18F’s human services portfolio
About the portfolio
Since 2016, several teams within TTS have worked on a number of projects that fall within the human services space. This body of work has led to a deeper understanding of the challenges of the space from a variety of angles. 18F formalized this body of work into a distinct portfolio in 2018, with the goal of increasing our potential for impact and making thoughtful choices about how and where we engage in this space moving forward.
We envision a world where:
- People actually receive the services they are eligible for.
- Government agencies of all levels work together effectively to deliver human services.
- State human services agencies operate efficiently, effectively, and sustainably.
- State workers are empowered to change how their agencies operate.
- Money spent on human services programs results in tangible value delivered.
- The marketplace of vendors and solutions serving these programs is accessible, competitive, vibrant, and efficient.
Our role in making this vision a reality
TTS is in a unique position to be a leader in this shift, influencing the ecosystem and its actors from a variety of angles due to our ability to work with agencies across the federal government, our experience supporting states through procurement consulting, our ongoing engagement with the vendor community, and our ability to build products and platforms for use across government.
Where and how we can help:
- Federal agencies: We can help federal agencies achieve better outcomes by improving their methods for delivering policy, oversight, and funding (e.g. through APD reform, etc).
- States: We can help states administering federal programs with federal dollars increase their capacity to run these kinds of programs effectively through a variety of consulting and training activities (e.g. our work with Alaska Eligibility & Enrollment, CA Child Welfare).
- The market: We can influence the market of solutions, vendors who can play, and the methods and expectations of delivery.
- The ecosystem: We can contribute directly to the ecosystem of reusable, modular components in the marketplace.
- The approach: We can proactively and publicly share our lessons learned, crafting influential communications and materials that help shape the direction of the broader movement, even advocating for policy change where possible (what 18F has done for general best practices in gov tech, we can do specifically for the human services community).
- MESC 2019 - Resources from two presentations from Portfolio staff at the 2019 Medicaid Enterprise Systems Conference.
We have worked with partners at the federal, state, and local levels learning about user needs from the beneficiaries in need of care to the federal agencies overseeing the programs, and experimenting with approaches to solve those problems.
HHS - SAMHSA Opioid Treatment Locator
SAMHSA’s (Substance Abuse and Mental Health Services Administration) mission is to reduce the impact of substance abuse and mental health in America’s communities. SAMHSA is the only federal clearinghouse for substance abuse treatment location information.
The goal of this project is to improve the experience of people visiting SAMHSA in search of treatment options or resources. When people look for information about substance abuse treatment, they need clear answers to the questions, and the answers they need may vary based on who is asking (someone looking for treatment for themselves vs someone looking for treatment for a loved one). The project is currently in the discovery phase, focused on understanding the problem space in order to identify a path toward build a welcoming and empathetic service for people trying to find the right kind of substance abuse treatment.
Alaska Eligibility & Enrollment (E&E) modernization
Our team has been partnering with the Alaska Department of Health & Social Services, Division of Public Assistance (DPA) for the last two years to help them take an iterative, user-centered and modular approach to procuring and building a modern, integrated eligibility system. DPA's goal in this modernization effort is to enable staff to more efficiently issue correct and timely benefits to Alaskans who need help meeting their basic needs, in a manner that not only meets state and federal standards, but is user friendly for their clients, their eligibility staff, and their technical staff.
Vermont E&E modernization
Our team has been partnering with the State of Vermont for the last 18 months to help them pursue a modular, iterative procurement strategy to move towards an Integrated Eligibility & Enrollment system and incrementally migrate away from their legacy systems, with the goal of better serving state staff who administer public benefits like Medicaid and SNAP to Vermont residents.
- Main Program Repo
- Internal project README for Year 1 on Google Drive
- Internal project README for Year 2 on Google Drive
10x Data Federation (w FNS Child Nutrition)
The Food and Nutrition Service (FNS) at the USDA provides free and reduced-price meals through the National School Lunch Program and School Breakfast Program. Part of administering this program requires states to collect and aggregate data from school districts and submit them to FNS. Though the standards for the data are set by FNS, state offices have primary responsibility for ensuring data quality, and currently go through a process of both automated and manual checks to ward against errors that would require a lengthy and burdensome remediation process.
Currently funded through 10x, the U.S. Data Federation, an initiative to create reusable tools and repeatable processes for federated data efforts, has partnered with FNS to create a centralized rules service, maintained by FNS and accessed by state systems via API. Instead of fifty states creating and maintaining separate edit-check systems, the states will all access one central system, significantly reducing effort, cost, and time devoted to data verification.
HHS/CMS Advance Planning Document(APD) modernization
In addition to our state work, we are partnering directly with the Centers for Medicare & Medicaid Services (CMS) to identify opportunities to make changes at the federal level to help states be more successful in their efforts to modernize their Medicaid systems.
Our current focus is on exploring ways to streamline the process by which states submit their project plans (called Advance Planning Documents, or APDs) for funding approval by CMS. We're starting by prototyping a web form states can use to build and submit their APD in a standardized way, focusing first on just HITECH APDs. The goal is to simplify the process for states by making the process formalized and well-defined, and to help CMS reach funding decisions more quickly so states spend less time waiting to find out if they’re getting money.
Previous: Austin Hernandez, James Hupp, Jennifer Thibault, Aviva Oskow, Ron Bronson, Brendan Sudol, Nicole Fenton, Meghana Khandekar, Nick Brethauer, Alex Pandel, Dan Williams, Zac Cohn, Robin Carnahan
10x E&E - Eligibility rules service
The eligibility rules service project is exploring the idea of providing shared web services that states could use to help make eligibility determinations for human services programs. Currently funded through 10x, we are working with the SNAP team at FNS exploring the feasibility of a rules service for the D-SNAP program and an accompanying online registration form.
- GitHub repo
- Presentation: What is the Eligibility Rules Service project?
- Internal project README on Google Drive
California Child Welfare modernization
18F has been partnering with the California Child Welfare Digital Services (CWDS) team since 2015. CWDS is a collaboration of state and local government agencies dedicated to building a new child welfare information system that responds to users’ needs while maintaining the best standards for security and data integrity. The goal is for CWDS to develop a strategy for building a new, intuitive, user-centric system that will have a direct impact on child safety, permanency, and well-being. The scope of the project includes supporting CWDS by providing hands on support to product owners, improving agile practices, and evaluating product and technical strategy.
- Leadership and innovation at California's Child Welfare Services
- California takes a new approach to procurement
- From 1,500 pages to 10: Helping California buy a new Child Welfare System
- Internal project README on Google Drive
Alaska Child Welfare modernization
The State of Alaska Office of Children’s Services (OCS) is starting process of transitioning from their legacy child welfare system to something that will meet the new CCWIS standard from ACF. In advance of this, OCS sought the assistance of the TTS Acquisition Team to develop an acquisition strategy to support to transition from the current system to a new CCWIS-compliant system. Developing a new acquisition strategy also entailed a review of their existing practices around procurement, software development and vendor engagement.
USDA/SNAP State waiver path analysis
The USDA's Food and Nutrition Services (FNS) contracted with vendors to build a system to improve the process for States requesting waivers related to administering Supplemental Nutrition Assistance Program (SNAP) benefits. With this system, they intend to reduce the time in the waiver decision making cycle, reduce inconsistencies across states, and increase customer service quality. The system would replace a paper process.
Unfortunately, work produced by the vendor did not meet FNS's requirements and FNS terminated the relationship. 18F will help FNS assess whether any of the work that they have is usable. We will also help set a path forward for a functioning system and for successfully managing it in the future.
CA MEDS - Medicaid Eligibility modernization
California is starting a large scale procurement effort to modernize their Medicaid eligibility system (known as MEDS). 18F was asked to create a technical prototype in order to de-risk this effort, generate enthusiasm for a more iterative, user-centered way of working, and identify stumbling points that need to be addressed before vendors join the effort.
DOL/Women’s Bureau - Paid Family Leave system prototype
The Women's Bureau at the Department of Labor works to support States that are implementing a variety of programs. They wanted to share information to help improve the way state governments contract for Paid Family Leave Programs. 18F worked with DOL to develop a prototype of a front end, the result of user research with current and prospective users of Paid Family Leave in NJ, CT, and CA.
HHS/CMS Multi-program enrollment prototype
The US Digital Service enlisted a team of 18F staff to help conduct a multi-pronged discovery effort in partnership with CMS to explore opportunities for the federal government to provide key technology and service improvements to the experience of accessing and enrolling in health and human service programs.
The team conducted research into the user experience of enrolling in and providing services such as Medicaid, SNAP and TANF, as well as evaluated possible improvements to the federal Data Services Hub to streamline eligibility determinations. This work culminated in the creation of a multi-benefit enrollment prototype designed to model how to create simpler, user-centered multi-program applications. The work was funded through GSA’s Great Pitch (now 10x) incubator program.
- Mollie Ruskin, Ginny Hunt, Lucy Brady, Clarence Wardell, Ross Dakin, Alex Pandel, Gail Swanson, Jamie Albrecht, Jeannine Hunter, Meghana Khandekar
Missouri Medicaid modernization
Following our initial collaboration with the State of Missouri through our first engagement with CMS, we began working directly with the state to assist in the development of a modular procurement strategy for modernizing their systems. After the initial on-site discovery workshop, the state team determined that the first project should be a premium collections module within their eligibility system. 18F collaborated with the state team on ways to use wireframes and prototypes to understand the constraints of their existing systems and better scope their follow-on RFP.
Web-Based Prototype Application for Free and Reduced Price School Meals
Our PIF colleagues worked with USDA's Food and Nutrition Service School Meals program to develop an electronic prototype application that is intended to be a model for how State and local program operators (or their designated vendors) may develop an effective and fully compliant electronic/online application for school meal benefits. The FNS School Meals team later collaborated on our U.S. Data Federation project.
People: Presidential Innovation Fellows, primarily Ross Dakin
SSA - Disability case processing system
The Social Security Administration's Office of Disability and Adjudication Review (ODAR) engaged 18F to conduct a technical assessment project to analyze the Disability Case Processing System 2.0 (DCPS) and help determine whether the approach and architecture used for DCPS, a case processing system being developed for a different part of the enterprise, were viable solutions for reuse, fully scalable, extensible, and maintainable over the long term. SSA also sought an assessment of both government-provided and commercially available alternatives in order to decide on the best approach for the creation of the new ODAR system.
HHS/CMS w MO, MN - modernization path analysis
In 2016, 18F entered into our first direct engagement with the Centers for Medicare & Medicaid Services (CMS). This was a 12-week path analysis to identify how we could best assist CMS in better supporting states’ efforts to modernize their Medicaid IT systems (which CMS oversees and provides funds for). This project led to follow-on work with CMS to explore a more streamlined approach to the process by which states submit funding requests to CMS, as well as direct follow-on work with the state of Missouri to assist them in developing a modular procurement strategy for their procurement.
HHS/ACYF w MS, CT, MD - Child Welfare path analysis
In 2016, 18F entered into an engagement with the federal Administration of Children, Youth and Families (ACYF) at HHS to explore ways to better assist states in modernizing their child welfare management IT systems. (ACYF oversees and provides significant funding for these state systems.) 18F led a series on on-site workshops for states’ child welfare agencies on modern software development and modular procurement approaches, including support for the state of Mississippi’s first “agile vendor pool” to allow state agencies to more quickly hire IT contractors prepared to do agile development work.
10x E&E (Phase 1) - investigation
After some initial work in the health and human services space through our collaboration with USDS and our direct work with CMS, ACF, and CWDS, we wanted to take a step back to identify where TTS is best positioned to support human services agencies to more effectively leverage modern technology in service of their missions.
Through an initial 4-week investigation sprint funded by GSA’s 10x incubator program, we explored current and past efforts in the space and identified areas where we believed TTS was best positioned to have a positive impact. This initial investigation led us to pursue and receive further rounds of 10x funding to support further exploration into the value and feasibility of providing a central rules service at the federal level to assist states in making eligibility determinations for human services programs.
HHS/ORR Unaccompanied Alien Children Portal
18F was invited to review the Unaccompanied Alien Children’s Portal and database to assess its health and make recommendations that ensure the agency can fulfil its mission. During our initial discovery, we conducted technical analysis, developed a modernization approach, and provided procurement recommendations. During a subsequent phase, we worked with Office of Refugee Resettlement (ORR) staff to iteratively develop a prototype scheduling application that would assist capacity planning and train staff on modern product management and software development methods.