How do we improve the model by which agencies deliver their services? It is a question human services leaders have been tackling for as long as public benefits programs have existed. The question has been even more provoking recently, given the rapid pace of change demanded by the pandemic and a global call to action for equity and inclusion. And while technological advances have given us new and modern ways to connect with the people in our communities, it is important to ensure that technology changes are also connected with business process changes to maximize impact and effect change. In part 2 of this mini-series, we highlight some states' approaches best to align technology modernization with broader business process transformation.
Our policy brief from August 2021 focused on Harnessing Data and Technology to Construct a Human Services System that Supports Thriving and Equitable Communities and specifically addresses the need to weave equity into technology modernization in order to impact disproportionality in human services more significantly. We must intentionally build equity into technology designs and the implementation of solutions. This is becoming more prevalent and expected in the application. The Indiana Family and Social Services Administration has included equity as a foundational component of its organizational mission and values. They have publicly committed to "compassionately serving our diverse Hoosiers community by dismantling long-standing, persistent inequity through deliberate human services system improvement." All the examples that follow begin with this same intention and commitment.
As part of the Work Support Strategies (WSS) initiative, six states implemented new or updated existing technology to improve and integrate the delivery of Medicaid, SNAP, and child care. One focus of this effort was to allow business process redesign to inform the technology approach intentionally. And while this is a well-documented best practice, we still repeatedly find projects where the technology is driving the business process change instead. The unintended result is "technology systems driving program changes, forcing processes to be structured to fit technological design."
Holistic Approaches to Technology Modernization
In Idaho, the Department of Health and Welfare has undergone a paradigm shift regarding technology transformation. There are no longer projects labeled as "technology projects" in the agency. Instead, the staff focuses on what processes need to improve, then explores the problems, identifies how the problems can be solved, and uncovers early wins to get the agency down a path for change.
Idaho applied this approach to its benefits eligibility process. Initially, the team believed they had a back-end eligibility determination problem that needed to be addressed with changes to their system. However, upon exploring the supporting business processes, Idaho discovered they had a front-end process problem. When clients arrived at the office to apply for benefits, they were given a lengthy paper application to take home and complete. Upon the client's return to the office with the completed application, 90% of the information was often inaccurate. As such, Idaho redesigned the front-end process by eliminating the paper application and implementing an informed choice interview. On average, clients have benefits determined within 40 minutes of arriving at an office. These process changes save time for workers and clients alike. As a result, Idaho is among the top five in the nation for accuracy and number one for timeliness. As Lori Wolff, former Deputy Director, shared, "Sometimes technology is not the solution. The least expensive and most important part of our project was spending time on business process redesign before bringing in the technology."
The Oklahoma Department of Human Services (OKDHS) is also undergoing a culture change, anchored in their "True North" guiding principles which drive all their work and support collaboration with partners to serve citizens together. Their transformation involves meeting clients upstream and aligning technology to support the work. Technology has helped the agency improve the eligibility determination process, redesigning it from all in-person screening to 100% virtual. When clients visit an OKDHS office now, they are greeted by a host who directs the client to an interview room for a virtual interview. "The virtual eligibility determination process is a home run," shared Secretary Justin Brown. "We have moved hundreds of staff who were in the "back office" determining eligibility to the frontline serving citizens." Oklahoma is building deeper relationships with the people they serve by embedding its workers in the community—such as homeless shelters, food banks, and prisons—to meet people where they are. This process change, enabled by technology, has allowed OKDHS to work shoulder-to-shoulder with community partners to serve Oklahomans better.
In Michigan, the Department of Health and Human Services is also adopting process changes by leveraging the use of community partner access sites. These are places where clients who do not have technology readily available to them can access the MI Bridges eligibility system. These partners include libraries, community centers, schools, and navigation partners whose role is to help clients find the services they need and to navigate the system to complete eligibility applications. In some cases, they can even help with direct service referrals. Given that the partners are aligned on the mission to serve their communities, this process change is a win-win and does not require additional state funding.
As we continue our quest to find new ways to efficiently and proactively serve communities with modern engagement strategies, we must not allow technology to get ahead of our program goals and dictate new processes but rather leverage technology to enable the new processes that have been designed. Solving the challenges of cross-programmatic service delivery and addressing inequity must begin with intentionality and a commitment to a necessary change in practice and technology.
Read additional posts from the Modernizing Technology for Change series:
Post 1 | Post 2 | Post 3