How Technology Can Ease the Strain on Health and Human Services Agencies

In 1960, the Medicaid system didn’t even exist. Today, one in five Americans are enrolled in that programⁱ. Other health and human services programs have grown dramatically as well, and that growth will likely continue in the wake of the COVID-19 pandemic. States need to process millions more program applications today than ever before. To meet greater demand for services with limited budgets will require them to streamline systems and leverage technology to enable self-services.

In fall 2019, we commissioned a study with the Center for Digital Government (CDG) to evaluate the availability and accessibility of key government services within the 50 states, including Medicaid and disability benefits applications.

Some of the key findings around Medicaid application processes included:

• All 50 states allow applications to be filled and submitted via an online portal.
• 23 states provide PDF forms that are not fillable, and yet, each of these states allow the public to upload these forms via their state portals.
• Mobile accessibility and the ability to sign and submit an application on a mobile device is the biggest differentiator between leading states and lagging states.
• 18 states do not offer mobile-accessible portals.

Some key findings on disability benefits application processes:

• Most states accept initial applications by phone, in person at a regional office, and through the federal website portal.
• Mobile accessibility and the ability to sign and submit an application on a mobile device is the biggest differentiator between leading states and lagging states.
• 10 states do not offer mobile-accessible portals.
• 20 states lacked clear information about eligibility or agency contact information.

While there is some positive news in the findings, it’s also clear there is a gap in how we serve the portion of the population that relies on health and human services programs. In the worse cases, that gap could translate into real-life consequences. Technology has the potential to help states manage those demands and close the gap, and some states are moving in that direction. However, there’s still plenty of room for improvement.

One easy step HHS agencies can take to improve accessibility is to digitize forms. DocuSign worked with a large state Child Protection Services agency that formerly relied exclusively on paper. Following the issuance of a court order requiring the organization to increase the number of foster parents in the system, the agency digitized their initial adoption application and used DocuSign to enable electronic signatures. Digitizing the application, which previously consisted of a 40-page handwritten form, resulted in a significant bump in the number of foster parent applications and enabled the agency to comply with the court order.

Because HHS programs generally require applicants to fill out numerous forms, anything that can be done to streamline the application process can help. As our research found, most HHS agencies now have a public portal that allows applicants to upload information. However, some of those portals simply replace paper processes with quasi-digital ones, requiring applicants to download a form, print it, fill it out and then upload it again. Agencies that fully digitize applications make it easier for citizens to complete and submit applications and to do so in fewer steps.

Digitizing forms can also help government employees. For example, expanding a case worker’s ability to submit certified documentation during investigations – including collecting signatures electronically rather than in-person or via the mail – could substantially reduce time and overall costs for child welfare systems across the U.S.

Enabling mobile accessibility is another easy step an HHS agency can take. Mobile accessibility is critical because the percentage of people without access to an actual computer is growing, especially among the population that would typically benefit from Medicaid. According to Pew Research Center, over 80 percent of Americans own a smartphone and a growing share of people are dependent on their smartphone for internet access, including 26 percent of low-income peopleⁱⁱ. Any state that doesn’t allow the public to access services from their mobile device is underserving a key constituency. Most states offer mobile accessibility today, but as our benchmarking study found, 18 states do not offer it for Medicaid.

At the most basic level, states can use technology to ensure they provide critical information to people seeking their services. Determining eligibility for HHS can be confusing. Our benchmark report found that, in the area of disability insurance, 20 states lacked clear information about eligibility or agency contact information. Fixing this can be as easy as ensuring information about HHS services are outlined clearly on your agency’s website and that your website shows up easily with a Google search.

State HHS agencies are already under pressure. It’s likely the COVID-19 outbreak will put additional burdens on them as they work to help more citizens in need. The good news is technology can help streamline HHS processes and services and make them a little easier for both citizens and employees to use and manage.

You can learn more about what leading states are doing to digitize health and human services processes in our benchmarking report.

---

i Henry J Kaiser Family Foundation https://www.kff.org/other/state-indicator/total-population/
ii Pew Research Center Mobile Fact Sheet https://www.pewresearch.org/internet/fact-sheet/mobile/