The Road to Rollout
Designing the path from idea to implementation at scale
By Alissa Kline
In the middle of January, without much fanfare, over 150,000 freshly minted paper applications arrived at Michigan Department of Health and Human Services (MDHHS) offices across the state.
Their arrival marked a major milestone in the two-year labor of love shared by Civilla and MDHHS: A human-centered redesign of the state’s application for public benefits, used by millions of residents each year, was officially in the wild.
The previous application — the longest in America — contained over 40 pages, with dated graphic design and jumbled content. The new application — one of the shortest in America — is 80% shorter with a clean aesthetic, updated typography, and bright pops of color.
But this is not a simple story about how a long, ugly form became short, beautiful one.
It is a long story about how a design studio named Civilla identified a problematic touchpoint named the DHS-1171 and engaged a complex agency named MDHHS.
It is about how these two infinitely dissimilar organizations banded together to reimagine a dated and cumbersome experience to work better for everyone.
It’s about how an experiment in what ought to be became what is. And how the road to enduring change stretches on ahead.
My role in this story, though small, traces back to the beginning. In August 2015, I was new to Detroit and looking for ways to get plugged into social impact work and meet interesting people.
I said “yes” to a mysterious invitation to contribute to research on Michigan’s public benefits system, facilitated by a brand-new startup in a storage closet turned studio.
Upon arrival at Civilla, I was whisked into a simulation of an MDHHS field office (staged in the hallway, with rows of chairs and background noise wafting from a speaker) and asked to fill out the DHS-1171.
As a professional writer, editor, and communications strategist, I struggled for twenty minutes to read and complete the form. I made it less than halfway through.
This brief empathy exercise was the gateway to an 8-week journey alongside a small, passionate group of community members at Civilla HQ. Every Thursday morning, we worked to imagine a new way forward for the residents and caseworkers who interact with the benefits system every day.
During that time, the team spent hundreds of hours at kitchen tables, in living rooms, and in State offices to understand their stories and perspectives.
Side by side, we began the process of defining, ideating, and eventually prototyping. I partnered with a graphic designer to help polish the scrappy prototypes into a single high-fidelity one.
Meanwhile, other teammates built an immersive storytelling exhibit that highlighted the negative impact the benefits system had on its users.
These outputs helped Civilla make the case for change to MDHHS leaders and, after many months of navigating funding and procurement, the project was officially a go.
Over the next year, Civilla worked to align the application with policy requirements, conducted extensive testing in the field, and made continual user-driven improvements. After compelling pilot results, State leaders gave the green light to take the new application statewide.
This triggered a new, much larger body of work for Civilla’s tiny team of six. They needed to communicate Re:form to key stakeholders, train thousands of MDHHS staff members, and ensure the application was print-ready. Each task was essential to a smooth statewide rollout.
Spreading the Word
Due to the interconnectivity of state government and the caring sector, Project Re:form would impact thousands of individuals beyond applicants and caseworkers. After extensive engagement of these two groups, the team needed to engage a wider audience of stakeholders.
Working with MDHHS, Civilla developed proactive strategies to identify every individual and group that needed to be engaged.
Within state government, this included field operations, legal teams, policy experts, legislators, community partner organizations, advocacy groups, union leaders, state agencies. Within the federal government, this included the Food and Nutrition Service (FNS) and the Centers for Medicare and Medicaid Services (CMS).
Rather than communicating through traditional government memos or powerpoint presentations, Civilla built a 5,000-square-foot exhibit that brought to life real stories of the people at the center of the work: residents and caseworkers. Civilla began building relationships through one-on-one meetings and tours of the Project Re:form exhibit in the Detroit studio. To better reach stakeholders in Lansing, the team created a copycat exhibit within walking distance of the Capitol building.
By November 2018, hundreds of stakeholders had met with the team or walked through the immersive exhibit. Support for Project Re:form grew, and news of the redesign continued to spread through peer-to-peer networks.
The team also established direct lines of communication with a core group of project stakeholders within MDHHS: the steering committee, the operational team, and various work groups. SMS-messaging became an important tool that enabled a regular rhythm of light updates. Lena and Mike made frequent trips to Lansing for in-person meetings, which deepened trust and kept the work on track.
Civilla’s method of clear, honest, and consistent communication left an impact on MDHHS leaders. As one stakeholder told the team:
“I have been involved with many initiatives within the State of Michigan over the years. I haven’t ever experienced the way this initiative is being communicated. You didn’t just tell us — you involved us.”
Training the Trainers
The redesigned DHS-1171 had far-reaching implications for process and procedure within MDHHS field offices. This required 5,000 staff across the state’s 105 locations to be trained on the new form — in just two months.
Rather than defaulting to webinars, Civilla committed to designing a training program that represented the human-centered spirit of the project. Based on input from staff, the team knew that peer-to-peer and face-to-face training would be the most effective.
Working in partnership with MDHHS’s Office of Workforce Development and Training (OWDT), the team created a training series with interactive tools and short videos.
Civilla’s Sam co-starred in the videos alongside OWDT’s Pam, which showcased a united front — and made for some catchy intro copy. (“Hey, folks! We’re Pam and Sam!”)
Next, the team “trained the trainers.” Two-hundred frontline workers were selected to train their local offices, using the prepared lessons and interactive tools as a guiding framework. The framework ensured consistent messaging, but left enough flexibility for trainers to inject their own personality and voice.
In two short months, the trainers engaged the entire workforce of 5,000. The experience was hailed the State’s “best training in over 30 years” by senior leadership, and has become the new gold-standard within the agency.
Staff are usually not receptive to change but this was different. We had people in the office that weren't open minded at the beginning. By the end, they were fully on board and believed this was good thing
Hitting Print & Going Live
As Civilla’s training and communication strategies played out across the state, the team poured over every detail of the form itself. They gained federal approvals, met ADA requirements, and advocated for well-translated Spanish and Arabic versions. They proofread it hundreds of times, backwards and forwards.
Then, in late December, after some last-minute policy tweaks and an eleventh-hour color update, the new DHS-1171 was sent to the printers.
On January 22, 2018, the new application went live in every office across the state. Civilla was prepared for a firestorm of reaction and troubleshooting, but there have been few reports from the field. Few besides photos from caseworkers showing off the origami hats, birds, and paper blouses they’ve fashioned from leftover stacks of the retired DHS-1171s.
Though it makes for an anticlimactic story, the rollout seems to have gone off without a hitch.
Back in 2015, burning the midnight oil on the original prototype, I did not think our little experiment would see the light of day. I doubted that — given the size and scope of the issue, — Re:form was going to be more than a noble thought exercise.
It is easy to poke on problems and dream big dreams. Successful execution is a whole different animal.
What separates Civilla from the pack, and wins over skeptics like me, is a deep awareness of and commitment to the long haul. Changing the way our institutions work requires a willingness to go the distance. That’s why, even though the new application is live, Project Re:form is far from complete.
Now Civilla’s working to improve the application’s digital counterpart and the complicated renewal process that follows every approval. The team’s also partnered with the Integrated Benefits Initiative to explore how mobile technology can deliver faster, more effective, and less expensive social services in Michigan and across the country.
In other words: Civilla’s still poking on problems and dreaming big dreams — and they’re in it for the long haul.