Upon reflection

The other day my wife asked me if my boss had ever responded to my email, in which I responded that he had, technically, by replying that it "was a long email," and that he would have to "give it some consideration." At that point in our conversation, I had that epiphanical 'Ah-ha!' moment. Yes, I made up the word "epiphanical," we're still allowed to make up words so long as Bush is in office.

Anyway, migrating back to the original point at hand, I'll need to give you some background on working at the state, specifically for the Oregon Health Plan. First, my manager/boss had been there at the state 3 weeks less than myself. He had come out of the Marines as a Staff Sergeant, and was now within the cubicle bliss like the rest of us. I mostly liked him, well, up until last Friday. Still, I respect him for his service in Iraq, and so on and so forth.

Next, when I was hired, it was expected that a worker would process 10 claims per day, 200 per month. In so doing, we were getting 10,000 applications processed per month (in September). In August, we were about 800 applications behind schedule. When I left, it was up to 5,000. This was due to the weakening economy, so more families were defaulting to OHP for medical coverage. Plus, the Reservation List applications were coming in too (there was a lottery for adults to get on OHP). So, succinctly put, we were getting inundated with applications.

Thus, it was completely unexpected when a new policy was handed down that we now needed to keep applications alive longer, twice as long, as previously. Again, some background for you; If you were to request an application for OHP benefits today, your Date of Request (DOR) would be 11/4/08. You now have 45 days to get that application in to an OHP branch, otherwise, your DOR is null and a new DOR is set the day we finally get the new application. The point of the DOR is that we will back-track your OHP coverage to that day.

Okay, moving forward, now let's say you have benefits already, and it's now time for recertification (recert). We mail you an application and you HAVE to get it back the month your coverage ends. If you don't then we DD deny them. Kind of redundant terminology, DD stands for Date Denial, so saying DD Deny means you're repeating words. But, that's the jargon.

Okay, so let's say that November is your recert month, you get your application in today, and you don't provide all your proof of income for the past 3 months. So we'll "pend" you for more information, giving you 45 days to respond. 45 days from today, by my layman math, is 12/19/08. If a worker doesn't get it, by the old standard, then you sent out the DD paperwork and the case was closed. Not so now, let's say you actually do get the information, but it's a week late or more. Well now you have to repull the denied application, and let's just say it wasn't all the "pended" information either, you now have to give them an additional 45 days, thus pushing the time into February for response. And, the benefits are still retroactive to November.

So, we're already 5,000 applications behind schedule and rising, and now we're supposed to hold onto application an additional 45 days for up to 90 days total, thereby creating more work? Well, in that same week, we were told that we now have to process 12 applications a day, 250 a month. They changed it a little, before we were "pushed" 10 apps (applications) a day by our supervisors. Now they are only pushing 7, but it was up to us to get the additional 5 done.

A little more background to understand: OHP is paperless. We don't get the paper app that you would fill out. Instead, we get a scanned version sent to our desktop. And the denials we send out are never seen by us in the tangible sense. Before hand, when you were done with the 10 apps and felt like doing more, you would check the general program queue that would list out names, DOBs, Case #, SS#, and any other salient information for cases waiting to be processed. But, because we now had the option to pick at least 5, all information save for the client name, were blocked out. Accordingly, they didn't want us to discriminate on the details of cases.

I can somewhat understand this, however, there was one serious repercussion, it also blocked out the information on our already processed and pended cases. So if you had already requested information on a case, it was in your queue waiting to be finished. If a client called, you could look up their name in the pend queue, see the case number, and look up what you did. Not anymore. You would now have to do a person search, and if their name was John Smith or Jose Garcia, good luck finding them, 1 in 10,000 at least.

I hope this gives you a good enough foundation to understand all that was swirling about. We had a team "huddle" -- I guess meetings are so passe -- and discussed these changes. There were lots of dissents. We had an airing of grievances, but I was pretty quiet since I was the lowest man on the totem pole. Anyway, I told my boss that I would send him an email, and I summarized the above, and added in some things that I thought would be helpful.

In hindsight, however, I see that I challenged his authority on that matter. I told him that blocking out that information wasn't necessary because all cases would be worked anyway, so there was no discrimination since every day, he would be pushing apps to our queue. Plus, it added an extra step to our processing as well since we couldn't see the case numbers in our pend queue. Blocking out that information was his idea. I also commented on the new policy which ultimately gave the client more reason to be lazy, and more work for us, plus, cost the department more money because it gave benefits where they weren't deserved.

Yeah, I overstepped my boundaries. It's kind of obvious now. I made it as professional as I know how. My early retirement was perhaps a culmination of things, but honestly, I was just trying to make things more efficient -- I guess I was barking up the wrong, uhm, state. And clearly, had I gone along with the sexual harassment thing as cited in the other post, I'd probably be a manager myself by now. I mean, I am efficient...