Read this if you are a director or manager at a Health and Human Services agency in charge of modernizing your state's Health and Human Services systems.
With stream-lined applications, online portals, text updates, and one-stop offices serving programs like Medicaid, SNAP, and Child Welfare, states are rapidly adopting integrated systems serving multiple programs. As state leaders collaborate on system design and functionality to meet federal and state requirements, it is equally important to create a human-centered design built for the whole family.
We know families are comprised of a variety of people with various levels of need, and blended families ranging from grandparents to infants may qualify for a variety of programs. We may connect with families who are on Medicaid, aged and disabled or SNAP, but also have cases within child support or with child welfare.
If your state is considering updating a current system, or procuring for an innovative design, there are key strategies and concepts to consider when creating a fully integrated system for our most vulnerable populations. Below are a few advantages for building a human-centric system:
- The sharing of demographic, contact, and financial information reduces duplication and improves communication between state entities and families seeking services
- Improvement of business services and expedited eligibility determinations, as a human-centric model gathers information upfront to reduce a stream of verification requests
- The cost of ownership decreases when multiple programs share design costs
- Client portals and services align as a family-focused model
Collaboration and integrated design
How many states use a separate application for Medicaid and SNAP? More specifically, is the application process time consuming? Is the same information requested over and over for each program?
How efficient (and wonderful) would it be for clients to complete task-based questions, and then each program could review the information separately for case-based eligibility? How can you design an integrated system that aligns with business and federal rules, and state policy?
Once your state has decided a human-centered design would be most beneficial, you can narrow your focus—whether you are already in the RFP process, or within requirements sessions. You can stop extraneous efforts, and change your perspective by asking the question: How can we build this for the entire family? The first step is to see beyond your specific program requirements and consider the families each program serves.
Integrated design is usually most successful when leaders and subject matter experts from multiple programs can collaborate. If all personnel are engaged in an overarching vision of building a system for the family, the integrated design can be fundamentally successful, and transforming for your entire work environment across agencies and departments.
Begin with combining leadership and subject matter experts from each geographic region. Families in the far corners of our states may have unique needs or challenges only experts from those areas know about. These collaborative sessions provide streamlined communications and ideas, and empower staff to become actively involved and invested in an integrated system design.
Next, delve into the core information required from each family member and utilize a checklist to determine if the information meets the requirements of the individual programs. Finally, decide which specific data can streamline across programs for benefit determinations. For example, name, address, age, employment, income, disability status, and family composition are standard pieces of information. However, two or more programs may also require documentation on housing, motor vehicle, or retirement accounts.
Maintaining your focus on the families you serve
When designing an integrated system, it is easy to lose focus on the family and return to program-specific requirements. Your leaders and subject matter experts know what their individual programs need, which can lead to debates over final decisions regarding design. It is perfectly normal to develop tunnel vision regarding our programs because we want to meet regulations and maintain funding.
Below are recommendations for maintaining your focus on building for the family, which can start as soon as the RFP.
- Emphasize RFP team accountability
- Everyone should share an array of family household examples who benefit from the various programs (Medicaid, SNAP, TANF, etc.), to help determine how to deliver a full spectrum of services.
- Challenge each program with writing their program-specific sections of the RFP and have one person combine the responses for a review session.
- If the integrated system design is in the requirements phase, brainstorm scenarios, like the benefit example provided in recommendation number one. When information is required by one program, but not another, can the team collaborate and include the information knowing it could benefit an entire family?
- When considering required tasks, and special requests, always ask: Will this request/change/enhancement help a family, or help staff assist a family?
- Consider a universal approach to case management. Can staff be cross trained to support multiple programs to reduce transferring clients to additional staff?
We understand adopting a human-centered design can be a challenging approach, but there are options and approaches to help you through the process. Just continue to ask yourself, when it comes to an integrated approach, are you building the system for the program or for the family?