From Law to Launch: Steps to Build a New Paid Leave Program

Statewide paid family and medical leave (PFML) programs deliver essential benefits to individuals who need time away from work to bond with a new child, recover from their own serious health condition, or care for a sick family member. Since 2004, 13 states plus the District of Columbia have launched new paid family and medical leave programs—eight of which have launched since 2019 or will soon launch. Notably, only the first four states had pre-existing temporary disability insurance (TDI) programs that provided workers access to personal medical leave to build their paid family leave programs on top of. The most recent 10 jurisdictions to adopt paid family and medical leave laws did not have this foundation and had to build their programs from the ground up.

Administrators and agency staff in these 10 programs have learned and iterated on important lessons for how to quickly build an entirely new government service. Through our partnerships with existing and forthcoming programs, the New Practice Lab has developed unique insights into the steps to build and administer these programs. We are a team of policy experts, user experience researchers, service designers, technologists, and product designers who partner with states like Minnesota and Maryland to help them improve delivery of paid leave benefits. We have learned the advantages of taking time to deliver paid leave benefits, right from the start — and the potential pitfalls of rushing through program setup without adequate time or resources.

Often, advocates and lawmakers focus only on the time between the start of premium collection and the payment of benefits. But the time required to stand up a program must take into account much more than just the solvency of the trust fund for benefits payments. It must account for all of the steps required to hire and train program staff; engage in state-required rulemaking processes; procure and build technology systems; develop processes for premium collection and benefit payments; conduct outreach to employers, workers, health-care stakeholders, and community partners; and test the program’s processes and systems before launch.

This blog explains why building an entirely new state paid leave program can take several years after the law is passed until individuals can enroll: It requires significant time, resources, and political support for an administrator and agency staff to work through the steps to build a successful and efficient paid leave program. It takes a minimum of two and a half years to effectively build a new program, and some states may benefit from slightly longer implementation periods.

Why Statutory Timelines Should Account for Multi-Staged Work Before Launch

Legislators and political leaders set timelines into paid leave laws, providing specific dates after the law is passed when payroll contributions must start being collected and benefits delivered. These timelines are often motivated by a well-meaning desire to provide real benefits to individuals as quickly as possible. They are also influenced by policymakers’ interest in showing that the policies they’ve passed lead to tangible benefits and impact — which ideally translates into support from voters (especially before these officials’ next election).

Rushing through any parts of the implementation phase before program launch can have consequences for benefits delivery, employer and beneficiary satisfaction, and public and political support. State paid leave programs that have launched after a rushed timeline have lacked functionality and used technology shortcuts that produced hard-to-fix program challenges. Through talking to and collaborating with various state paid leave program teams, we’ve learned that teams who have built a program the right way from the start have a much easier time than those who have to modify an existing but flawed program.

Legislators and policymakers can achieve the shared goal of getting a political win and providing paid leave benefits quickly to people who need them by ensuring the administering government agency has the time and resources they need to set up the new program successfully from the start.

Why Building a New Paid Leave Program Takes Time

There are many complex steps involved in building a new government service program. Based on the experience of previous states without pre-existing TDI programs, we estimate that it takes a minimum of two and a half years to start delivering benefits after a paid leave law is signed. (See, for example, milestones in the implementation timeline of Washington state’s program.) Some critical steps contributing to that timeline include the following.

Hiring New Program Staff

Providing efficient, equitable paid family leave requires hiring staff who are knowledgeable and experienced in a range of fields, including communications, service design, and software systems. Given the complexities of government hiring, it can take a surprisingly long time to scope the program’s roles and then recruit, interview, and finalize hiring new staff. This is especially true for leadership positions and highly technical staff, due to job classification and pay scale constraints in government salaries that make it difficult to compete for top talent against private industries. Planning for hiring also requires sequencing new staff hires, typically onboarding senior leaders before entry-level staff and determining which tasks need dedicated staff before others (for example, software engineers need to build new technology systems early on; claims examiners aren’t needed until launch). Hiring can be sped up if the agency is able to transfer staff from another team or borrow staff time with specific skill sets, such as legal counsel.

Depending on the resources available to spend on hiring (as discussed later), some new paid leave states have taken longer than others to find qualified applicants willing to work at those states’ approved pay scales. In Washington state, for example, after the law was enacted on July 5, 2017, the state agency quickly hired a program director, policy manager, technology manager, research manager, and contract specialist by early fall 2017, then ramped up to 50 dedicated program staff by April 2018 and 93.5 full-time equivalent employees by fiscal year 2019 (July 2018 to June 2019).

Rulemaking

After a paid family and medical leave bill is signed into law, the state agency administering the program must follow the state’s rulemaking process to issue regulations that further refine, define, and operationalize the law. For example, while all current paid leave statutes specify that applicants must certify their reason for and duration of leave, rulemaking may be needed to further explain what information is required from claimants and/or their medical providers to consider a claim certifiable. The rulemaking process varies by state, but typically includes consulting with the public, including families, advocacy organizations, employers, and other stakeholders; issuing a draft proposed rule; seeking public comment on the proposed rule during a set period; revising the rule; and issuing a final rule. Rulemaking can take a substantial amount of time, depending on the state’s procedure. For example, Oregon took roughly 90 days from issuing each batch of proposed rules to adopting the final rules (in total, seven batches in the 1 year and 9 months before launch, but more rulemaking after launch), and additional time was required before this period to draft the proposed rules. Minnesota’s rulemaking process took one year and five months.

Designing Applicant, Employer, and Administrative Processes

A new paid leave program needs time to set up workflows for a number of new processes that will determine how applicants, employers, and staff experience the program. Each of the following processes may first require rulemaking, developing or procuring technology systems, and consulting with internal and external stakeholders:

• Collecting and tracking information about employers and employees
• Establishing a trust fund, determining premiums, and setting up a system to collect payroll taxes from employers
• Creating an application process and oversight system for employers using private plans (if allowed under the law)
• Creating an application process for individuals applying for paid leave benefits, including identify verification and medical or bonding certification forms
• Designing a workflow for examiners to review and process paid leave claims
• Creating a data schema, analytics plan, and reporting infrastructure

Designing or Procuring Technology and Data Systems

Starting a new government service program requires many new technology systems, either developed from scratch or procured, which both take time and dollars. For example, Washington state estimated in early 2019 (before its program launched) that the total cost of implementing technology for its paid leave program was nearly $50 million. Most existing paid leave programs have relied on a mix of three sources for their new technology systems—developing by in-house technical labor, procuring and customizing off-the-shelf software, and contracting custom software development.

If a program chooses to develop new systems, it must hire a large team of skilled software engineers who can build it. Using commercial off-the-shelf technology requires the program to find software that meets their needs (which may not exist), go through government procurement processes to acquire it, and then configure it to suit their workflows. If a program’s needs aren’t met by customizing existing off-the-shelf software and the program is not in a position to build technology internally (or does not wish to do so), it will be necessary to procure services for custom software development—a common endeavor for governments, but one that is lengthy and complicated. In Washington state, it took the agency five months from issuing technology requests for proposals (RFP) to signing contracts. Government procurement requires multiple steps—solicitation, evaluation, award, and finalizing a contract agreement—because it is highly regulated to ensure fair competition, accountability, and responsible spending.

After procurement, the paid leave agency needs to plan and gather information to adapt the new systems to its specific needs. The program team should design their core processes and claimant workflows before procuring or developing new technology so they can adapt the technology to fit the needs of the program, and not the other way around. This includes deciding what the application process will require, what the online claimant portal needs to include, what kind of workflow claim examiners will follow, and how the program will collect, store, and secure data. Program needs will likely evolve during the path toward launch, and the program’s technology development processes need to be able to respond to those evolving program needs.

Creating and Conducting a Communications and Outreach Plan

An essential component of launching a successful paid leave program is taking time to develop and conduct a detailed communications and outreach plan to ensure that people know about the program, have accurate and clear information relevant to their individual situation, and understand how to apply for and receive benefits. This process begins by hiring or detailing knowledgeable communications and marketing staff who can develop clear, consistent informational materials, including materials available in multiple languages and at accessible reading levels. The communications team must then begin a dedicated outreach campaign to reach employers, workers, health care stakeholders, and other community partners who may engage with potential eligible beneficiaries. (See, for example, Washington state’s media strategy before launch.) These activities can take time to reach the public and should be built into implementation timelines, especially in the lead-up to and right after the launch.

Testing and Piloting the Program

A critical and often undervalued step in building a new paid leave program is testing, iterating, and piloting aspects of the program with test claimants; medical providers; adjacent agencies, departments, or programs; and other stakeholders before launching to the public. While these steps take additional time, they can more thoroughly de-risk implementation by earlier and quicker detection of flaws, process gaps, and other issues that could otherwise have a massive impact on customer uptake, experience, and program success. This can help to lessen the chance of “front-page failures” and surprises later. Communications materials and new technology systems are good candidates for testing and piloting.

Why Fully Resourcing a New Paid Leave Program Ensures Success

In addition to time, agency staff also need adequate funding to efficiently and successfully build their new program. As previously mentioned, hiring knowledgeable staff is a critical step in establishing a new government program. A key part of hiring is ensuring the agency has the financial resources to hire the appropriate number of staff to meet the demands of the program (such as enough examiners to process the anticipated volume of claims) and to pay competitive salaries, especially for highly technical staff who could earn more in the private sector.

Additionally, the agency needs dedicated funding to develop or procure technology that will ensure the program operates smoothly. Inadequate budgets for technology procurement or development can contribute to poor outcomes for the procured systems, such as off-the-shelf software that doesn’t fit the core needs of the program or custom software that is haphazardly built and challenging to maintain or modify as the program evolves.

Why Political Support Is Necessary to Efficiently Build a New Paid Leave Program

After a paid family and medical leave bill is signed into law, state political leaders still have an essential role to play in building the program. It is important that state leaders protect the quality of the program and benefits promised by the law. This includes protecting against privatizing administration of the program, which can undermine the quality of customer service and benefits provided to the public while also costing more under profit-seeking operations. State leaders should protect the trust fund against use for other purposes. And state leaders should use data, evidence, and experience from their state or other states’ programs to protect the program against any outside groups lobbying to undermine the program.

Perhaps most importantly for implementation, state leaders should lend their authority to align incentives between agency staff to help them overcome barriers that may slow progress. While it is not always possible to overcome existing rules that govern interactions between different agencies, state leaders can encourage intra-state collaboration, such as government data-sharing agreements that can confirm information about an employer or a claimant and reduce the amount of paperwork needed from both employees and employers. Additionally, clear operational authority within the executive branch can enable staff to be more responsive, flexible, and creative in overcoming challenges when ownership is unclear. This can include acting decisively if a vendor is slow to respond to the program’s needs rather than managing contract interactions entirely through another agency’s staff. State leaders committed to the goal of an efficient and successful paid leave program can send a strong message to program staff and others across the government that they have support to work together and find creative solutions.

Additionally, advocates and community groups can play an important role in supporting and working with a state agency during the implementation phase. These external nongovernmental organizations can sustain and grow political and public support for the program by celebrating the new law and amplifying the value of paid family and medical leave for improving health outcomes and financial stability. They can also support early testing and learning by the agency as it begins “soft” launch. They can provide input in, and engage the public with, the rulemaking process. And they can help spread the word about the forthcoming new benefits by conducting outreach to businesses, workers, and health care providers using the program’s communication materials.

Looking Forward

As new paid family and medical leave laws get passed, the lessons provided by existing state paid leave programs can help ensure we build new programs with enough time, resources, and political support to be efficient and successful. The New Practice Lab will continue to apply these lessons in our work—helping agency staff administer their programs successfully and ultimately helping deliver paid leave that meets the needs of workers, families, and businesses.

Please contact us at NPLwork@newamerica.org if you are interested in partnering with our (no-cost) implementation teams on improving delivery of your paid leave program.

Thank you to Julie Hersh, Vicki Shabo, and Molly Weston Williamson for their review and contributions to this blog.