The state, which once had the longest health and human services applications in the nation, has cut the size of paper copies by 80 percent and is now working with Code for America to do the same online.
Until last week, Michigan had the largest application for public benefits of any state in the nation.
Many of the residents there who were applying for programs such as food assistance, state emergency relief or health care, did so by filling out a document made up of more than 40 pages, 18,000-some words and 1,000 questions. This, however, has now changed. Through extensive end-user research and human-centric design — practices many states have recently begun to explore — a new form was implemented in Michigan this month, clocking in at a slim 3,904 words, 18 pages and 213 questions.
This revised application grew from something called Project Re:form, which was created and led by the Detroit-based design studio, Civilla, and later evolved into a collaborative effort with the Michigan Department of Health and Human Services (MDHHS). Project Re:form seeks to address a common problem that plagues government services both online and off: forms, platforms or websites that are designed to satisfy bureaucratic requirements or regulations without taking into account the actual humans who use them to access services, often during stressful periods in their lives.
If properly researched and executed, human-centric design can make things easier for constituents, while at the same time greatly reducing the amount of work public servants must do to process forms and make decisions. This has the potential to save hours of time, which can ultimately free them up to do other work.
In Michigan for example, Civilla’s researchers found that the state’s old unwieldly form was on average only 72 percent complete when it was turned in, which meant case workers often had to spend time reaching out to applicants for additional info. Early indications, however, show that the new human-centric design form is coming in on average 94 percent complete, which generally accounts for all vital questions. This has reduced the time it takes to process individual cases by 42 percent.
To put that in perspective, if it theoretically used to take 10 hours to process each case, it now takes about five hours and 48 minutes, giving state workers an extra four hours and 12 minutes a week to perform other duties. Extrapolate that over the course of a year and it adds up to more than 218 hours of work time saved.
This is all without reducing the amount of info the state received. Such a redesign might sound really simple, but state officials said it was exceedingly complex work that within the day-to-day crunch of providing government services they simply did not have the personnel or time to complete without cooperating with an outside actor like Civilla.
Civilla was founded by Michael Brennan, who spent 30 years in a leadership role in Michigan with the United Way. Brennan, who was first introduced to human-centric design in the mid-'90s, has long been interested in ways human-centric design could improve society, specifically how it could be used to help navigate increasingly complex systems. He was invited to work on and research this topic at Stanford University’s Hasso Plattner Institute of Design, where he met Lena and Adam Selzer, design experts who later joined him at Civilla.
On Project Re:form, the group did extensive end-user research, a theme often discussed by developers of government services but rarely executed as thoroughly as it was by Civilla. Researchers spent more than 4,000 hours (dating back to September 2015) interviewing applicants for public benefits in their homes, as well as shadowing and interviewing relevant public servants. The group also spent a lot of time rehearsing the experience of applying for benefits, learning all the ways they could help the state.
Now, this is the point where stories like Civilla’s often hit a snag. Civic tech companies’ grand ideas can be blocked by the inherent difficulties of teaming with government, whether it be by an inability to engage the correct stakeholders, not knowing where to start or myriad other hurdles.
Civilla, however, invited prominent leadership from Michigan’s Department of Health and Human Services to its downtown Detroit office, which Brennan jokingly described as a tiny, heated storage closet. Brennan and the rest of the team had converted that closet into a facsimile of the sort of offices where applicants filled out public benefits applications. When officials from the state arrived, Brennan welcomed them and gave them the monster form, asking them to read every word and answer every question.
“That was the first time some of them had seen the application,” said Lena Selzer, Civilla’s director of design. “I think it was really eye-opening for them.”
After they were finished, Brennan walked them through a 100-foot journey of what applicants go through once they’ve turned in an app, which the team had laid out on the floor.
“It was designed intentionally to have them feel how it felt to interact with the system, not just intellectually understand it,” Selzer said. “We feel today this is one of the biggest reasons we ended up taking a step toward working with them.”
Brennan praised Michigan’s leadership, specifically Terry Beurer, the deputy director of field operations in the Michigan Department of Health and Human Services, for having the courage to embrace such an intricate overhaul.
Bob Wheaton, a spokesman for the MDHHS, said the application didn’t start out being so big, but that it had evolved and grown as agencies and application processes were consolidated over the years. The department had been interested in finding more effective ways to meet the needs of constituents since it merged into its current form back in 2015.
“It helped having the resources from Civilla to do this because our staff is devoted to doing other things on a day-to-day basis,” Wheaton said. “It’s just impressive that the application could be that much more concise and still include everything that was included in there. All that key information we’re still getting from clients. It just underscores the importance of trying to look at the services we provide from the eyes of the clients we’re serving, find out how we can improve the services from them, and take that into consideration.”
Civilla is currently working to ensure the adoption of the new form is successful, having launched statewide less than two weeks ago, but the company is also teaming with Code for America (CfA) to simplify online and mobile applications much the same way it did for paper versions. This coincides nicely with CfA’s ongoing work to use tech to make governmental benefits accessible to everyone who is eligible for them, perhaps demonstrated best by the group’s work on GetCalFresh, which seeks to facilitate easier access to food assistance in California.
That work is part of Code for America’s recently announced Integrated Benefits Initiative, an effort to improve enrollment rates among eligible people who apply for multiple government programs across the country. Laura Ramos, senior director of integrated benefits at CfA, said the MDHHS is the owner of the work it's doing, while Civilla is the managing stakeholder.
Developers with CfA have already built a prototype based off work done on GetCalFresh, the goals of which are in line with what project Re:form did with paper forms. In fact, the new mobile food assistance program application now takes 10 minutes or less to complete. Ramos said that as with all of CfA’s work, part of the goal here is to create something that can be easily replicated and deployed in other states.
Indeed, most — if not all — state and local governments would concede that human-centric design is something that could improve life for their constituents while also making work easier for public servants, and that it’s something they’d like to deploy. Brennan said that there was a “universal nature” to the obstacles and situations Civilla’s research uncovered and to what they learned, not just within Michigan but also within the entirety of the United States.
“Whether we’re talking about the federal government or state governments, they are wrestling with the same type of barriers,” Brennan said. “These are not just unique struggles that Michigan took a courageous step at solving through human-centered design.”