Reaching all individuals and families with Paid Family and Medical Leave

Using user-centered design and data to make sure all families benefit from these critical policies
Blog Post
March 31, 2021

Picture this: you have just had your first child. You have just put the two-week-old infant to sleep (it was a struggle). You look up — you need to do laundry, feed yourself, and try to submit those forms from your state to cover the weeks home with your newborn, in the two-hour window before your baby wakes up (please let it be two hours). You are so tired you can’t remember your own middle name, but you are lucky enough to live in one of the six states with paid family and medical leave. You take out your smartphone and look up how to apply — there’s a pretty simple paper form, but you need a printer for that, and you don’t have one. So you click over to the web form — but you can’t open it on your phone, you need a laptop. And your laptop’s back in the office, where you hopefully won’t be until your leave is over — doh!

Of course, if you have paid family leave available to you, you’re one of the lucky ones in the United States. About half of American adults report taking leave to care for a loved one,

to spend time with a newborn or newly adopted child, or take care of an older relative, but far fewer are paid for that leave. Today, just 21 percent of Americans have access to paid parental leave, with low-wage workers far less likely to be covered.

But as that parent struggling to use her limited minutes to get benefits knows, policies don’t matter if they don’t reach those who need them when they need them most. Even in states with paid leave programs, there is work to do to make sure every new parent, every person in need, every family caregiver, is able to access the benefits they deserve. That’s the challenge that our team at the New Practice Lab decided to explore in collaboration with the Better Life Lab.

The New Practice Lab is focused on family economic security and well-being. Knowing that policies are only as good as their ability to reach those they serve, we work with governments to help understand how policies really impact families, in an effort to improve the delivery and future design of family economic security policies. We focus on policies that impact millions of families: paid leave, unemployment benefits, and access to cash and tax credits. We help states and government agencies improve their efforts to serve families today by identifying meaningful changes to improve program delivery. We select problems that have broad applications and work to extract lessons from one state to share with other states or communities tackling the same challenge. Finally, we aim to bring the stories of how policies are really working for families to the forefront of the conversation, making delivery — how policy actually reaches families — part of the policymaking process.

In this project, we partnered with the New Jersey Department of Labor (NJDOL), which administers that state’s paid family and medical leave benefits, to learn about the barriers stopping some New Jerseyans from taking leave, and develop recommendations to improve access. Over four weeks in late 2019, we had a multi-disciplinary discovery sprint team do a deep exploration of New Jersey’s program focused on the experience of birthing parents — talking to former and potential beneficiaries, reviewing business processes and interviewing program staff, and analyzing data. At the time of our project, state political leadership had recently changed parties, and the relatively new NJDOL executive team was revitalizing the program after years of staff cuts and neglect under the previous administration. Our team helped leaders in New Jersey really test how things were going for the families they serve as they pursued these improvements, and learned more from actual beneficiaries about how they think about paid leave benefits.

You can learn more about our findings in this report which has detailed recommendations for state administrators and others seeking to design or implement state and federal paid leave programs. Here are a few of the most important things we found:

1. Paid family leave programs serve people in family crises or important life moments — the programs don’t help if they are unable to reach all individuals and families in a timely fashion.

Families and individuals seeking paid leave need help urgently. The birth or adoption of a new child, a personal health crisis, time off to take care of a sick loved one — these are challenging, important, and time-sensitive issues. If benefit processing takes weeks or months, the relief of leave misses the mark. Many family members can only take time off and sacrifice income to care for themselves or their loved ones if they know they can make up for their lost wages. If they can’t get quick reassurance that they will get benefits, they simply won’t take the leave. As one potential beneficiary told us: “My husband wanted to [take leave to spend time with our newborn] but he couldn’t cause we didn’t know when we’d get the checks. They [DOL] said 2 weeks but when he talked to people [HR department, and friends], they said it came when it wanted. We can’t have that. It’s not worth the risk. That’s our house.” (Interviewee #14)

2. Make sure your applications, forms, and flyers are easy to find and understand. Use plain language and test your materials with the people you aim to reach.

How many people open up a web browser and search “need TCI” or “need PFL”? Temporary Caregiver Insurance (TCI) and Paid Family Leave (PFL) are the official names of the programs parents use to take time off with newborns in Rhode Island and California. How many people would think to Google that though? Not most people. People search “having a baby need leave” not “TCI.” They look for benefits in terms of the life events that they are facing. If a program office doesn’t communicate that way, they lose their beneficiaries before they even get started. All too often agencies make forms and applications easy to find — only if you know their technical name or the law behind them.

This dynamic played out clearly in our exploration of paid leave. Potential beneficiaries were frequently tripped up over the two separate laws and thus two separate programs that make up paid leave in New Jersey (Temporary Disability Insurance, or TDI, for your own health issue including pregnancy/birthing leave, and Family Leave Insurance, or FLI, for taking care of a loved one or bonding with a new child), a pair of programs that a mother who just gave birth can in fact use in succession. But we also found widespread confusion between these programs (which provide wage replacement for time off) and a pair of separate state and federal laws (the Family and Medical Leave Act, or FMLA, and the New Jersey Family Leave Act, or NJFLA), which provide legal protections against retaliation for workers who take leave. In fact, all fifteen of our beneficiary interviewees expressed at least one significant misunderstanding of the program. Said one: “I don’t think I really grasped it for a while… everything has similar initials.” (Interviewee #2)

Just as they need to make sure their outreach and publicity materials are comprehensible to regular people, programs need to do the same for their application forms. Not only are clearer applications easier on their users, but we found that the vast majority of the program staff’s time was taken up by requesting follow-ups and clarifications on applications that were incorrect the first time around. If the applications were simply written so that their users could understand them, hundreds of thousands of fewer people would make the mistakes that trigger delays and create the backlog. Simply put: for many programs clearer applications not more adjudicators to process applications is the solution to dramatically eliminate these delays and backlogs. One of our interviewees, for example, told us about how an innocent mistake on her application, stemming from unclear language, resulted in delays: “I didn’t add one employer because I didn’t work a lot of time with them. And then it stalled my application by 6 weeks. It wasn’t clear to add all employers.” (Interviewee #1)

Remember that paid family and medical leave programs are serving people in the middle of big life events — a sick or dying parent, the birth or adoption of a new child — who have little time and high stress. New parents are systematically sleep-deprived and high stress levels among caregivers are a known medical issue in their own right. Government efforts for these people should feel like help -— not a pop-quiz. One of the interviewees in our sprint described the complexity this way: “You need a maternity leave pay for dummies so people know what to do, when to do, and how to do it.” (Interviewee #11)

→ Read more about communicating about paid leave, and about user testing applications.

3. Real-time data monitoring — you cannot fix what you can’t see

When you fly a plane, you have real-time data on your speed, altitude, location, angle of attack. So often agency leaders are asked to drive a program, demonstrate progress, and fix problems without simple instrumentation data that would allow them to see who they are reaching, how long it takes to issue benefits, and where systems might need improvements. In the words of former White House Chief Technology Officer (CTO) Jen Pahlka, this data is how you course-correct and make sure you are en route to your destination. This focus on data to drive solutions and stories of organizations that are really getting it done is at the center of one of the authors’ upcoming book.

Benefits programs need clear, actionable, real-time data to understand how their customers are being served. Collecting data a year or months later doesn’t help managers steer their programs and ensure that all populations are getting through.

In New Jersey, the lack of clear real-time data came up in two contexts. In both cases the limited analysis we did to illustrate the usefulness of more robust reporting was insightful. When it came to outreach, the team did not have a clear estimate of what portion of eligible beneficiaries were actually using their programs. Using program data paired with Census data, we produced some estimates. It turned out that, when it came to parental leave, lots of mothers were using the program, but frequently not to its full extent; birthing parents are generally eligible both for medical leave for themselves and family leave to bond with the newborn, but, most of the time, beneficiaries were using one and not the other. Usage rates among fathers, on the other hand, were about 80% lower than for birthing parents. Meanwhile, our analysis of application processing clearly illustrated that the vast majority of delays stemmed from applications that originally arrived incomplete or incorrect, and that sending such applications to a dedicated reconsideration unit was more likely to hurt than help processing time.

Paid leave programs need estimates of the eligible population they aim to reach and need to understand in real-time the experience of people seeking information and applying for benefits. This need not be complicated. In the case of application processing, programs could consider tracking just a few simple metrics:

  • Portion of applications that are fully processed within two weeks (among applications submitted 2-6 weeks ago), broken out by application type
  • Portion of applications that are fully processed within 30 days (among applications submitted 30-60 days ago), broken out by application type
  • Current count of applications in each division’s work queue
  • Portion of applications rejected, and, if applicable, reasons for rejection

This is basic, good-enough data that allows benefits administrators to know which populations they are reaching, and who is stuck and where. Without a way to see who came to your site and call center — and data to see what parts of the application are tripping many people up, how long does it take from starting an application to receiving a check — there is no way to understand bottlenecks or make improvements.

Reliable tracking of application processing times is not just important for administrators, but for beneficiaries as well. Users of paid leave want accurate and realistic expectations of how long it will take for benefits to arrive, so they can plan accordingly, and have one less source of uncertainty during a stressful time. Providing a realistic and honest assessment is critical for economically vulnerable families who can’t afford to go a few more weeks than planned without a paycheck.

→ Read more about data for outreach and application processing.

4. Job protection is not a nice-to-have.

Most workers, especially economically vulnerable workers, cannot take weeks off from their job without the assurance they can go back to work when the leave is over. Thankfully, many (though not all) workers’ jobs are legally protected while they are on leave; their employers cannot fire or retaliate against them. Less encouragingly, those protections are largely in other laws, enforced by other agencies — the NJ Office of the Attorney General, Division on Civil Rights; or the U.S. Department of Labor.*

“Once I realized I was protected, it was instant Xanax. This is not going to throw my life off any more than it already is.” — Interviewee #2

What we heard over and over from potential beneficiaries is that, however, the laws may be structured, job protection was — to them — a central part of the program. They expected to see clear information about it when they applied for benefits, and they expected the state Department of Labor to be able to answer their questions about it. Simply deferring these questions to another agency will not cut it. Whatever the law may say, paid leave administrators need to understand that job protections are critical to their beneficiaries, and therefore to their programs.

→ Read more about job protections and paid leave

5. Employers are indispensable partners.

Nearly every beneficiary we spoke with told us that the first place they turned when they needed to take leave was their HR department. And why not? Taking leave from work is, after all, something most workers associate with their work. Said one, when we asked if she had known about the program before her pregnancy: “Nope, and honestly I didn’t expect to. I expected my employer to know.” (Interviewee #16)

But this means that employers are a critical source in distributing paid leave information. Employers who get the information right will help their employees apply smoothly and get their benefits. Employers who don’t know the right information — or, worse, have it wrong — become a significant barrier to their employees.

Program administrators can and should try all sorts of avenues in getting benefit information out to the public. But there is no getting around the critical role of employers. Administrators need to make sure their materials are clear and accessible to businesses if they want most workers to learn about the program.

→ Read more about employers as messengers

Thankfully, paid family and medical leave programs have been expanding in recent years, with new state programs coming online nearly every year, and pressure growing for a federal program. These programs provide critical relief to American families. But they will only have their full effect if they reach the people who need them, when they need them. These findings — as well as many others in our longer report — were developed to help design and implement paid family medical leave programs and make sure that these efforts really deliver the help our families need.