From Projects to Bodies of Work

How Civilla is transforming the user experience in Health and Human Services

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By Lena Selzer

In January 2018, Civilla’s first major project went live. The work was a three-year labor of love for our team, focused on designing a faster, simpler, and more humane application for public assistance programs like Food and Healthcare in the State of Michigan.

Known as the DHS-1171, the previous application was the longest of its kind in America at over 40 pages—a formidable barrier for over 2.5 million residents each year. The redesign resulted in a beautiful, streamlined application that was 80% shorter and could be processed in half the time.

As the project wrapped up, we knew it was some of the most meaningful work we’d done as an organization. We felt proud as we reflected on the positive impact the new application would have on millions of people each year.

For the first time, we also had a proof point for how human-centered design could be used to create government services that were more compassionate, more effective, and less expensive to operate.

As the project moved from center stage to the rear-view mirror, everyone we encountered began to ask, “What will you do next?” They inquired about our next project and our next partner. But as they did, we found ourselves questioning whether we were ready to step away from the work we had started.

01 Our streamlined application for public assistance, created in partnership with the State of Michigan, demonstrated how human-centered design could be used to create government services that work better for everyone.

01 Our streamlined application for public assistance, created in partnership with the State of Michigan, demonstrated how human-centered design could be used to create government services that work better for everyone.

Up until this point, we had oriented our time and energy around individual projects; we focused on bringing a project to life and then moved on to the next. While our commitment to implementation did result in tangible impact, we were beginning to see that no single project could transform people’s experience accessing public benefits.

This type of systems change would require multiple interventions from many angles including rethinking the policy, technology, and processes that influenced the programs we were designing for. There was still so much work to be done.

As we reflected on how to extend the impact of the work we had started, we began to think about what it would mean to fully redesign public benefit delivery—not just the enrollment application. What if we saw Project Re:form as the beginning of a much deeper body of work, rather than the end of a single project?

Intuitively, we liked the idea of committing to a body of work. But what did it mean in practice?

For us, taking on a body of work meant redesigning the full experience, rather than a single moment in the process. It meant looking at our work holistically to reconsider policy, technology, and process decisions—rather than working solely within the current constraints. And it meant beginning to view our work as a model for public benefit delivery across the country, not just in Michigan.

Through ongoing conversations with leaders in the State of Michigan, we realized that they too saw this opportunity. The success of Project Re:form instilled the confidence they needed to double down on human-centered design as an approach to changing the way public benefits were delivered.

After many months of discussion, we linked arms again—this time, with the goal of working together to transform the end-to-end experience.

This was no small task. Over the next year, we spent time locating other “key dominoes,” specific interventions that could have a disproportionate impact on improving service delivery.

Today, our efforts have expanded to encompass three areas of focus: redesigning the enrollment experience, redesigning the renewal process, and exploring the national impact of our work.

Modernizing Online Enrollment

02 Gaby works side-by-side with a Michigan resident to test new mobile functionality for Michigan’s online application.

02 Gaby works side-by-side with a Michigan resident to test new mobile functionality for Michigan’s online application.

Building on the success of the new DHS-1171 paper application, the next step for our team was to modernize the online enrollment process. Of the 2.5 million people who access public assistance in Michigan each year, about 50% apply online. However, the legacy application was complex, requiring over 45 minutes to apply.

In partnership with MDHHS and their IT vendor, Civilla designed a new online application that is simple to use and easy to understand. Since it was released statewide in 2018, over a million people have used it to enroll for assistance.

The impact of the redesign is clear: It now takes less than 15 minutes to apply for assistance online. In addition, applicants are able to easily submit documents, report life changes, and manage benefits directly from their mobile devices.

The work has received a number of national and state awards for excellence in technology and human-centered experience in digital government, including Best Use of Technology for Customers at APHSA (2018) and the IDG 2019 Digital Edge 50.

Streamlining Renewals

03 After streamlining Michigan’s enrollment process, Civilla and MDHHS partnered to redesign the way people renew their benefits on paper and online.

03 After streamlining Michigan’s enrollment process, Civilla and MDHHS partnered to redesign the way people renew their benefits on paper and online.

Once the new enrollment process rolled out, we turned our attention to redesigning the way people renew their benefits.

Currently, renewals in Michigan are reminiscent of the old enrollment process, characterized by institutional language and design that results in confusion, frustration, and payment errors.

On average, over 25% of new applications result from people who fail to renew their benefits and return to reapply within 90 days. This cycle—referred to as “churn”—is estimated to cost the state more than $10 million each year.

Civilla and MDHHS recently launched a new phase of work focused on redesigning renewals. In 2019, our team will pilot changes to streamline the user experience and cut red tape for MDHHS staff.

Exploring National Impact

04 Our partners from the Integrated Benefits Initiative and MDHHS map out opportunities to improve social service delivery in Michigan.

04 Our partners from the Integrated Benefits Initiative and MDHHS map out opportunities to improve social service delivery in Michigan.

Civilla is transferring the learnings from our health and human services work across the country.

As part of the Integrated Benefits Initiative, we’ve partnered with the Center on Budget and Policy Priorities, Nava, and Code for America to work with state governments. Together, we’re piloting new ways to improve the way people enroll in safety net programs.

In the Michigan pilot, we developed simple and intuitive technology that enabled residents to submit assistance applications from their mobile devices. We then built a way for applicants and caseworkers to submit the required paperwork and communicate with each other through text messaging.

We are now working with a small cohort of states to help them adopt the learnings so that residents across the U.S. can access the valuable services they are eligible for.

05 While we’ve taken bold steps to simplify the experience accessing public benefits, there is still a lot of work to be done. We’re committed to continuing the work until we’ve radically changed the system as we know it today.

05 While we’ve taken bold steps to simplify the experience accessing public benefits, there is still a lot of work to be done. We’re committed to continuing the work until we’ve radically changed the system as we know it today.

Nearly three years into our journey with health and human services, we continue to design a safety net that is more compassionate, more effective, and less expensive to operate in Michigan and across the US.

Each component of our work impacts the benefits experience differently, but all play a role in changing the system to work better for everyone. Together, our efforts represent a body of work that has the potential to deeply transform the benefits experience.

More recently, we’ve found ourselves asking the question that everyone we encountered was eager to ask back in January of 2018: How we might widen our impact by taking on new bodies of work? This is a question we’re actively pursuing, and not one we take lightly.

In evaluating opportunities for our next effort, we’ll look for a team of courageous leaders who are committed to taking a long walk together. We’ll seek funding opportunities that allow us to dedicate our time and energy to a multi-year effort. And we’ll search for a design opportunity that is both tightly scoped and has the potential for widespread impact.

Changing the way our public-serving institutions work will take time. The truth is, we don’t think that one-off projects will be enough to create the positive social change we want to see.

Instead, we believe that by bringing focus to a few major bodies of work, we can demonstrate how human-centered design can change the way our public-serving institutions operate. In doing so, we can contribute to a more beautiful civil society for all.

 
 
Adam Selzer