Our story

Scroll through more than 25 years of change that matters.

Smart Policy Works was founded in 1992 – during the era of welfare reform – with the sole purpose of improving access to public benefits programs and preserving the integrity of the Social Security Disability Income programs. Our work has grown exponentially since then, but we work today toward the same purpose: to break down economic, social, and structural barriers to health and well-being.


Supportive Housing Strategy

project-idd-housing-99010-unsplash-640-2xA mixed use housing and medical destination for people with intellectual disabilities and seniors

Because housing and services for adults with intellectual and developmental disabilities are underfunded and scarce, family members may end up never relinquishing their caregiver roles, even as they age into needing services themselves. Aging parents may remain in housing that no longer fits their needs or provides the safety they require. Because this is also often the case for seniors generally who remain the community, a suburban-Chicago building developer saw a potential market demand for housing that would accommodate all three populations. Smart Policy Works served as a disability policy and services consultant on this project. Continue reading “Supportive Housing Strategy”


Advocacy to Preserve the ACA and Medicaid

Detail from our fact sheet infographic on Medicaid cuts.The change of administration in Washington brought with it renewed threats to the protections embodied in the Affordable Care Act and the fundamental principles of the 50-year state federal compact represented by Medicaid. The attacks included proposals to cut federal Medicaid funding, convert the program to block grants, introduction of the “American Healthcare Act” as well as a forthright campaign to “repeal and replace” the ACA, and numerous less-flashy regulatory adjustments designed to undermine both programs. In response to these attacks on health security and the heightened confusion they created, we launched a campaign of education and re-information. Continue reading “Advocacy to Preserve the ACA and Medicaid”


Advisor to NCSL and CSG

Logos - white on blue - of the NCSL and CSG.According to data available in 2016, the percentage of Americans living with a disability – already estimated at 1 in 5 – was expected to double in the next two decades. Recognizing that despite ability and willingness to work, many of them experienced significant barriers to employment, the National Conference of State Legislatures and Council of State Governments joined in creating the National Task Force on Workforce Development for People with Disabilities. As consultants to the task force, we drew on our years of experience with programs such as Ticket to Work. Continue reading “Advisor to NCSL and CSG”


Patient Empowerment

Barbara Otto addresses the patient empowerment cohort, grouped around a universal-design U-shaped table arrangement.Here in America, we spend a great deal on medical research that often does not reflect the interests of people who have the condition being studied. The Patient-Centered Outcomes Research Institute was established by the Affordable Care Act to engage people with lived experience in studies on the condition they are living with. In 2016, PCORI funded our project to prepare patients with trauma-induced spinal cord injuries to become “research ready” and to play active roles in research to improve their health and quality of life.

Continue reading “Patient Empowerment”


Healthy Chicago Hospital Collaborative

Logo of the Healthy Chicago Hospital Collaborative.A provision of the Affordable Care Act requires all tax-exempt hospitals to perform a community health needs assessments (CHNA) every three years, and to subsequently design and plan to address those needs. The goal was to use this community-centered approach to improve population health by focusing resources towards data and prevention. We saw an opportunity to pool resources and strategies even further by having nonprofit hospitals share their CHNAs and plans to find areas of synergy and avoid duplicated efforts.

Continue reading “Healthy Chicago Hospital Collaborative”


Toolkit for VR Counselors

Logo in vintage shades of red and blue of the Institute on Rehabilitation Issues.For people with disabilities, having access to health care is often a key factor in making employment possible – but conversely, that often depends on an individual’s ability to maintain a connection to the healthcare system through work. The ACA opened another way for people to purchase adequate, affordable health care coverage. But for vocational rehab counselors oriented to helping a special population wend their way through existing bureaucracies, there were new twists and turns to learn. We helped develop a toolkit covering these changes from a VR perspective, so they could effectively help clients seize the new opportunity.

Continue reading “Toolkit for VR Counselors”


Small Business Health Collaborative

Young woman cafe owner behind the counter with her juicer.Small businesses have long been at a disadvantage in the health insurance market, paying about 18% more on average than large firms for the same policies. In Illinois, they’ve also had to struggle with unpredictable and unreasonable premium increases. But in 2011, some 194,000 small businesses in Illinois were expected to become eligible for substantial tax credits through the Affordable Care Act, making it easier for them to provide employer-sponsored coverage; and starting in 2014, they could buy coverage through the ACA’s Small Business Health Options Program, or SHOP. Most small business owners, however, were unaware of how the ACA’s provisions applied to them, so we launched an educational campaign aimed at them.

Continue reading “Small Business Health Collaborative”


ACA Enrollment Training

ACA assister training at the UIC School of Public Health, October 1, 2013.Uncertainty about whether the Supreme Court would uphold the Affordable Care Act, and whether Illinois would establish a health insurance exchange, led to delays in preparing for marketplace operations. One important need involved training of people to assist consumers in the process of obtaining coverage under the new plans. We created a curriculum of training and outreach readiness for navigators and assisters in Illinois, so that when the Obamacare marketplace opened in 2013, resources were there to help people get covered. Continue reading “ACA Enrollment Training”


Visualizing Health Care Reform

This interactive data map showed who would be eligible for health coverage in 2014 under the Affordable Care Act.

The Affordable Care Act was the most sweeping reform of the U.S. healthcare system since Medicare, potentially opening a path to care for millions of Americans. How many of them were in Illinois? Who would be eligible for affordable, guaranteed health coverage in 2014, where did these people live, and how would they access coverage? Policymakers, providers, and citizens wanted to know. We created this data-mapping project at Illinois Health Matters to illustrate the potential impact of the ACA on uninsured Illinoisans.

Continue reading “Visualizing Health Care Reform”


Illinois Warrior to Warrior

W2W homepage: 300,000 returning veterans have TBI. Coming home should be the easiest part of military service.Coming home should be the easiest part of military service. But for many, the transition is a challenge. Thirty percent of service members develop mental health challenges within 3-4 months of being home; a third of veterans with PTSD do not seek treatment; 9% of the homeless population are veterans. Many returning service members and their families do not know what resources exist for them. The Illinois Warrior to Warrior program was created to bridge the gaps for returning veterans.

Continue reading “Illinois Warrior to Warrior”


Military Sexual Trauma Awareness

Closeup of a person in Army uniform with arms crossed on a table.More military service members are sexually assaulted than killed in combat, and these assaults cause PTSD at higher rates than actual combat. “Military sexual trauma,” or MST, is the term used by the Veterans Administration to refer to sexual assault or repeated, threatening sexual harassment that a service member experiences during his or her military service. After the topic gained awareness following release of the 2012 documentary “The Invisible War,” we started a training and outreach effort to bring the issue of MST to the forefront and to improve the supports available to survivors.

Continue reading “Military Sexual Trauma Awareness”


Neighborhood Stories

Henry Edwards, a boxer who has chronic asthma, was uninsured until the birth of his son qualified him for public aid.Now the Affordable Care Act was law, but what would the coming changes mean to real people? Partnering with the Local Reporting Initiative, Illinois Health Matters created content about how healthcare reform is impacting underserved communities on the South and West sides of Chicago. These stories brought together reporting, photography, and video to present accessible, personal stories of people who had long gone without health insurance, or wished they could afford it for their employees. Continue reading “Neighborhood Stories”


Illinois Health Matters

Illinois Health Matters was a project created to pave the way for ACA implementation in Illinois.

Once the Affordable Care Act became law in March 2010, the State of Illinois started implementing the changes required to provide affordable and quality care for all Illinois residents. Some changes came quickly, such as the “Patient’s Bill of Rights,” which put an end to some of the most extreme insurance abuses. But most were phased in over several years, during which there was an unmet need for information on all aspects of how the process would operate. Illinois Health Matters filled that need, serving to pave the way to the state’s Get Covered Illinois marketplace.

Continue reading “Illinois Health Matters”


Our Family Security

Carol's disabled brother Robert has been living with her and her family for 23 years since their parents passed away.

Challenges to Social Security had been intensifying, and reached the stage where Congress was considering proposed cutbacks projected to total 25% of program funding. It was clear that many regarded the program as a burden for American taxpayers. We created this website to show that Social Security is not a costly program for “other people” but rather a vital resource in maintaining the economic well-being of ordinary American families.

Continue reading “Our Family Security”