Mel Fabrikant reports fragile households seeking solid footing in a weak economy will receive reinvigorated support as Colorado, Idaho, Illinois, North Carolina, Rhode Island, and South Carolina take up the challenge of streamlining services aiding low-income working families.

The six states have been awarded three-year grants to test and implement easy-to-navigate, quick-to-deliver public benefit systems. The grants, the centerpiece of the Work Support Strategies: Streamlining Access, Strengthening Families (WSS) initiative, average about $460,000 per state for each year.
The initiative aims to boost the share of families who receive and keep all the public benefits for which they qualify (especially Medicaid, children’s health insurance, food stamps, and child care subsidies), minimize states’ administrative burden delivering benefits, and disseminate lessons to inform state and federal policies and practices.
Many low-income households depend on these programs to stay in the workforce as they strive to climb the economic ladder while managing family, health, and other needs. Participation rates for working families — many of whom earn hourly wages below what’s needed to keep a family out of poverty (2011 incomes at or below $22,811for a family of two adults and two children) — are often tempered because it can be excessively time-consuming and difficult to meet the procedural demands for eligibility while holding down a job and caring for one’s children.
At the same time, states and counties are eager for more efficient and effective ways to serve the large and growing need in their communities as they contend with battered revenues and reduced staffs. Taking advantage of new technology, simpler policies, and business processes that trim unneeded steps, states aim to modernize old, paper-heavy procedures, improve the customer experience, and reduce state worker burden. State interest in streamlining and program integration is also spurred by the large jump in Medicaid enrollment expected under the Affordable Care Act.
To secure grants, the states had to participate in a year of rigorous data analysis, pilot-testing, policy review, and consultation with key stakeholders, to pinpoint their strengths and weaknesses and bolster their implementation plans. They also had to demonstrate, among various criteria, a commitment from the governor and the heads of relevant agencies.
The six states represent varied regions, program sizes, administrative approaches (state- vs. county-operated programs), perspectives on health reform, and political contexts. They and three other states were chosen competitively last year from 27 applicants to use just-concluded single-year grants for fact-finding, planning, and design.
The Ford Foundation, the WSS project’s lead funder, has committed $21 million over five years. The Open Society Foundations and the Annie E. Casey Foundation have provided additional support.
The Urban Institute directs the project in partnership with the Center on Budget and Policy Priorities, which provides states with technical assistance. The Urban Institute will evaluate the effectiveness of each state’s activities.
“This effort holds tremendous potential to advance two important goals simultaneously: increasing innovation and efficiency in government while better meeting the needs of families working hard to make ends meet,” said Helen Neuborne, director of the Quality Employment Unit at the Ford Foundation. “We are incredibly encouraged by the fresh thinking and commitment that states are bringing to these important issues.”
What’s Ahead?
Colorado. As a locale whose work support programs are county-administered and state-supervised, progress in Colorado may have important lessons for other county-administered states, such as New York and California. Colorado’s plan, designed as a partnership between the state and the counties, focuses on re-engineering business processes in the counties; improving staff capacity, training, and communication; enhancing automated verification and eligibility systems; and aligning policies across work support programs. Mini-grants to counties for call centers and modernization are anticipated. Colorado’s plan includes numerical goals for improving families’ participation in work support programs and faster application processing.
Idaho. Idaho’s plan highlights the role of effective government practices in minimizing bureaucratic obstacles and helping eligible families secure appropriate work support benefits. It envisions a self-service customer portal; a “verification aggregator” so workers can use information already on file for other government programs to determine eligibility; and further movement toward a “universal workforce” that can handle work from any part of the state or any program, avoiding bottlenecks and improving the customer experience. The plan includes explicit goals for increasing families’ enrollment in the package of programs that meets their needs, reducing their cycling on and off key programs, and speeding up the handling of applications.
Illinois. Illinois’ plan looks to new business processes piloted last year to improve service delivery in 90 local offices. The state has chosen to focus on local operations because its policies encouraging families’ benefit access were too often blunted by overburdened and stressed local offices. Keys to rolling out innovation to all offices include a data dashboard featuring office-specific information about the quality and timeliness of service delivery and a comprehensive operations guide; leadership development, peer-to-peer support, and training; and collaboration with nonprofit agencies that determine eligibility for child care subsidies. These efforts will be complemented by policy updates to reflect cross-program reviews. Because of the state’s sizeable population, success in Illinois can have important implications for other large states.
North Carolina. North Carolina, the second county-administered, state-supervised grantee, will build on the rollout of NC-FAST, an integrated, automated system for eligibility determination. The goals are to improve service delivery in local offices, reduce counties’ workloads, and enable families to “tell their story once only” to get what they need. Beyond NC-FAST, strengthened county-state partnerships will develop outcome indicators and guided self-assessments for local offices. Other activities will include integrated policy development and training. During the planning year, state and county leaders identified disconnections between programs, high churn among beneficiaries, and slow application review among the major issues.
Rhode Island. New team-based approaches to eligibility review and benefit delivery in local offices and implementation of the Affordable Care Act will be Rhode Island’s launch pads for improving technology and integrating work support programs, systems, and processes. The goal is to simplify operations in order to help workers more effectively manage increasing demand while ensuring that families receive the help for which they are eligible as quickly as possible. Improved communication and outreach, retooled business processes reflecting successful pilots during the planning year, and better use of data are expected. Lessons learned here can be applied in other states with similar demographic and workforce characteristics.
South Carolina. South Carolina, like a number of other states, particularly in the south, has separate human services and health systems, operating their own computer systems and supervising separate local staffs. Because this disconnection poses major barriers to families in need of work supports from both agencies (such as Medicaid and the Supplemental Nutrition Assistance Program) and burdens local staff with duplicative work, South Carolina aims to link the two systems seamlessly for clients and workers. To make this work, the state will reform business processes in the local offices, integrate policy development, and develop interagency infrastructure and technology.
“Transforming state and county delivery of large public programs, like Medicaid and food stamps, is not easy, given the challenges of outdated technol
ogy, complex rules, inadequate staff training, and overwhelming local need,” said Olivia Golden, project director and Institute fellow at the Urban Institute. “I know from my own experience in government that highly ambitious reforms can and do succeed, but only when leaders are creative, committed, focused on results, and, above all, persistent, qualities shared by this project’s state teams.”

WSS’s National Advisory Board provided assistance reviewing grant applications. The group includes representatives from the National Governors Association, the National Conference of State Legislatures, and the National Academy for State Health Policy, along with other experts in child care, health, and income support programs.
As part of their grants, technical assistance on policy, operations, program evaluation, and project management will be available to Colorado, Idaho, Illinois, North Carolina, Rhode Island, and South Carolina.