Management and Performance Review of County Government ...

Health & Welfare/Library/Veterans Services of Jefferson County
The biggest difference between the two units for the welfare division somewhat
tracks the health division workload, as Exhibits 5-5 shows. The majority of applications
for IHC and PHC, however, are denied due to ineligibility. In addition caseworkers
conduct periodic reviews, as required for the CIHC program to verify eligibility.
Consistent with Unit 2 serving a larger IHC population, it has more claims processed
than for Unit 1.
There may be some inaccuracies in the data entered and tracked for the two
welfare units. Although difficult to say for this review, HWD may want to review its
internal procedures for entering, coding and tracking welfare health eligibility caseload
data. In addition, HWD may want to confer with the county MIS department to ensure
that the software created to track welfare department workload is correctly capturing
data. Accurate data is an important management tool for resource allocation as is the
ability to see changing trends.
Overarching Issues
The county’s Health and Welfare Department has adopted many efficient and
cost-effective processes over the years to counter a decrease in staffing and a rising
workload. Some of these practices include:
‣ common access to online client tracking systems for both nursing and
welfare staff;
‣ the contract with UTMB for outpatient clinic and inpatient services;
‣ cross-training of staff in both units;
‣ extensive written policies and procedures for nurses and caseworkers;
‣ the use of two distinct file colors, white for IHC and orange for PHC, to
avoid mixups;
‣ controls to prevent excessive patient use of emergency room visits for
routine care; and
‣ controls to prevent patient abuse of prescription medication.
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