During this phase, the agency is using the technology to administer people’s benefits. This phase can also include revisions to the system which potentially lead to new Contracting and Building phases. The majority of challenges to benefits tech that we are aware of began when the tech was already in use. This is because advocates have most often learned of benefits tech that is contributing to denials, terminations, or cuts in benefits when they see multiple clients experiencing these harms.
Are we missing any information sources, ways to participate, or case studies at the Operating phase? Let us know using our contact form!
In the Operating phase, formal sources of information are limited, thus making it difficult for advocates to know that an agency is working on benefits tech. It’s useful to highlight these information gaps so that advocates can demand more information throughout the lifecycle and intervene before harmful technology is used.
- Federal approval: For some benefits with federal funding (especially Medicaid and SNAP), state agencies might have to get approval from federal agencies to implement changes involving benefits tech. If the system is in use, the state agency will already have submitted a formal application to the federal agency and gotten approval, this should be available through a public records request.
- Promulgation: To implement certain kinds of changes involving benefits tech (especially those that will affect what benefits people receive and how much), the agency has to go through a formal process of publishing the proposed changes called “promulgation” or rulemaking. An agency may propose changes to a benefits tech system that is already in use and may be required to share information with the public about the changes. The exact requirements vary from state to state, but common information includes the purpose of the changes, the projected costs, and the advantages and disadvantages of the changes. Promulgation often requires a chance for members of the public to give their thoughts on the changes through written comment or public meetings (see the ways to participate below). The agency may also have to provide information to the state legislature, which may also hold public hearings to approve the changes.
- Benefits cuts, terminations, or denials: If you are seeing patterns of denials of benefits (for example to people with certain conditions or needs for Medicaid Long-Term Services and Supports), or sudden changes in the amount of benefits people are getting, these could be due to a benefits tech system. Check out our Key Questions Guide to start unpacking what is going on and how the technology might be affecting benefits decisions.
- Client files: Individual client files can be helpful ways to understand how a benefits determination is being made and flag potential issues. Use our Key Questions Guide and Making Sense of Technology Problems Framework to get a sense of whether and how issues with the benefits tech might be at play.
- Administrative hearings & appeals: Administrative hearings and appeals can be a helpful way to learn more about the determination process and what benefits tech is being used. Check out our Fair Hearing Guide for Attorneys and Fair Hearing Guide for People Getting Benefits for tips on how to use the hearing process to learn more about technology being used to administer benefits as well as to get yourself or your clients the benefits you or they are entitled to.
- Public records request: By the time benefits tech is in use, the agency will have developed a record of internal communications and communications with vendors about the purpose and design of the system. There will also be manuals for staff who are using the system, training materials, and other resources that describe how the benefits tech functions and how it is used. These are all documents that you can request through a public records request, often known as a Freedom of Information Act (FOIA) request. Check out our Public Records Request Guide for more information about this process and how to use it to learn more about benefits tech.
Ways to Participate
The list below highlights ways that advocates and people getting benefits can participate in the Operating phase of the lifecycle. As with information sources, the ways for advocates to participate in shaping benefits technology are limited, especially early in the lifecycle. We seek to increase meaningful participation mechanisms throughout the lifecycle. This includes demanding more robust formal mechanisms as well as developing strategies for informally influencing the benefits tech lifecycle to prevent harmful benefits tech, or at least mitigate negative effects.
- Administrative hearings & appeals: Administrative hearings and appeals can be used to challenge automated benefits determinations for individual clients and to build a systemic case showing the pattern of harms. Check out our Fair Hearing Guide for Attorneys and Fair Hearing Guide for People Getting Benefits for tips.
- Litigation: Advocates have brought lawsuits against state agencies to force them to address issues with benefits tech. Check out our Case Study Library to learn more about different litigation. If you are a legal services attorney, contact us to request additional documents and information.
- Legislative hearings: As part of rolling out changes to benefits administration, agency officials may need to participate in hearings in front of the state legislature. You can get more information about their plans by attending the hearing and reviewing the written transcripts and documents the agency submitted. You can also participate in the hearings by testifying yourself to raise concerns about the agency’s plans.
- Public comment: As part of the promulgation and federal approval processes we mentioned in the information sources above, you may be able to submit public comments in response to agencies posting proposed changes to the administration of benefits. Check out our Public Participation Advocacy Guide for tips on engaging in the public comment process.
- Advocacy to state agencies: There are other formal and informal ways to put pressure on state agencies to address problems with benefits tech. Check out our Public Participation Advocacy Guide for more information and ideas.
- Media: Traditional and social media can be useful ways to put pressure on the agency and legislature to address issues with benefits tech. Check out our Media Advocacy Guide for tips.
- Community advocacy: Building relationships with community groups, ideally those led by people impacted by the harms of the benefits tech, can put pressure on the agency and legislature to address the issues with benefits tech systems and help build towards longer-term shifts in the agency’s approach to benefits tech and benefits administration. Take a look at our case study on the Idaho Medicaid Home and Community Based Services Care Cuts and this essay by Richard Eppink of ACLU-Idaho to learn more about the role community advocacy played in challenging tech-related cuts to care in Idaho. Check out our Community Building Advocacy Guide for more suggestions about working with community groups to push for changes to the benefits tech during the Building phase.
The following case studies are about challenges to benefits technology that began at the Operating phase of the lifecycle.
In 2016, nearly half of beneficiaries in Arkansas’s Medicaid home and community based services (HCBS) program experienced unexpected and dramatic cuts to their care.
In the late 90s, Colorado began a process to replace its multiple legacy benefits systems with one single system, called the Colorado Benefits Management System (CBMS).
The Idaho Medicaid agency adopted a new formula for assessing individual budgets available to people with intellectual and developmental disabilities through their home and community based services (HCBS) waiver program.
In 2013, Florida released a new unemployment benefits website called CONNECT, built by Deloitte. Applicants immediately experienced issues causing unemployment benefits to be delayed or incorrectly denied.
The Michigan Unemployment Insurance Agency rolled out the Michigan Integrated Data Automated System (MiDAS) in 2013, which was built by contractor Fast Enterprises starting in 2011 for $47 million.
In 2013, Michigan implemented a data-matching system to enforce federal Supplemental Nutrition Assistance Program (SNAP) regulations (CFR 273.11(n)) which ban people fleeing from a felony prosecution from accessing SNAP benefits.
In 2011, a North Carolina regional managed care organization called Piedmont Behavioral Health sent out alarming notices to people with intellectual and developmental disabilities in the home and community based services waiver program of Medicaid.
For many years, the Social Security Administration (SSA) has incorrectly assessed people getting Supplemental Security Income (SSI), who qualify for the program depending on their finances.
In March 2019, Tennessee launched the TennCare Eligibility Determination System (TEDS), which was designed to streamline enrollment and redeterminations for Tennessee’s Medicaid program.
In January 2017, Wisconsin began using an automated system to determine if someone fit the regulatory definition of having an intellectual or developmental disability (IDD).
A guide attorneys and advocates for using the fair hearing process to both challenge benefits tech decisions and gather information for further advocacy.
A guide for people have had their benefits denied, reduced, or terminated with public benefits technology used as part of the decision process.
This guide will help you start piecing together why and how benefits tech is being used and how it is impacting people.
This guide talks about ways that people impacted by benefits technology and advocates can use both traditional news media and social media to fight harmful benefits technology.
This guide talks about ways that people impacted by benefits technology and advocates can use community advocacy to fight harmful benefits technology.