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In the wake of the Katrina disaster, one Louisiana state agency leader used the “clean slate” provided as an opportunity to re-design the eligibility determination process for health care benefits provided to citizens in need. This report is a first-hand story of commonsense management, using basic process management techniques to re-design a vital element of service delivery. Author Vicki Grant describes step-by-step processes used by a front-line agency leader to make a huge difference for thousands of beneficiaries of Louisiana's public healthcare system. In the process, she shows that, while technology helps, it is leadership that matters.