Triage
Overview
The basic concepts of triage are such that upon call or arrival, customers are categorized based on complexity of the
case need. For many counties this means a decision-maker is stationed at the front desk to address eligibility-type issues
that can be dealt with quickly and simple interactions that can be addressed quickly (e.g. reporting address change,
picking up an application) and customers can be put on a fast track. For other counties it simply means someone is
available to quickly answer questions and address needs, physical proximity to the front desk is perhaps not an option,
but the concept still rings true.
Detailed below are the counties who, in some way, triage customer needs for a more efficient, timely resolution.
County
Henderson
Rowan
Camden
Rutherford
Process
Triage Meets Computer Center
 Position(s): Four IMC IIs sitting at the desk, and two to man the copier/scanner for
information a customer brings and to man/teach in the computer lab. They hope the
computer lab will be finished by 8/1. They are using existing positions to support these
functions.
 Duties: Those sitting at the desk will be reviewing recertification documents and sending
to appropriate workers if they require more than an update. They will be doing everything
that can be done to secure verifications required without sending tasks to the worker in
maintenance. Those at reception will not do applications, but the two in the computer
kiosk room will be assisting clients with self- completion of their applications and
attempting to handle folks wanting medical insurance coverage only for the ACA.
Mini-Triage with Front Desk Reception and Triage Via Rotation
 Position(s): Reception staff plus 4 rotating IM Techs.
 Duties: Order duplicate Medicaid, EBT cards; complete address changes in NCFAST &
EIS; provide customers w/duplicate recertification forms; mail applications to customers;
review 8650 or 5097 & inform customer additional items needed for processing; handle
fishing license request.
 Approach: Their approach is two-pronged. They have not physically moved “triage” to
front of the building; however they utilize front reception as “mini” triage. The front
reception staff have customers complete change forms, w/info such as address change,
request for Medicaid card, EBT card or Fishing licenses. The mini triage will then scan the
request directly to the caseworker. If customer need is more involved a triage team
member – 4 IM Technicians see customers on rotating basis, seeing customers across
all programs except WFFA.
 Benefits: Used existing positions to significantly reduce the amount of walk-in traffic for
caseworkers.
 Position(s): One IMC (of 5 total in the agency) rotates onto Triage each day. They also
serve as the first back up for the Intake worker if it gets busy or they have to leave. This is
not a new position, just a change in the rotation of Intake that they were formerly doing.
 Duties: The Triage person is handling taking any changes clients need to report, helping
fill out recert forms, etc.
 Approach: They are not stationed at the front desk as there are empty offices directly
thru the doors from the reception area, so they just take them in there or sometimes to
their own office, whatever they’re comfortable with.
 Position(s): 2 PAs who see all walk-ins and changes (one dedicated to each, walk-ins
and calls) for FNS so IMCs are rarely interrupted. They are currently training additional
staff to do the same for the F&C program. Looking at a new job description of Public
Information Specialist. The positions came from one FT position that they sliced and
made two positions with no benefits.
County
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Scotland
Pitt
Cleveland
Process
Duties: Currently specialized to see only FNS; they take the information or help the client
complete their review if the front desk can’t answer their questions or if the customer
needs help filling out their FNS review form or want to report a change and won’t
complete a change report at the front desk.
Approach: Important to note that front desk staff have been taught how to go over the
SR (FNS Review) and Med review forms as well. They’ve been taught to make sure
every question has been answered and they even ask them for the wages and encourage
them to go back to the car and get necessary information such as rent receipt of wages.
They report that this has been a tremendous help to the Caseworkers. They have also
directed the front desk staff to encourage the clients to report changes to them or give
them a change report form versus having to call someone to see them. A few of the front
desk staff have made small changes such as Carolina Access Changes and ordered MA
cards while working the front desk.
Benefits: Just the fact that workers are not bothered has improved productivity
tremendously. Also, the tech positions usually move right into full time positions so
training time is reduced once they are promoted to an IMC.
Position(s): Two triage people are at the reception windows at all times, and an
additional person rotates in from Medicaid. Their classification (IMC I for FNS, IMC II for
Medicaid) is due to the existing classification of staff who filled those roles.
 Duties: Triage assists unless the information is too case specific or there is a backlog of
individuals to be seen.fishing license, address change, duplicate Medicaid card, general
questions, send intake to queue, provide recertification documents. They also give paper
Med applications to those individuals who are here for multiple programs.
 Approach: All persons coming to DSS for FNS or Medicaid are routed through Triage
from the reception person. The two triage workers send application to queue if person
needs to apply or informs customer of steps that need to be taken to continue with
benefits. In addition, Triage helps with “simple” tasks like fishing license, address
change, duplicate Medicaid card, or general questions. If the individual needs more
specialized assistance, the triage worker contacts someone from the “back” to assist
them. Many times, the customer wants to know something specific about their case and
triage will not have that information. Depending on how crowded the lobby gets, the
triage does not have the ability or time to address more specific needs and may need to
refer more individuals to the ”back”.
Customer Service Team
 Position(s): Pitt has two permanently assigned workers who are IMC Is and four other
IMC IIs who rotate in on a daily basis. The IMC I sits in an office that is close to the front.
Because of concerns around security, the Due to security and workers take each walk-in
to their office and give them personal attention. We did not obtain any new
positions. When looking at staff, workload and how we were going to become universal,
we also looked at the customer care unit. We had to come up with a plan using only the
positions we had.
 Duties: They currently see FNS walk ins, but will be phasing in Medicaid in August. They
help them complete review paperwork, obtain information regarding changes, and answer
any questions they may have.
 Approach: When a client walks in and asks to see a worker, they forward an email to
one of the customer care workers on that day, who will assist the client. Their front desk
does not answer any questions.
 Important Note: Pitt learned quickly they needed a “cheat sheet” to help workers
navigate NC FAST, with regards to knowing what information to obtain etc. They had
some general instructions, but now have a supervisor working on — for lack of better
word — a “Cheat Sheet”. They found that workers obtain the changes, but failed to ask
for or advise on what was needed to process the change.
Call Resolution Team
 Position(s): 8 IMC IIs reallocated from other units in IM.
County
Process
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Nash
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Pasquotank
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Duties: Handle MA and FNS triage; divided into two teams, one for phone one for walk-in
traffic.
Approach: The receptionist assesses the need of each walk in client as: intake, review,
or triage. Absolutely anything that isn't intake or review is triage. The job of the Resolution
Team is to resolve whatever need the client has, no matter how big or small. The only
thing they don't do is applications or reviews; however, if they get the client by mistake
they will do apps/reviews if at all possible just to keep the client from having to be
transferred to another person. All calls go to this unit, and they attempt to handle the call
even if another worker is working on the review or application. Rarely is that necessary.
Important Note: Unable to make structural changes to the intake area, Cleveland Co.
realized triage can actually occur anywhere, even at someone’s desk.
Benefits: They “paid” for themselves so to speak by eliminating interruptions for the other
staff, especially the review workers.
Approach: Using Reception staff. They have advised their FNS receptionist that if it's
something they can handle and the worker does not need to see the client, they need to
handle it. They are in discussion and may go in the direction of having a caseworker at
the front desk to handle eligibility-related items. If they do this, they will reorganize the
staff that they have to do the job that needs to be done.
Position(s): One OA IV (soon to be 2 additional positions) taken from clerical in
IM. Currently handles FNS; additional positions will mean the team of 3 can support all
IM programs.
Duties: Taking information provided by the client to include reported changes, reviewing
recert forms for completeness, and information requests from the clients.
Approach: The OA IV has her own office and when called for any situation where the
front desk would call the caseworker to see a client. She uses an interviewing office
located near reception, and takes the information the client would have shared with the
IMC and does her best to handle the client’s situation. Most clients accept seeing her as
an alternative to not seeing their regular caseworker.
Benefits: This has worked to give “breathing room” to the FNS staff and prevent
interruptions.
Contacts
 Pitt County: [email protected] or [email protected]
 Camden County: Beth Sawyer - [email protected]
 Nash County: [email protected]
 Pasquotank County: [email protected]
 Scotland County: James McQueen - [email protected]
 Cleveland County: [email protected]
 Rowan County: [email protected]