Project Re:form delivered the first human-centered application for public benefits in America. It streamlines access to the five largest assistance programs, such as food and healthcare, for 2.5 million residents in the state of Michigan. The insights from Project Re:Form have the potential to fundamentally shift the way government designs its programs for low-income families and lead the way to a more human-centered safety across the country.

Context

Millions of Americans struggle to access critical government services each year, leading to billions of dollars in allocated benefits left unclaimed. Civilla is on a mission to make government work, starting in the State of Michigan.

In partnership with the Michigan Department of Health and Human Services (MDHHS), Civilla launched Project Re:form to design a faster, simpler, and more humane application for public benefits 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 and a major inefficiency for the state.

Process

Convinced there was a better way, Civilla began meeting with local residents and MDHHS field staff to hear their stories about navigating Michigan's public benefits system. The team spent over 4,000 hours conducting qualitative research at kitchen tables, in living rooms, and in MDHHS offices to map the entire benefit delivery journey and to identify where the biggest opportunities for change existed. The stories that emerged revealed that the DHS-1171 was a significant hurdle to individuals receiving the state's most critical services.

Driven by these insights, Civilla and MDHHS linked arms to redesign the application process to be as short and simple as possible. The application would be designed from the perspective of residents and caseworks, rather than policy requirements and business process only. It would be easy to read, complete, and process – and beautiful to look at. By reimagining this central touchpoint through the eyes of its most common users, we would design the process to work better for everyone.

Impact

The intensive user-centered redesign lasted nearly three years and resulted in a beautiful, streamlined application that is 80% shorter and can be processed in half the time. The new application process rolled out statewide in January 2018. It has measurably reduced the State's operational burden while improving experiences for millions of residents. Moving forward, we believe this work has the potential to cascade across state lines and lead the way to a more human-centered safety net for all Americans.

What others are saying

"This is some of the best work I've done in my 35 years of public service." –Director of Field Operations, MDHHS

"The cost savings [of our work with Civilla] is an added benefit...this is about coming together as a department to do the right thing in how we serve people." –Director of Communications, MDHHS

"Civilla's work provides a blueprint for lasting and effective governmental change." –GovTech Magazine

Over the course of three years, Civilla and MDHHS streamlined access to public benefits in Michigan by redesigning the application process–ensuring that user voices remained at the center all the way through.

The design process spanned the entire user journey–resulting in a new application, a full redesign of the online portal, policy approvals from two federal agencies, a proactive stakeholder engagement effort, and a training program that prepared 5000+ field staff for implementation at scale.

Designing a Simple and Intuitive Application

Applying for public benefits is an inherently vulnerable experience. Thoughtful service design can go a long way in providing assurance and peace of mind for people who are seeking support.

Government applications are often centered around the needs of policy, legal, audits, and fraud prevention. During Project Re:form, Civilla worked to develop application content that was grounded in policy, but designed the questions to channel the voices of real people. In this case, the voices of MDHHS field staff.

The application's visual design was carefully crafted and tested so that it would resonate with a wide audience – including people with low literacy, low vision, and language barriers. Clear, large headers gave important context clues to what was coming next. Plenty of white space ensured that text wasn't bleeding together. The use of color helped residents identify what sections must be completed. A pragmatic and contemporary typeface delivered clean and crisp character as well as highly readable body text.

Civilla and MDHHS piloted the new application in two local offices to test its efficacy and measure its impact. In the end, 90% of residents felt confident that they could complete the new application on their own and 90% were able to fill it out in less than 20 minutes.

For staff, the new application came in 94% complete and the time they spent correcting errors on the application decreased by 75%. End-to-end processing time dropped by nearly 50%. By the end of the pilot, the decision to go statewide was clear.

"After filling out the new application I feel like I can breathe again" –Michigan Resident

"The old application would have taken me a whole day. This one was more understandable and less stressful. It asks you the questions but with respect." –Michigan Resident

"With the new application, I wasn't stressed out. I knew the answers. Filling out the old form made me question my own life." –Michigan Resident

Designing a New Online Portal

Building on the foundation of the paper application, Civilla worked 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 long and complex – requiring over 45 minutes to complete.

Working alongside MDHHS and their IT vendor, Civilla designed a new online application portal that is simple to use and easy to understand.

During development, Civilla conducted ongoing user research and usability testing to ensure the product was built on a deep understanding of residents' needs. The team worked in fast, iterative cycles to improve the portal's design based on user feedback.

The impact of the redesign is evident: it now takes less than 15 minutes to apply. In addition, the number of documents submitted online has tripled year-over-year. Residents are able to easily submit documents, report life changes, and manage benefits directly from their mobile devices.

The new portal received recognition for Best Use of Technology for Customers at APHSA in 2018. It was also recently an award winner for the IDG 2019 Digital Edge 50.

"That was amazing! I did the app on the resident's phone and he finished in 5 minutes. He was so ecstatic that he could do that." –MDHHS Lobby Navigator

"It was the best thing ever. The language was so much easier. The resident understood everything and was able to fill the app out confidently on their own." –MDHHS Lobby Navigator

Securing Policy Approvals

The idea of simplifying an application can sound like a straightforward process, until the full weight of policy requirements arrive.

Inside MDHHS, there are five separate policy teams: Food Assistance, Healthcare, Cash Assistance, Child Care, and State Emergency Relief. Collectively, these policy teams were responsible for ensuring that the new application met 1,700 pages of federal, state, and departmental regulations.

Working closely with all five teams, we conducted deep analysis into every policy area to understand each requirement and where it originated. We then pursued alignment on how to meet requirements while simultaneously meeting user needs. We sought out national experts through organizations such as the Center on Budget and Policy Priorities (CBPP) to discern best practices in implementing policies across other states.

After six months of policy reviews, the final result was a human-centered application that was 80% shorter in length while still meeting all federal, state, and departmental policy requirements.

Reshaping the Stakeholder Engagement Process

Due to the interconnectivity and scale of state government, our work would impact thousands of individuals beyond end users.

To navigate the complexity of MDHHS, we developed proactive strategies and engaged a wide audience of stakeholders to build awareness, establish buy-in, and carefully secure the appropriate sign offs. Within state government, this included field operations, legal teams, policy experts, legislators, community partner organizations, advocacy groups, union leaders, and state agencies. Within the federal government, this included leaders at the Food and Nutrition Service (FNS) and the Centers for Medicare and Medicaid Services (CMS).

Instead of communicating through traditional government memos or powerpoint presentations, we built a 5,000-square-foot exhibit that brought to life real stories of the people at the center of the work: residents and field staff. We built strong relationships with stakeholders through 1:1 meetings and 90-minute tours of the Project Re:form exhibit. We walked thousands of stakeholders through these stories to develop shared context and win new advocates for a human-centered approach.

In addition to hosting tours of the exhibit, we communicated frequently through the MDHHS Steering Committee, the core operational team, and work groups to problem solve and provide oversight. In order to keep this wide network of stakeholders informed, we kept a constant rhythm of light updates through SMS-messaging. The approach resulted in high engagement from state leadership and provided the support that was needed to navigate the project through implementation.

"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." –MDHHS Stakeholder

Designing Training for Implementation at Scale

In order to prepare staff for implementation, Civilla and MDHHS trained over 5,000 workers in 100+ offices. Rather than defaulting to webinars, we intentionally designed a training program that represented the human-centered spirit of the project.

During the pilot, we learned from staff that they wanted peer-to-peer and face-to-face training. Working alongside MDHHS's Office of Workforce Development and Training (OWDT), we created high-impact, peer-to-peer training modules that could be distributed through a train-the-trainer model across the entire state.

Two-hundred frontline workers were selected to train their local offices. They were equipped with interactive tools and videos that maintained the integrity of the content while enabling them to facilitate sessions in person. The training went down as the best in the history of the department.

"Staff are usually not receptive to change but this was different. At the beginning, we had people in the office that weren't open minded. By the end, almost everyone was on board." –MDHHS Caseworker

"I feel like this is the first project that got designed at a field level. It's not just what the leaders in Lansing want. I appreciate all the input I've been able to provide." –MDHHS Caseworker

Measuring Impact and Designing for Replicability

The new application process rolled out statewide in January 2018. It has measurably reduced the State's operational burden while improving experiences for millions of residents. The project was recently recognized by Harvard Kennedy School as one of the Top Innovations in American Government.

Since then, Project Re:form's human-centered approach to delivering benefits has garnered the attention of states across the U.S. and support of the federal agencies that oversee public benefits for 25% of Americans.

The transferability of best practices between jurisdictions can be expected, particularly since states are each subject to the same policy requirements for distributing what are primarily federal resources. Michigan has already received inbound requests from leaders in states such as Missouri and Vermont who are interested in leveraging best practices as they look to streamline their states' application processes.

Project Re:form offers a striking example of how to design government services that are more compassionate, more effective, and less expensive to operate. We believe these insights can cascade across state lines and lead the way towards the creation of a more human-centered safety net for all Americans.

Credits to Marisol Dorantes and Janice Cho for all photos included in this submission.