Attachment_I_-_OMHA_Workplace_Recommendations_Report_(HOK_POR).pdf

Workplace Recommendations Report

U.S. Department of Health and Human Services Office of Medicare Hearings and Appeals Western Field Office, Irvine, California

Final Issue February 14, 2013

Table of Contents

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA| i

1.0 Executive Summary 1‐1

1.1 Introduction

1.2 Key Findings and Recommendations

1.3 Engagement Strategy

1.4 Participants

2.0 Research Data 2‐1

2.1 About the Office of Medicare Hearings and Appeals

2.2 Vision Session

2.3 Workplace Characteristics

2.4 Employees Work Profile

2.5 Key Findings

3.0 Recommended Workplace Strategies 3‐1

3.1 Workplace Strategies and Implementation Assessment

3.2 Share Resources

3.3 Reduce Types and Sizes

3.4 Create Multi‐use Spaces

3.5 Reduce File Storage

3.6 Telework and Desk Sharing

3.7 Workplace Strategies Enablers

3.8 Integration of Sustainability

4.0 Workplace Features Evaluation and Future Recommendations 4‐1

4.1 Existing Workplace Evaluation

4.2 Existing Workplace Performance Summary

4.3 Successful Features Analysis

4.4 Underperforming Issues Analysis

4.5 Existing Workplace Standards

4.6 Recommended Individual Workspace Standards

4.7 Recommended Shared Support Spaces

4.8 Organizational Adjacencies: Overall OMHA Irvine

5.0 Team Profiles 5‐1

5.1 Administration Team

5.2 Administrative Law Judge Teams

5.3 Adjudication Support Team

6.0 Appendix 6‐1

6.1 Headcount Worksheet

6.2 Employee Survey and Focus Group Participation Rates

6.3 Employee Survey Verbatim Comments

6.4 Existing Floor Plans

6.5 Space Program Recommendations (dated Feb 14, 2013)

Table of Contents

Executive Summary

1.0

1.1 Introduction

1.2 Key Findings and Recommendations

1.3 Engagement Strategy

1.4 Participants

This chapter of the Workplace Recommendations Report describes the project background, key findings and recommendations, engagement strategy, and participants.

1‐2

1.0 Executive Summary

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

This report outlines the future space needs and functional requirements of the Office of Medicare Hearings and Appeals (OMHA), Western Field Office in Irvine, California. This organization is part of the U.S.

Department of Health and Human Services (HHS). The purpose of this study is to determine the space requirements of OMHA in anticipation of a replacement lease procurement.

Currently, OMHA has approximately 138 employees located at 27 Technology Drive, Irvine, California. The current lease expires in June, 2015.

The new lease is required to comply with the HHS Facilities Program Manual (Volume II) Utilization Rate for Office and Related Space, dated October 13, 2011. This policy outlines the maximum utilization rate (measured in usable square feet per person) for OMHA offices and support space. The maximum utilization rate (UR) for space planning is 170 UR on average. The current UR in OMHA Irvine is approximately 297 UR. Therefore, OMHA will need to identify significant space savings in order to comply with the 170 UR.

1.1 Introduction

27 Technology Drive, Irvine, CA

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Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

1.2 Key Findings and Recommendations

The following common themes emerged from the study of OMHA:

Space Utilization The need for improvement in current workplace efficiency was frequently mentioned by OMHA leaders, especially with regard to file storage, team work flows and team colocation.

Technology Upgrade While existing technology is able to meet OMHA’s current needs, some components are outdated. Additionally, technology upgrades may be required to support the future implementation of the E‐Case file system.

Flexibility There are many significant changes anticipated at OMHA, including implementation of the E‐Case file system, standardization of job functions and work spaces, and an increased workload due to policy change. OMHA leaders believe that organizational and spatial flexibility is needed to effectively meet the challenges ahead.

Standardization It is anticipated that many aspects of the OMHA organization will become standardized across regional field offices . Standardization of team structure, job functions, work processes, and space standards, are expected to improve overall organizational performance and efficiency.

Openness and Sharing The current OMHA organizational culture is somewhat siloed. There are no common practices for resource and knowledge sharing across teams or across regional field offices.

The recommended workplace strategies will help OMHA make progress towards addressing the common themes.

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Recommended workplace strategies include…

Based on study findings and analysis, the following summary table includes key recommended workplace strategies that would allow OMHA to use space more efficiently and to provide an effective workplace. An assessment of the ability of the Irvine office to implement the recommended strategies is also provided. Each strategy is described in more detail in Chapter 3.

Key Findings and Recommendations (continued)

WORKPLACE STRATEGIES IMPLEMENTATION ASSESSMENT

Share Resources:

Eliminate duplication in support spaces

High ability to implement this strategy since support spaces such as copy/scan and break areas are currently shared among teams. However, hearing rooms are not equally accessible to all judges or staff.

Reduce Types and Sizes:

Use space more efficiently; have fewer space types and sizes to support interchangeability

Relatively high ability to implement this strategy if union concerns can be addressed, and space inequity is avoided by the implementation of new standards in all OMHA locations.

Create multi‐use spaces:

Configure spaces so that they can be used for a variety of functions

This strategy can be easily implemented. There is a general consensus within OMHA that flexibility and efficient use of space are key attributes of a desirable future workplace.

File Storage Reduction:

Reduce the need for paper storage; Use a more efficient file storage system

OMHA Irvine is somewhat limited in their ability to implement file storage reductions in the short term due to constraints that are out of their control such as: timing of E‐Case file implementation; high volume of incoming cases in paper format; inconsistent folder tabs format from central docketing; and budget constraints for digitizing backlog case files.

Telework and Desk Sharing:

Encourage all eligible employees to work remotely and share desks at the office

OMHA Irvine is well positioned to implement this strategy since they already have a flexiplace program that permits employees to work remotely. However, there are impediments to success such as union concerns with desk sharing and supervisors’ perception of employees’ effectiveness when they work remotely.

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Enablers that support the successful implementation of recommended workplace strategies include…

People, technology, and physical space need to be aligned to support the implementation of new workplace strategies. The following aspects are enablers of successful workplace strategy implementation:

Create Flexibility

• Remove physical and organizational barriers that hinder the organization’s ability to implement new workplace strategies.

Technology

• Provide appropriate technology and equipment to support how employees work, communicate and collaborate with others, and access information –when in the office and from remote locations.

Culture and Work Habits

• Success depends on active engagement from senior leaders, managers, and all employees. Introducing new work processes and behaviors should be supported by an appropriate change management effort.

These enablers are further described in Chapter 3.

INTEGRATED SUSTAINABILITY

A relocation allows OMHA to incorporate sustainable design principles and create an improved work environment for occupants. Implementation of sustainable principles can include: site selection, energy conservation techniques, building materials selection, enhanced access to daylight and views, and waste reduction. Please refer to Section 3 for more detailed information.

Enablers

Create Flexibility

Technology

Culture and Work Habits

Key Findings and Recommendations (continued)

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Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

This report is the result of a consultant‐facilitated programming and concept study by the US General Services Administration (GSA). The GSA Requirements Development Process is designed to provide workplace criteria and space programming information. By garnering a better understanding of the customer through input from all levels of the organization, the consultant facilitates the development of organizational goals and business strategies. Through this process, GSA aims to develop a more strategic approach for delivering real estate solutions to its clients, with a focus on addressing organizational change and evolving work processes.

Key objectives of the Requirements Development Process include:

• Working with the client organization to enhance user engagement in the workplace development process;

• Assisting the client agency in defining the organizational context, business goals, and work processes to be addressed by the workplace design;

• Developing project goals and concepts that address key business strategies to guide the design process, ensuring that organizational needs are addressed;

• Leveraging the value of the workplace to enhance organizational performance and image, and, where appropriate, use the workplace as a catalyst for organizational change; and

• Contributing to the refinement of the process through identification of lessons learned and the development or refinement of client engagement tools and methodologies.

Background information was provided by OMHA: organization charts, floor plans of existing spaces, telework policy, and space management policy.

1.3 Engagement Strategy

1‐7Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

HOK collected and analyzed data from OMHA Irvine. Prior to an onsite visit the following data gathering tool was used:

Employee Survey: A workplace survey was distributed to all OMHA Irvine employees in late November 2012. The survey was open for 2 weeks and approximately 49% of employees responded.

During an onsite visit from November 27 to 29, 2012, further data was gathered via:

Leader Vision Session: OMHA leaders from the Irvine office and the Headquarters in Arlington VA office participated in a vision session.

Employee Focus Group: A Focus Group was conducted with Administrative Law Judges to review and validate survey findings. Focus Group attendance was voluntary. No focus groups were conducted for other staff due to union concerns.

On‐Site Leader Interview: Interviews were held with Administrative leaders, supervisors and ALJs. These interviews offered the opportunity to discuss space saving strategies, organizational priorities and future changes in staff and work patterns.

Workplace Assessment Walkthrough: A tour of the existing space was taken with the Field Operations Manager to inventory key features of space and to document underperforming workplace issues.

The information gathered was used to determine the recommended workplace strategies that will effectively support OMHA missions and the agency‐wide goal to increase space utilization.

Engagement Strategy (continued)

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Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

OMHA participants during the HOK/GSA onsite visit were as follows:

1.4 Participants

Vision Session

Remote participants:

• Anne Lloyd

• Bruce Goldin

• Eileen McDaniels

• Randy Vanderpool

• Segundo Pereira

In person participants:

• Amy Porter

• Andreas Frank

• Judge Wein

Leader Interviews

Administrative Supervisors

• Amy Porter

• Andreas Frank

• Debbie Lang

Attorney/Paralegal Supervisors

• Cari Cohn‐Morros

• Hildee Brahm

• Trina Beckner

Administrative Law Judges

• Judge Wein

• Judge Chinn

• Judge Cowan

• Judge Kelton

• Judge McCormick

• Judge Smith

• Judge Takos

• Judge Turner

• Judge Weber

Focus Group

Administrative Law Judges

• Judge Smith

• Judge Trudelle

• Judge Turner

• Judge Weber

Research Data

2.0

2.1 About the Office of Medicare Hearing and Appeals

2.2 Vision Session

2.3 Workplace Characteristics

2.4 Employees Work Profile

2.5 Key Findings

This chapter describes the research data collected by HOK using the workplace diagnostic tools.

2.0 Research Data

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The Office of Medicare Hearings and Appeals (OMHA) is a part of the U.S.

Department of Health and Human Services (HHS). OMHA reports directly to the Secretary of HHS. OMHA administers nationwide hearings at Level 3 of the Medicare claims appeal process. The organization consists of four field offices and the headquarters office.

OMHA was created by the Medicare Modernization Act of 2003 to simplify the appeals process and make it more efficient. During an appeal, an OMHA Administrative Law Judge conducts a new ("de novo") review of an appellant's case and issues a decision based on the facts and the law.

The Western Field Office of OMHA is located in Irvine, California. It is the building’s only tenant, occupying two floors of the building. Refer to Section 6.0 Appendix for existing floor plans.

OMHA Irvine was established only 7 years ago, so work processes, space standards, and job functions have not yet been standardized across the organization. Currently there is an effort headed by the OMHA headquarters to establish various organizational structure and work processes standards. The Irvine office will be the pilot location to implement the new space standards and serve as a model for other OMHA field offices nationwide.

As a result of these upcoming standardization initiatives, it is expected that OMHA will undergo several significant changes over the next few years. OMHA currently operates four field offices but anticipates establishing additional field offices in time.

2.1 About the Office of Medicare Hearings and Appeals

OMHA Irvine Office: Front Entry

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2.2 Vision Session: Overview

At the project outset, HOK facilitated a Vision Session with OMHA leaders to understand the current organization and future aspirations. Participants included leaders from the OMHA Irvine office and the Headquarters office in Arlington (via video teleconference). The intent was to help OMHA’s leadership set a clear project direction and to align the project team on goals and expected outcomes. The goals, challenges and opportunities that emerged would serve as a foundation for developing workplace strategies recommendations.

Participants were engaged in the following activities:

1. Goal Setting: A balanced scorecard approach was used to discuss overall goals for the project and for the future OMHA organization.

2. Barometer for Change: Participants were asked to rank OMHA’s current and desired state on different aspects such as technology, mobility and knowledge sharing.

3. Current Conditions and Performance: Key themes relating to ‘What’s Working’ and ‘What’s Not Working’ elements of the current workplace were discussed.

4. Image and Character Review: HOK conducted an exercise to understand what workplace characteristic and images are desired for the future OMHA workplace.

Key findings are summarized on the following pages.

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA| 2‐4

The format of the balanced scorecard encourages a holistic consideration of the work environment. This approach is used to help OMHA relate the workplace to a broader range of strategic operational and management issues.

Researching the current workplace identifies aspects that impact the achievement of the overall goals. The recommendations for the future workplace will include workplace strategies that help support OMHA achieving these goals. Key issues to consider in implementing the recommended strategies will also be identified.

The objectives as identified by participants were sorted into the four quadrants of the balanced scorecard (seen at right).

OVERALL PROJECT GOALS

• Comply with the HHS space utilization rate policy of 170 UR.

• Optimize workplace effectiveness to support the OMHA organizational missions.

• Use Irvine office space allocation standards for other OMHA regional offices.

• Design a flexible workplace that will better accommodate flux in

OMHA’s organizational structure and work processes.

2.2 Vision Session: Goal Setting

The balanced scorecard captures the common organizational objectives cited by OMHA senior leaders during the Vision Session. Human Capital

• Increase collaboration and knowledge sharing across teams and regional offices.

• Leverage the telework program as a talent retention and attraction strategy.

• Be a flexible organization adaptable to oncoming changes.

• Establish standard roles and responsibilities for job functions.

• Establish specialized pools to address known bottlenecks within the adjudicatory process.

• Provide space and resources to support computer‐based training.

Business Process

• Standardize workspaces across regional offices to comply with 170 UR target.

• Implement the standardized ‘Adjudicatory Business Process’ across field offices.

• Leverage technology to increase efficiency in processing caseloads

• Implement E‐case file system for appeals.

• Reorganize existing paper storage and mail system for better efficiency.

Finance

• Optimize space utilization thereby allowing reallocation of cost savings to opening new field offices.

• Minimize future renovation costs by designing an easily adaptable workspace.

Customer

• Provide fair, credible and timely decisions on Medicare appeals.

• Provide high‐quality customer service to appellants and their representatives.

• Follow the congressional mandate of 90 day time frame for adjudication.

• Anticipate customer concerns or needs following implementation of the E‐case file system.

• Provide more effective customer services to appellants through a self‐services model.

OMHA ORGANIZATIONAL OBJECTIVES

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2.2 Vision Session: Barometer for Change

Knowledge Sharing The Irvine office participants felt that knowledge sharing is limited in the organization. There was a consensus among the participants that there should be much higher sharing and collaboration across teams and field offices.

Technology Participants agreed that the current technology is dated, and having modern, up‐to‐date technology is the desirable in the future, especially for video conferencing. However, the Headquarters office participants noted that state‐of‐the‐art technology is not necessary because of its often high implementation cost. There is a large gap between the current and future desired state indicated by the participants.

Mobility The Irvine office participants felt that employees were mostly anchored to their desks when in the office. However, Headquarters and Irvine offices both use the current flexiplace program to allow many qualified employees to work remotely. Participants agreed that enabling employees to be more mobile and in the future is very desirable. The Irvine office participants also believe that the implementation of the E‐case file system will greatly enhance the ability of certain job functions to work remotely.

Vision session participants shared their perception of several metrics describing how the organization is currently performing, and the desired future state.

1 2 3 4 5 6 7 8 9 10

H R Low High

R H

1 2 3 4 5 6 7 8 9 10

Dated State-of-the-art R H R H

1 2 3 4 5 6 7 8 9 10

Anchored Agile R H H R

‘H’ denotes ranking by the Headquarters participants ‘R’ denotes ranking by the Irvine office participants

Current state Desired state

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1 2 3 4 5 6 7 8 9 10

H R R H

Barometer for Change (Continued)

Performance All participants felt that OMHA is currently doing reasonably well but hope to achieve a higher level of performance in the future. They believe the standardization of work process and E‐Case file implementation will help improve efficiency and customer service.

Work Processes The Irvine office participants felt that the current work process is somewhat individual‐focused and teams are very independent. The participants want to see more collaboration within the Judge team and across teams in the future. Similarly, participants felt that the regional field offices are very isolated and expressed a need to increase cross‐collaboration in the future.

Individual Collaborative

Attitude to Change The Irvine office participants felt that in past employees were mostly flexible regarding change, but that there may be increasing resistance due to an overwhelming number of recent and upcoming changes.

Comparatively, Headquarters participants rated the attitude to change as more resistant. In the future, all participants desire an organization that is more flexible and adaptable to change.

To bridge the (significant) gap between current and desired states, OMHA should consider developing a comprehensive change management plan to help employees transition through the anticipated changes.

Resistant Open

1 2 3 4 5 6 7 8 9 10

HR

Low High

R H

1 2 3 4 5 6 7 8 9 10

H R RH

‘H’ denotes ranking by the Headquarters participants ‘R’ denotes ranking by the Irvine office participants

Current state Desired state

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA| 2‐7

The image exercise stimulates a discussion about the desirable characteristics of the future workplace.

A matrix of images (seen at right) references different aesthetic styles and characteristics. Participants each selected 3 images that resonated positively with them and 3 images they felt negatively about, and shared their selection rationale with the group.

The following pages summarize key findings from the discussions.

2.2 Vision Session: Image and Character Review

A discussion about the look, feel, image and character of the future workplace…

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA| 2‐8

TOP 6 ‘FAVORABLE’ IMAGES

Image Comments

• Openness, views, and airy

• The lack of cubicle walls is desirable

• Modern, less bureaucratic image

• Glass‐front offices and open workstations are appealing

• Like the use of wood

• Interior glass‐front offices

• Good natural light penetration

Image Comments

• Natural light and views, openness

• Circulation space being efficiently used for hoteling desks

• Private offices not on the building perimeter

• Like the warm appearance of wood

• Functional look (some participants considered this space too utilitarian due to the lack of color)

Image and Character Review (Continued)

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TOP 6 ‘UNFAVORABLE’ IMAGES

Image Comments

• Fixed, inflexible space and furniture

• Lack of adaptability

• Excessive, wasted space

• Dark

• Fuorescent lighting

• Depressing, isolating

• Institutional (one participant appreciated the clean, minimalist space)

• Potentially noisy with no panels in such a large open area

Image Comments

• Space does not look useful

• Not realistic to meet HHS utilization rate target

• Too casual for OMHA’s image

• TV in work area gives wrong impression

• Image is not related to OMHA business processes

• Fixed furniture, wasted space

• If a reception area is needed, it needs to be extremely functional and have a small footprint

Image and Character Review (Continued)

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA| 2‐10

ALJ Interviews Leader Questionnaires

Disorganized Cluttered

Cramped Overwhelming

Cluttered Crowded

Oppressive Overrun with files

Outdated Messy

Fragmented Bland

Maze‐like Infrequent interaction

Collaborative (Team) Sterile

Noisy Monotone

Attractive

Warm

Unsafe

2.3 Workplace Characteristics

ALJ Interviews Leader Questionnaires

Efficient/Practical/Integrated Professional Professional Organized Organized Clean

State‐of‐the‐art Conducive to interaction Flexible/Forward‐thinking Legal

Formal Modern Energizing Flexible Innovative Open

Quiet Light Airy

Spacious Inspiring

Comfortable Appropriate for the task

Current Future (Desired)

The current OMHA workplace is frequently described as ‘disorganized, cramped, and overwhelming’, while the desirable characteristics are ‘organized, efficient, and flexible’.

More about the characteristics of the future workplace …

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA| 2‐11

CO

LL

AB

O

RA

TI

O N

Lo w co lla bo ra tio n H ig h c ol la bo ra tio n

Limited Mobility Highly Mobile MOBILITY

LEGEND

Long Periods Of Concentration

Short Periods Of Concentration

ASH

Collaboration: Amount of time that staff spend on interaction such as phone calls and in‐person meetings.

Mobility: Amount of time that staff spend away from their desk in the office.

*These job functions are externally mobile, i.e. a significant amount of time is spent working away from the office.

Legal Asst.

Admin Mgrs.

Intake Clerk

Office Asst.

Attorney*

Admin.

Law Judge

Prog.

Analyst

2.4 Employees Work Profile

Current work patterns.

The following diagram graphically depicts the subjective descriptions of employee work patterns provided by the senior leaders, surveyed employees, and focus group participants. The mapping shows different job functions’ general tendency for collaboration, mobility, and long/short periods of concentration. The circle size represents the relative number of people in that job function.

Paralegal*

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The common issues from survey data, leader interviews and focus group are:

Adjacency: Many Administrative Law Judges (ALJ) want their team members to be colocated. They feel strongly that colocation is key to be an effective team. Currently many members are not colocated with their team due to the union’s concern about staff moving to an office or workstation that is perceived as inferior to their current location.

Hearing Rooms: There is a perception of inequity in ‘space ownership’.

Currently, there are different sizes hearing rooms and not equally accessible to all Judges. Hearing rooms are used by Judges: to conduct hearings; to meet with teams; as a quiet space to prepare for upcoming hearings; and to issue decisions post hearings. Currently due to lack of team work space, some teams are using the hearing rooms with a large table as a layout area while preparing for ‘big box’ hearings, i.e. hearings with a high volume of case file boxes.

Acoustics: Sound currently travels between hearing rooms, offices, and circulation areas. This is highly undesirable. Acoustic privacy is essential for hearings.

File Storage: Disorganized and fragmented storage has compromised the workflow efficiency and professional image of the workplace. Employees feel demoralized and overwhelmed. The proximity of team to file storage is essential as long as paper files are still part of the work flow, but that will change when the E‐case file system is implemented. Many are concerned about how the workspace can accommodate the transition.

Technology: While current technology is able to support current work processes, there is much room for improvement. OMHA hope to leverage technology such as E‐Case file system to streamline work process and enhance the ability to work remotely.

2.5 Key Findings

Telework: Attorneys and Paralegals telework the most, up to 6 days per pay period (2 weeks). Others telework up to 2 days per pay period. Administrative Supervisors support teleworking, while some ALJs feel that teleworking negatively affects productivity and supervision.

Flexibility: The organization and physical space need to be more agile and have better ability to quickly respond to change.

Case files racks ‘taking over’ the large multi‐purpose room used to support large group meeting and training.

3.0 Recommended Workplace Strategies This chapter presents the recommended strategies that optimize workplace effectiveness to support the organization’s mission.

3.1 Workplace Strategies and Implementation Assessment

3.2 Share Resources

3.3 Reduce Types and Sizes

3.4 Create Multi‐use Spaces

3.5 Reduce File Storage

3.6 Telework and Desk Sharing

3.7 Workplace Strategies Enablers

3.8 Integration of Sustainability

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

3.0 Recommended Workplace Strategies

3‐2

3.1 Workplace Strategies and Implementation Assessment

By implementing a variety of workplace strategies, OMHA can create an effective workplace and comply with the mandate for 170 UR.

Workplace strategies to achieve 170 UR:

• Share Resources: Eliminate duplication of support spaces.

• Reduce Types and Sizes: Use space more efficiently; have fewer space sizes for similar functions (e.g. fewer sizes of offices and workstations).

• Create multi‐use spaces: Configure spaces (especially shared support space) so that they can be used for a variety of functions.

• File Storage Reorganization and Reduction: Reduce the need for paper storage. Reorganize necessary items to increase efficient storage.

• Telework and Desk Sharing: Encourage all eligible employees to work remotely and share desks when at the office.

Each workplace strategy is further discussed in Sections 3.2 through 3.5.

High

Medium

Low

Share Resources

File Storage ReductionReduce Sizes

Telework/ Desk Sharing

Ability to Implement

Multi‐use

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

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OMHA organizational readiness and ability to implement the workplace strategies will impact the timing and priority of adopting the new strategies.

Workplace Strategies and Implementation Assessment (continued)

Workplace Strategies Implementation Assessment

Share Resources:

Eliminate duplication in support spaces

High ability to implement this strategy since support spaces such as copy/scan and break areas are currently shared among teams. However, hearing rooms are not as equally accessible to all Judges or staff.

• There is a significant opportunity to increase space utilization by sharing reservable hearing rooms that are standardized (size and technology) to reduce the notion of ‘space ownership’.

• Sharing resources requires a behavior and culture change as well as a space re‐design. A change management plan is needed to help introduce and support the transition to the new desirable behaviors.

Reduce Types and Sizes:

Use space more efficiently; have fewer types of space and sizes to support interchangeability

Relatively high ability to implement this strategy if union concerns can be addressed, and space inequity is avoided by the implementation of new standards in all OMHA locations.

• The potential for space saving can be substantial if the individual workspaces and hearing rooms are right‐sized to achieve efficiency while continuing to support employee work activities and space usage patterns.

Create multi‐use spaces:

Configure spaces so that they can be used for a variety of functions.

This strategy can be easily implemented. There is a general consensus within OMHA that flexibility and efficient use of space are key attributes of a desirable future workplace .

• OMHA Irvine should clearly communicate the multi‐use space concept to the selected design team to ensure that it is incorporated into the future workplace design.

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

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Workplace Strategies Implementation Assessment

File Storage Reduction:

Reduce the need for paper storage

OMHA Irvine is somewhat limited in their ability to implement file storage reductions in the short term due to constraints that are out of its control such as: timing of E‐Case file implementation; high volume of incoming cases in paper format; inconsistent folder tabs format from central docketing; and budget constraints for digitizing backlog case files.

• As these barriers are removed over time and accompanied by a reduction in the amount of paper file storage, OMHA Irvine could benefit from significant space savings .

• Despite the constraints, OMHA Irvine should aggressively seek alternative solutions to address the current file storage situation. The feasibility of digitally scanning and storing backlog case files is under review. This would be a potential interim solution to address the growing storage need.

Telework and Desk Sharing:

Encourage all eligible employees to work remotely and share desks at the office

OMHA Irvine is well positioned to implement this strategy since they already have a flexiplace program that permits employees to work remotely. However, there are impediments to success such as union concerns with desk sharing and supervisors’ perception of employees effectiveness when they work remotely.

• The potential impact of telework and desk sharing within OMHA Irvine space is significant. The implementation of a desk sharing or hoteling concept can help improve space utilization by negating the need to have unused space when employees are working remotely.

• The current flexiplace policy is being review by a OMHA committee. Any changes to the policy could have an effect on the implementation of desk sharing.

Workplace Strategies and Implementation Assessment (continued)

Workplace Recommendations Report | Office of Medicare Hearings and Appeals| Western Field Office, Irvine, CA|

3‐5

Share common resources, such as hearing rooms, meeting rooms and printers, to maximize their use and the efficient use of floor space.

While OMHA Irvine is already sharing some support spaces among teams in the current facility (such as copy/scan stations and break areas), there is a significant opportunity to increase space utilization by extending the ‘share resources’ strategy to other support spaces such as hearing rooms. In addition, sharing resources could provide an opportunity to facilitate collaboration and increase interactions among teams.

Currently, each Administrative Law Judge (ALJ) team’s work process is autonomous. Some hearing rooms are shared between two Judges, but generally there is a strong notion of ‘space ownership’. Due to the different sizes of hearing rooms, there is a perception of inequity among the ALJs.

Although OMHA Irvine has shared common print/copy stations throughout the facility, some employees still have personal printers/scanners at their desks. Many organizations are only providing central printers (along with a policy of no personal printers) to:

• Eliminate storage space for toner cartridges;

• Reduce maintenance cost for a variety of printer models;

• Reduce time spent on IT support; and

• Reduce multiple sources of noise and air pollutants.

3.2 Share Resources

Recommendation

• Centralize and share all support spaces where possible.

Recommended support spaces to share include: hearing rooms, centralized printer/copier areas, break rooms, meeting rooms, quiet rooms, hoteling touchdown stations/offices.

Hearing/Meeting Rooms:

• Provide a reservable pool of hearing rooms that have standardized layout, furniture, and technology set up to address the space ownership and inequity concerns.

• Utilize an online reservation system. Where necessary, establish a protocol for unforeseen, high priority meetings.

Central Printers:

• Utilize high capacity printers and copiers that can accommodate multiple users and large production jobs.

• Leverage technology to address confidentiality issues associated with sharing printers and copiers. Enable access code controls so that print jobs are held until the authorized employee enters their code.

• Train staff to utilize equipment functions that allow them to protect the confidentiality of print and copy jobs.

Hoteling Workspaces:

• Provide a reservable pool of shared hoteling workspaces

(office or workstations) for workers who spend majority of their time working away from the office.

Behavior Change:

• Develop new workplace protocols that describe appropriate behavior for sharing resources.

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3.3 Reduce Types and Sizes

Standardize workstation and office sizes to create a more flexible workspace. Reduce office allocations to create a more efficient workspace.

By reducing and optimizing hearing rooms, office and workstation sizes, significant space savings can be realized. Standardization provides for flexibility as teams grow and change.

It is anticipated that the E‐case file system implementation will have a significant impact on the OMHA work flow. It will reduce or eliminate the need to accommodate paper format case files and thereby reduce the amount of space required. However, it is important to consider the transition period where paper files may still be needed, at least until the entire backlog is processed.

A separate study being conducted by the ‘Center for Legal & Court Technology and the Courtroom 21 Project’ is establishing future space standards and requirements for OMHA hearing rooms.

A smaller percentage of office allocation is another option to further reduce space need to meet the 170UR target. With fewer offices in the future workplace allocation, it is necessary to create quiet work zones or neighborhoods to support concentrative work in the open work area.

A key potential obstacle to the implementation of this strategy is union negotiation of workspace sizes at the national level. The outcome of the negotiation could impact the possible space savings.

Recommendation

• Standardize workstations and offices to allow for planning the OMHA space as a flexible, modular grid, making it easier to change room functions with minimal associated costs. Correspondingly, furniture and equipment should also be standardized for ease of interchangeability.

• Provide central file storage solutions to minimize storage required at individual desks.

• Minimize the number of enclosed office allocation and create open workspace neighborhoods.

• Supply touchdown stations for intermittent workers such as temporary staff and extern students.

• Establish workplace protocols and provide furniture and technological solutions that support a concentrative work environment.

• Optimize hearing room sizes to reflect the future work process and provide flexibility to accommodate the transition period from paper to electronic file format.

• Communicate with union representatives regarding overall OMHA goals of the future workplace and involve them early in the project planning process and change management planning.

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3.4 Create Multi‐use Spaces

Configure spaces so that they can be used for a variety of functions.

In order to meet the 170UR goals, the future workplace has to be smartly designed to “do more with less”. Workspaces should be designed for a variety of uses and accommodate organizational and work process changes in the future, as much as economically feasible.

Below is an example of the same space module configured for 4 alternative uses.

Recommendation

• Consider dividing large meeting rooms with operable partitions so that they can transform into multi‐use spaces for larger meetings and functions.

• Use movable furniture that is modular for easy reconfiguration to accommodate different activities.

• Leverage circulation space to become part of a usable space that support multiple functions.

• Clearly communicate the multi‐use space concept to the selected design team to ensure that it is incorporated into the future workplace design.

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Recommendation

• The future workplace design should take into consideration the possibility of a transition period where the workspace has to support paper‐based work processes until all case files are in electronic format. File storage space that is no longer needed should be designed for easy re‐purposing to support other needs.

• Prioritize implementation of the E‐Case file program and address any potential barriers (technological or cultural) early in the process to prevent any potential delays in full implementation.

• Select workplace furniture that maximizes file storage opportunities, i.e. high‐density file system. Ensure that storage systems being selected are compatible with existing file tagging protocol.

• Engage a file management consultant to advise on the selection of high‐density file system that is suitable for the current file folder tagging format.

• Increase the frequency of file processing, shredded materials removal and closed files so that they do not consume excessive space.

• Set printers to default to double‐sided printing, so that less paper needs to be stored.

• Encourage and advocate that OMHA/HHS headquarters updates document retention policies to minimize paper filing. Also advocate a change in regulation to address the current offsite storage restriction.

3.5 Reduce File Storage

Minimize onsite file storage by expediting implementation of the E‐Case file program, storing backlog files at accessible offsite locations, and creating digital copies (where feasible).

By implementing an electronic file system, workplace flexibility and employee mobility will increase as employees are able to access the information they need remotely.

In its current facility, OMHA Irvine has some 5,000 sf of space occupied by file storage. This represents more than 10% of the total useable space. Due to the increase in Medicare appeal cases, new case files are being delivered to OMHA Irvine daily, perpetuating the struggle against growing demands for file storage. Hallways, vacant offices, even a large meeting room have been taken over for files.

OMHA headquarters is in the process of obtaining approval and funding for the E‐Case file program. The program may be approved in early 2013 but is anticipated to require at least 2 years before being ready for processing new cases. No decision has been made regarding backlog files that are still in paper format.

The feasibility of digitally scanning and storing backlog case files is under review by OMHA Irvine. This would be a potential interim solution to address the growing storage need.

OMHA Irvine indicated that offsite storage is currently not an option because the laws and regulations concerning PII and security prohibit the agency from renting offsite storage. The current purchasing regulation is also an obstacle for considering offsite storage as a solution.

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3.6 Telework and Desk Sharing

Continue to implement the current telework policy and provide those who mostly work remotely with access to shared workspaces when they come into the office.

Enabling staff to work remotely more than half of the work week has the potential to decrease overall space requirements, only if those employees abdicate their individual desks in order to share desks when in the office. When remote workers need to be in the office, they can either share assigned desks or share a pool of available desks.

OMHA Irvine has a high rate of eligible employees participating in the flexiplace program. HR survey also indicates that flexiplace participants are highly satisfied. The current policy allows attorneys and paralegals to telework up to 6 days per pay period (2 weeks). Currently, many attorneys telework 3 days per week, while most paralegals telework only 2 days per week.

Existing Barriers Paper Case files: Employee survey results indicate many respondents feel that the need for physical files has a significant impact on their ability to telework. Employees who telework have to carry boxes of paper files to and from home to work on their assignments. When E‐ Case file system is implemented, it will increase employee mobility by reducing the need to carry high volumes of paper files.

Supervisors Perception: Many supervisory ALJs have a strong opposition to telework because they find it difficult to supervise and collaborate with teleworking employees. Many ALJs insist that it essential to have all team members physically in the office in order to be efficient in processing cases.

Recommendation

• Remove existing barriers that prevent qualified employees from teleworking regularly at least 3 days a week.

• Train leaders and managers in new methods for successful supervision of remote workers. Focus on achieving performance metrics, results and work products rather than on ‘seeing’ people at work.

• In lieu of assigned desks, provide unassigned shared hoteling workspaces (office or workstations) for workers who telework more than 3 days per week.

• Create a online reservation system for the hoteling workspaces to enable staff to plan ahead and schedule the appropriate resources when in the office.

• After the implementation of E‐case file, offer IT support and training so that staff can reliably and easily access the resources they need to work remotely.

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EnablersEnablers are essential to support successful implementation of the workplace strategies.

People, technology, and physical space need to be aligned in order to support the implementation of new workplace strategies. The following aspects are enablers of successful workplace strategy implementation:

• Technology

• Create Flexibility

• Culture and Work Habits

Each of the enablers is described in more detail in Sections 3.8 and 3.10.

Technology

Create Flexibility

Culture and Work Habits

3.7 Workplace Strategies Enablers

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3.7 Workplace Strategies Enablers: Technology

Provide appropriate technology and equipment to support how employees work, communicate and collaborate with others, and access information – in the office and from remote locations.

Physical space in the office is only one of the many aspects that support work processes. Technology is also a requirement for supporting work:

it is a key enabler of employee productivity and has a significant impact on the implementation of any new workplace strategies.

Mobility technology helps employees work from multiple or remote locations. These include VPN connections, laptops, and VoIP, etc.

Communication technology helps employees share information easily.

These include softphones, cell phones, email, text messaging, and laptop video conferencing cameras, etc.

Collaboration technology helps employees work together more efficiently. These include video conferencing equipment, projector and online meeting capability, groupware, etc.

Knowledge Management technology allows easy access to information repositories. It requires fast, secure, and reliable connection to the central network and the ability to easily search for information and electronic files.

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Technology Description

VPN • Virtual private network (VPN) allows employees to access the organization’s central network from remote locations.

• To be effective when working remotely, employees need a secure, reliable and fast VPN connection.

VoIP and Softphone

• Voice over Internet Protocol (VoIP) is a technology that transmits voice communication through the Internet.

• Softphone is the same as an office VoIP phone but functions through the laptop rather than a handset. It has call forwarding and conference capabilities.

Electronic Filing Electronic filing requires:

• Adequate network capacity for file storage

• Standard organization and folder structure for ease of locating files

• Searchable records

• High quality scanning to preserve document legibility

Virtual Collaboration

• Video conferencing and other online tools can support virtual meetings and collaboration.

Centralized Network Printing

• Printing with a secure code can reduce the fear of losing the confidentiality of sensitive documents.

Network

ISSUES TO CONSIDER

• One of the most important technological requirements at OMHA is the VTC equipment in the hearing rooms. Any technology being considered for these spaces must be intuitively easy to use, and if necessary, adaptable for use within private offices.

• In order to enable a broader acceptance of teleworking, remote network connectivity must better support the transfer of large files without compromising productivity.

• To enable sharing of hearing rooms, conference rooms, hoteling workspaces, a common online reservation system must be implemented and be accessible by all teams.

• Future requirements to consider: install a secure wireless network and VoIP in the workplace in order to increase employee mobility within the facility.

• Provide training to managers and supervisors in technologies that support communication with staff working remotely.

Technology (continued)

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3.7 Workplace Strategies Enablers: Create Flexibility

Remove physical and organizational barriers that hinder the…