Making emergency social program delivery effective
The COVID-19 pandemic has not only put a brake on life in the fast lane for most of us but has also shown how poorly prepared we are to deal with natural disasters and pandemics. Other than the obvious impact on health and wellbeing, loss of livelihood and associated income for a significant portion of the population is a major ripple effect. This, in turn, puts the spotlight on the social safety net and programs offered by the federal, state and county governments. Some lessons have been learned from Katrina and Sandy, however the scale of COVID-19 is unprecedented and will require solutions that require quick and flexible deployments.
The big ideas to solve big problems are also the simplest. If we breakdown what is exactly needed, it comes down to:
- Easy Access
- Real time response
- Quick Delivery
During an emergency like the one we are facing now, people should have remote easy access to look up the available emergency programs and apply for themselves and their family.
Systems developed as a result of the Affordable Care Act (ACA) provide a view of what is possible. The ACA allowed anybody with a device and an internet connection to quickly ‘apply’ for MAGI Medicaid and/or select a plan from the market place with insurance assistance.
The entire process starting with ‘Screening’ for eligibility, creating an application, real-time verification and eligibility determination, selecting an MCO and/or plans and actually paying the first month premium – all part of a single transaction, took less than 20 minutes from start to finish. The infrastructure that was built for the ACA needs to be expanded beyond MAGI Medicaid to all social programs, especially for any emergency programs.
Just like the Federal Hub, SSA, DOL, and DMV provided real-time verifications, and applications and cases became ‘no-touch’ or ‘quick-touch’. All emergency programs have to follow suit. Support requirements in times of emergency vary greatly — from basic needs like food and shelter to direct cash, heat/energy payments and transportation passes. Use of bar coded emails to avail services, and commercial cash cards like VISA/AMEX instead of EBTs, will make delivery instant.
There already are programs in place like Disaster SNAP (D-SNAP) and Transitional and Migrant Worker Assistance, however, the different departments that handle these programs both at the federal and state level need to collaborate to present a unified front that simplifies the process for both the citizen who is seeking assistance and the workers who administer the services.
For example, all the HHS agencies like CMS, FNS, OCYF should have a data sharing agreement. Data verified by one program (like MAGI) should be used by other programs. Although the ‘no wrong door’ approach is a good move, behind the scenes, most of the states have a bunch of disintegrated systems that keep the wheels moving, albeit slowly. A collaborative approach to data will also help ease the operational challenges of administering emergency programs. The IT systems will naturally follow the state and federal policies, and with incredible strides in technology and scalability, will be able to help the state to provide the necessary safety net for its most vulnerable citizens.
Vijay is the HHS Consulting Lead and Head of Medicaid Practice at Infosys Public Services. He has over 20 years of experience working with multiple HHS agencies across multiple states to help them achieve their IT vision.