Structuring a Casework Operation
BY ANNE MEEKER
Introduction
When setting up a new casework system, the most important question to ask is: How do you want constituents to feel when they interact with your office? All decisions on structuring an office, setting processes, and running an operation should come from this fundamental principle: put the constituent first.
However, prioritizing constituents also requires creating a casework team structure that supports caseworkers. The nature of casework often requires a team to focus on the present: how do we solve today’s crisis, how do I handle the constituent on the phone this second? The position of caseworker is notoriously one of the highest-stress positions in a Congressional office, in part because good caseworkers will go above and beyond to serve the people who come to them for help. In the long-term, this can lead to burnout, compassion fatigue, and staff turnover, resulting in a loss of the institutional expertise needed to serve constituents well and contribute to big-picture solutions to casework problems.
Designing a thoughtful team structure and standard operating procedures is crucial for supporting both constituents and caseworkers. There are several key decisions that will shape a team early on.
Personnel Structure
There is no one best way for offices to structure a casework team and allocate responsibilities. However, two major matrices shape casework roles:
Casework-dedicated vs. Casework-shared Employees
Some offices have full-time staff entirely dedicated to casework, and some offices distribute casework responsibilities into other employee roles.
Some advantages of having casework-dedicated employees include letting employees truly master casework without juggling other responsibilities, including developing fluency with casework software. Fully-dedicated caseworkers can also manage their time and responsibilities to be more accessible to constituents than shared employees.
However, casework-shared employees can avoid some of the burnout that comes from only focusing on casework, and take a more holistic approach to casework by integrating it into other areas like outreach, policy, and communications.
Casework Specialists vs. Casework Generalists
Some offices choose to have their caseworkers each focus on a particular agency or set of agencies (ex: caseworker A handles Social Security, Medicare, and Workers Comp, caseworker B handles the VA and housing, etc.), and others choose to have caseworkers split responsibility by geography or handle incoming cases on a schedule (e.g. caseworker A handles Monday intakes, caseworker B handles Tuesday and Wednesday intakes, etc.).
There are pros and cons to both models: casework specialists can develop significant expertise and agency relationships in a particular area, but specializing can make the work repetitive, cause problems if an issue-area caseworker leaves the office without training a replacement, and make it harder to work on complex cases involving multiple agencies.
Casework generalists can build redundancy into a casework team and help caseworkers make connections between different agencies; however, generalizing can also prevent caseworkers from developing very detailed expertise or relationships on particular agencies, and cause confusion for agencies handling inquiries from multiple caseworkers from the same office.
For many offices, these approaches are also not mutually exclusive. For example, a team may have several dedicated issue-area caseworkers and a small portfolio of “miscellaneous” cases handled by a staff assistant; or a team that splits cases by issue area may have still have one staffer with a particular interest who takes a specific type of case from the entire district or state. While all approaches have their pros and cons, building a good process and supporting caseworkers can help minimize disadvantages of a particular structure.
Task Structure
Within the structural decisions above, casework teams also have to decide how to allocate agency portfolios or geographic responsibilities.
The total number of cases and the types of cases your team handles will largely be determined by your district: for example, districts with large military installations will tend to see higher numbers of Defense and military cases while districts with high percentages of retired constituents will tend to see more Social Security and Medicare cases.
For most districts, a majority of cases will fall under the following agencies and programs. Note that this is not an exhaustive list of agencies caseworkers work with, but a summary of agencies with traditionally high levels of casework inquiries.
Social Security
Social Security cases include both of Social Security’s disability programs (Supplemental Security Income or SSI and Social Security Disability Insurance or SSDI), retirement benefits (formally known as Old Age and Survivors’ Insurance or OASI), social security numbers, and Medicare enrollment.
Center for Medicare and Medicaid Services
CMS casework primarily covers Medicare services through the four parts of Medicare enrollment: part A handling long-term care, part B handling “traditional” Medicare, part C or “Medicare advantage” private plans, and part D handling drug coverage. Medicare cases may involve disputed coverage, payments and premiums, medical records, durable medical equipment, and more. Congressional offices may also field inquiries on Medicaid, but in most cases these programs are administered at the state level and therefore handled by state legislative offices.
Department of Labor, Office of Workers’ Compensation Programs
DOL-OWCP handles disability benefits, medical coverage, and vocational rehabilitation for workers who are injured in non-military federal employment. Common issues include medical determinations, interactions with Medicare, and more. The majority of OWCP recipients are US Postal Service employees.
Department of Defense/Military
Military casework covers all branches of the military, including active and separated or retired service members. DOD casework may include compensation, advancement, disciplinary proceedings, in-service training and medical care, outprocessing, and more. While they are separate agencies, it’s worth noting that many military cases also involve military records through the National Archives and Records Administration, or medical coverage for service members, retirees, and their families through TRICARE.
Department of Veterans Affairs
VA cases include both Veterans Health Administration (VHA) cases and Veterans Benefits Administration (VBA) cases. The two operate relatively independently: VHA cases include care at VA medical facilities or reimbursed from community providers; VBA cases include a wide range of benefits from Compensation and Pension (disability benefits for injuries sustained in military service) to VA-backed home loans to GI bill tuition to Vocational Rehabilitation services and more.
Internal Revenue Service
IRS cases may include tax refunds, back taxes, business tax IDs, and more. Congressional tax cases are mostly handled by the Taxpayer Advocate Service (TAS), an independent oversight and customer advocacy service within the IRS that reports directly to Congress.
Immigration
Immigration comprises a wide spectrum of cases covering both US citizens and foreign nationals residing both in the US and abroad. Immigration cases primarily concern two major agencies: the Department of Homeland Security (DHS), including US Customs and Immigration (USCIS) and Immigration and Customs Enforcement (ICE); and Department of State, including consular affairs, Americans living and working abroad, and passports.
United States Postal Service
Postal Service cases may include lost package investigations and compensation, mail delivery problems, zip code assignment, and more. Post Office cases are largely handled through local postmasters.
Office of Personnel Management
The Office of Personnel Management handles benefits and employment for federal employees across the country. Districts with significant federal installations will often see higher numbers of OPM cases.
Department of Housing and Urban Development, Section 8
Housing cases may include distribution and/or waitlist for Section 8 (low income housing) vouchers, landlord/tenant responsibilities under Section 8, and more.
Small Business Administration
Many offices are still handling higher-than-normal caseloads related to SBA loans to businesses during the pandemic. Common post-pandemic SBA programs include Paycheck Protection Program and EIDL, debt relief questions, and issues with payments on SBA loans.
State and Local Referrals
For many constituents, the differences and relationships between levels of government are not exactly clear. Offices with a “no wrong door” policy may spend time referring constituents to their state and local counterparts. Common referrals depend on the state, but often include programs like Medicaid, unemployment benefits, permitting and licensure questions, and more.
Allocating Caseload
To start deciding how your team will allocate responsibilities, we would strongly recommend reaching out to district staff from the previous Member: ideally, the outgoing Member will have authorized transferring in-progress and/or closed case data to your team, and you will be able to review historical data to see average caseloads by town or by agency.
However, for offices without the benefit of support from the outgoing Member, it’s worth looking at the following district-level data (available at census.gov/mycd) to start to form educated guesses for demand:
Your team also may want to reach out to local stakeholders who may refer cases to your team to gauge demand: we will cover outreach and referrals in a later chapter, but these may include senior centers or Medicare counselors, veteran service officers, immigration support networks, disability advocacy services, federal unions, and more.
Keep in mind that aiming for equal numbers of total cases for each caseworker at any given time may not always be representative of equal workloads: some types of cases move more quickly or require more investment than others. We will cover in later chapters how to assess and manage your team’s workload.
Defining Your Casework Roles
Conversations to Have with Leadership
As your team starts to set your structure, we’d recommend having some early conversations about the role your casework team will play in your office. These may include:
Who is directly responsible for managing the casework team? If it is someone with a casework portfolio of their own, do they have adequate bandwidth to manage other caseworkers as well, and is there adequate oversight for their own cases?
If any caseworkers are shared employees (doing casework as well as other responsibilities), will they have multiple managers? If so, how will these managers work together to stay on top of that employee’s overall performance?
While the Member and/or Chief of Staff ultimately have hiring and firing authority, how will the team handle recommendations from the casework manager about hiring and firing?
If the casework team’s resource needs change, for example, in an emergency, how will additional staff/equipment/time needs be triaged?
Chain of Command for Casework Staff
To eliminate any confusion, chain of command and responsibilities for casework should be outlined in writing where feasible. These should be living documents that change and evolve with the team. Ex:
