Report: States Have Flexibility Needed to Improve Efficiency, Access to Work Supports
As the public debates key work supports like Medicaid and the Supplemental Nutrition Assistance Program (SNAP), Work Support Strategies’ (WSS) final evaluation report provides crucial evidence about what works and what doesn’t to support low-income people. WSS was a multi-year, foundation-funded initiative providing states financial support and technical assistance to reform their delivery of public benefits. It was led by CLASP in partnership with Urban Institute and the Center on Budget and Policy Priorities.
The report finds that the six states participating in WSS (Colorado, Idaho, Illinois, North Carolina, Rhode Island, and South Carolina) substantially improved eligible children’s and parents’ participation in safety net programs, as well as dramatically reduced the time it takes to deliver benefits. Moreover, states accomplished these goals without spending more money on administrative costs or increasing errors; rather, they used existing flexibility within the programs, proving that block grants aren’t needed to achieve these striking results.
It’s essential to ensure more eligible families receive the full package of benefits in light of mounting evidence that core work supports reduce poverty, help people meet basic needs, and improve children’s long-term health and economic success. In 2015, SNAP alone lifted 4.2 million people out of poverty and health care coverage was extended to 4 million people. Recent studies show that people who access SNAP and public health insurance as children experience positive outcomes into adulthood. In particular, access to SNAP in early childhood promotes improved health and economic outcomes later in life. Additionally, expanding health insurance coverage for low-income children significantly affects high school completion, college attendance, and college completion.
Despite these lifelong benefits, many families are unable to access all the supports they need. When families apply for multiple programs, they regularly face burdens and delays, resulting in family destabilization, food shortages, or foregone medical treatment. State staff are burdened by delays, too. Confusing, unnecessary, or repetitive paperwork requirements; long lines in local offices; and delays in processing applications make it harder for low-income workers to meet their families’ needs, hinder state administrative efficiency, and undermine staff morale.
To turn this situation around, the six WSS states took on the challenge of reforming technology, policy, and business processes. All six states either updated existing technology or implemented new technology to improve cross-program integration across departments, monitor service delivery, and reduce the number of trips applicants had to make to the office. States also made significant policy changes, eliminating requirements that exceeded federal law, aligning benefit determination so families could renew two or more programs at the same time, and utilizing electronic data to auto-enroll SNAP recipients in Medicaid. Further, states upgraded their business processes, including improving customer greetings and addressing workflow inefficiencies. Several states also trained workers to process applications for multiple programs, referred to as a “no wrong door” policy, so that clients could wait on one line, tell their story once, and get the full package of benefits for which they were eligible.
The evaluation report illustrates significant gains in key areas. Most notably, families are getting their benefits faster, in many cases on the same day they apply. This dramatic improvement, which was consistent across states, resulted in increased satisfaction according to client surveys. In Rhode Island, the share of SNAP applicants who received same-day benefits tripled from 2011-2015; in Colorado, the share doubled from 2013-2015. In some programs, states were also able to reduce churn (the loss of benefits due to procedural issues while a family is still eligible).
Four of the six states increased the number of eligible families who received both SNAP and Medicaid/Children’s Health Insurance Program benefits. From 2011-2013, joint participation rates for people under age 65 rose from 73 to 87 percent in Colorado; from 70 to 78 percent in Illinois; from 73 to 81 percent in South Carolina; and from 93 to 96 percent in Idaho. These figures most likely increased after 2013 as states implemented the Affordable Care Act as well as new systems and business processes.
WSS provides strong evidence that states can significantly improve delivery of public benefits without drastic changes—such as block grants—to the structure of the underlying programs. The states were able to be more responsive to increased demand for services and implement the Affordable Care Act with fixed staffing levels. Throughout WSS, evaluation reports have shown that making benefits more timely and accessible needn’t impact accuracy. This lesson that is transferable across a variety of policies and programs.
State flexibility is another important lesson from the evaluation. Upon examining their policies, many states discovered that problems they’d long attributed to federal rules were actually internally imposed and thus could be eliminated. One state official said they discovered that “there are steps in our program application processes that are not required under federal or state law. The more we study the steps in the application process, the more we learn that we have promulgated rules that are not mandated.” They also adopted a customer-focused approach that recognized that families’ needs do not fall within program silos and leveraged their investments in technology across programs. Additionally, the WSS states also learned key lessons on program innovation, as well as adapting to change, that apply across program contexts. A CLASP report from earlier this year summarizes twelve lessons learned about planning, leadership, communications, use of data, and the value of a peer learning community.
In today’s political context, the lessons from WSS are more important than ever to informing the public debate. Despite transitions in governors and senior officials, the six WSS states remained committed to improving families’ access to core work support programs over the span of five years. Democrats and Republicans shared common goals of reducing red tape, improving the customer experience, and providing families access to the full set of work supports—helping them stabilize and improving their success at work. Idaho Governor C.L. “Butch” Otter (R) said his state’s WSS work “created a holistic, family-centric approach to the design and delivery of services.”
The WSS evaluation provides clear, practical lessons to help other states improve their services to low-income families and address administrative bottlenecks. Colorado, Idaho, Illinois, North Carolina, Rhode Island, and South Carolina have all reaped the benefits of streamlining processes, fostering collaboration between agencies and programs, and ensuring families get and keep the work supports for which they’re eligible, without raising administrative costs. Moving forward, we hope more states will take on the challenge. And we encourage Congress and the president to maintain the strong entitlement structures that have made these improvements possible.