How an E. Coli Outbreak Changed My View of Civic Engagement

If anyone tells you that you can’t change government, call them liars.

If anyone suggests agencies and policies are impossible to change, call them deeply flawed cynics.

Maybe its best for all parties for you to say that in your head, instead of out loud.

Because truth is, even a single person can make an impact, changing governance, changing an agency, changing policy. —And all that change adds up to changed lives outside of government. When you start a petition (or engage lawmakers), yours will be one of them.

Civic engagement—fostering change to improve a community issue or community project — requires some skill. For years, I’d created transparency and advocacy tools to help citizens engage lawmakers. I even trained low income communities and kids how to engage in legislative processes. I viewed online petitions as a lazy form of civic engagement. All that changed when I started a petition. Here’s the story of how an E. coli outbreak and a Change.org petition changed my view of civic engagement.

Given my civic engagement philosophy, I surprised myself by starting a petition to create transparent, accessible (online and off) restaurant inspection scores in King County, Washington (aka the Seattle Area). Other municipalities posted scores at restaurants—and their studies seemed to indicate posted scores impacted total food poisioning rates. Toronto reduced their total infections by 30% (!!!). Others, like NYC and LA, saw 14 to 19% reductions in food poisioning hospitalizations.

I’ll spare you most of the details, but let’s just say that when you bleed internally for over a week, have debilitating stomach cramps, think you’re gonna die, and run up $29,000 in medical bills, you start to wonder how this could have been prevented.

For me, I wanted to reduce restaurant-related food poisonings, saving lives in the process. I was inspired by my two bouts with E.coli, the first in the Jack in the Box outbreak 20 years ago, and when I was caught E. coli in a month-long outbreak in 2013. I’ll spare you most of the details, but lets just say that when you bleed internally for over a week, have debilitating stomach cramps, think you’re gonna die, and run up $29,000 in medical bills, you start to wonder how this could have been prevented. So, being the open government advisor and transparency advocate I am, I started looking into the restaurant that caused the outbreak and what information about them was available publicly. They had received an “unsatisfactory” on 5 out of 6 inspections in the last couple years. Their scores were difficult to find in a database that hadn’t been improved since 2002. When I tested the score interpretation on citizens, they couldn’t interpret the scores accurately.

Despite their dismal inspection scores, they batted a 4.5 star score on Yelp.com—which is why I chose the restaurant over their peers. Consumers don’t swab a restaurant, don’t check cooking temperatures, and don’t make sure there’s proper hand washing. Consumers don’t know a restaurant is unsafe until it’s too late. I didn’t know until it was too late.

From the research I was reading, it seemed like posted restaurant inspection scores could be an important in indicator for consumer choices and encourage more consistent safety compliance within restaurants. These posted scores could also be improved with a modernized online database, a better search tool, posting these scores on Yelp (as other metros have done), and standardizing the scores so that they were easy for consumers to interpret.

I thought this was all pretty straight forward, something that perhaps King County, Washington’s Public Health office just didn’t have the budget, time, or tech skills to do. So, I started to engage them directly, asking if a staff member or two would like to meet up for coffee and discuss how their system worked and how it might be improved. The response I got was phone calls and letters from their risk management office. King County refused to talk to me.

At one point, I was told they thought I wanted a contract with them — no, I just didn’t want more people to get sick or die from preventable foodborne illness.

After months of me trying to engage Public Health leaders and staff, dozens of follow up calls, I became fed up with their defensive, cynical responses. They mailed responses to my lawyers (who were working on the class action case against the restaurant that sickened me). It was like they thought my bringing new ideas to them was some clever way to sue them. They wanted to avoid talking to me at all costs. At one point, I was told they thought I wanted a contract with them (I’d volunteered my time)—no, I just didn’t want more people to get sick or die from preventable foodborne illness. I had tried to engage them casually, I’d been friendly, I’d offered up my skills probono. I’d offered to network them to experts in the field. This is where I learned my first new lesson on civic engagement.

Lesson One

If a government feels a twinge of guilt, they will rally their troops to cut you off from engaging them. No amount of traditional, friendly, low-key engagement will work on them. They will have a knee-jerk reaction for self-preservation. Their fear turns your engagement into a battle.

The last half-decade has seen a rapid growth of petition tools for citizens and consumers. Change.org the most widely known, but there’s others from companies like Care2 and CREDO Mobile. Even the White House got into the game a few years ago. Observing petition trends, they appeared to be most effective in engaging unelected bodies (like government agencies, offices, or committees), companies, an elective executive (like a governor, mayor, or president), and entities which could otherwise be difficult to engage through methods like meetings or letter-writing (such as an association run by volunteers).

I was trying to influence an unelected body (a public health agency) and their governing body, a semi-elected body called Board of Health (BoH). BoH is made up of City of Seattle council members, King County Council members, and appointed doctors from King County. The unique structure of the governing body that oversees King County Public health also made it a good choice to target with a petition.

Lesson Two

Use a petition strategically: organizations that don’t have traditional engagement windows, aren’t elected to represent you (and you aren’t a member of the organization), have an unusual governance structure, or are a company are good targets for a petition.

When I started the Change.org petition, I reached out to friends and peers through Facebook and email, asking them to sign and share. Some of these friends included friends who were in media. Within a couple hours, I’d collected nearly 100 signatures and was scheduled to be on a news radio program. I shared the petition through social media and leveraged a Bitly link so I could track click-throughs. With Change.org promoting my petition, the rate of signatures soared. The petition turned my ideas into an action. Actions are easier for media to cover than ideas. The media interviews started pouring in.

Lesson Three

Your capacity to tell your story —and why it matters to others— is more important than your story.

My first TV interview about getting E. Coli in the (recent) outbreak, where I tried to get the reporter interested in the lack posted restaurant scores, went nowhere. I was furious with the coverage and how it’d been clipped to suit the journalist’s sensationalism. Truth is, I wasn’t very good at expressing how posted restaurant inspection scores could prevent outbreaks. I didn’t connect the facts of my case with larger national trends in safety and foodborn illness. My quotes played into what reporters could easily report, “Woman gets sick with ecoli twice! Crazypants! Hear her terrifying story of having diarrhea!”

I called up my friend, Dorie Clark, a media professional, public speaker, and author of the best-selling book, Reinventing You. “Dorie, how do I get out the more complex story about the opportunity to reduce foodborne illness? Reporters want to know my symptoms, hear about the restaurant, etc. It’s not about that.” Dorie coached me to whittle my statements down to 5 to 15 second sound bites, rehearse my answers to common questions, and how to pivot from “symptom” questions to posted score and foodborne illness statistics. My next TV interview went much smoother. Read the transcript for the KING 5 News segment here. When asked if I felt unlucky getting E. coli twice, I responded, “I don t feel like I’m somehow cursed to get E. coli. It’s just symptomatic of the kind of world we live in and the types of challenges we have around foodborne illness.”

As I did more and more media interviews, more petition signatures came in, but not as many as I’d expected. Sometimes, media didn’t link to the petition. And it’s one thing to support the petition you heard of, another to dig through Google for it.

The effects of multiple news stories on the petition was that it forced King County Public Health and Board of Health into a conversation they didn’t want to have. They had to engage the public about this issue and examine the topic—which made it clear I wasn’t looking for either thing they feared (a lawsuit or me trying to guilt them into a contract). It also put pressure on elected members of Board of Health to recognize the issue and start engaging with me—either directly or by telling their staff to talk with me. Finally, it established the legitimacy of the ideas I put forward by creating community consensus—1,500 signatures and counting, supportive-sounding media voices, online comments voicing support, etc.

Lesson Four

Media and petition signers can become a community of support and legitimacy, forcing conversations that otherwise won’t happen.

As petition signatures slowed, King County Board of Health’s chair, Council member Joe McDermott, responded with a vague, but somewhat supportive response. “I agree that our Food Program’s rating system should be more understandable and accessible to King County residents. You’ll be happy to know that work to update the Seattle-King County Public Health’s Food Program was already underway when the petition was started.” I wasn’t hopeful. I knew I’d need to keep the pressure on.

Signatures trickled in and media attention slowed over a month. It was uncertain if the consultant’s report would be made public or what would happen after he submitted it. This was the transition point for my civic engagement via a petition. A point which those who didn’t know government as well as I might have declared victory and become embittered about government if things didn’t work out later. But that’s not me.

I moved into “consistent advocate” mode. Every once-a-month Board of Health meeting? I was there, using my two minute comment time to give voice to the status of the petition and Public Health’s potential improvements. I scheduled meetings with legislative aids for Board of Health’s elected members. Each meeting was left with a thick stack of petition comments and signatures. I provided reports from other municipalities on impact. I told my story. I dressed professionally, never got angry or brash, never made it personal, and continued pressing towards the 2,000 signatures goal for the petition.

Damn straight, I wasn’t going away. I would work this bureaucratic process until King County got a more transparent, accessible restaurant scoring system.

Being a consistent advocate was probably the most crucial part of making change. As I walked into an otherwise empty meeting room to pick up something I’d left behind, I overheard a public servant talking to a lawmaker about me. “I don’t think she’s satisfied—and she’s not going away.” They looked warily at me. Damn straight, I wasn’t going away. I would work this bureaucratic process until King County got a more transparent, accessible restaurant scoring system.

With the consultant’s recommendations and what King County described as “support from leadership,” King County Public Health launched two committees to propose a new posting system for restaurant inspection scores, and a committee to propose new risk classification systems for restaurants (this influences the inspection process). They committed to improving their website, placing scores on Yelp, and even creating a mobile app. New leadership took over Public Health’s food safety program, and things looked hopeful. Then, I showed up at the committee meetings, which were almost entirely made up of restaurants. Restaurants who saw me as the enemy. Restaurants who belittled the idea of posted restaurant inspection scores. I was the only “public” member of the committee who wasn’t a member of government or an epidemiologist. Being a voice for the public was all on me in the committees.

Lesson Five

Until the project has been funded, the legislation passed, policy changed, and necessary actions taken, you need to “stay in the game.” Or, all that work goes to waste.

The meetings were held at times inconvenient for members of the public to attend. (9 AM on Monday mornings, lasting two hours, every two weeks.) I’d learn from Public Health staff that their priority wasn’t to engage the public, rather, to engage restaurants in the process. The only process planned for designing restaurant scoring signs and the risk classification system. Media had been asked to step out of these public committee meetings to help members “speak freely.” So I decided to live-tweet the meetings, to provide highlights of what we learned, new directions, and major concerns. Apparently, none of the restaurants were pleased with this and they anonymously threatened Public Health with pulling out of the whole process if I was allowed tweeting.

Public Health allowed both committees to vote on how to handle social media—never mind that these were public meetings—and both voted to prohibit members from using social media during meetings. One member, after I’d missed the vote by a few minutes, stopped the entire meeting to tell me I was not allowed to tweet. Ironically, that restaurant member is a food vendor for a major tech company who owns social media products. I felt my 1st Amendment rights had been violated and probably an open meetings law, too. I walked out of the meeting in protest.

This led to more meetings with Public Health and even one-on-one discussions with the food service leader who made it clear this rule was to prevent me from engaging the public during the meeting (it was pretty civil and productive). Through these discussions, it has become more clear to me that Public Health has created too little opportunity for public citizens to engage in the process. There’s a comment box on their website (just 30 comments after a couple months). And, thankfully, there will be a usability test of the system the restaurants suggest. But it’ll likely be scoring and posting system designed by the very industry its been tasked with creating transparency around.

You know by now I don’t give up easily. So, I contacted the ACLU to find out if my rights had been violated. I reached out to lawyers who could assess if a public meetings law was broken. Not to sue anybody—but to examine if this was legal in the first place (I’d hate for a precedent like this to hang out and muzzle other committees). I did follow-up meetings with Public Health staff to voice concerns and to encourage citizen engagement strategies. And, I’m searching for other ways to engage the public in the committee process—-with or without Public Health’s help. I’m looking at fundraising for a public engagement program on restaurant inspection scores, bringing in independent feedback on what the committee proposes (I wouldn’t run it—I’d had it off to grad students). I’m also reaching out academics on what research could be done to capture the process we’re in or what types of posted scores have impact on food poisioning rates. In short, I’m back to where I started—bringing citizen voices into a civic engagement process.

Lesson Six

The petition is the platform your civic engagement launches from; you need to plan to put in more work, long after the petition declares “victory.”

If King County were to implement meaningful, intuitive, publicly posted restaurant inspection scores, it could result (based on the data I’ve looked at and population statistics I’ve seen) in prevention of over 100,000 foodborne illnesses and over two deaths per year in King County. And that’s what keeps me focused and dedicated. It’s what has me clearing my calendar for committee meetings where no restaurant representative even wants to sit at the table with me. And, the process leaves me hopeful that what we create together in King County will spread throughout Washington State. I’ve been told other counties and state government are watching this process; the change we’re making here will likely spread. When it does, these lessons will serve me well on the next round.

http://www.youtube.com/watch?v=QOFjcKXmv2Y