communications that are early, often, complete, consistent, candid and two-way
         •     What‟s in it for me?
         •     How will it impact my job and career?
         •     Will it really be done or is this just another initiative that will die on the vine?
   Implement Quick Wins and advertise their achievement to reinforce credibility of the UI Modernization
    project
   Continue the „new tradition‟ of inclusive discussions across the whole agency, to help eliminate the view
    that headquarters is „doing it to us‟
   Remember that change is a journey, not an event and that it will require commitment, time and patience
    from the leadership who demonstrate that they are „walking the talk‟
   Celebrate achievement of major milestones
Next Steps
                                                                                                            Next steps…


So, We Have a Framework and Blueprint…
The Business Process Conceptual Design is a major deliverable in this strategic design phase of UI
Modernization.




                         Analysis
                        Analysis
                         Analysis                  Design
                                                  Design
                                                   Design                   Plan
                                                                           Plan
                                                                            Plan


     UI Process        Review current state   Design business
                                              processes
                                                                    Detail all requirements   Implementation
     Review            ID gaps with vision                          Get approval for new      RFPs
                                              Design architecture   system design

                       Review initiatives     Manage project        Plan delivery              Manage the
     Managing          Planning               Review                Plan migration            change
     the Program       Agree controls
                                              interdependencies
                                                                    Consider change needs

                       Detailed work plan      Business process
                                              Business process      Requirements
                                               conceptual design
                                              conceptual design
     Deliverables      Baseline description   Technical architecture Strategic plan plan
                                                                     Draft strategic
                                              Interface document     Strategic plan



                         Nov 2002                Feb – May               May – July
                        – Feb 2003                 2003                    2003
                                                                                                                                             Next steps…


             … What Comes Next?
              Formally, the next project steps to complete are the Technical Architecture and Interfaces List, and then the
              Strategic Plan for implementation of UI Modernization.

                    2
                    The Strategic Plan will identify the best change path for UI Modernization, taking into account
                    • The need to deliver the benefits of each project, as it is implemented
                    • Implementation risks such as continuity of service
                    • The impact on staff and customers of each change
                                                                             nk                       e
                                                                      Th
                                                                         i
                                                                                                 ef
                                                                                                    in                 Do
                                                                                             D
                                                                        Analysis
                                                                       Analysis
                                                                        Analysis                    Design
                                                                                                   Design
                                                                                                    Design                   Plan
                                                                                                                            Plan
                                                                                                                             Plan

1
                                                       UI Process     Review current state   Design business       Detail all requirements   Implementation
The Technical Architecture and Interfaces              Review         ID gaps with vision
                                                                                             processes
                                                                                                                   Get approval for new      RFPs
                                                                                             Design architecture   system design
deliverables will
• Be delivered in parallel                             Managing
                                                                      Review initiatives     Manage project        Plan delivery              Manage the
                                                                      Planning               Review                Plan migration            change
• Describe the architecture and                        the Program    Agree controls
                                                                                             interdependencies
                                                                                                                   Consider change needs
    functionality required to support the                                                     Business process
                                                                                             Business process
                                                                      Detailed work plan                           Requirements
    processes described in this business                              Baseline description
                                                                                              conceptual design
                                                                                             conceptual design
                                                       Deliverables                          Technical architecture Strategic plan plan
                                                                                                                    Draft strategic
    process conceptual design                                                                                       Strategic plan
                                                                                             Interface document
• Identify the best architecture in terms of
    overall cost: benefit                                             Nov 2002 –                  Feb – May             May – July
                                                                       Feb 2003                     2003                  2003



         By July 2003, UI Modernization will be fully planned out and the Division will be in a position to trigger
                                             the first implementation phase.
                                                                                                              Next steps…


The Division Is Continuing to Deliver Quick Win
Improvements
Many participants in UI Modernization have suggested „quick win‟ changes that could be implemented
immediately and thereby start improving the work environment immediately.
In order to give these ideas their full due, the Division has created a parallel work stream to the main UI
Modernization process, headed up by Jim Boney.
Potential quick wins are assessed in parallel to the Project, with the expectation the cost-effective and
appropriate ones will be implemented as soon as is possible, and need not be encumbered by the UI
Modernization implementation timeline.
Examples of quick wins include:
    Posting ranges of social security numbers being serviced by the RCC on a board next to One Stop
     courtesy phones, so that claimants do not waste time on the phones only to learn that their SSN is
     blocked
    Communicating to claimants that they do not qualify for a particular UI benefit check more simply and
     clearly than sending a non-negotiable check
    Providing voicemail for certain staff positions, so that they are more accessible for claimants and
     employers (for example, adjudicators)
                                                                                                                     Next steps…


         We Are Aware of Ongoing Risks and Continue to
         Mitigate Them
          At this stage of UI Modernization, risks to success center around gaining support for the direction and
          approach to delivering such large-scale change. The table below outlines our approach to mitigating the top
          three risks.

                       Risk                                                     Mitigation action

                                                     -
                                                     -   an inclusive workshop approach
Stakeholders and particularly staff do not support
the initiative                                       -
                                                     -   ongoing communications activities and change management
                                                         plan (see slide 217)
                                                     -
                                                     -   many UI experts from across the Department and wider have
                                                         been involved in developing and assessing the conceptual
                                                         design
                                                     -
                                                     -   where there is a need for detailed implementation analysis, this
Business process conceptual design is questioned
                                                         will start in the strategic plan phase (e.g., cost:benefit of each of
for lack of detailed analysis
                                                         the potential payment methods)
                                                     -
                                                     -   emphasize need to create the strategic framework and blueprint
                                                         quickly, so that detailed design issues are resolved in a shared
                                                         framework

                                                     -
                                                     -   the business process conceptual design has defined broad
                                                         functions for the future UI
                                                     -
                                                     -   acknowledgement that further design needs to be done for
Insufficient consideration of human resources,           human resources – this will start immediately and continue
management and managing change requirements              through the strategic plan will identify
                                                     -
                                                     -   continuous open communication with staff on ideas being
                                                         discussed – emphasizing positive, unthreatening nature of any
                                                         changes

				
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