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Business Principles Improving Health Services

By Governor Pete Ricketts

July 25, 2017


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Just over one year ago, Department of Health and Human Services (DHHS) CEO Courtney Phillips and I launched the first-ever DHHS Business Plan.  It included 25 initiatives aimed at integrating services, promoting independence, focusing on prevention, leveraging technology, and increasing operational efficiencies.  DHHS touches the lives of countless Nebraskans every day as they serve some of our most vulnerable citizens.  This plan promised better services and efficiencies through strategic actions, measurable outcomes, and transparency.  It reflected three of my top priorities: to make state government more efficient and effective, be more customer focused, and reduce regulatory complexity.


CEO Phillips and the team at DHHS delivered. 


Their work is resulting in real improvements, sustainable progress, and better lives for Nebraskans.  The plan became a road map for employees and offered accountability to stakeholders and the public.  DHHS has fully completed 19 of the 25 initiatives and has made substantial progress on the others.  In fact, 199 of the 213 deliverables – over 93 percent – have been completed.  This is great news, and it is one example of the changes we are bringing to state government through measurable improvements to services for Nebraskans.


For example, our commitment to continuous improvement resulted in sustained progress for ACCESSNebraska.  The timely processing of Supplemental Nutrition Assistance Program (SNAP) applications is now at 95.28 percent, improving Nebraska’s national ranking to 15th compared to 48th in April 2015.  The average call wait time for economic assistance programs has improved from nearly 24 minutes in August 2014 to under the goal of five minutes with call wait times for Medicaid programs consistently under five minutes. 


Another initiative focused on reducing the amount of time it takes to process certain health professional licensing applications.  Through an operational excellence approach using Lean Six Sigma principles, DHHS simplified applications and streamlined screening procedures resulting in faster turnaround times for nurse and medication aide licensing.  Medication aides saw the most significant improvement as we reduced the licensing process from 39 days to nine.  We also reduced the licensing process for nurses from 96 days in November 2015 to 63 days during peak application season in June 2017.  These changes make a difference for our professionals and the businesses who hire them, helping to deliver the healthcare our workforce needs to keep Nebraska growing.


We launched the DHHS Behavioral Health System of Care for Children, Youth, and Families to establish a framework for integrating mental health services for children who have a serious emotional disturbance by working with public and private partners.  The framework has been established and the first statewide service began in May.  We heard from families that Nebraska’s response when they are in crisis was fragmented and the new crisis response program is a real response.  Teams in each of the six behavioral health regions can provide immediate mental health crisis counseling and may partner with others on risk assessment, crisis intervention, and stabilization.  They can also make referrals to resources in local communities, helping some of our most vulnerable citizens at a critical time. 


The DHHS team also heard that applying for developmental disability services was confusing and difficult, and made changing it a priority.  By working with stakeholders, families, and individuals receiving services, we streamlined the application from 14 pages to three and added it to the ACCESSNebraska website so people could apply day or night.  The time to determine eligibility was slashed from an average of 69 days to 14, improving customer service.


One last example.  Heritage Health was launched in January and combines Medicaid's physical, behavioral, and pharmacy services into one coordinated system.  Having one health plan responsible for a more complete range of services addresses the health care needs of the whole person and is an investment in more cost-effective services.  The plans are required to process 90 percent of complete and error-free claims within 15 days of receipt.  In May and June, they paid more than 97 percent of these clean claims within 15 days.  Continued improvements will result in even better outcomes for Medicaid members.


The initiatives outlined in the DHHS Business Plan and the outcomes achieved demonstrate that the determination to improve services and processes can and will result in real change for Nebraskans.  The successes can also be attributed to a talented team dedicated to their mission of helping people live better lives, a commitment to excellence, and an openness to change and ongoing improvement. 


Thank you to CEO Phillips and the team at DHHS.   This year, we will continue to partner together to help Nebraskans live better lives, and I look forward to sharing our plans in the coming months!  If you have ideas on how we can continue to improve state government to better serve Nebraskans, I hope you’ll contact my office by emailing or calling 402-471-2244.