By Maya Uppaluru Mechenbier, Alana Buroff, Alex Bornkessel, Allison Abbott, and Whitney Robinson

This blog is part two in a four-part series that highlights our work on the Having a Child and Early Childhood Life Experience. You can read the first blog, “Why We’re Designing Government to Work Better and Smarter for Families” on the U.S. Digital Service blog.

Human-centered design (HCD) is a problem-solving method that prioritizes research and collaborative creativity to develop solutions for people’s needs.

In this blog, we will explore how an ongoing human-centered design research process can help to modernize and implement services that are more simple, accessible, and equitable.

The lived experience of a new mom

The HCD approach starts by listening to the stories of people who have gone through similar experiences and using their insights to develop solutions.

Our team connected with hundreds of mothers and caregivers who shared their real-life experiences with our interagency team, comprised of researchers, designers, evaluators, technical experts, and policy professionals. We created several composite profiles from these stories that represent the challenges people face.

Kailee* is a first-time mom. When she discovered she was pregnant, she had mixed feelings, both excited and nervous, about embarking on this journey as a single mother who had just lost her job.

During one of her first prenatal appointments, Kailee received a stack of pamphlets about different government benefit programs. However, she had felt ill all day, and the information overwhelmed her, so she put the information away in her bag to read when she could pay closer attention. But after leaving the doctor’s appointment she was engulfed with her other responsibilities and forgot about the benefit program pamphlets.

Several months after giving birth, Kailee received an unexpected medical bill, even though she was enrolled in Medicaid. Panicked, she reached out to her church for advice. Her pastor shared that Kailee might be eligible for federally funded programs such as:

· The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

· The Supplemental Nutrition Assistance Program (SNAP)

· Temporary Assistance for Needy Families (TANF)

She called each office but was frustrated with the wait times or confusing phone systems. Instead, she figured going in person would be easier, but visiting each office required her to take several bus rides with her newborn and hours of sitting in a waiting room.

It was a stressful situation for Kailee, and she did her best to keep her newborn comfortable during these extended periods. This process spanned several days, and the cost of transportation cut into her grocery budget for the week.

Finally, after collecting all the required documents and providing nearly identical information in three separate applications, she waited to find out if she’d been approved.

Weeks passed without an update, and Kailee struggled to cover the cost of baby essentials, such as diapers and a stroller. Stretched thin, she reached out to a moms’ mutual aid group for diapers and formula to hold her over as she waited for her benefits to kick in.

This story was typical of many mothers and caregivers who shared their experiences with us.

*Kailee’s name is fictional to protect her privacy.

Our approach

The prenatal period is a critical time to learn and apply for benefits. Illustrated through Kailee’s story, the access to easily understood information about relevant benefits, reinforced by touchpoints with trusted community advocates, is fundamental to preparing expectant parents for the journey ahead. Without support before birth, families may struggle with meeting their needs and navigating benefits with the added activity and stress of having a newborn.

The unique mandate of the Customer Experience Executive Order empowered our team to employ an HCD approach and develop solutions for improving the experience of families accessing multiple government resources, beginning with insights from stories like Kailee’s.

The “Birth of a child and early childhood” designated Life Experience team had the task of identifying ways to improve how we deliver federally funded services across agencies and programs to families with young children in America.

This area has decades of research behind it, with well-defined problems, but there are no easy solutions. We wanted to understand better how we could connect and deliver existing programs, using the resources and tools we had.

We wanted to ensure that we were:

· Co-designing with families

· Researching the ideas and work of civic thought leaders

· Synthesizing, not duplicating, existing research

We started by building a team of people with diverse experiences conducting research in and delivering programs related to maternal health, social determinants of health, and early childhood across agencies and levels of government. Additionally, we brought in experts with agile skillsets to synthesize knowledge and develop feasible solutions for long-standing issues.

How we worked

Throughout the Discovery and Design phases of our projects, we adhered to several principles that can better enable more equitable solutions for real problems:

Design with users, not for them

Collaboration at every level is necessary to achieve co-creation. It is essential to consider diverse viewpoints from partners in the federal government, local government, community organizations, and individuals. To achieve fairness, we adopted an asset-based approach and asked questions that helped us understand:

· What are the community’s strengths?

· How can we build from them?

In practice

We created a safe, non-judgmental environment for vulnerable families to share their experiences. We collaborated with trusted community partners to identify families and conducted interviews at a comfortable location. We included Spanish speakers when possible and ensured families understood how their information would be used. Families were given the option to end the interview if they felt uncomfortable.

During our initial discovery phase, we conducted over 120 interviews within a few months. As we progressed into the design phase, we conducted site visits across the country, which further increased the number of interviews. We interviewed families, community workers who serve them, and program employees of federal, state, local, and tribal governments.

We spoke with families from diverse backgrounds, including recent immigrants, non-native English speakers, and Tribal members, with varying geographic locations, income levels, and rural/urban spectrums.

Many communities in this country have creatively designed supports and provided vital services to new parents, despite limited resources and administrative and logistical barriers. We drew inspiration from these on-the-ground civic leaders and solutions to learn how our federal team could elevate and scale solutions that had proven outcomes driven by the power of innovative and courageous communities, rather than assume we knew what could work for them.

In our process, we created concept sketches based on their stories and insights. Visiting pilot sites early and often in our approach allowed us to have families and community leaders shape, validate, or change the design direction. Together, we built a path to a set of interventions that will be valuable to families.

Provide incentives to research participants for their time and effort

Federal agencies recognize the importance of including hard-to-reach populations — particularly those from underserved communities — in customer research to improve quality and representation.

With those insights, we obtained budget and legal approval to incentivize our user research participants for their time and effort. Given that we wanted to include underserved communities, providing incentives was essential for ensuring that the feedback we received was from an unbiased sample. For instance, many of our more vulnerable participants are juggling multiple jobs, caretaking duties, or complex illnesses while trying to renew their benefits; the sessions may be frustrating and stressful for the participants, or they may have had a poor experience with government services in the past and would not otherwise participate.

In practice

We gave our research participants flexible gift cards in a fixed amount as an incentive for their time and effort.

Design for the user with the most challenging path today, inherently improving the usability for all

When designing with equity and inclusivity in mind, it’s critical to design for the most complex use case, as this ultimately can make the service more simple, seamless, and accessible for all.

In practice

Our participant population was intentionally selected to include a higher proportion of families that often face more obstacles when raising a child during the early years. This included families with limited English proficiency, single-parent households, immigrant families, families of color, including Black and Indigenous families, and families with a caregiver experiencing substance use disorders.

Starting with lived experiences can improve solutions by accounting for stigma, language accessibility, technology, and distrust of government. Solutions provided in advance can be helpful to those who do not encounter the same obstacles. Even if someone has multiple college degrees, they may not have the time to decipher complex instructions. In such cases, they would much rather read a plain language version when filling out a form.

Discovery phase findings

After conducting our HCD research, we put together a journey map that represents a significant portion of the experiences we learned about from families from their point of view. The map covers the period from when a family discovers they are expecting a new child to when the child begins kindergarten. The map includes interactions with medical providers, their community, and various benefit programs they use along the way.

We combined familiar stories that paint the picture of a family’s lived experience. In addition to Kailee’s story at the beginning of this blog, we also mapped out recurring themes for those navigating the zero to five years with limited English proficiency.

We also mapped a story for those who move to a new state and must navigate transitioning their supports.

We knew any solution we designed must also work for the professionals on the front lines, serving families (for example, those who work in WIC offices or community health workers). To account for this perspective, we also developed a persona that reflects the common themes we gathered from our conversations with community workers.

In compiling these stories, mapping journeys, and synthesizing interviews, the team identified hundreds of pain points families face during their child’s zero to five years. We focused in on what our team could feasibly address through interagency collaboration and executive action. Which problems could we solve with the resources we have available to us, given the need for legal and technical feasibility? How could we meaningfully move the needle in a reasonable timeframe?

Four pain points rose to the top.

1. Families aren’t getting the right information at the right time.

On one end of the spectrum, many new parents are unaware of the available programs. On the other hand, other parents may receive a one-time flood of resources that is difficult to digest, such as in the hours following giving birth.

2. Families face administrative barriers applying to programs.

The application processes for expecting and new parents can be time-consuming and resource-intensive, with siloed procedures adding to the burden. Additionally, limited virtual options and inconvenient office hours prevent parents from being able to apply at a time that works for their work or transportation schedules.

3. Families lack key physical goods — like diapers and breast pumps — after giving birth.

The cost of critical family supplies, such as diapers and breast pumps, fall outside most benefits program coverage, and reimbursement can be slow and cumbersome for items that Medicaid covers.

4. Families face barriers to maintain benefits as they juggle the responsibilities of parenthood.

Benefits program communications about re-enrollment requirements and timelines can be confusing, especially as they often rely heavily on mail-based communications methods.

What’s next?

As we implement the design phase, we’ll continue to use a human-centered design approach that drives how we design, launch, and deliver public services.

Based on the insights we’ve gained from innovative community leaders and families, we are confident our team, working with communities and our pilot partners, can improve the way the federal government serves families in the early years.

Learn more about our pilot solutions and projects, and how we’re testing them through continued co-design with families at the Having a child and early childhood life customer experience page.

This blog is part two in a four-part series that highlights the “Birth and early childhood” Life Experience team’s work. Brought together by the Customer Experience Executive Order, teams are tackling the extraordinary challenge of modernizing and implementing government services that are simple, accessible, easy to use, and equitable for families.

Read the team’s first blog, “Why We’re Designing Government to Work Better and Smarter for Families” on the U.S. Digital Service blog.

***

If you’d like to work on projects like this, consider joining USDS! We’re hiring mission-driven engineers, product managers, designers, bureaucracy hackers, procurement specialists, and operations experts who want to make an impact on the lives of their fellow Americans.

Apply here and learn more about us at the links below.

USDS.gov | LinkedIn| Twitter | Instagram | Facebook | GitHub

Solutions by Families, for Families was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

By Mina Hsiang, USDS Administrator

Nine years ago, the United States Digital Service, or “USDS,” got our start as a small team based at the White House to change how Government delivers services in a digital age. Since August 11, 2014, we’ve been laser-focused on our mission to deliver better Government services to the American people through technology and design.

We do this by partnering with Federal agencies — we’ve worked with more than 20 at this point — to create, update, redesign, reimagine, and transform Government services for the better and to help those agencies build their ability to continue to do so into the future.

Our teams are a mix of engineers, data scientists, product managers, designers, procurement specialists, communicators, talent professionals, and operators, and over the past nine years, we’ve grown from a handful of folks to more than 200 professionals. Through that time, we have enabled the delivery of dozens of improved services and supported the curation and formation of digital service delivery teams to expand and continue this important work — creating long-term impact in the Federal Government.

For our ninth birthday, I wanted to share nine great examples of programs we have been working on across the Government and in close partnership with agencies to ensure the Government delivers more simple, seamless, and secure services. Let’s dive into the nine impactful projects we believe you’ll enjoy learning more about.

1. Helping the Nation Navigate a Critical Infant Formula Shortage

In the summer of 2022, the country experienced a historic and severe shortage of infant formula, with some media outlets reporting an out-of-stock rate of 70 percent by the end of May. This shortage affected babies and older medical patients who depend on feeding tubes for nutrition.

USDS jumped into action and partnered with the Department of Health and Human Services (HHS) to create data systems and perform critical analysis, allowing Operation Fly Formula to effectively predict needs for what should be brought into the country and then target formula deliveries nationwide.

We also helped the department re-launch its formula homepage, hhs.gov/formula, targeting users’ needs through direct user research. That site provided an important resource with more than a half-million visits from caregivers looking for practical medical guidance on infant formula.

2. Launching a Five-Star Mobile App for Veterans’ Benefits

We have had a long, nine-year partnership with the Department of Veterans Affairs (VA), which has included helping them re-launch their main website that allows Veterans to access services. Over time, we’ve seen that about half of all Veterans visiting the VA’s website were using a mobile device.

Our support led the VA to build and launch a top-rated mobile app in late 2021 that lets Veterans do an expanding array of important tasks such as checking benefits, booking appointments, messaging healthcare providers, and looking at lists of VA payments.

Since its launch, over one-million Veterans have used the app, and it’s garnered nearly perfect ratings in the app store, with over 80,000 five-star reviews. Find out more about this project on our blog.

3. Reducing the Burden of Child Care Assistance Applications

The $7 billion child care assistance program run by the Office of Child Care (OCC) at HHS helps almost a million lower-income families nationwide pay for child care so parents can work, pursue an education, or attend job training. It’s a Federal program, but states, territories, and Tribal Nations create the applications, determine eligibility, and issue payments to child care providers.

USDS worked with the OCC team at HHS’s Administration for Children and Families (ACF) to tackle the burden on families navigating the confusing and unnecessarily complicated application process. The complex processes also create challenges for state staff to approve the applications quickly.

The result is a guide for states, territories, and tribes called the Guide to Creating a Family-Friendly Child Care Assistance Application, which will help reduce burdens and break down the barriers for families that need child care assistance. Read more about this work on our blog and at USDS.gov.

4. Helping the Government Smartly Buy Technology

Acquiring the right digital tools and capabilities is essential for Federal agencies offering services to the American public. The process Government uses to purchase goods and services, called procurement, can make or break efforts for the Government to meet the needs of all people.

Since 2016, we have partnered with the White House’s Office of Federal Procurement Policy to create and run an immersive development and training program for digital services procurement to help contracting professionals across the Government learn and use best practices — saving money, improving security, and improving outcomes for the public.

The program is called DITAP, which stands for the Digital Information Technology Acquisition Professional Program, and more than 850 Federal contracting professionals have graduated from the program so far. Learn more about DITAP at this link.

5. Helping SSA Launch a More Useable Front Door

About 180 million people visit the Social Security Administration’s website each year to accomplish critical tasks, from enrolling in retirement benefits to managing disability and survivor benefits and getting new Social Security Cards. SSA wanted to redo their site to be more intuitive, accessible and to make it easier for the public to accomplish what they need to do and brought us in to help them do just that.

Through an iterative process, including extensive user research and incorporating new interactive tools, our combined team launched a new site in late 2022. Since then, customer satisfaction scores have increased by over 15 percent, and task completion rates have risen 10 percent, allowing more public members to be efficiently and effectively served online.

6. Agency Transformation: The Digital Service at the Centers for Medicaid & Medicare Services

The Centers for Medicare & Medicaid Services (CMS) knew after their rocky 2013 launch of Healthcare.gov that they needed to build out new capabilities. That problem had been tackled by an interdisciplinary team of engineers, product managers, and designers, who worked to restore service and improve access to healthcare benefits.

Based on that experience, CMS knew that they needed a dedicated team of technologists to tackle digital challenges, including Healthcare.gov and beyond, and beginning in 2015, they partnered with USDS to build a joint team providing those capabilities.

Over the years, professionals from USDS and CMS have worked side-by-side to implement and redesign critical healthcare infrastructure, like re-launching the 9–8–8 Suicide and Crisis Lifeline, modernizing the systems that pay $1 trillion a year in Medicare claims, implementing the Quality Payment Program, launching the No Surprises Act webpage; and promoting the importance of seamless and straightforward digital services at the agency. Read more about one of CMS’s projects on USDS.gov.

7. Creating Open-Source Tools to Understand the Impact of Climate Change

When the Federal Government announced the historic Justice40 Initiative, committing to invest 40 percent of the dollars from many Federal Government programs in the disadvantaged communities that are marginalized, underserved, and overburdened by pollution, it was clear that agencies needed tools to enable those investment choices.

USDS collaborated with the Council on Environmental Quality and the Office of Management and Budget to build the Climate and Economic Justice Screening Tool, which collects and transparently synthesizes data from 13 different sources, allowing agencies to do their analysis and determine how dollars should be allocated.

This supports ongoing work to ensure that Government can appropriately support the communities and people most negatively impacted by the changing climate. Read more about this program and our work on our blog.

8. Designing Programs to Help New Parents

Spurred by an Executive Order on Customer Experience to re-orient Government services around how people experience significant — and often challenging — life events rather than around how Federal agencies might interact with those events, we partnered with the Office of Performance and Personnel Management in 2021 to identify and understand key pivotal moments in people’s lives.

Unsurprisingly, carrying and delivering a child is one of the most life-changing experiences for many people. For low-income families, interacting with a tangled web of Government websites and offices can add to the stress of this experience.

Our 0–5 Life Experience team and our partners at HHS listened to families nationwide about their lives as parents of babies and young children and how the Government could reduce burdens from programs and better support them. Based on that research, we are helping HHS pilot three programs:

• The Benefits Bundle connects families with new babies to a collection of supportive Government services through personal case management.
• The Newborn Supply Kit provides families with basic physical supplies and health products through hospitals and community organizations.
• The Federal Notification Service helps families stay connected to Government services at crucial moments (e.g., when it’s time to enroll or renew benefits) through text messages.

Learn more about this work on our blog and Performance.gov.

9. Agency Transformation: Helping the CDC Become more Pandemic-Ready

The outbreak of COVID-19 showed the need for flexible, scalable public health data and technology systems that can support a rapid response. Coordinated action requires capabilities that can provide real-time data for public health action and emergency response at all levels of Government.

We began our multi-year partnership with the Centers for Disease Control and Prevention (CDC) in 2019 to help them create tools and programs that connect labs and care providers to public health departments and send cleaner, faster information to state, territorial, local, and Tribal health departments.

Our work includes creating pandemic-ready data pipelines and systems to support local public health departments and the CDC to detect better, respond to, and prevent public health emergencies, now and in the future. Over time, we have also supported the CDC to build their own teams and capabilities, to ensure a long-term vision and capacity for ongoing public health data work. Learn more about this work on CDC’s website.

And this is just a sampling of the diverse work we engage in daily.

We know that every interaction between the Government and the public is an opportunity to deliver the value, service, and efficiency people expect and deserve and to build trust between the public and our Government. To do this requires expertise from both Government and industry, implementing the best equitable user experience and modern technology.

Our goal every day is to do the greatest good for the greatest number of people in the greatest need. Accomplishing that means tackling important problems today in ways that have long-term impact — partnering with agencies to help them deliver great experiences while also building their capabilities to deliver critical services into the future.

If this mission and skill set sound like you, consider joining us! Find out more and apply to USDS here, and check out the links below for updates.

USDS.gov | LinkedIn| Twitter | Instagram | Facebook | GitHub

USDS Marks Nine Years of Transforming Government Services was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

For any parent, carrying and delivering a child is one of the most life changing experiences they will go through. And yet, the stresses and burdens are more difficult for low-income families. Too often, parents have to navigate a tangled web of government websites, offices, and phone numbers to access the services they are eligible to receive.

The Life Experience team spent the last year speaking with families nationwide about this moment in their lives, to better understand where government services could better support them. We’ve now launched three projects to directly address the feedback we heard. This blog post is part of a series we’ll be sharing throughout 2023 tracking our projects’ progress, learnings, and results.

In December 2021, President Biden’s Executive Order on Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government emphasized a customer-centric approach focused on understanding individuals’ needs during significant life experiences — such as the birth of a child. By adopting a “Life Experiences” framework, the government aims to improve accessibility and responsiveness, ensuring services meet people where they are and simplify their journeys.

Understanding the Journey: Collaborative Insights into Supporting Families from Pregnancy to Age Five

The challenges parents face after having a child can be overwhelming. Access to essential resources such as healthcare, nutritious food, housing, transportation, and affordable child care are crucial for the well-being of families. However, the reality is that too many American families are constantly in survival mode.

The multidisciplinary, multi-agency team, including leadership from the U.S. Digital Service (USDS), General Services Administration (GSA), Department of Labor (DOL), Department of Housing and Urban Development (HUD), Department of Agriculture (USDA), Office of Management and Budget (OMB), Department of Education (ED), and the Department of Health and Human Services (HHS) set out to understand families’ experiences with federally funded support as they go through the journey of welcoming a new baby to their household.

In this process, we collaborated with over 120 families, community leaders, and numerous experts with extensive experience in managing family support programs to gain valuable insights into the root causes of the financial struggles faced by parents with young children. Beginning the discovery phase, we already knew that:

• Mothers experience a partial loss of income following birth, significantly impacting their households — the absence of paid leave and the growing expenses worsen the situation.
• Over five million children live in poverty during crucial developmental stages, with Black and Hispanic households disproportionately affected.
• Particularly during the pandemic, mothers have borne the weight of domestic violence, job loss, and limited access to child care options.

Despite government programs in place, approximately $60 billion in benefits intended for eligible families in need remains unused. Story after story, and expert after expert, confirm a troubling reality: the complex and fragmented system of services presents an insurmountable challenge for families to navigate.

Improving access to the safety net will contribute to a continuing post-pandemic economic recovery for working families and their communities, and improve families’ health and well-being, as emphasized in the 2022 White House Blueprint for Addressing the Maternal Health Crisis.

Helping Families Navigate the 0–5 Benefit Enrollment Experience

Our team is working to simplify the benefit enrollment experience for new mothers and caregivers. As part of our research, we learned that parents are on their own without an authoritative, clear roadmap on how to navigate government support. This leaves parents in a maze of complex information, duplicative requests for documentation, waiting lists, hour-long phone calls, and administrative hoops — where any missed deadline or forgotten requirement could result in a family not receiving resources to meet their basic needs.

Some critical supports for young families include:

Medicaid: Provides health coverage to people with limited income and resources.

Special Supplemental Nutrition Program for Women, Infants, and Children (WIC): Provides supplemental foods, health care referrals, and nutrition education for low-income pregnant, breastfeeding, and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk. Historically, WIC accounts for over half of U.S. formula consumption.

Supplemental Nutrition Assistance Program (SNAP): Provides nutrition benefits to supplement the food budget of needy families so they can purchase healthy food.

Temporary Assistance for Needy Families (TANF): Provides states and territories with flexibility in operating programs designed to help low-income families with children achieve economic self-sufficiency. TANF dollars fund monthly cash assistance payments to low-income families with children and other services.

Child Care and Development Fund (CCDF): Provides financial assistance to low-income families to access child care so they can work or attend a job training or educational program.

Housing vouchers: Assists low-income families, the elderly, and the disabled to afford decent, safe, and sanitary housing in the private market.

Having identified which federal programs young families use most frequently, we created a composite diagram that mapped enrollment timelines for the pregnancy and early childhood journeys based on examples from four states.

This task map shows that figuring out and managing these workstreams are daunting for overworked, under-resourced parents. The systems that are supposed to support families during this life experience may in fact be causing more stress than their perceived worth by the family. This is especially difficult for eligible families with limited English proficiency, those who need transportation or child care, or those who cannot take time off work. Further, eligible families seeking assistance often must submit the same information over and over when they apply for each program individually and navigate slightly different requirements for each program.

Research demonstrates a possible connection between administrative burdens when applying for programs and increased anxiety and psychological harm. Parents’ stress and mental health can directly impact family well-being and children’s emotional and social development.

By improving access to these systems, we can contribute to the post-pandemic economic recovery of working families and their communities, while enhancing their overall health and well-being — a cornerstone priority of this Administration.

Advancing Maternal and Child Health: Collaborating for Innovative Government Services

To alleviate these burdens, we must streamline families’ support systems. By reducing redundancy, ensuring clear communication, and minimizing barriers, we can foster an environment where families can access the assistance they need without undue stress and anxiety. Our team’s work continues to drive better, more innovative government services for moms, families, and children. And it isn’t — nor can it be — done alone.

We are working alongside federal, state, and local partners as well as external organizations with decades of expertise in advancing maternal and child health to help elevate and amplify promising practices while continuing to center families and their experiences at the center of how we administer government programs and supports.

Visit Having a Child and Early Childhood Life Experience page to explore the full portfolio of work, including the findings from our research, journey maps, customer stories, and common pain points.

If you’d like to work on projects like this, consider joining USDS! We’re hiring mission-driven engineers, product managers, designers, bureaucracy hackers, procurement specialists, and operations experts who want to make an impact on the lives of their fellow Americans.

Apply here and learn more about us at the links below.

USDS.gov | LinkedIn| Twitter | Instagram | Facebook | GitHub

Why We’re Designing Government to Work Better and Smarter for Families was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

Nearly one million American families benefit from federally funded child care assistance. But it’s often difficult for families to navigate an application process that can be confusing and unnecessarily hard, and for staff working in states to quickly approve those applications.

The U.S. Digital Service partnered with the Office of Child Care (OCC), which is part of the Department of Health and Human Services’ Administration for Children and Families (ACF), to tackle this process. The result, the Guide to Creating a Family Friendly Child Care Assistance Application, will help reduce the burden and break down the barriers for families that need child care assistance.

What’s Child Care Assistance?

This program helps families with lower incomes pay for child care so parents can work, pursue an education, or attend job training.

Though the program is federally funded, each state, territory, or Tribal Nation is responsible for administering the program. They must create their own application, collect applications from families, determine whether a family meets the eligibility criteria, and send payments to providers.

Many states take different approaches to the application process. For example, some states require an in-person interview or an original, hard-copy birth certificate — requirements that can make it harder for families who need this assistance to attend a job interview, complete their degree, or go to work.

Our Research

We approached this project with a focus on what peoples’ actual experience is with the application, first working to understand what wasn’t working well — both for families using the application and for staff reviewing applications.

The team noticed that state applications ranged in length, layout, and the content of the questions that states were asking families. Some applications were one page; others were 16 pages.

We heard from families during our research that gathering the information needed to complete long, complicated applications could be daunting when you’re also managing children at home and looking for child care.

State administrators, too, weren’t satisfied with the applications, which often included questions that neither administrators nor families understood. It was unclear to them what parts of the application were required by law, such as which family members should be included in the application and what documentation is required.

If the application is confusing for families, it’s also more prone to errors. We learned that families are frequently confused about which family members needed to be on the application, which personal information is needed from those family members, and what counts as income, among other questions — and so families don’t always accurately reflect their situation in applications. Frontline staff reviewing the applications then spend more time working with families to clarify details and figure out who actually qualifies.

Designing a New Application Model

The teams at USDS and ACF worked together to provide a sample application for interested states along with clarifying the verification and documentation requirements that were unclear.

Designers applied user experience best practices to create a Model Child Care Assistance Application that clearly describes what information is required to meet all federal requirements. It also demonstrates best practices for designing an easy-to-use form and process — for example, allowing for flexibility when families have a non-standard income or non-traditional living arrangements, or automatically skipping certain questions if those questions don’t apply to the applicant.

Designers also tested the new application with real families to see where they got stuck or where they had questions, which informed the Model Application.

In keeping with our value to “design with users, not for them,” we made sure to not only speak with families and states during the research phase, but to also continually involve them in the design process and show them drafts of the product as we created it.

Using the Guide

Ultimately, it’s up to each state to adopt the recommendations in the Guide.

Our research showed that state administrators want to make applications easier, but are often unsure what’s allowed under the federal program. We partnered with the policy and subject matter experts at ACF to create a Model Child Care Assistance Application and eligibility verification practices that meet federal guidelines and show the “art of what’s possible.”

Already state child care offices have expressed interest in this work. They’re also expanding support resources to help put these practices to work and improve efforts to reduce burden on working families.

If you’d like to work on projects like this, consider joining USDS! We’re hiring mission-driven engineers, product managers, designers, bureaucracy hackers, procurement specialists, and operations experts who want to make an impact on the lives of their fellow Americans.

Apply here and learn more about us at the links below.

USDS.gov | LinkedIn| Twitter | Instagram | Facebook | GitHub

Reducing Burden of Child Care Assistance Applications was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

The Veterans Health Administration is America’s largest integrated health care system, providing care at more than 1,200 facilities across the country and serving nine million Veterans annually.

Technology that comes about to fix a problem is great, but a tech product that exists to drastically improve a critical experience is much better. The VA’s Health and Benefits mobile app is the latter.

An Opportunity to Better Serve Veterans

As one of our first agency partners, USDS has collaborated with the VA on many exciting developments over the years, including the launch of an in-house digital service and an app that allows Veterans to apply for healthcare. This longstanding partnership enabled USDS and VA teams to spot some pretty interesting data: about 50 percent of Veterans were accessing VA.gov from a mobile device. Not only that, but Veterans were performing a small subset of tasks on the website much more frequently and consistently, like checking their appointments, messaging with their healthcare provider, and retrieving lists of VA payments made to them.

Working closely together, VA and USDS recognized the opportunity to better serve Veterans by intentionally making these common actions easier. Enter the Health and Benefits mobile app.

Since debuting in late 2021, more than 923,000 Veterans have used the app and more than 66,000 users have left ratings or reviews, averaging 4.8 out of 5 stars in the Apple App Store and 4.6 out of 5 stars in the Google Play Store. In the past year, the app has also seen an increase in daily active users from 25,000 to 85,000.

Understanding the Impact of the App

The app’s success is guided by a core tenet: To intentionally meet Veterans where they are and make their lives easier with accessible technology. Here are two examples of the pain points the app works to solve:

• Authentication makes sign-in easier: Teams knew that signing in to VA.gov was an issue for some Veterans, particularly Veterans who were aging or might have suffered brain trauma. The Health and Benefits mobile app allows Veterans to sign-in once and then use their face or fingerprint to sign into the app for up to 45 days, thereby eliminating a major pain point.

• Mobile Claims Upload saves time and processes more quickly: Before the launch of the Health and Benefits app, sending supporting documents to prove a benefits claim meant having access to either a computer and a digital scanner (and then scanning your evidence, transferring it to a computer, and uploading it) or having access to a photocopy machine and a post office to mail physical copies of your documents. With the app’s upload feature, Veterans are now able to use their smartphone cameras to take photos of their evidence and upload in minutes. Since this feature became available, more than 8,000 documents have been uploaded, representing about 20 percent of all claims in “under development, needs evidence” status.

Accessible from the Start

“Since this was the modernized VA.gov’s first foray into native apps, we wanted to set a high bar and think about accessibility from Day One,” explained Martha Wilkes, who is a USDS designer and accessibility strategist at VA’s Office of the Chief Technology Officer.

The team made sure to carry over accessible design principles from VA.gov to the app, like flexible font and button sizing, integration with biometrics to log in, and plain language that people of many different levels of ability understand. These principles were elevated when combined with the capabilities of smartphones.

“We also wanted to take full advantage of all the excellent accessibility options built into smartphones. For example, dark mode!” Wilkes continued. “Dark mode is a classic example of an accessibility feature being useful for everyone. Over 80 percent of people use their phone in dark mode, so we made sure to add a dark theme after the initial release.”

Judging by the reviews and feedback from Veterans, the efforts are much appreciated. Here are a few of the comments:

• “As someone who frequently uses the VA website for disability claims and healthcare, this is a huge time-saver.”
• “I love this idea. I’m glad there’s [going to] be an easier way to access important documentation without having to sign into a computer or laptop.”
• “Love the sign in options, the biometrics are a huge time saver over the two-step verification.”

On both the Apple App and Google Play stores, Veterans have continuously left helpful comments on improvements and additional features for the app, which have been incorporated into the product’s road map. The app is updated every two weeks with new releases.

Download the VA Health & Benefits app for Apple or Google Play.

We’re hiring mission-driven engineers, product managers, designers, bureaucracy hackers, procurement specialists, and operations experts who want to make an impact on the lives of their fellow Americans.

Apply here and learn more about us at the links below.

USDS.gov | LinkedIn| Twitter | Instagram | Facebook | GitHub

Meeting Veterans Where They Are with Accessible Mobile Tech was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

Veterans now have on-the-go access to their benefits and healthcare, thanks to an authenticated mobile app launched by the Department of Veterans Affairs and the U.S Digital Service. Delivery of this product is one of the commitments of the Department in Executive Order 14058, Transforming Federal Customer Experience and Service Delivery to Rebuild Trust in Government, which the President signed in December last year.

The app allows veterans to locate personalized health and benefits information quickly and conveniently while considering their range of accessibility needs.

“The new VA app makes it faster and easier for Veterans to do the things they need to do at VA,” said Charles Worthington, chief technology officer at the department.

Veterans can view upcoming medical appointments, check their claims, and download important letters from the agency. The app also features biometric login, push notifications, and integrations for location and calendars. Veterans are able to locate facilities, securely message providers, access the Veteran Crisis Line, and more. To date, 150,000 Veterans have viewed medical appointments through the app.

Veterans are also able to speed through the app with modern authentication features and accessibility that make common transactions faster.

Read more about our work with Veterans’ Affairs:

• Improving Access to Benefits
• Introducing a new digital application for health care at VA

More than 210,000 veterans have downloaded and logged into the app, averaging about 18 sessions per person.

In the future, the VA will add helpful functionality, including prescription refills, appointment requests, debt management, and payment viewing.

Download the VA Health & Benefits app for Apple or Google Play.

The best of technology.
The best of government.
And we want you.
We’re looking for the most tenacious designers, software engineers, product managers, and more, who are committed to untangling, rewiring, and redesigning critical government services. You’ll join a team of the most talented technologists from across the private sector and government.
If you have questions regarding employment with the U.S. Digital Service, please contact us at usds@omb.eop.gov or visit our Hiring FAQ.

New VA Mobile App Serving 210,000 Veterans — and Counting was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

With great pride, we announce that Mina Hsiang is the new Administrator of the United States Digital Service (USDS). She will be the third Administrator since USDS launched in 2014, and she will be the first woman and first Asian-American to lead our agency.

“I am so excited to lead this organization which tackles problems that are both important and hard. It’s a place I care so much about; it represents what I think is best about people stepping up when their country needs their skills. I’m proud of what the team at USDS has done so far and am eager to continue that work. And I remain committed to bringing in highly skilled and experienced technologists who are diverse on all axes- because government builds for everyone, and we should reflect that public.”

Mina brings deep technical experience to the position, having spent over a dozen years in private industry building products, teams, and organizations to deliver analytics and digital services, and having also served in government in roles spanning both policy and implementation.

During the Obama-Biden Administration, she was a vital member of the HealthCare.gov rescue team before the founding of USDS. She became an early team member of USDS, serving as founding Executive Director of the Digital Service at the Department of Health and Human Services (HHS) and leading work from MACRA implementation to precision medicine. In the past year, she served on the Biden-Harris Transition as part of the HHS agency review team and working on the Transition’s COVID-19 Response team. She carried that work back into USDS as a Senior Advisor for Delivery. In that capacity, she successfully led the delivery team to roll out the Vaccines.gov integrated consumer experience.

Hsiang was most recently Vice President of Technology Products and Vice President of Policy at Devoted Health, an integrated insurance and services startup for seniors in the private sector. She helped start and grow Devoted into a 700+ person company. Before that role, she led new product development for the analytics division of the $60B healthcare tech & services company, Optum. As an investor and advisor on company boards, she also lent her insight and expertise to help start and build innovative and high-performing organizations.

Mina is well equipped to help USDS deliver on its mission in a historical moment when the users of government services need it the most. Her connection to the work is evident. Raised by a math professor and computer science professor, she was encouraged to be curious and focus on complex and critical challenges. Her civil servant grandparents also imbued her with a strong sense of how vital and impactful government is. As a result, she has a profound interest in how people, technology, and government can fit together to deliver positive outcomes. And she wants to build that outcome-driven government for her daughter’s future. As we work to emerge from this pandemic stronger, having a leader with experience in building and designing equitable service delivery systems is critical.

We’re thrilled that Mina has stepped up to serve as we enter this next chapter of USDS’ history.

When technologists sign up to join USDS, it is for a limited tour of duty. In April, the previous Administrator Matt Cutts reached the end of his tour. We’re grateful that Edward Hartwig stepped up to serve as Acting Administrator in the interim to support the organization during this transition.

The best of technology.
The best of government.
And we want you.

We’re looking for the most tenacious designers, software engineers, product managers, and more, who are committed to untangling, rewiring and redesigning critical government services. You’ll join a team of the most talented technologists from across the private sector and government.

If you have questions regarding employment with the U.S. Digital Service, please contact us at usds@omb.eop.gov and visit usds.gov/apply.

Introducing the Administrator of the U.S. Digital Service: Mina Hsiang was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

When it was founded in 2014, the U.S. Digital Service was a dozen or so technologists staring down the intimidating task of modernizing government services. All had big hearts and even bigger appetites to make the federal government more accessible and understandable to the millions of people who rely on it.

Almost seven years later, we are a team of 180 with a network of over 500 alumni. Some alumni have gone on to become career federal leaders, including CIOs and CTOs at the Department of Homeland Security, Department of Veterans Affairs, Center for Medicare and Medicaid Services, and beyond. Whether by empowering career civil servants to more effectively leverage design and technology or by joining their ranks, we have made government services more accessible and easier to use for students, refugees, immigrants, military families, Veterans, farmers, retirees, doctors, patients, and many more.

When I joined USDS in 2016, I came with an outsider’s perspective, technical skills, and desire to use my talents for good. I thought I would serve for just three to six months. More than four years later, at the end of this month, my service at USDS will end. When technologists join USDS, they sign up for a limited tour of duty. I am no different, and it is my time to step down. I’m so grateful to have been a part of this team. And I am enormously proud of everything our team has accomplished across two Administrations.

In my time as USDS Administrator, we’ve been busy. The team has created and deployed tools to help better fulfill the promises we’ve made to our Veterans. We’ve digitized the naturalization process and reimagined hiring across the federal government. We began supporting states in building more responsive systems for the millions of Americans who rely on them. In every project, we strive to address the immediate needs of the country while building a more resilient and responsive government for decades to come.

As a new Administration gets underway, the core mission of USDS remains the same: to do the most good for the most people who need it the most. We continue to support our partners at the Center for Disease Control and across the Department of Health and Human Services in responding to the COVID-19 pandemic. We are expanding our work to help immigrants and refugees, students with federal loans, and those most in need of financial assistance amidst the economic crisis. We continue to help agencies across the government adopt the Digital Services Playbook, reform technical procurement, and improve the federal hiring process. This work will be led by my accomplished Deputy with support from our senior team until a new Administrator is appointed.

USDS was created to provide private sector technologists an opportunity to serve their government for a short period of time. This year, in addition to those that joined the civil service permanently, we’ve seen an impressive number of alumni return to serve their government a second time. People continue to serve because it’s clear that they can have impact. A year of service can improve the lives of millions of people, many of whom are experiencing the most difficult moments of their lives. Recent endorsements from the President and Congress continue to drive the movement forward. New funding allows us to continue to grow to meet the moment we are in. By partnering with even more agencies and teams across government, we can help more people navigate government and showcase government at its best. There has never been a better time to apply and help out.

Serving at USDS offers incredible potential for impact at scale. As this new Administration takes off, we need the help of even more folks who are passionate about how technology can make government more equitable and accessible. If you’re an engineer, designer, product manager, acquisition strategist, or policy expert who cares about making government work better for real people, please consider applying to join us, or reach out.

The best of technology.
The best of government.
And we want you.
We’re looking for the most tenacious designers, software engineers, product managers, and more, who are committed to untangling, rewiring and redesigning critical government services. You’ll join a team of the most talented technologists from across the private sector and government.
If you have questions regarding employment with the U.S. Digital Service, please contact us at usds@omb.eop.gov or visit our Hiring FAQ.

Join the U.S. Digital Service | Follow us on Twitter | Visit our Site | GitHub | Follow us on Instagram | Like us on Facebook

The Next Chapter for USDS was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

Discovery sprints are a quick (between 2 to 4 weeks) way for our teams to understand the landscape, the people, and the root causes of any issues of importance to the agency we are supporting. With a small footprint inside the federal government, USDS uses discovery sprints as a tool in our initial conversations with new partners.

The pandemic shined a brighter light on how some of our most critical systems are not meeting people’s needs. At the same time, there is a renewed focus on improving them. The teams forming at the federal, state, and local levels might benefit from our experiences, or could at least avoid repeating our mistakes. We sit down with Kat Jurick and Jenn Noinaj who co-authored the guide to learn more about discovery sprints and their process of writing the guide itself, in hopes that others can document and share some of their own best practices for working within and around public interest technology.

Kat is currently an advisor at USDS. She was the USDS Design Director from 2018 to 2020, and has led, participated in, and staffed many discovery sprints, and she also often facilitates post-sprint retrospectives. Jenn leads the Public Interest Technology Workforce project as a fellow at the Beeck Center for Social Impact + Innovation at Georgetown University. Prior to this role, she was a user experience design expert at USDS, where she both led and participated in multiple discovery sprints.

What is a discovery sprint anyways?

JN: USDS is often invited to find ways technology can fix an issue an organization may have, but technology is rarely ever the solution. Instead, USDS strives to be outcomes-focused. That means understanding what people need, where they’re coming from, and the context in which they’re operating. Coming from a human-centered perspective, it’s imperative for teams to start by understanding where an organization has been and where they are now, before helping them figure out where they want to go.

The purpose of doing a discovery sprint is to help identify root causes, issues, and opportunities; not to try and solve them in the time window of the sprint.

Teams spend the first two weeks interviewing stakeholders and talking to people who engage with the organization (the ‘users’). Depending on the type of engagement, they’ll also observe processes, analyze data, and review code. This process makes sure that any technology that the team introduces or modifies will work for the people it’s intended to serve.

KJ: We use discovery sprints to quickly build an understanding of the status of a complex organization, system, or service. “Discovery” is a common phase in design and development processes, so it’s not unique to USDS. What is unique is how we’ve adapted some of the methods in these processes for the context of government. The federal government has nearly unlimited budgets, complex procurement and vendor arrangements, and a stark division of labor that separates program officers from budget officers from legal and technical teams. That means it is hard to see the whole picture of what is working or not working. Discovery in a public interest sense is about developing a holistic awareness and focusing all these silos on a common approach to a solution.

Why did you decide to write this guide?

JN: USDS conducts discovery sprints to quickly build a deep understanding of an organization and to help our stakeholders uncover and identify opportunities for improvement. I had been on a handful of sprints at USDS and I remember, for my first one, spending a lot of time preparing for the sprint, trying to figure out what needed to be done, and what was expected of me. After a few of them, I started compiling the resources I used and realized they could be helpful for others. This initially started as something that would be shared internally at USDS but after partnering with Kat on this work, we figured that how we run discovery sprints could be a useful tool for everyone, whether that be within government or in other places.

KJ: During my time as Design Director I was responsible for staffing our designers onto discovery sprint teams. I also would frequently run internal team retrospectives when sprints were complete. I saw a lot of the same types of questions and challenges come up repeatedly across different types of sprint efforts. We had been kicking around the idea of updating our internal sprint documentation for a while and it just became clear that we needed to write this guide. Once Jenn and I started to work together and look at the documentation and references to discovery exercises, we realized that there was likely a broader audience for documentation like this. We were both very impressed with the guides that 18F has been publishing, and we took inspiration from them as a place to start from.

JN: And also, let’s be honest — we kept getting pinged and asked about the resources we were using, so one day, we finally threw up our hands and began. I always want to document more but it’s so hard to do when you are heads down on project work. It was nice to take a step back, prioritize, and make the time to document.

Who is this guide for?

KJ: USDS works at the federal level, but we’re hoping that other teams can adapt and use the guide. After the Digital Services Playbook was written we found that it had a much broader reach than I think USDS had originally assumed. Recently the concept of civic tech and public sector focused technology work has gotten more attention, even though the work has always been there. The Playbook has become a way for other groups to either use themselves or to come across USDS and then reach out to talk about working together. We also find that sometimes when we propose the concept of a discovery sprint to a new agency partner that it can be challenging to explain the concept, so this guide is a way for us to share our methods and best practices more broadly.

JN: Our list of who this guide is for is long! New digital service teams at the state and local levels, stakeholders at organizations USDS is engaging with to run discovery sprints, students who are thinking about public interest technology as a career path, technologists that are considering a tour of duty with USDS, current USDSers who are new to discovery sprints… Kat and I struggled with how to write this guide at the beginning but settled on the largest audience and so it reads more like a “How to” guide than anything.

Speaking of struggles, what were some of the challenges in writing this and what did you learn from them?

KJ: Like Jenn mentioned, identifying the audience that we were writing for was one of the biggest challenges of this document, and we actually started over a couple of times along the way because of it. The concept of a guide has been on the radar at USDS for a long time and different types of documentation have been done before. The part that Jenn and I added was an approach to try and write for the broadest possible audience that would be interested in learning about our discovery methods.

JN: I would say my three struggles were the audience, the writing, and not having enough time. Both Kat and I have a background in human-centered design so we kept going back and forth on how we should structure the guide and who it should be for. This perspective became both a blessing and a curse. We wanted to make sure this was useful for everyone but, in the end, we knew it would be more beneficial to start somewhere first.

Writing was also… hard. Haha. We knew that we wanted this to be a living document but I think both of us are also perfectionists. To help with that, we made sure to work iteratively and constantly get feedback as we were going. Our push to get it published also helped. Once we got our content up on GitHub and started working in our staging environment, things happened quickly. Seeing the guide online was a good reminder for us of the fact that we were creating this for others to use and build upon.

Lastly, making time to prioritize this work was difficult. To be honest, it was a side project for many months before either Kat and I could dedicate more of our time on it. Now that I’m at the Beeck Center working on professionalizing the public interest technology field, I realize how important it is to spend time documenting as we go or even afterward. This helps build momentum for these types of methods that work and to share best practices with other teams in this space.

How should people use this guide?

JN: This guide is meant to be a “How to” on discovery sprints, based on lessons learned at USDS from conducting them over the past few years. Kat and I hope that people adapt the guide based on their organizational needs and use it as they see fit. To that end, we’ve open sourced this so others can add their lessons learned and their own tips to it over time. We want people to contribute to it so that this becomes a growing resource for everyone to leverage. We’ve also got a section specifically for case studies so others can share their discovery sprint stories and experiences doing them. As this grows, I’m interested in seeing what changes people make to our process and how they adapt our methods to their own situation.

KJ: Like the Digital Services Playbook, and like the fantastic guides that 18F has been producing (De-risking Gov Tech Guide, UX Design Guide, Content Guide). We know that people inside governments are interested in this kind of work and looking for references to help them not have to start from scratch. Jenn and I know from experience that every discovery sprint can be different, so we have tried to bake in some of the “Why” behind our recommendations to help teams find their own paths.

Do you have any last thoughts or comments?

JN: We couldn’t have done this without the help of others! Thank you to Eddie Hartwig, Mark Lerner, and Kathy Pham for being helpful editors, to Drew Gardner and Lisa Chung for their development expertise, and to Melissa Braxton and Julie Strothman at 18F for their advice and words of wisdom.

KJ: Yes! Thank you to the USDSers who wrote earlier iterations of our sprint documentation. Also Chris Given, Hank Knaack, Shannon (Sartin) West, Shelly Smith, Jeff Barrett and Cyrus Sethna for being reviewers and, most importantly, making sure Jenn and I were making sense in what we were writing. And thank you in advance to our future readers and contributors of this work. If you use the guide, we’d love to hear your feedback!

The best of technology.
The best of government.
And we want you.
We’re looking for the most tenacious designers, software engineers, product managers, and more, who are committed to untangling, rewiring and redesigning critical government services. You’ll join a team of the most talented technologists from across the private sector and government.
If you have questions regarding employment with the U.S. Digital Service, please contact us at usds@omb.eop.gov and visit usds.gov/apply.

Join the U.S. Digital Service | Visit our Site | Follow us on Twitter |Follow us on Instagram | Like us on Facebook | GitHub | Upcoming Events

An Introduction to Discovery Sprints was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.

By: Shelby Switzer (they/them), Software Engineer

Medicare: you may have heard of it. This is the federal health insurance program for individuals 65 and older, as well as younger people with certain chronic conditions. As of January 2021, the program covered more than 61 million Americans (19% of the total US population), making it the largest single insurer in the country. Every day Medicare pays out an average of $1 billion for inpatient and outpatient services. In other words, Medicare moves about 2 to 3% of the United States’ GDP every year.

Because of Medicare’s size, it is positioned to drive significant change in the healthcare industry. If you’re someone who wants to tackle the hardest problems or the most impactful ones, the Centers for Medicare and Medicaid Services (CMS) is the place to be. One of the projects our CMS team is tacking is a multi-year project to modernize the Medicare claims processing system. The age, complexity, and criticality of both the technology of this system and the healthcare system itself present unique challenges that require creativity and tenacity.

For many of the USDS engineers who work at CMS to modernize this system, it has also required climbing a steep learning curve: we’ve had to learn to work with, and on, the mainframe.

What is the mainframe?

As one of our colleagues at CMS likes to say, you can think of the mainframe as an operating system where all the code and data come from another planet, and that planet is the 1960s. As headlines during the pandemic have revealed, mainframe servers still power many levels of government, large corporations, and universities. Some of these organizations not only maintain mainframes but also still deploy new mainframes and build new apps on top of them.

Mainframes have two processing modes: batch and online. You can think of batch processing as highly efficient bulk data processing, where the workload scales with time and the size of the workload is measured in records processed. The online mode is the mode for user interaction: this mode powers applications and interactive, real-time transaction processing. With this mode, the workload scales with memory/CPU, and the size of the workload is measured in users.

Mainframes are mostly made by IBM, although others exist, and the programming languages they commonly support are COBOL and ASM, although you can run Java, C, and C++ on mainframes with compilers that must be installed and licensed. COBOL itself is an interesting and relatively simple language. As one of the first high-level languages, data is stored in “copybooks” and is written in sentences and paragraphs.

Like with many software systems, the programming language isn’t the hard part — although most of the engineers at USDS have never seen COBOL before, let alone programmed in it. It’s the systems themselves, which have been built and maintained and added on to for decades that are the hard part.

What is so hard about the mainframe?

1. It’s hard to learn.

Most software engineers in 2021 are totally new to the mainframe and to COBOL. Some folks on our team have used COBOL before, but that was over 15 or 20 years ago. Unfortunately, the learning resources are limited.

“I’ve been learning mainframes at CMS by trying to reverse engineer the Java code that has been deployed to the mainframes,” says Alberto, a USDS engineer who got so hooked on solving Medicare tech problems that he recently transitioned to be a full-time employee at CMS.

Other engineers have tried finding resources online to learn COBOL, without much luck. USDS engineer Jonny Eskew said the Coursera series on mainframe development, but didn’t find it helpful. “It was basically an IBM sales rep going over products you can add to the mainframe to make it better,” he said.

Another engineer on the team, Gina Maini, discovered the GNU Cobol community that helps generate documentation, however according to Gina “the community is smaller and has struggled with their own monumental modernization challenges, which tend to be a lack of portability in their monoliths that they are converting to Java or the proprietary data formats.”

The lack of learning resources led a former USDS engineer, Marianne Bellotti, to write a series of blog posts about it, which can help you get started with running a mainframe emulator and creating your first Hello World app. Even then, this is just a starting point.

2. COBOL is old and quirky.

The quirks of COBOL have tripped up engineers not used to it. For example, as part of the process of modernizing a claims pricing application to use Java, we discovered that COBOL math is fixed point while Java’s is floating point. In COBOL, numbers are rounded off between every compute statement, and you have to emulate that rounding in Java at every step to make sure the calculations come out the same.

Another “gotcha” on top of this is that in COBOL the precision constraint works on both sides of the decimal point. If you’re allowed a precision point of 3 digits, but then have a claim that goes up to $1,000, COBOL chops off the most significant digit and the value is left at 000. This obviously has huge implications for the calculation of how much a claim should be paid and our understanding of how to transfer this program to a more modern system.

At a higher level, when working with COBOL you may not be able to use the modern programming techniques you’re used to using elsewhere. Other relatively old languages like Java have had a lot added to it over the years to keep it modern. COBOL, on the other hand, hasn’t grown that much as language, and can’t be used in architectural styles it wasn’t built for, such as object-oriented programming.

COBOL also doesn’t lend itself to encapsulated reuse. There is no notion of importing a library into a COBOL application. Unless what you’re trying to do is a core feature of the language, you have to roll your own code, and copy and paste it around to where you want to use it.

On top of this, the mainframe itself is all file-based. If you want to get data in or out of the mainframe, you can’t use an API access token — you have to move files. This means that everyone is replicating the ETL process to get usable data — and one of our lofty goals is to eventually transition out of this to an API-first approach to reduce this duplication.

3. The mainframe is hard to test.

As we work to modernize the Medicare payment system and make it more modular, cloud-based, and API-first, we have to make sure we don’t break anything. This is incredibly difficult because of the absence of reusable executable testing. For over 50 years mainframe development has lacked not only testing tools but a testing culture.

Automated code tests that can be run locally or in a continuous integration pipeline simply don’t exist yet for the mainframe, which means testing changes is an arduous process. Virtually all testing of changes happens manually and takes up to 9 months. This in turn means that development and deployment of even small changes is a long and complex process.

What’s next for the mainframe?

If modernization is successful, the Medicare claims payment system will no longer be a monolithic black-box system on the mainframe but a cloud-hosted system implemented with best-in-class modern software development practices. The mainframe itself may become a big container for hosting environments, or it may become simply a set of databases with APIs providing access. Most importantly, the claims payment system will be ready to grow and support new payment models and innovation in policy such as value-based care.

This is a huge undertaking: USDSers have been neck-deep in the CMS mainframe for the past three years, and we expect to be working with our CMS colleagues on this problem for years to come. We work with CMS teams and contractors to understand, document, migrate, and sometimes even dramatically rearchitect these archaic and vital systems. It’s hard, interesting, and incredibly rewarding. Come join us.

The best of technology.
The best of government.
And we want you.
We’re looking for the most tenacious designers, software engineers, product managers, and more, who are committed to untangling, rewiring and redesigning critical government services. You’ll join a team of the most talented technologists from across the private sector and government.
If you have questions regarding employment with the U.S. Digital Service, please contact us at usds@omb.eop.gov and visit usds.gov/apply.

Join the U.S. Digital Service | Visit our Site | Follow us on Twitter |Follow us on Instagram | Like us on Facebook | GitHub | Upcoming Events

So you want to tackle the mainframe? was originally published in U.S. Digital Service on Medium, where people are continuing the conversation by highlighting and responding to this story.