By Sam Gill, Indi Dutta-Gupta, and Brendan Roach.
This is a challenging moment in human services. Needs are increasing at the same time that, for many states and localities, budgets are still smarting from the Great Recession. While there is no silver bullet solution for human services agencies seeking to maximize their ability to respond to surges in need, there are emerging tools that can make a difference.
Technology represents one such opportunity. Just as innovative information technology has revolutionized commercial and social life, so, too, do new approaches to enterprise technology have the potential to help state and local human services agencies do their work more efficiently and effectively in the years to come.
After speaking to over 100 hundred experts and stakeholders involved in human services and technology for our new report, Gaining Ground: A Guide to Facilitating Technology Innovation in Human Services, we encountered dozens of examples of how successful technology innovation can reshape human services for the better. Across these examples, five specific kinds of benefits conferred by technology emerged: Automation, Integration, Empowerment, Analysis, and Accountability.
AUTOMATION: REDUCING INEFFICIENCIES, ENHANCING SERVICES
Technology presents the opportunity for program administrators to remove inefficiencies in workflow, allowing staff to focus more on the provision of services and benefits to needy families. This can be achieved through various approaches to automating programmatic and administrative functions. For example, the Idaho Department of Health and Welfare – in implementing a ‘no wrong door’ service delivery model – developed an advanced telephone system which automatically routes calls to personnel across the state, directing callers to the caseworker best able to provide assistance. In Olmsted County, Minnesota, county administrators have automated core administrative functions, such as travel reimbursements, as part of the LEAP (Lean Engineered and Automated Processes) initiative, allowing county employees to spend more time performing core programmatic functions. These efforts have been guided by kaizen process review practices, which focus on incremental opportunities to streamline workflow.
In addition to supporting more efficient work and business practices, technology can simply automate routine practices. In Florida, the Department of Children and Families has developed and deployed voice recognition software, which assists caseworkers in the field by automatically transcribing case interviews. Similar tools also enable self-service, allowing clients to renew benefits and check applications without requiring in-person assistance. Another example is the New Jersey Division of Taxation’s express-lane eligibility check, automatically finding tax data on individuals to determine eligibility for Medicaid and SNAP benefits and sending notices encouraging eligible, unenrolled residents to apply for these benefits. This process is similar to efforts undertaken in Louisiana, Alabama, and Iowa.
INTEGRATION: GIVING WORKERS THE FULL PICTURE
Many states and localities have recognized that effective human services delivery and benefits provision requires a more effective flow of information among and between various programs and offices. Tools that facilitate integration typically assist caseworkers by providing a holistic, cross-program view of client information. In this way, technology can aid states and localities in collaborative service delivery. An example of this emphasis can be found in Boulder County, where integrated case management tools allow employees in the county’s Department of Housing and Human Services to track their clients across services. These case management tools also allow caseworkers to easily refer families to other county-administered benefits and services, and to create a more seamless experience for clients.
As San Diego County undertakes its Live Well San Diego initiative to create a more proactive human services delivery system, technology tools play a key role in integrating practice. For instance, a community-based care transitions program (CCTP) relies upon a technology infrastructure to share patient data among hospitals, community service providers, and caretakers, improving care transitions from hospitals to the home and reducing hospital readmissions for medically and socially complex patients. A similar tool in New York City, called Worker Connect, enables users with role based access the ability to identify how clients have interacted with various New York City Health and Human Service agencies. Users are able to access agency data in order to increase service delivery and improve client and worker experience.
EMPOWERMENT: PROVIDING CLIENTS GREATER CONTROL
Innovative technology tools can help human services agencies to streamline the process of obtaining needed benefits and services, but they can also directly empower individual clients as well as families by allowing them to manage benefits and services according to their own schedules and from the privacy of their own homes. This has the potential to improve access to benefits and can remove some of the stigma and burdens traditionally associated with public benefits and services. For example, the Washington Connection benefits portal allows users to screen for eligibility for federal, state, and local benefits, apply for benefits such as health care, SNAP, TANF, and child care, and submit renewals and change in circumstances. Clients may create their own Client Benefit Account for additional access to information about their case.
Technology tools have also enabled agencies to better serve long-marginalized groups. In Minnesota, state officials developed the Autism Help app, which enables individuals with autism to communicate with and obtain necessary services – especially in emergency situations – through color-coded communications. Similarly, the New Mexico Department of Public Health’s Project ECHO initiative reaches hepatitis C patients in isolated parts of the state. The project has developed a teleconferencing infrastructure which allows patients to access medical assistance and clinics which might otherwise have been inaccessible to residents located in rural areas.
Mobile technology is making a difference as well. With the help of a local university, New York’s Office of Children and Family Services obtained and deployed mobile technology such as laptops, permitting staff to access information needed to assist clients while out in the field. These tools can allow caseworkers to spend more time with their clients, rather than being tethered to a desk. Similarly, the Arkansas Department of Higher Education developed a smartphone app, called YOUniversal, which allows students to determine eligibility for state scholarships, and even submit applications.
ANALYSIS: EVALUATING EFFECTIVENESS
Using technology, human services administrators, supervisors, managers, and frontline staff can gain access to data that helps them understand their clients at both the individual and population levels and that allows them to track and evaluate program performance. These innovations typically assist high-level program administrators in decision-making through data aggregation and analytics, allowing them to assess program performance, uncover long-term trends, and develop possible improvements. A lauded success story is Allegheny County’s Data Warehouse (Pennsylvania). The county’s Department of Human Services has developed numerous search queries to analyze data, enriching the information available to both administrators and third-party researchers, including those at local foundations and universities.
Improved analytical capabilities can also allow agencies to identify and implement more effective services for clients. In Oklahoma, as part of the SoonerCare (Medicaid) program, officials analyzed patient data including comorbidity factors to identify individuals prone to poor health outcomes. Equipped with a list of at-risk Medicaid recipients, managers have worked to sign these individuals up for intensive, managed-care programs. Meanwhile, the Rhode Island Department of Children, Youth, and Families developed the Real Connections program, which analyzes data on a child’s social network. Using this analysis of existing information, the Department is able to identify mentors best suited to enable the best outcome for each child.
ACCOUNTABILITY: IMPROVING PERFORMANCE
Technology innovation plays an important role in improving the delivery of human services and public benefits by building upon analysis to improve transparency around program performance. Technology innovation can be used to better communicate important information to residents and administrators alike, enhancing the scrutiny and decision-making of administrators, elected officials, and the general public. One example of this opportunity is the California Healthcare Associated Infections map, which emerged from a legislative mandate that the state’s hospitals publish information on infection rates. The visual presentation of health data in the map increases transparency of the state’s network of hospitals, ultimately holding hospitals accountable to the public for delivering safe and effective care for patients.
Similarly, North Carolina officials developed a ‘data dashboard,’ which uses existing data collected by the Department of Health and Human Services to compile metrics on program performance. Every month, the Department releases public reports which present information on family outcomes. A separate Medicaid dashboard also permits the general public to view financial data. In Arkansas, technology is driving better provider accountability in health care. Partnering with insurance providers in the state, the Department of Human Services launched the Payment Improvement Initiative. This project allows care providers to input payment information, and provides data to providers and insurers alike on the costs and outcomes of care episodes. Providers are even entitled to share in savings when high-quality outcomes are achieved at below-average cost.
LEVERAGING THE OPPORTUNITY
There are many examples of how technology can help human services agencies meet key needs. Those listed above are not exhaustive, but they do show the range of specific benefits technology can offer. Agencies seeking to improve performance and outcomes will find that, while not a panacea, technology innovation can be a crucial component of any effort to address needs and better serve individuals and families. Over the next few weeks, we will be highlighting key themes and exploring cases from our research here on Data-Smart City Solutions; check back soon for more.
Sam Gill is Vice President, Indi Dutta-Gupta is Senior Policy Advisor, and Brendan Roach is a Senior Associate at Freedman Consulting, LLC, a strategic consulting firm based in Washington, DC. This article draws upon findings from a paper undertaken with support from the Ford Foundation, entitled “Gaining Ground: A Guide to Facilitating Technology Innovation in Human Services.”