Attachment C_ Literature Review

ATTACHMENT C: LITERATURE REVIEW

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Introduction

The United States Department of Agriculture’s Food and Nutrition Service (FNS) commissioned the Understanding States’ Supplemental Nutrition Assistance Program (SNAP) Customer Service Strategies study to describe how States define and measure customer service for SNAP applicants and participants, and how they implement and refine their customer services approaches. To support a systematic exploration of customer service approaches in SNAP, we began with a research review, created a list of relevant studies, reports, and data that surface lessons learned and best practices in customer-centered approaches to service delivery, and developed this Final Annotated Bibliography, which includes each study’s title, author, major findings, publication date, and publication source.

Final Review List

The sources included in the Final Review List have been selected to provide information on a wide range of customer service topics, including (1) materials focused on government safety net programs, such as SNAP and Temporary Assistance for Needy Families (TANF), (2) broader industry research as it relates to client relations and safety net programs, and (3) innovations and promising practices related to customer service. The information on these diverse topics will inform the selection of case study States, development of data collection instruments, collection and analysis of case study data, and development of a Final Report that will help guide and improve SNAP customer service initiatives and processes.

The 57 sources included in the Final Review List, all published between 2008 and 2022, range from descriptive briefs and guides to implementation and outcomes studies. All sources provide information and recommendations about serving low-income individuals who access government or other safety net programs. The research team coded these sources to explore the topics of interest in more detail. This Final Review List reflects updates made to the Draft Review List and an earlier version of the Final Review List based on the research team’s coding and analysis work and FNS feedback.

Below we provide an updated summary of our methodology and describe some of the variation across the included sources, on such aspects as the methodologies associated with the evaluation report, the programs reviewed, the types of strategies or interventions covered, the geographic scope of the sources, and the populations of focus. Using the previous iterations of the Review List as a starting point, we added additional sources to our analysis, looking especially to find those that cover the characteristics of interest that are a clear priority to FNS. For example, we added sources specifically addressing customer service incentives and customer service strategies targeted towards older adults. We also removed sources that were outdated or were not explicitly concerned with customer service.

Methodology

We used a multi-step process to conduct the research review, relying on the Internet as the primary vehicle for our search. Our work built on previous literature reviews we have conducted for SNAP and related programs and populations. To develop the Research Review, we took a broad approach, noting all sources related to customer service across government and non-government programs. We added these sources to an NVivo database and developed detailed categorization and coding to document the type of publication, the industry or program(s) represented, target population(s) addressed, and geographic location(s). We also coded each source to one or more category in our conceptual framework for this study (Exhibit 1). For example, a publication that described a customer service-related training to county staff would be coded to the “Capabilities” category of the framework.

Exhibit 1: U.S. Veterans Affairs and U.S. Digital Service Framework

Strategy: What are the agency’s customer service initiatives? Do they have buy-in from multiple levels of SNAP operations staff? Operations: Are customer experience indicators built into agencywide performance metrics? Funding: Are customer experience improvement efforts properly funded, and how? Organization: Are there customer experience-focused staff positions at various levels within the organization? Culture: Is customer experience included as an agency core value? How is this reinforced? Are employees involved in designing customer experience solutions? Incentives: What recognition (including monetary) is there for employees who promote a customer experience agenda? Partnerships: Is there collaboration and sharing of best practices from experts inside and outside of government? Capabilities: Do agency staff have the time and resources to provide positive customer service? Does the agency have the right tools (e.g., customer experience surveys, access to data analytics & artificial intelligence) to monitor customer service performance?

Research Methods Used

The research team coded sources by the approach and methods upon which research findings were based (e.g., implementation study, outcomes study). Several sources (such as briefs or guides) were also coded, which, although do not necessarily report on independent research conducted by the authors, do provide useful summaries of other research studies and highlight promising or best practices on key topics.¹ For example, we include several Customer Experience (CX) guides that draw on private sector technology and modernization insights. Exhibit 2 illustrates the number of sources by type.

Exhibit 2: Number of Sources by Type

Several sources were classified as multiple types, such as several large efforts that included findings from both implementation and outcomes studies of the same intervention. For these sources, the exhibit above shows the primary research methodology. Briefs and guides (21), sources reporting implementation findings from individual programs (often implemented in multiple sites) (19 sources), and case study research (10 sources) are the most frequently represented source type.

Types of Programs Examined

When the program being described or evaluated was clear from our preliminary review, the study team also coded the sources on the types of program(s) examined. For example, some sources focus specifically on SNAP while others cover other government programs or funding streams, such as TANF and Medicaid. Exhibit 3 groups sources by the type of program examined or funding source.

Exhibit 3: Number of Sources by Type of Program/Program Funding Source

Most sources examined customer service-related approaches within a SNAP context (26 sources). Sources in the “Multiple government safety net programs” (10 sources) named multiple programs and included broad strategies that were relevant for different agencies. Of the sources labeled “Other government safety net program” (10 sources), one focused on the U.S. Department of Health and Human Services’ Administration for Children and Families (ACF), two on the Workforce Innovation and Opportunity Act (WIOA) and the remaining seven on government safety net programs outside of the U.S. While not directly examining food insecurity programs, these international studies provide helpful context on expanding digitalization across the public sector to streamline service delivery and illustrate how customers can be involved in co-producing and co-creating public services. Several sources specifically explore TANF (4 sources), and Medicaid (2).

Framework Component

Our conceptual framework is critical in helping to organize and inform customer service-related strategies, approaches, and initiatives in this study. As such, we coded each source to one or more of the components in the framework. All sources were coded as focusing on at least one component in the framework, such as “Capabilities” or “Operations,” with some focusing on more than one. Exhibit 4 summarizes sources by their framework component.

Exhibit 4: Number of Sources by Framework Component Type

Almost all sources (52 sources) were coded to the “Strategy” component as they offered specific customer service practices or initiatives. The “Operations” component was the next most commonly coded group (42 sources) and included findings on measuring customer feedback and satisfaction. Sources coded to “Capabilities” (30 sources) and “Culture” (18 sources) focused on improving staff and agency capacities and agencies’ customer service goals, respectively. The least frequently coded framework component types were “Organization,” “Funding,” “Partnerships,” and “Incentives.”

Project Service Area

To ensure sources reflected the country’s geographic diversity, the research team also coded them by service area (e.g., national, statewide, county-level). Exhibit 5 illustrates this information.

Exhibit 5: Number of Sources by Service Area

Overall, most sources (37) were national in scope, meaning they either included multiple sites across the country or can be applied broadly to agencies around the U.S. Ten sources looked at state-specific initiatives while eight sources featured programs or strategies from outside of the U.S. Only two sources were based locally—one at the county level and one at a specific company.

Participant Type

The research team also coded sources by the type of participant or population of focus. All were coded as focusing on at least one participant type, such as low-income or individuals with barriers to employment, with some focusing on more than one. Exhibit 6 summarizes sources by participant type.

Exhibit 6: Number of Sources by Participant Type

By far the most sources were coded as targeting low-income participants (54 sources) and those who were food insecure (19 sources), which are a deliberate focus given the goals of this project. “Barriers to employment” is a composite category that included participants facing barriers not specifically named in the chart, such as having a disability or facing transportation challenges. A few sources specifically focused on parents (8 sources) and older adults (5 sources). Note that the total number of sources coded here sums to more than 57 since some sources targeted several types of participants. Sources coded to the “Other” category included participants who were English Language Learners and youth (10 sources).

Evidence-Based Customer Service Strategies and Practices

This section summarizes findings from sources in the Review List that that speak to various customer service-related strategies and practices and is organized by the categories in the U.S. Veterans Affairs and U.S. Digital Service Framework (Exhibit 1).

Strategy

The framework defines “strategy” as an agency’s customer service initiatives and how the agency achieves buy-in for these initiatives from multiple levels of staff. The most common strategy involves increasing access to services and ensuring customers are receiving their benefits in a timely manner. Other strategies include capturing customer feedback, leveraging new technologies to improve customer engagement and experience, and collaborating with partners to deliver customer-centered services. These latter strategies are described in more detail in the following sections.

Most sources assert that increasing access to services is an effective way to improve customers’ experiences obtaining services. This includes simplifying or streamlining eligibility and enrollment processes and redefining staff roles. Exhibit 7 provides examples of these strategies.

Exhibit 7: Methods of Increasing Access to Services

Method	Examples
Simplifying or streamlining eligiblity and enrollment processes	New Mexico’s Work Support Strategies Initiative switched to a “process-based” model, where caseworkers took on one step in the enrollment process (e.g., checking eligibility or interview customers) instead of working with a customer through all the steps of the application process. It also established a same-day interview policy to make it faster and easier for families to enroll in benefits (Kassabian 2013). During the COVID-19 pandemic, many state SNAP agencies requested temporary waivers from certain federal regulatory requirements (e.g., faster application processing, waiving in-person interviews, utilizing telephonic signatures), allowing for benefit enrollment and delivery that is designed with customers’ specific needs in mind) (Smith et al., 2020). Also during the pandemic, the New Jersey state SNAP office worked with the state’s Chief Innovation and Techonology Officers and volunteers from the U.S. Digital Response to identify and implement an online tool that would accept virtual elgibilty documents from customers (Smith et al., 2020).
Redefining staff roles	Florida’s Department of Children and Families’ business model, ACCESS Florida, established separate intake and processing functions that leveraged different staff roles. A “meeter-greeter” met clients first entering the lobby and directed them to the appropriate location, a computer helper assisted customers using the electronic application, and an intake specialist conducted abbreviated application interviews. ACCESS Florida also established customer call centers in Jacksonville, Miami, and Tampa to field general inquiries and provide basic information about program eligiblity and enrollment (Cody et al., 2008). South Carolina’s health insurance exchange employed “navigators,” individuals who provided hands-on assistance in applying for health coverage and made referrals to appropriate work support services (Courtot 2013).

Operations

The next category in the framework focuses on how customer service indicators are built into agency-wide performance metrics. In our review, we looked at specific performance measures that are tracked by organizations and how organizations collect that information from their customers.

Though performance measures vary across organizations and programs, they generally fall into two categories: relational measures and transactional measures. In this context, relational measures refer to customers’ experiences engaging with the agency and its staff, such as perceptions of how staff treat customers, staff attitudes and behaviors more generally, and how easy is it to navigate agency processes (Blaug et al., 2006; Fusting et al., 2019; Hanh 2011; Isaacs et al., 2016; Pratt and Hanh 2021; Rod and Ashill 2009; Serving Citizens 2014; and Wiseman and Choudhury, 2020). Transactional measures focus on services and service delivery indicators, such as application processing times, churn, and specific program outcomes (Courtot 2013; English et al., 2019; Fusting et al., 2019; Hanh 2011; Hulsey et al., 2013; Isaacs et al., 2016; Keefe et al., 2012; Williams 2015). Exhibit 8 provides examples of relational and transactional performance measures.

Exhibit 8: Examples of Relational and Transactional Customer Service Measures

Relational Customer Service Measures	Transactional Customer Services Measures
How are customers treated by staff? How responsive are staff to customer needs? To what extent do customers understand and navigate agency requirements and processes? How well do staff explain and support the customer through the application process? To what extent is customer privacy and confidentiality maintained?	Is program eligiblity and enrollment streamlined across programs? Does the service meet customer needs? Are customers progressing towards their goals (e.g., educational attainment, earnings stabalization, success of job skills training)? How quickly do customers receive their benefits?

Just as performance measures vary, so do ways in which organizations collect feedback from their customers. The most common methods include administering customer satisfaction surveys, conducting individual interviews or focus groups, and hosting “listening sessions” or town halls. Less frequent methods of data collection include convening customer advisory groups, exploring website analytics, and observing customer-staff interactions. Exhibit 9 provides examples of these and other data collection methods.

Exhibit 9: Examples of Customer Satisfaction Data Collection Methods

Method	Data Collection Examples
Survey	Maryland Department of Human Services regularly reviewed positive (praise) and negative (complaints) customer feedback from its email and website surveys to inform and improve its services. (Fusting et al., 2019). Allegheny County Department of Human Services in Pennsylvania surveyed youth in foster care and used their feedback to address challenges among specific populations, such as women, minority, and LGBTQ youth (Wiseman and Choudhury 2020).
Interviews or focus groups	The Multnomah Idea Lab in Oregon obtained feedback from families experiencing homelessness through interviews and focus groups, homeowners, and people from local businesses on solutions for addressing homelessness in the community. One idea that surfaced and was implemented was the installation of small homes in the backyards of participating homeowners (Rosinsky 2022). New York Medicaid leaders conducted focus groups in several langauges to understand consumers’ knowledge of health systems and their experiences with care. Findings were used to design educational messaging and projects to improve care provided to Medicaid patients (Zhu et al., 2020).
Listening sessions and town halls	Several state Medicaid leaders convene public committee meetings and town halls to connect with consumers in ways that “meet them where they are.” For example, Minnesota leverages its partnerships to host listening sessions at local community centers (Zhu et al., 2020). The County Welfare Directors Association of California convened county human services agency representatives and key stakeholders at a symposium to examine components of successful customer service practice (Fife 2013).
Other methods (e.g,. advisory groups, website analytics, and observations)	Washington state’s performance management effort, Results WA, includes regular “results review” meetings focused on specific government goals (e.g., suicide prevention, improving the availability of a skilled workforce, achieving clean energy, disparities in high school graduation rates) that are open to the public. Typically, customers receiving the relevant service are included so they can provide feedback on the quality of service being delivered (Wiseman and Choudhury 2020). Challenge.gov engages the public to crowdsource ideas and concepts through prize competitions. The website enables federal agencies to develop software, scientific, and technology solutions to help achieve their agency missions (Wiseman and Choudhury 2020).

Funding

The framework includes whether and how customer experience improvement efforts are adequately funded. We found limited sources that specifically addressed funding, though a few made references to pooled funding, philanthropic funding, and federal funding. For example, seven counties in Maryland pooled Child Support Administration resources as part of an effort to improve processing times for customer transactions, and disbursed over $900,000 owed to custodial parents (Fusting et al., 2019). In another instance, private philanthropy supported the Work Support Strategies initiative by offering one-year planning grants to nine states for connecting low-income families to work support benefits. These projects ultimately supported agencies’ customer service-related initiatives (Golden 2013; Hanh 2013; Hill 2013; Isaacs et al., 2016; Kassabian 2013; and Loprest et al., 2013). An example of federal funding is leveraging Affordable Care Act (ACA) funds to make technological changes required by the ACA that would improve agencies’ customer service overall (Loprest et al., 2016). Similarly, agencies can tie funding requests to the Integrated Digital Experience Act (IDEA) Act and other federal authorities that drive customer service/customer experience implementation (The Customer Experience Cookbook, 2020).

Organization

This framework category centers on whether there are customer experience-focused staff positions at various levels within the organization. Sources that spoke specifically to this category are limited, though those that did expressed a need for customer service “champions” across staff levels and agencies. A strategy to improve or expand customer service must describe how leaders, mid-level managers, and frontline staff will play a role in advancing relevant activities, including how each will be trained, how feedback will be incorporated, and how technology will be leveraged to meet strategy goals (Wiseman and Choudhury, 2020). Other approaches include establishing a permanent “Chief Customer Experience Officer” position to demonstrate the agency’s commitment to customer service and assigning key leadership positions at different levels for monitoring and improving customer satisfaction (The Customer Experience Cookbook 2020 and Serving Citizens 2014). For example, the U.S. Department of Veterans Affairs (VA) created the Veterans Experience Office to capture feedback from customers at VA health centers. To date it has implemented several customer and staff ideas, such as creating more welcoming environments in hospitals and updating forms with more plain language (Wiseman and Choudhury, 2020).

Culture

The framework’s “Culture” category focuses on if the customer experience is included as an agency core value, and if so, how it is reinforced and whether employees are involved in designing customer experience solutions. Core values include written commitments to providing high quality customer service. These guiding principles serve as a “blueprint for how government should approach the customer experience” and requires “serious and public commitment across government, from the senior officials to the frontline employees who serve customers every day” (Government for the People 2021).

Our review surfaced a few examples of how customer service principles are articulated in agency missions. Alameda County Social Services includes both “Customer Service” and “Initaitive” as two of its core values. “Customer Service” focuses on the agency’s relationship with its clients and community partners while “Initiative” centers on the agency’s collaborative approach to decision making and staff contributions in shaping the agency’s work (Alameda County Social Services Agency Strategic Priorities 2019). In its Customer Service Annual Report, Maryland Department of Human Services similarly declares its “commitment to providing the highest level of customer service has been and remains steadfast. Every piece of feedback received from customers is evaluated, helping us to put into action plans that enable the Department to exceed expectations. Indeed, you will find evidence that customer service is part of DHS’ DNA. In every interaction, internal or external, DHS strives to provide timely, accurate, and pleasant service” (Fustings et al., 2019).

A few sources offered examples of how including staff in designing customer experience solutions led to improvements in service delivery. For instance, the Work Support Strategies (WSS) team in North Carolina engaged frontline workers in discussions around redefining customer service. When staff expressed worry that automating certain tasks would make their jobs redundant, the team was able to address those concerns and allay fears that streamlining the enrollment process would put workers out of a job (Loprest et al., 2013). Similarly, the WSS team in Rhode Island involved local staff in developing a successful same-day service model for SNAP applicants. Frontline workers were charged with creating a client journey map, identifying roadblocks and inefficiencies, and piloting and adjusting a new process. Staff found this activity engaging and instructive (Hanh 2013). To best leverage the expertise of staff, researchers recommend activities be carefully aligned with agency goals and properly incentivized so staff have the time and capacity to participate (Kershaw et al., 2016). Further, agency leadership should voice their support of staff contributions so staff feel valued and encouraged (Lages et al., 2012).

Incentives

The framework defines incentives as recognition (including monetary) for employees who promote a customer experience agenda. Like “Funding,” little research surfaced around incentives for providing high quality customer service. Sources that did mention incentives generally referred to nonmonetary rewards, such as public recognition of good work and promotions or special assignments.² For example, the County Welfare Directors Association of California includes recognizing staff who deliver excellent customer service in its “10 Building Blocks of Excellent Customer Service” framework (Fife 2013). Maryland’s Department of Human Services annually honors staff members who consistently display strong commitments to customer service with a Customer Service Excellence Award (Fusting et al., 2019). Similarly, the state SNAP office in Georgia presents a Governor’s Awards to call centers that meet their performance standards, while in Pennsylvania Executive Directors of local offices with top performance are recognized monthly. In New York and Washington, top-performing staff are offered special assignments or advisory roles (Keefe et al., 2012).

Partnerships

This framework category focuses on collaboration and sharing of best practices from experts inside and outside of government. Partnerships within government refer to relationships across different agencies or divisions. Partnerships outside of government include relationships with customers, private businesses, and community-based organizations.

In its review of federal agency customer service plans, the Partnership for Public Service found that agencies “primarily focus on strengthening customer service by improving interactions within their own organizational silos” and assert that agencies could do more to support customer needs by “better collaborating to serve shared customers” across agency boundaries (Serving Citizens 2014). The Work Support Strategies (WSS) planning grant case studies demonstrate the challenges and benefits to building relationships with other agencies that serve similar populations. For example, in South Carolina, the Department of Health and Human Services manages Medicaid and the Children’s Health Insurance Program, while the Department of Social Services administers SNAP and TANF. Though their customers overlap, each has its own leadership, staff, technology, and eligibility and enrollment processes that make it difficult to work together. As part of its WSS planning grant, an interagency data workgroup comprised of staff from both agencies identified data on the proportion of customers enrolled in their programs to then develop simplified and streamlined policies (Courtot 2013). Similarly, the Rhode Island WSS team developed close relationships with the state’s health reform activities, which allowed it to align eligibility and enrollment requirements across the state’s WSS programs (Hanh 2013). In North Carolina, a state where public programs are overseen by the state but administered at the county level, customers are often required to submit the same paperwork with multiple offices. The WSS team adopted a “no wrong door” policy and worked to break down programmatic silos at the state and county levels to improve its quality of customer service (Loprest et al., 2013).

Partnerships outside of government often involve community leaders, such as employers, nonprofit organizations, and customers themselves. Community partners can perform a variety of functions, such as making referrals to public services, providing access to computers and fax and photocopying machines, and engaging in co-designing public service delivery. These partners typically work closely with the same populations as public agencies or have an incentive to enroll clients in services (e.g., hospitals enrolling clients in Medicaid) (Cody et al., 2008). For instance, Michigan’s Project Re:Form is a collaboration between Detroit design studio Civilla, the Michigan Department of Health and Human Services, community partner organizations, and community members to design a faster and simpler application for social services. These stakeholders were convened early in the research phase to help inform the design, development, and implementation processes, resulting in a human-centered approach to benefit application and delivery (Smith et al., 2020). Code for America’s (CfA) work is another example of a public-nonprofit partnership. Since 2011, CfA has worked with state and local governments to utilize technology to deliver effective and efficient services. CfA’s collaboration with California’s SNAP agency demonstrates a different approach to delivering benefits that centers the customer experience (Williams 2016).

Involving customers in the service delivery design process is another example of external partnerships. This goes beyond capturing customer feedback (described in the “Operations” section) and consists of co-designing public services or systems with their users. Doing so promotes empathy between providers and users, encourages innovation, and creates a more democratic process of service creation and utilization (Laitinen et al., 2018). For instance, participatory budgeting is one approach that empowers customers to decide how their public systems spend tax dollars. In Boston, schoolchildren decide how to spend $1 million each year learning about government process and developing a sense of civic duty. Similarly, students in Brooklyn voted on how to allocate $1 million; the winning projects ranged from bathroom renovations to new drinking fountains (Wiseman and Choudhury 2020).

Sources also offer recommendations for how to develop strong partnerships with stakeholders within and outside of government. For example, the Partnership for Public Service urges the Office of Management and Budget to “identify opportunities to better integrate systems and customer interactions across government agencies, and direct agencies to collaborate when appropriate” (Serving Citizens, 2014). Another suggestion is to involve people with lived experience, or those who have “shared experiences or backgrounds and who can bring insights to inform and enhance systems, research, policies, practices, and programs that aim to support people with similar lived experiences” (Rau et al., 2022). The Customer-Centered Design Playbook (2017) and the Customer Experience Cookbook (2020) encourage teams to bring partners in early in the process, both to collect feedback and to engage them in program or service design.

Capabilities

The final framework category focuses on whether agency staff have the time and resources to provide positive customer service and whether the agency has the right tools to monitor customer service performance. Strengthening staff capacity can be done in a number of ways, such as by establishing clear communications, streamlining enrollment and eligibility processes, and providing training and leadership opportunities.

Supporting staff’s ability to provide high quality customer service is a key focus for many public agencies as poor working conditions, including low pay, inefficient management, and low trust, undermine teamwork, and lead to low morale and poor customer service outcomes (Lages et al., 2012; Topp 2015; and English et al., 2019). As such, ensuring staff have the skills and tools they need to carry out their duties is critical in maintaining high quality customer service standards. One way to do this is to minimize fatigue and exhaustion by simplifying agency policies, processes, and duties. For example, in order to provide efficient customer service, some agencies have reorganized staff into teams based on services they provide (e.g., moving from a caseworker to a task-based service delivery model) or implemented changes in agency policy in phases through pilots or learning labs (Laird and Holcomb 2011 and Rowe et al., 2010).

Another approach to bolster staff capacity is to provide adequate training so expectations are clear and staff can focus on customer service. Training can specifically address customer service. For example, Maryland’s Department of Human Services provides a GOLD standard Customer Service training for all full-time and contractual staff, including periodic online refresher modules (Fusting et al., 2019). Agencies can also develop staff’s emotional intelligence and empathy through service walk-throughs, customer journey mapping, and anti-bias training (Groth et al., 2012; Laitinen et al., 2018; Maxwell et al., 2018; and Pratt and Hanh 2021). Guidance can also include cross-training staff from different agencies or divisions so they are capable of assisting customers regardless of the program. For instance, the Utah Department of Workforce Services requires that all local One-Stop Career Center staff have a basic knowledge of all workforce programs offered and are able to assist customers or direct them to the right services (Laird and Holcomb 2011). Training can also include providing concrete guidance, such as reference materials on how to complete and process paperwork (McCutcheon 2019). An important recommendation is that trainings be offered continuously, not as discrete activities, which requires an investment of resources and ongoing support from agency leadership (Loprest et al., 2016 and The Ultimate Guide to Government CX 2019).

Technology supports are also foundational for improving customer engagement and experience, and can be implemented internally to help staff carry out their duties with more ease and externally to support customers accessing services. Exhibit 10 provides examples of staff- and customer-facing technologies.

Exhibit 10: Examples of Technology Supports

Staff-Facing Technologies

Customer-Facing Technologies

Management information systems that effectively store, secure, and share customer data within and across agencies (Alameda County Social Services Agency Strategic Priorities 2019 and Laird and Holcomb 2011). Data analytics that document churn, identify eligiblity overlap, and measure program outcomes (Kassabian 2013; Courtot 2013; and Lopresent et al., 2013). Search tools and databases that clearly communicate community program policies and procedures (Alameda County Social Services Agency 2019).

Web-based tools that applicants use to apply, submit documents, or get information about their cases, including online web portals, screening tools, email listservs, and electronic notices (Ambegaokar 2018; Zhu et al., 2020; Williams 2016; and Keefe et al., 2012). Mobile-based technology, including texting, mobile applications, and instant messaging (Ambegaokar 2018 and Williams 2016). Call center tools, including interactive voice response and telephonic signatures (Ambegaokar 2018; Fusting et al., 2019; and Rowe et al., 2010).

Next Steps

The Final Review List and Annotated Bibliography will be included as an attachment to the Final Report.

Studies and Annotations

Alameda County Social Services Agency Strategic Priorities 2019-2024. (2019). https://www.alamedacountysocialservices.org/acssa-assets/PDF/About%20Us/Agency_Strategic_Plan_Rev_2019-10-08.pdf

This document outlines the Alameda County Social Services Agency’s (SSA) 2019-2023 Strategic Priorities that identify and highlight key goals for success. The agency’s primary goals include ensuring access to public benefits programs (such as CalFresh and Medi-Cal), safeguarding the well-being of children by supporting biological and resource parents (an umbrella term to refer to adoptive or foster parents and other types of out-of-home caregivers), as well as promoting lifetime connections for foster youth, increasing access to vital programs and coordinating systems of care for vulnerable older adults and persons with disabilities, facilitating access to emergency and stable housing, investing in the workforce through improved recruitment, retention, succession planning and professional development, improving technology and information systems, and tracking outcomes and performance. The agency utilized various technologies to create a positive customer experience, such as providing self-service waiting rooms with charging stations and interactive, multifunction kiosks where clients could access and submit forms (with language selection and disability accommodations) for all agency-administered programs.

Ambegaokar, S., Podesfinski, R., & Wagner, J. (2018). Improving Customer Service in Health and Human Services Through Technology. Social Interest Solutions and Center on Budget and Policy Priorities. https://www.cbpp.org/research/health/improving-customer-service-in-health-and-human-services-through-technology

This paper examines methods for improving client-facing government interactions through technology to increase accuracy and efficiency of the application, renewal, and case management processes for Medicaid, SNAP, TANF, and other human service programs. The paper first outlines the real-world technological challenges experienced by agencies and then goes on to outline best practices in technology. Next, the paper takes note of important considerations when implementing technology, exploring technological advancements on the horizon such as artificial intelligence (AI), biometrics, voice responsive services, and blockchain. One of the primary points made in this paper is that technology must focus on the user – both clients seeking benefits as well as eligibility workers handling overwhelming cases – for it to be truly effective.

Blaug, R., Horner, L., & Lekhi, R. (2006). Public value, citizen expectations and user commitment. The Work Foundation. https://www.academia.edu/64329547/Public_value_citizen_expectations_and_user_commitment_a_literature_review

This paper reviews the existing evidence on user satisfaction with and citizen expectations of public services. It highlights the so-called “delivery paradox,” whereby satisfaction with services is not rising in line with delivery improvements. The paper explains why the delivery paradox exists by exploring public views of public services, delivery responsiveness, managing public expectations, and various mechanisms for responsiveness across many services. It further highlights approaches to measuring customer satisfaction, focusing in particular on the Service Quality (SERVQUAL) model, designed to capture consumer expectations and perceptions of a service along five dimensions: reliability, assurance, tangibles, empathy, and responsiveness.

Carvalho, C., & Brito, C. (2012). Assessing Users’ Perceptions on how to Improve Public Services Quality. Public Management Review, 14(4), 451–472. http://dx.doi.org/10.1080/14719037.2011.649976

This article aims to evaluate the perceptions of users of public services in order to improve their quality. The article follows a marketing perspective, paying special attention to citizens' expectations and perceptions and to the role of emotions in the citizens’ public services encounters. Given the nature of the research issue, the investigation followed a case-study methodology. The authors present an adaptation of the Critical Incident Technique and analyze qualitative and quantitative data collected in six Portuguese Citizen Shops. The findings show that expectations are extremely dynamic and play a relevant role in users' satisfaction. For example, the positive and negative emotions that customers associate with the service, as well as their intensity and frequency, have growing importance in the creation of satisfaction. It is also argued to be extremely important to understand citizens’ feelings and reactions when they are dealing with public services.

Cody, S., Nogales, R., & Sama Martin, E. (2008). Modernization of the Food Stamp Program in Florida: Final Report. U.S. Department of Agriculture, Food and Nutrition Service. https://fns-prod.azureedge.us/sites/default/files/FloridaModern.pdf

This study documents the changes that Florida’s Department of Children and Families (DCF) made in administering their food stamps, cash assistance, and Medicaid programs from July to September 2006. Known as ACCESS Florida, the new business model was designed to simplify the client application process, reduce administrative costs, and increase client access to services. Key changes under ACCESS Florida included: (1) Organizational restructuring, such as ensuring that different workers handle separate aspects of each case, (2) improved policies and procedures, such as reducing eligibility interviews from 1 hour to less than 15 minutes, and (3) improved technology utilization, such as the opportunity for clients to call the customer call center instead of a caseworker for assistance. The effects of modernization on participants were largely positive, but did vary. For example, shortened interview procedures and relaxed verification policies made it easier for clients to access the program, while closing some Customer Service Centers made it difficult for clients to get help with their applications. Similarly, wait times associated with obtaining and completing applications both shortened and lengthened under ACCESS Florida. For instance, clients entering a Customer Service Center could find a computer and begin the application process immediately, waiting less than 15 minutes to see a caseworker; however, the web application sometimes took clients longer to complete than a paper application, especially for those with limited computer and/or literacy skills.

Courtot, B. (2013). Early Lessons from the Work Support Strategies Initiative: South Carolina. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-south-carolina

This study explores South Carolina’s approaches to delivering key work supports, including health coverage, nutrition benefits, and childcare subsidies as a recipient of a Work Support Strategies (WSS) planning grant supported by private philanthropy in 2011. South Carolina was one of nine states awarded the grant, and they used the WSS initiative to identify ways to integrate and streamline how the Department of Health and Human Services (DHHS) and the Department of Social Services (DSS) administer work support services. Ultimately, the state wanted to develop an integrated plan to improve processes and ease administrative burdens on beneficiaries and program staff.

Customer-Centered Design: A playbook for workforce service delivery. (2017). Code for America. http://swchi.org/wp-content/uploads/2020/10/CCD_Workforce-Playbook-Final_Code4America.pdf

This guide intends to supplement lessons in the free Human-Centered Design class offered by IDEO and Acumen by bringing together a set of practical methods and advice for those using customer-centered design (CCD) in workforce development. The guide encourages readers to do the following: 1) learn from their peers – professionals across workforce development – that have used CCD and realized success from those efforts; 2) expand skills to use design thinking principles to approach problems in a government context; and 3) find support in the CCD process. Some of the main areas of focus in this guide include collaborative design, picking a problem one can solve and building momentum, listening to customers, testing ideas using simple prototypes, using feedback to guide decisions, and sharing one’s own CCD story.

Egan, E. (2022). With Customer Satisfaction at a New Low, Federal Agencies Still Fail to Measure It Well or Provide Enough Digital Services. Information Technology & Innovation Foundation. https://itif.org/publications/2022/10/24/federal-hisp-digital-customer-experience/

This brief provides an overview of customer experience in the context of the Federal government by describing Federal customers (e.g., individuals enrolled in Medicaid or Medicare, businesses that received COVID economic injury disaster loans) and Federal high-impact service providers (HISPs) (federal agencies that provide or fund high-impact customer facing services, such as the Centers for Medicaid and Medicare Services and the Social Security Administration), and highlighting the importance of digital services for customer experience in the Federal government. Findings from the 2021 American Customer Satisfaction Index report show that generally, customer satisfaction across Federal agencies is at a historic low and despite recent executive guidance (e.g., the Biden administration’s management agenda for Federal agencies). HISPs are slow to adopt digital services due to regulatory barriers, poor organizational processes, and limited access to funding. The brief makes several recommendations to address these issues, including having the Government Accountability Office (GAO) investigate HISP compliance with 21^st Century Integrated Digital Experience Act (IDEA) measures, requiring HISPs to improve customer research data collection by integrating feedback surveys across their platforms, and having Congress reform regulatory frameworks that limit the growth of digital services in federal government.

English, B., Baumgartner, S., & Mastri, A. (2019). Foundations for Innovation: How Three Human Services Programs Laid the Groundwork for Sustainable Change. Mathematica. https://mathematica.org/publications/foundations-for-innovation-how-three-human-services-programs-laid-the-groundwork-for-sustainable

This practice brief introduces three foundations for improving outcomes for children and families in a human services environment that has become more complex and challenging, and is based on evidence collected and analyzed as part of Project IMPROVE: Improving Program Outcomes Via Evidence-Based Technical Assistance. Investments in reducing complexity and bureaucracy, building skills of supervisors and staff, and putting humans back at the center of human service delivery can help programs meet the needs of families facing challenges like low educational attainment, unemployment, criminal records, mental and physical health issues, and children with special needs.

Eriksson, E. M. (2018). Representative co-production: Broadening the scope of the public service logic. Public Management Review, 21(2), 291–314. https://doi.org/10.1080/14719037.2018.1487575

This case study examines public service logic (PSL), a public administration and management theory that evaluates how stakeholders co-design, co-produce, and co-create public services, and its application in minimizing health disparities among different population groups. The author proposes to blend the typical PSL approach with one that recognizes the impact of social structures on service creation and delivery, and the importance of community, family, and other entities in targeting historically disadvantaged groups (collectively called the “social context”). In doing so, shared barriers in accessing services become clearer and resources can be designed or aligned to meet a groups’ needs and expectations.

Esbenshade, J., Vidal, M., Fascilla, Gina, & Ono, M. (2015). Customer-driven management models for choiceless clientele? Business process reengineering in a California welfare agency. Work, Employment and Society, 30(1), 77–96. https://doi.org/10.1177/0950017015604109

This article explores how business process reengineering and lean production principles are used to restructure public sector work at a California welfare agency. Some of the findings of the case study include work intensification and decreased workforce autonomy, which ultimately resulted in deteriorating service for clients. This article highlights the consequences of prioritizing cost cutting and quantitative efficiency over worker empowerment and service quality, particularly in the context of a government agency with severe budgetary pressures that are exacerbated under neoliberalism, and a clientele consisting of indigent individuals and families with no alternative options.

Fife, B. (2013). A framework for advancing a culture of customer service in health and human services. Child and Family Policy Institute of California. https://www.cwda.org/sites/main/files/file-attachments/framework-for-advancing-culture-of-customer-service.pdf

This report aims to equip county human services agencies in California with best practice information which can be used as a framework for providing first class customer service to individuals seeking help under the Affordable Care Act and enhance local agency culture to effectively promote health care coverage and access to vital human services for all eligible persons. The report 1) looks at what constitutes as “excellent customer service”; 2) examines customer service delivery in public and private sectors within California and other States; 3) conducts two case studies of successful culture change (California’s implementation of the CalWORKs program in the late 1990’s and another State's (not identified in the report) efforts to implement a statewide customer service program that produced initial success but abruptly lost momentum); and 4) surveys current theories and research concerning organizational culture change. The report develops a basic framework to help human services agencies to prepare individualized action plans, consisting of ten Building Block of Excellent Customer Service and eight Core Principles for Achieving Culture Change.

Fusting, P., & Schuster, T. (n.d.). Maryland Department of Human Services Customer Service Annual Report FY2019. Maryland Department of Human Services. Retrieved October 19, 2022, from https://dhs.maryland.gov/documents/Data%20and%20Reports/Customer%20Service%20Annual%20Reports/Customer%20Service%20Annual%20Report%20FY19%20Final%20Revised.pdf

This Fiscal Year (FY) 2019 annual report provides an example of how a State SNAP agency has approached their customer service strategy. It outlines the Maryland Department of Human Services’ overall customer service approach, best practices, and plans for improvement. Topics include the statewide implementation of the online Long Term Care application, development of a statewide Integrated Voice Response (IVR) system, piloting a new Common Customer Intake (CCI) process, development of metrics to evaluate customer satisfaction, and honoring 47 staff from across the State with a Customer Service Excellence Award. Over the 2019 Fiscal Year, the department utilized several industry best practices, such as maintaining a Customer Relationship Management (CRM) database, providing trainings on creating a customer-centric culture, recognizing customer service excellence among staff, engaging customers via social media, and investing resources into IT modernization efforts.

GAO. (2010). Managing for Results: Opportunities to Strengthen Agencies’ Customer Service Efforts (GAO-11-44). United States Government Accountability Office. https://www.gao.gov/products/gao-11-44

This report authored by the U.S. Government Accountability Office (GAO) (1) assesses the extent to which Federal agencies are setting customer service standards and measuring related results, (2) assesses the extent to which agencies are reporting standards and results to customers and using the results to improve service, and (3) identifies customer service management tools and practices used by various governments. GAO surveyed 13 Federal services that had significant contact with the public, reviewed literature, and interviewed agency officials as well as knowledgeable individuals in the area of customer service.

Golden, O. (2013). Early Lessons from the Work Support Strategies Initiative: Planning and Piloting Health and Human Services Integration in Nine States. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-planning-and-piloting-health-and-human-services-integration-nine-states

This report examines nine States—Colorado, Idaho, Illinois, Kentucky, New Mexico, North Carolina, Oregon, South Carolina, and Rhode Island— that received one-year planning grants under the Work Support Strategies (WSS) initiative to help them improve their systems for connecting low-income families to work support benefits like Medicaid, the Children’s Health Insurance Program, and SNAP. This report summarizes how States aimed to improve customer experience through streamlined business processes and policy changes; improved forms and communications with families; new governing teams and structures to bridge divides between agencies and levels of government; improved data collection and analysis; new training for managers and staff; and major eligibility system redesigns. In keeping with WSS’ overall approach of learning by doing, States continued to refine their plans—most notably as the implementation of the Affordable Care Act (ACA) and the design of new integrated eligibility systems have opened new opportunities to improve services to families.

Government For the People: Designing for Equitable and Trusted Customer Experiences. (2021). Partnership for Public Service. https://ourpublicservice.org/publications/government-for-the-people/

This report makes the case that the government should reset its relationship with the public, taking a holistic view of the services it provides and focusing on the customer journey. The research was conducted through interviews with more than 50 leaders who oversee Federal services, as well as examination of customer feedback data on high-impact services collected by agencies across service channels. Two of the main challenges considered are distrust in government and inequity in service provision and persistent threats to election integrity and voter access. The report recommends that the federal government should focus on ensuring federal services are equitable and inclusive of all customers, particularly those who may need services most or struggle hardest to access them. This will require agencies to expand their perspectives beyond addressing the symptoms of bad customer service to pursue the root causes of bias and distrust in service design and delivery.

Groth, M., & Grandey, A. (2012). From bad to worse: Negative exchange spirals in employee–customer service interactions. Organizational Psychology Review, 2(3), 208–233. https://doi.org/10.1177/2041386612441735

This literature review examines employee-customer interactions from the perspectives of both the employee (i.e., the problem is a difficult customer) and the customer (i.e., the problem is service failure) to show that these experiences are linked in a way that creates a “negative exchange spiral.” The paper then suggests a few factors can accelerate or slow down negative exchange spirals, such as organizational practices that enhance employee autonomy (e.g., the latitude to correct problems as they occur) and socialization practices that communicate realistic service expectations for both employees and customers (e.g., how long customers can expect to wait in line).

Hahn, H., Golden, O., & Compton, J. (2013a). Early Learnings from the Work Support Strategies Initiative: Illinois. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-illinois

This study explores Illinois’ approaches to delivering key work supports, including health coverage, nutrition benefits, and childcare subsidies as a recipient of a Work Support Strategies (WSS) planning grant in 2011. Illinois was one of nine States awarded the grant, and ultimately, the State wanted to develop and test a strategy for improving its processes “on the ground” in the local offices to amend the status quo of inefficient business processes, antiquated technology, and unsustainable paper case files. Improving local office operations was a critical first step to promote the success of technology and policy change. Approaches included creating a “culture of caring” within the agency to improve staff-customer relations, shifting from a caseworker model to a task-based model, and setting up an “express desk” so clients could be seen by the next available caseworker. The urgency of these goals increased as health reforms caused hundreds of thousands of people to enroll in Medicaid, creating the need to improve quality and efficiency of service in order to accommodate the influx of clients.

Hahn, H., Hawkins, R., Carther, A., & Stern, A. (2020). Access for All: Innovation for Equitable SNAP Delivery. Urban Institute. https://www.urban.org/research/publication/access-all-innovation-equitable-snap-delivery

This brief addresses the current Electronic Benefits Transfer (EBT) system and how future benefit delivery could be more equitable and inclusive. Based on interviews with National SNAP experts, State officials, consumer advocates, and representatives of food retailers, EBT processors, and related technology companies, it examines current and future SNAP benefit delivery models that prioritize principles of equity and inclusion for customers. It also explores specific features of cost-effective benefit delivery systems that ensure equitable access to benefits, and ultimately establishes the need for the SNAP program to continuously adapt to evolving customer payment methods (e.g., mobile payments and online purchases). A primary objective of this brief is to help Federal and State policymakers make informed decisions about modernizing SNAP to promote truly inclusive benefit delivery.

Hahn, H., & Kassabian, D. (2013b). Early Learnings from the Work Support Strategies Initiative: Rhode Island. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-rhode-island

Work Support Strategies: Streamlining Access, Strengthening Families (WSS) was a five-year, multistate initiative to help low-income families get and keep work supports. This report, one of 10 describing State activities during the planning year, highlights Rhode Island’s accomplishments and lessons learned during the first year of the initiative. The State’s project goals centered on improving client access to benefits, increasing cross-program integration, and making service delivery more efficient. To work towards these goals, Rhode Island engaged staff at the senior and middle levels and relied on advisory groups to get everyone, including local staff, on board. The State also took steps to better understand how clients and staff navigated the benefits application process, and met with the employee union to engage frontline workers in developing new policy decisions. Rhode Island’s final plan included implementation of a communications strategy targeted to underserved populations, a staff engagement and training strategy centered on providing quality services, and a “no wrong door” service delivery model through a single application for all WSS programs, redesigned lobbies, and streamlining procedures across the department.

Hahn, H., Katz, M., & Isaacs, J. B. (2017). What Is It Like to Apply for SNAP and Other Work Supports? Findings from the Work Support Strategies Evaluation. Urban Institute. https://www.urban.org/research/publication/what-it-apply-snap-and-other-work-supports

This brief looks at the typical process of applying for SNAP and various work supports, then discusses clients’ reports of what they would do to improve the application experience, and finally examines how the experience differs for different groups of clients. The study finds that clients’ experiences applying for work supports point to three areas where process could be improved including faster benefit receipt, better interactions with staff, and receiving clearer information.

Hahn, H., & Loprest, P. (2011). Improving state TANF performance measures. Urban Institute. https://www.urban.org/research/publication/improving-state-tanf-performance-measures

This report synthesizes information from five States employing innovative performance measurement systems to improve program performance and address accountability in the Temporary Assistance for Needy Families (TANF) program. While the primary performance measure used by the federal TANF program is the work participation rate (WPR), a few States have added additional performance measures for their State TANF programs, including both employment (new job placements, employment retention) and nonwork outcomes (educational attainment, case closures for positive reasons). Each site in this study shared several factors that they believe contributed to the success of their performance measurement systems. These include limiting the number of measures and keeping them simple, actively reviewing performance measures to foster collaborative efforts and improvement, committing to use data to inform policy, including top managers in review meetings, and having a system that can evolve to align with changing program needs and goals. Ultimately, the sites want to be held accountable to measures focusing on customer outcomes, especially employment, and that allow States greater flexibility to meet the varied individual needs of their customers.

Hill, I., Loprest, P., & Compton, J. (2013). Early Learnings from the Work Support Strategies Initiative: Oregon. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-oregon

This study explores Oregon’s approaches to delivering key work supports, including health coverage, nutrition benefits, and childcare subsidies as a recipient of a Work Support Strategies (WSS) planning grant in 2011. Oregon was one of nine States awarded the grant, and they aimed to more efficiently and effectively deliver work support benefits in the context of a major focus on health care reform. The State made substantial headway on integrating its work support programs but faced challenges such as transitioning from a mostly paper-based application system to a fully dynamic web-based version while serving growing caseloads with declining revenues and hiring freezes.

Hodge, L., & Stienstra, A. (2022). Embedding Equity in Civic Design to Transform Customer Experience. https://digital.gov/resources/embedding-equity-in-civic-design-to-transform-customer-experience/

This article discusses how civic designers (a team of people dedicated to improving customer experience and equity) in the Federal government are leveraging design methods to help build a foundation for improved customer experiences for all people. The article argues that equity and customer experience are inextricably linked; and in government, there is no single “target customer.” Civic designers are said to have a responsibility to re-center their approaches, from how they form teams, plan customer research, build bias checks into processes, and validate with and involve customers in their work. The article recommends workshops, customer research, and prototyping as methods to implement these changes on the ground and outlines recent actions to improve equity and customer experience.

Hulsey, L., Conway, K., Gothro, A., Kleinman, R., Reilly, M., Cody, S., & Sama-Miller, E. (2013). The Evolution of SNAP Modernization Initiatives in Five States. U.S. Department of Agriculture, Food and Nutrition Service. https://www.fns.usda.gov/evolution-snap-modernization-initiatives-five-states

In response to rising caseloads and limited resources, States have sought to reduce administrative costs while maintaining or increasing access to the Supplemental Nutrition Assistance Program (SNAP). The changes States make are commonly referred to as modernization. This report presents findings from in-depth case studies in five States (Florida, Georgia, Massachusetts, Utah, and Washington) with modernization initiatives in place between July 2000 and February 2012 to describe their experiences, assess potential impacts, and identify key lessons learned. Each State implemented modernization initiatives in four categories with the vision that faster customer service would lead to greater customer satisfaction: (1) restructuring administrative functions, (2) expanding uses of technology, (3) simplifying policy, and (4) partnering with other organizations.

Isaacs, J. B., Katz, M., & Amin, R. (2016a). Improving the Efficiency of Benefit Delivery: Outcomes from the Work Support Strategies Evaluation. Urban Institute. https://www.urban.org/research/publication/improving-efficiency-benefit-delivery\

This report utilizes data provided by six States that participated in a multiyear, foundation-funded effort, the Work Support Strategies (WSS) initiative, to help low-income families get and keep the full package of work supports for which they are eligible. This report examines the outcomes of State efforts to streamline service delivery and reduce administrative burdens in order to increase participation and retention in work support programs that support the well-being of families. The analysis of outcomes in this report relies on examining time trends to measure if the timing of State reform efforts and changes in outcome measures imply a connection between the two. By the end of the initiative, most States issued benefits in fewer days, saw reductions in churn, and had lobbies that were less crowded. In addition, clients experienced lower wait times for services, and families eligible for both SNAP and Medicaid/Children’s Health Insurance Program were more likely to participate in and receive benefits from both programs.

Isaacs, J. B., Katz, M., & Kassabian, D. (2016b). Changing Policies to Streamline Access to Medicaid, SNAP, and Child Care Assistance: Findings from the Work Support Strategies Evaluation. Urban Institute. https://www.urban.org/research/publication/changing-policies-streamline-access-medicaid-snap-and-child-care-assistance-findings-work-support-strategies-evaluation

This Urban Institute report describes how six States participating in the Work Support Strategies (WSS) initiative identified and adopted policy changes to reduce administrative burdens for clients and workers as they worked to streamline access to Medicaid, SNAP, and childcare assistance. These policy changes were: 1) developing an integrated application across programs, 2) using electronic data on SNAP eligibility to automatically enroll and retain individuals in Medicaid, 3) aligning definitions or requirements across programs, 4) aligning recertification dates across programs, 5) establishing processes for cross-program review of new policies, and 6) developing integrated policy manuals. Achieving these policy changes required overcoming significant barriers, including working with multiple Federal agencies and local offices and making time to focus on policy alignment given other, sometimes more pressing, tasks.

Kassabian, D., & Mills, G. (2013). Early Lessons from the Work Support Strategies Initiative: New Mexico. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-new-mexico

Work Support Strategies: Streamlining Access, Strengthening Families (WSS) was a five-year, multistate initiative to help low-income families get and keep work supports. This report, one of 10 describing State activities during the planning year, highlights New Mexico’s accomplishments and lessons learned during the first year of the initiative. The grant built off an earlier redesign of New Mexico’s business process model, where the program switched from a case management model to a process-based model in which the entire process from client application to determination of eligibility was reviewed to find places to reduce duplication and gain efficiency. This new model reduced worker distraction, made it easier for staff to work across programs, reduced clients’ need to provide duplicate information, and cut down delays to approving benefits. When New Mexico moved into the initiative’s planning phase, it shifted priorities to advance a new eligibility system—the Automated System Program and Eligibility Network (ASPEN)—to further support the integration of work support programs.

Keefe, K., Sama-Miller, E., Castner, L., Bardos, M., Clary, E., Wissel, S., & Vittoriano, L. (2012). Performance Measurement for Supplemental Nutrition Assistance Program Modernization Initiatives: Individual State Findings. U.S. Department of Agriculture, Food and Nutrition Service. https://www.fns.usda.gov/performance-measurement-supplemental-nutrition-assistance-program-modernization-initiatives-0

This report is the second part from a data collection effort that examined how States were modernizing their SNAP programs by focusing specifically on how they monitor and measure the success of their initiatives. That effort sought the participation of all States and the District of Columbia, and the reports are based on the responses of the 45 that were able to participate. This report specifically delves into States’ experiences with measuring their modernization initiatives, focusing on a subset of eight modernization initiatives, including call centers, online systems, document imaging, kiosks, partnering, waiving the face-to-face interview, shortened interviews and online expedited applications. This report: (1) describes each State’s performance measures and standards in detail (particularly in State-specific appendices that constitute most of this report), and (2) explains how these measures are implemented and how States use the results.

Kershaw, A., Dahl, S., & Roberts, I. (2016). Designing for Public Services. Nesta and IDEO. https://www.nesta.org.uk/toolkit/designing-for-public-services-a-practical-guide/

This guide sets forth practical tools and methods for using design in public services. Created by Nesta and IDEO as part of Design for Europe, it offers ways to do things differently by introducing the process of design thinking. It also provides guidance on how to introduce this new approach into day-to-day work in the public sector. Specifically, this guide establishes principles of design thinking and how they can be used in a government context and examines different stages of the design process, as well as challenges and methods to overcome them.

Lages, C. R., & Piercy, N. F. (2012). Key Drivers of Frontline Employee Generation of Ideas for Customer Service Improvement. Journal of Service Research, 15(2), 215–230. https://doi.org/10.1177/1094670511436005

This study investigates the factors that influence frontline employees’ generation of ideas for service improvement (GISI), or how employees read customer needs to provide the exact service needed. It asserts that there are five drivers that can affect employee GISI: 1) employees’ perception of the way their organization treats them, 2) employees’ ability to pick up on customers’ verbal and non-verbal communication, 3) employees’ level of job satisfaction, 4) employees’ positive attitude towards their organization, and 5) employees’ emotional exhaustion. The study found that employee reading of customer needs is the major driver of GISI, and that relationship becomes stronger when employees have high job satisfaction and commitment to the organization.

Laird, E., & Holcomb, P. (2011). Integrating Intake Among Workforce Programs: Key Strategies. U.S. Department of Labor, Employment and Training Administration. https://www.mathematica.org/download-media?MediaItemId=%7B98EAD0C6-046D-4AFC-8B14-07E4D71DB1BB%7D

This brief is one in a series of technical assistance tools that provides key strategies for creating a common intake process for customers throughout the workforce system. The focus of this study is on developing an efficient “integrated intake”, which refers to a single, streamlined process in which a customer enters the system, provides their information once, and is determined eligible or ineligible for multiple services and programs, including Trade Adjustment Assistance (TAA), Unemployment Insurance (UI), and Workforce Investment Act (WIA) or Employment Services (ES)/Wagner-Peyser. For workforce practitioners interested in creating a more streamlined intake process, this brief presents the key characteristics of integrated intake and provides detailed examples of integration drawn from states and local areas that have moved toward an integrated intake model.

Laitinen, I., Kinder, T., & Stenvall, J. (2017). Co-design and action learning in local public services. Journal of Adult and Continuing Education, 24(1), 58–80. https://doi.org/10.1177/1477971417725344

The paper argues that from a new public governance and service management perspective, local public services are best conceptualized as service systems in which users co-produce and co-design. This differentiates public from private services, which have lower levels of trust and shared values resulting in a goods-dominant logic and are an alternative to the new public management viewpoint. Referencing new case studies from Finland and Scotland, this paper analyzes two main cases of co-design and argues that since public services are subject to public scrutiny, and since design is a social activity, there exists a wider democratic footprint. This paper also asserts that co-design of local public services is best analyzed from the perspective of action learning, for which an analytical framework is suggested.

Loprest, P., Gearing, M., & Kassabian, D. (2016). States’ Use of Technology to Improve Delivery of Benefits: Findings from the Work Support Strategies Evaluation. Urban Institute. https://www.urban.org/research/publication/states-use-technology-improve-delivery-benefits-findings-work-support-strategies-evaluation

This report provides findings on the experiences of six States involved in Work Support Strategies in changing their technological systems to improve and integrate the delivery of work supports. The following key lessons and challenges emerged in the study: 1) while many WSS States planned technology changes before the Affordable Care Act (ACA) passed, ACA had an enormous influence on the changes eventually made and on the priority and timing of technology efforts; 2) leadership played an important role in planning for technology, including deciding among priorities and developing plans for implementation; 3) there was a close connection between implementation of new technology and the way programs move cases through the eligibility system; 4) training and integration of staff in technology implementation was important; and 5) in addition to training, States faced some common challenges connected with implementation, especially of large new eligibility systems.

Loprest, P., & Giesen, L. (2013). Early Lessons from the Work Support Strategies Initiative: North Carolina. https://www.urban.org/research/publication/early-lessons-work-support-strategies-initiative-north-carolina

Work Support Strategies: Streamlining Access, Strengthening Families (WSS) was a five-year, multistate initiative to help low-income families get and keep work supports. This report, one of 10 describing State activities during the planning year, highlights North Carolina’s accomplishments and lessons learned during the first year of the initiative. The State’s project goal centered on designing a comprehensive, cross-cutting service-delivery model that would reduce administrative burden and increase client access. North Carolina began by setting and communicating their vision of a “no wrong door” policy, investing in new technology that would speed up case processing through automation, and inviting county leaders to provide their feedback on various aspects of the project. In their planning year, North Carolina broke down program silos and communicated a clear vision to its county, State, and other stakeholders.

Maxwell, N., Sullivan, M., Anderson, M. A., & Westbrook, T. (2018). Participant-Driven Delivery of Integrated Social Services: Building a Model and Examining Its Implementation. Mathematica Policy Research. https://www.mathematica.org/publications/participant-driven-delivery-of-integrated-social-services-building-a-model-and-examining-its

In this Mathematica study, researchers examine a model for participant-driven integrated social service delivery which features two components: 1) access to a wide variety of services in multiple program areas, and 2) a process for integrating those services that allows customization to participant needs. Survey data from 71 organizations using integrated service delivery showed that 70 percent of organizations implemented a participant-driven model of service integration by using partnerships to offer a range of services and goal setting as a mechanism for integrating and customizing services.

McCutcheon, A., Bodenlos, K., & Mastri, A. (2019). Putting Paper to Work: How Rethinking Forms Can Put People First and Improve Engagement in Human Services Programs. Mathematica Policy Research. https://www.mathematica.org/publications/putting-paper-to-work-how-rethinking-forms-can-put-people-first-and-improve-engagement-in-human

This brief outlines key strategies human services programs can use to improve customer experience. It draws on the experiences of Philadelphia Works, Inc., the administering workforce development board for the Temporary Assistance for Needy Families (TANF) and Workforce Innovation and Opportunity Act (WIOA)-funded services in Philadelphia, Pennsylvania. Their approach employed the Learn, Innovate, Improve (LI²) framework to reduce the complexity of bureaucratic processes, simplify paperwork, and promote a customer-focused culture. The first step involves learning about what paperwork exists, how it is used, and what programs’ requirements it is designed to meet. The next step is to review the paperwork with a people-focused perspective and identify small but meaningful changes to reduce burden and improve customer and staff experience. The final step is to implement the change on a small scale and determine whether it is addressing the problems identified.

Negoita, M., Levin, M., & Paprocki, A. (2022). Can the State Take the Burden? Implementation of Policies to Increase Elderly Enrollment in SNAP. Administration & Society. https://doi.org/10.1177/00953997221115473

This paper asserts the role of frontline workers in the implementation of policies to redress significant inconveniences for participants in a variety of social safety net programs. This paper analyzes two policies aimed at increasing elderly participation in the Supplemental Nutrition Assistance Program and suggests that policies that increased burdens for frontline workers were implemented less faithfully and more unevenly, possibly leading to more administrative burden on program participants. The article also proposes several methods to decrease implementation burden on frontline workers, such as attending to the difficulties experienced by frontline staff, recognizing potential staff burdens at the policy design stage and addressing them in the implementation stage, and providing adequate training, careful planning, and specialization for both staff and clients.

Pratt, E., & Hahn, H. (2021). What Happens When People Face Unfair Treatment or Judgment When Applying for Public Assistance or Social Services? Urban Institute. https://www.urban.org/research/publication/what-happens-when-people-face-unfair-treatment-or-judgment-when-applying-public-assistance-or-social-services

This brief describes adults’ perceptions of unfair treatment due to their racial or ethnic background while seeking social services or public assistance in the months leading up to and during the COVID-19 pandemic. In order to remedy this, several strategies are noted that may reduce experiences of unfair treatment or judgment based on race or ethnicity. Findings from an analysis of Urban Institute’s December 2020 Well-Being and Basic Need Survey, a nationally representative survey of adults ages 18 to 64, show that Black and Latinx adults were more likely than white adults to report experiencing unfair treatment or judgment based on their race or ethnicity, and this was especially prevalent among adults with low incomes. Overall, more than 95 percent of adults who reported unfair treatment or judgment said they faced a consequence from or acted in response to that experience, and more than 40 percent reported not getting the public assistance or social services they needed. Among adults who reported unfair treatment or judgment, 27 percent reported delaying getting social services or public assistance and 35 percent reported looking for other ways to apply.

Rau, L., Boland, B., & Holdbrook, J. (2022). Gathering and Using Family Input to Improve Child Support and Temporary Assistance for Needy Families Services: Approaches from the Human Services Field. Office of Planning, Research & Evaluation. https://www.acf.hhs.gov/opre/report/family-input-knowledge-development-summary-brief

This brief describes practices from across the human services field that can inspire novel approaches to engaging families during program improvement, especially in Temporary Assistance for Needy Families (TANF) and child support programs. Highlighted are key findings from a scan of academic and non-academic literature, including guidebooks and frameworks, related to collecting and using family input in human services programs, as well as findings from discussions with program leaders from State, local, and Tribal human services agencies that collect and apply families’ input to their program operations. This brief ultimately details current practices for gathering input from families, how programs infuse that input into program policies and service delivery, and approaches to build trust with families throughout the process.

Rod, M., & Ashill, N. J. (2009). The effect of customer orientation on frontline employees job outcomes in a new public management context. Marketing Intelligence & Planning, 28(5), 600–624. http://dx.doi.org/10.1108/02634501011066528

This report examines the role of customer orientation—employees’ ability to meet the needs of customers—in “new public management” settings, or a mode of governance that more closely aligns with private sector management. Based on self-administered questionnaires to frontline employees, the study suggests a significant influence of customer orientation on job satisfaction and employees’ feelings towards the organization.

Rosinsky, K., Murray, D. W., Nagle, K., Boyd, S., Shaw, S., Supplee, L., & Putnam, M. (2022). A Review of Human-Centered Design in Human Services (No. 2022–78). ACF. https://mefassociates.com/wordpress/wp-content/uploads/2022/09/A-Review-of-Human-Centered-Design-in-Human-Services.pdf

This brief introduces Human-Centered Design (HCD) in the context of human services programs. It first defines HCD in this context and compares it to other design and problem-solving approaches, such as participatory design, user-centered design, and systems thinking. It then synthesizes HCD evaluation efforts through a literature review and three case examples of HCD being used in human services programs. Though this is still an emerging field, with more qualitative case study reports than rigorous evaluations, there are several key findings implementors should consider, including: HCD is both a process and a mindset and requires continuous engagement, and HCD is being utilized for many challenges across human services programs, however its sustainability is unclear. In 2021 the project team began a pilot study with three additional sites to help understand the feasibility of a HCD approach in human services programs; findings are forthcoming.

Rowe, G., O’Brien, C., Hall, S., Pindus, N., Eyster, L., Koralek, R., & Stanczyk, A. (2010). Enhancing Supplemental Nutrition Assistance Program (SNAP) Certification: SNAP Modernization Efforts. U.S. Department of Agriculture, Food and Nutrition Service. https://www.fns.usda.gov/snap/enhancing-supplemental-nutrition-assistance-program-snap-certification-snap-modernization-efforts

This report presents findings from a national survey on State modernization efforts that were conducted in 2008, focusing on in-depth case studies in 14 States. For the purpose of this report, modernization is defined as not only technological innovations, but also policy and organizational changes that affect the way SNAP is delivered to clients. This report’s findings showed that modernization efforts were widespread across States, catalyzed by increased staff caseloads, as well as economic downturns, state legislation, and high staff turnover in local SNAP offices. In order to address some of these issues, all States established partnerships with community organizations, private businesses, and other government agencies to increase customer access to SNAP services, and most States reengineered administrative structures, with about half the case study States implementing self-service capabilities in the reception area.

Serving Citizens: Strategies for Customer-Centered Government in the Digital Age. (2014). Partnership for Public Service. https://ourpublicservice.org/wp-content/uploads/2014/09/809b0d873a2bebe10611a1c4a054e5f0-1422459562.pdf

Since citizen satisfaction with government services is low and declining, this paper seeks to explore methods for implementing a customer-centered approach to digital services through the examination of promising Federal initiatives. This report specifically profiles four collaborations that successfully demonstrate the possibility of a customer-centered government. Although the recommendations made in this paper – such as continually collecting customer feedback and developing customer service standards - can guide agencies toward improved service delivery, the study emphasizes the need for strengthening customer service through more high-impact services and better utilization of technology. The four collaborations profiled in this paper are: 1) Business USA, which is a one-stop shop for information and services that the Federal government provides to businesses, 2) the Disaster Assistance Improvement Program, which streamlines the processes of applying for disaster assistance by sharing customer data across Federal agencies, 3) recreation.gov, which is a collaboration among 12 Federal agencies providing a single portal for citizens to access recreation opportunities such as obtaining camping and wilderness permits, and 4) USA.gov and MyUSA, which helps guide citizens to governmental information that is most relevant to them.

Simmons, R., & Brennan, C. (2017). User Voice and Complaints as Drivers of Innovation in Public Services. Public Management Review, 19(8), 1085–1104. https://doi.org/10.1080/14719037.2016.1257061

This case study introduces an analytic framework for understanding how user voice and complaints can provide insights and ideas that lead to more effective public service responses. It considers how consumer knowledge is valued and managed and how innovation is captured from this process to generate appropriate responses. The paper then reviews six real-world examples of how this is operationalized in practice. Key takeaways from its implementation across various public agencies include the importance of acknowledging and confronting issues to develop creative solutions and rebuild confidence, the value in having staff and clients co-design services, and the need for “relational work,” or the development of relationships between service providers and their users.

Smith, C., & Soka, S. (2020). Technology, Data, and Design-Enabled Approaches for a More Responsive, Effective Social Safety Net. Beeck Center for Social Impact + Innovation. https://beeckcenter.georgetown.edu/wp-content/uploads/2021/02/SSNB-Living-Report-Jan-2021.pdf

This living report was updated at regular intervals throughout 2020 and examines data, design, technology, and innovation-enabled approaches that make it easier for eligible people to enroll in and receive federally funded social safety net benefits. This report aims to help government executives, policymakers, and philanthropy organizations to take system-wide action to improve and implement social safety net benefits in the wake of increased demand and system stress due to COVID-19. Key recommendations include the following: 1) investing in government technology made of modular, linked software components rather than monolithic systems, 2) establishing linkages across government databases, 3) activating policymakers to think like designers, 4) valuing user research through work, 5) accelerating government transformation that supports better benefit deliver, 6) using text and voice enrollment and recertification options, 7) viewing social safety net benefit policy and delivery through the lens of racial justice, 8) using alternatives to remote identity proofing, 9) removing barriers caused by EBT authorization requirements, and 10) designing better approaches to delivering cash assistance.

Steigelman, C., Bozzolo, C., & Page, N. (2022). Modernizing channels of communication with SNAP participants. Prepared by Insight Policy Research, Inc. U.S. Department of Agriculture, Food and Nutrition Service.

This study highlights best practices and lessons learned from various mobile communications strategies (MCS) implemented by SNAP State agencies. Strategies include text messaging (SMS), mobile applications, and/or mobile-optimized websites that facilitate communication between participants and SNAP agencies. The study was designed to meet four objectives: 1) provide a general overview of how MCS are used by States and program recipients for case management and notification, 2) conduct case studies of selected State projects that use MCS and describe in detail the app or technology used, 3) gather information on client satisfaction with and perspectives on MCS, and 4) identify best practices and lessons learned. The perceived benefits of MCS included reduced churn, faster updates to clients, reduced barriers to access, and continuous services during emergencies. The perceived limitations of MCS included lack of some desired functionality, security and data privacy concerns, limited broadband or cellular service, and discomfort with technology.

The Customer Experience Cookbook: A collection of key ingredients & recipes for embedding customer experience in federal services. (2020). Department of Veterans Affairs. https://www.performance.gov/cx/assets/files/va-customer-experience-cookbook.pdf

This guide, developed by the Veterans Experience Office in the Department of Veterans Affairs, outlines eight key customer experience (CX) practices for Federal agencies looking to improve service delivery, trust, innovation, and other operational efficiencies. These are: 1) utilizing internal and external levers in government to fold CX practices into the agency; 2) folding CX into agency governance, performance metrics, and human resources; 3) securing funding to execute, scale, sustain the agency’s CX program; 4) positioning the CX program in the agency for maximum support; 5) utilizing the agency’s mission, training, and leadership development programs to drive CX initiatives; 6) reinforcing CX as a core business discipline by incentivizing CX performance and behaviors; 7) leveraging partnerships inside and outside of the government to meet the agency’s mission, build capacity, and develop innovative CX practices; and 8) implementing CX through customer understanding, human-centered design, measurement, and service design and delivery of tangible CX tools to staff.

The Ultimate Guide to Government CX: Insights from 6 leaders working to transform government service delivery. (2019). Salesforce. https://www.govexec.com/media/guide_to_government_cx.pdf

Developed by Salesforce, this guide presents six customer experience best practices shared by leaders working in public service delivery. These are: 1) Understand customers’ needs to drive service delivery and engagement, 2) Engage and empower employees to deliver better customer service, 3) Meet or exceed the public’s expectations for customer service and use that to build trust, 4) Simplify points of entry to government service and meet customers where they are, 5) Invest in and utilize digital applications and experiences, and 6) Learn from peers who have pioneered a new process or technology.

Topp, S. M., & Chipukuma, J. M. (2015). A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres. Health Policy and Planning, 31(2), 192–204. https://doi.org/10.1093/heapol/czv041

This multi-case study investigates how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Through interviews with providers and patients across four health centers in urban, peri-urban, and rural settings, and direct observations of facility operations, researchers found that low workplace trust was a result of poor working conditions, perceptions of low pay, and inefficient health center management. The weak trust further resulted in resentment among providers and contributed to a culture of blame-shifting that undermined teamwork and patient care. While patients had higher trust in their health workers, repeated experiences of disrespect or unresponsive care led to patients trying to secure better or more timely care in other facilities.

Williams, A. J. (2016). User-Centered Design and Food Stamps: Delivering a 21st Century Government Service. User Experience Magazine, 15(5). https://uxpamagazine.org/user-centered-design-and-food-stamps/

This paper explores how Code for America (CfA) has worked with State and local governments to create a public sector that delivers effective and efficient services that are both digital by default and continually evolving to meet user needs. For example, CfA has worked with Human Services agencies such as CalFresh in California, implementing a three-phase project that heavily focuses on the client journey. Now, their research extends to both government workers and clients in order to build the feedback loops necessary to meet user needs in a myriad of ways, including software, business processes, and policy. This collaboration between CfA and CalFresh has also allowed for easier document submission, eligibility estimations, and smoother interactions for clients overall.

Wiseman, J., & Choudhury, C. (2020). Customer-Centered Government: Innovation and Ideas for More Responsive Public Services. Institute for Excellence in Government. https://scholar.harvard.edu/files/janewiseman/files/customer_centered_government_01.pdf

This report highlights technological approaches from the United States and countries around the world that aim to improve government performance and center the voice of the customer. It addresses the role of the customer in designing and co-creating better public services and establishes a framework for customer feedback in government that includes understanding the public sentiment towards government, gathering ideas from customers on government tasks, and putting those ideas into action. Examples of initiatives that fall within this framework include agencies that are electronically capturing customer feedback at the point of service delivery, using digital platforms that allow for online “town hall” sessions to gather reactions from the public, engaging the public in idea generation via online and in-person portals, and utilizing participatory budgeting methods to empower the public and implement innovative ideas. The report ends with a case study looking at how the United Arab Emirates’ customer-centered government improved service delivery through its Global Star Rating System for Services (GSRSS).

Zhu, J. M., & Rowland, R. (2020). Increasing Consumer Engagement in Medicaid: Learnings From States. Oregon Health & Science University. https://www.ohsu.edu/sites/default/files/2020-12/Increasing%20Consumer%20Engagement%20in%20Medicaid%20-%20Learnings%20from%20States%2012.14.20.pdf

This brief summarizes key findings from interviews with 50 Medicaid program leaders about increasing customer input in program design and implementation. Researchers found that consumer engagement took on different forms across States. For example, federally mandated Medical Care Advisory Committees (MCACs), which are required to include at least one consumer, varied in the proportions of providers, advocates, Medicaid consumers, and other stakeholders represented. While some States limited who they included on their MCAC, others created subcommittees that focused on specific populations. In addition, a few States went beyond the MCAC to include town halls, stakeholder partnerships and outreach, focus groups, and email surveys in their efforts to better engage customers. Researchers also learned that States primarily relied on email listservs to connect with consumers about program changes and recruit consumer participants for advisory groups, and that many interviewees are interested in learning from other States’ experiences around overcoming barriers to engagement.

1 While six of the briefs and four of the guides included here are summaries of other research, the remaining briefs and guide do report independent research. Typically, these are part of a larger series of deliverables related to a major research study and focus on a very specific topic that can be covered in a shorter format.

2 Keefe et al., 2012 notes that in many instances monetary rewards “have been discontinued due to financial strain.”