Four Lessons from Our Journey to Deliver Human-Centered Integrated Benefits

Imagine that your neighbor loses their job. They’re stressed, and unsure how they’ll cover childcare and health insurance during this period of unemployment—or, more pressingly, how they’ll pay for food this month. They don’t know that there are several hours-long benefits applications at different agencies that may interpret their complex situation differently, or that their county delivers some services, while the state delivers others. They just need support during a destabilizing life event.

Now imagine a single, integrated resource that allows them to apply for all the available benefits at once, and access the support they need to do so. It works on a phone, is available in different languages, and offers live chat support and timely follow-up. This isn’t a futuristic fantasy. Our social safety net can and should work this well. 

In 2017, Code for America partnered with the Center on Budget and Policy Priorities, Civilla, and Nava to launch the Integrated Benefits Initiative. Over the next three years, we set out to test and pilot human-centered approaches to improve outcomes, and learn what an optimal safety net could look like at all points in the benefits enrollment journey. 

We started in Michigan, where in partnership with Civilla we helped create a streamlined combined application for SNAP and Medicaid, while in Louisiana we tackled churn with text message reminders to 27,000 Louisianians across WIC, SNAP, Medicaid, and TANF recipients at risk of losing their benefits if they didn’t renew them. Those short-term pilots had lasting impact: Michigan now has one of the best integrated benefits applications in the country, while Louisiana has since scaled up the text messaging pilot as a key part of their ongoing COVID-19 response. We tied this work to larger, comparative efforts like documenting the national online benefits status quo. 

The first version of the Integrated Benefits Initiative’s key success metric (our “North Star”) read: “Define the optimal integrated application and enrollment experience for clients, caseworkers, and managers.” But in five pilots across five states and five different points in the benefits journey, we quickly learned that there is no optimal experience of securing public safety net benefits, because there is no single, monolithic person trying to access those benefits. As we articulated the principles for an optimal, human-centered safety net, we considered what our next phase of work could look like. 

In 2020, we partnered with the state of Minnesota to apply our evolved understanding and approach with Integrated Benefits. That evolution is evident in MNbenefits, an ambitious collaboration to build a service that puts client needs at the center. MNbenefits is a new, people-centered, digital application for nine safety net benefits that clients can complete in less than 12 minutes. We also have a new North Star: “Prove a human-centered, integrated application for food, cash, and healthcare can be submitted in less that 20 minutes with better outcomes.” MNbenefits represents where we’re at in our own journey towards creating that human-centered benefits delivery system. Lessons from the first three years of our integrated benefits work inform this effort, and help set a course for our future efforts.

MNbenefits is a people-centered, digital application for nine safety net benefits that clients can complete in less than 12 minutes

1. Welcome complexity

We chose to work in Minnesota in order to grapple with unusual complexity in delivering services, working alongside motivated government and community partners who saw the need for change. Proving that a better, simpler system is possible in Minnesota will yield lessons in a variety of contexts. Our efforts must accommodate:  

• County-administered: Each of the 87 counties have wide latitude to support services, from structuring their workforces to procuring electronic document management systems. 
• State-based healthcare exchange: Rather than using the federal marketplace, Minnesota established and maintains its own health insurance marketplace website. 
• Tribal nations sovereignty: 11 federally-recognized tribal nations exist within Minnesota, and some administer their own federal programs. 
• Racial disparities: Minnesota has some of the greatest racial disparities in the nation, with its Black residents particularly hard hit by health and wealth gaps.  
• New Americans: Minnesota accepts more refugees per capita than any other state, forming a complicated legal status for various benefits program eligibility. 

Despite this complexity, everyday people rarely care about the acronyms, administrative schema, interwoven policies, and funding streams undergirding these programs. They just want help when help is needed. Outdated technology systems, bureaucratic enrollment processes and agency siloes have created a growing gap between those eligible for public benefits and those receiving them. MNbenefits is our effort to smooth over that inscrutable bureaucracy with a single source for streamlined questions that complete applications for different programs—even if those programs span different forms, eligibility considerations, and state and county workforces. We want the application experience to feel dignified and humane, and that experience to be backed by better outcomes for people who are often marginalized or underserved by the government. 

2. Meet the moment 

We kicked off our project with Minnesota in late January 2020. One of our activities included writing hypothetical headlines for what we would achieve together in the project. Nobody wrote “survive a global pandemic” or “face unprecedented demand for government services.” In discovery research with county field offices, we planned to test versions of the application in person with residents. And yet, about one month after we started, COVID-19 swept through the country, reshaping daily life and our safety net. 

Minnesota stakeholders envision a brighter future for benefits delivery (January 2020)

The pandemic illuminated how necessary improved digital services are to Minnesota’s safety net. For example, the legacy digital application does not work on a mobile phone and is only available in English, a problem that intensified when county offices and community hubs like libraries closed. It also highlighted urgent new opportunities. In April, Code for America and Minnesota quickly identified the need for digital registration, messaging, and data matching support to Minnesota’s implementation of the new Pandemic EBT program, which provided cash assistance to families whose children qualified for free and reduced lunch support. In a matter of months, we stood up an award-winning P-EBT application that would help Minnesota serve more than 250,000 children with tens of millions of dollars in critical food assistance. 

This mid-project pivot allowed us to build trust and rapport with our Minnesota partners. It also informed our approach for MNbenefits. For instance, seeing that more than 80% of families accessed the P-EBT application by mobile phone affirmed the importance of our mobile friendly approach for the new benefits application. 

3. Offer more benefits 

At the time of writing, Minnesota residents can apply for nine different benefits programs through the integrated MNbenefits application. For the first time in a Code for America project, we offer a pathway to childcare assistance, housing support, and additional state programs like Refugee Cash Assistance. With an integrated approach, instead of painstakingly adding a new feature to each individual program, all nine programs improve simultaneously from upgrades to the status quo, including: 

• Mobile-friendly application that works across all browsers, computers, laptops, and phones
• Availability in Spanish (with more languages to come)
• Easy document upload, including the acceptance of photos from a mobile phone
• No account login necessary, a common barrier to access
• Frequent accessibility testing against standards like WCAG 2.0 AA, Revised Section 508

Future benefits programs will similarly benefit from these features as they are incorporated into MNbenefits.org. We’re excited to build a pathway for healthcare into MNbenefits, and have already started preliminary conversations around additional benefits programs. 

4. Build for sustainability 

One of the key goals on all our projects is to create an environment where we and our partners can think beyond product improvement to move towards changing systems. Our pilot projects helped inspire and even catalyze longer term change, but they were only envisioned as that: pilots. 

With MNbenefits, we aim to reshape the status quo in a way that will far outlive our engagement. From the beginning, we sought a government partner with an appetite and commitment to learning and building with us—one who would ultimately own the service delivery. This required shifts in our typical technical approach. We are developing the new application in the state’s preferred programming language (Java), and delivering those applications by using the existing routing and document storage services used by their legacy application.

This seemingly small decision opened up a wealth of opportunities for both parties. The same state employees who developed and maintain the legacy application in Minnesota pair daily with the Code for America team to write code and participate in agile product development rituals, from daily standups and iteration planning meetings (IPMs) to team retrospectives. Through this process, our team rapidly gained a sophisticated understanding of the system architecture, helping us co-create a roadmap to sustainability for the state after we leave.

We believe this is a blueprint for rebuilding capacity within government digital service delivery teams, rather than the continued trend of outsourcing core services to external contractors. 

Code for America and the state of Minnesota worked collaboratively to determine what the goal outcomes of an integrated MNbenefits site

At their core, these lessons helped us help people. More than 12,000 benefits applications, representing more than 25,000 people, have been submitted via MNbenefits.org as of mid-May 2021. Before MNbenefits, it took about an hour to apply for benefits—now, it takes around 12 minutes. This represents more than 10,000 hours in saved time for people to date, valuable time that families can use to search for a new job, find stable housing or childcare, or do any number of other things to take care of themselves in a difficult stretch. 

Last week, we scaled MNbenefits from four pilot counties to 16, and we hope to roll the service out to the entire state later this year. We’re eager to continue to unlock government benefits for hundreds of thousands of Minnesotans, and to build enduring technical capacity and ownership with our government partners. More than anything, we hope this proves that it’s possible to deliver a national social safety net that meets people’s needs while treating them with dignity and respect.