This is San Francisco’s main Food Stamps office. People call it twelve-thirty-five, as in 1235 Mission Street. The first time I went was on Thursday, February 7th, 2013. I walked past the concrete pillars, through the metal detector with two security guards, past a table of scattered paper forms, and into the main waiting room. It was loud. Voices echoed from speakers on the ceiling and off the linoleum floors. There was one big line leading to one big countertop, called Service Counter B.
A tall black man stepped to the front of the line. He hunched forward and leaned his hands on the countertop. A thick, clouded sheet of bullet proof glass separated him from the worker (short for social worker in the world of human services); they spoke through two skinny, conference-style microphones mounted on the glass. He was having trouble hearing. He leaned in and grabbed the mic to flex it upwards, but it wouldn’t go any further. He hunched a bit lower, putting his ear to the glass. Then, after a few more moments, he lowered his knees to the ground, pulled the mic down to his face, and rested his arms along the countertop. He finished the conversation on his knees.
So there I was: In San Francisco — one of the greatest and most prosperous cities in our country — watching a man on his knees, struggling to hear through bullet proof glass, trying to access nutrition assistance from our Federal government.
Something is drastically wrong
This was the beginning of my 2013 Code for America fellowship. Later in February, I visited the Mission Neighborhood Resource Center, one of San Francisco’s four shelter reservation sites. I learned that it can take over 12 hours to access a shelter bed for a single night, that some people prefer streets to shelters, and that clients routinely leave their shelters at 4am just line up for the next night’s bed. The more desperate you are, the earlier you should show up.
My teammate also enrolled in Food Stamps. She started getting letters. Lots of letters. They were intimidating:
They were wordy and confusing:
And they were nonsensical:
During her 7-month enrollment, she got about 20 letters and her case was nearly terminated 3 times. Scroll through this timeline to take a look for yourself.
We disdain users
This is how we interface with our government: We beg on our knees, we queue all night for shelter, and we get aggressive letters in the mail. Our services disdain those they are envisioned to help.
dis·dain verb: consider to be unworthy of one’s consideration.
This disdain shows in huge, controversial, life-changing ways. We take 260 days to get disability benefits to our veterans. We spend $3,000 to room a family for a month while the family begs for $900 in cash instead.
And the disdain shows in small, quiet, often unnoticed ways. Try to apply online for free school meals in SF and you’ll find this warning highlighted on the welcome screen:
Please only fill out one application online. If you make any errors you will need to fill out a paper application.
Or download the Calwin iPhone app, the companion application to the ~$750 million client welfare data system in California, and this is what you’ll see:
It’s disdain all the way down. The challenges with healthcare.gov sparked a long overdue conversation about what’s wrong with Government IT (and the surrounding critique), but Ezra Klein cuts straight to the core of our disconnect:
…one privilege the insured and well-off have is to excuse the terrible quality of services the government routinely delivers to the poor. Too often, the press ignores — or simply never knows — the pain and trouble of interfacing with government bureaucracies that the poor struggle with daily. That can allow the problems in those bureaucracies to fester. — Ezra Klein
The problem is not the website. It’s the man on his knees at twelve-thirty-five and the disdainful machine that doesn’t help him up.
Let’s build with empathy
So here we are, struggling against our own disdainful machine. And nobody wants it. The worker doesn’t want clients on their knees. The CalWin developer doesn’t want his work embarrassingly truncated on the home screen. Nobody wants homeless people waiting in line all night. It goes beyond politics.
I wish I could end this with a heroic call-to-action. “Are you with me? Do YOU want to fix our broken government?? Click here to donate now!!” But I can’t. My fellowship year clarified more problems than solutions. Instead, I’ll offer a question: How can we build empathetic government services?
Well, first things first: User needs. An empathetic service would ground itself in the concrete needs of concrete people. It’s not about innovation, big data, government-as-a-platform, transparency, crowd-funding, open data, or civic tech. It’s about people. Learning to prioritize people and their needs will be a long slog. It’s the kind of change that happens slowly, one person at a time. But we should start.
We have so much creativity, so many tools, and so many awesome examples to help us identify, document, describe, and address user needs. But we’re not doing it. I feel awkward and ashamed to know the relative sizes of all 400 Sci-Fi starships, but I barely have a clue how our homeless shelters or prisons work.
Amidst the anger and insults of healthcare.gov, Tim O’Reilly reminds us of the immense opportunity:
Rather than bemoaning the problems with healthcare.gov and seeking to find fault and political advantage, now is a great time to seize the moment and commit ourselves to create government services that give all citizens services that are simple, effective, and easy to use. — Tim O’Reilly
So let’s gently but persistently bring our awareness back to users and build an empathetic machine; one that finds the man on his knees and helps him up.
Our immersion month in February was the most meaningful professional experience of my life. That’s why I wrote about it; to share our unique access with the world. I hoped it would engage the broader community in a discussion about solving problems. Mostly, I think it succeeded. And I’m proud of that. But some of my observations elicited some questions and even some blame. So I want to take a step back and offer a bit more context about what it was like to work in local government, social services, and specifically the San Francisco Human Service Agency (HSA).
My biggest lesson this year was that local governments are constrained. They’re constrained by a complex web of local politics, State legislation, and Federal laws. The constraints cascade downhill, as does the responsibility. Even changing a letter or sending a text message can take a herculean effort and collaboration with State and Federal stakeholders. All this can be frustrating. But that’s why I joined Code for America in the first place; to learn what it takes to solve real problems in the real world.
HSA was the perfect place to understand the constraints and learn what it takes to work through them. Here are some accomplishments I witnessed during my time there:
- HSA completely redesigned their Medi-Cal lobby to improve the in-person client experience, and began an equally ambitious redesign of the Food Stamp office at twelve-thirty-five (and yes, they’re removing the plexiglass and the microphones).
- HSA is implementing the Affordable Care Act and the hundreds of new regulations. So far they’ve expanded Medi-Cal to thousands of new San Franciscans, opened their call center on nights and weekends, and cross-trained hundreds of staff in new program requirements, moving closer to a system with “no wrong door.”
- HSA cut the reporting requirements for Food Stamps in half, from quarterly to semi-annual reports.
- HSA eliminated the face-to-face interview requirement for Food Stamp recertifications, allowing clients to get it done over the phone.
- HSA proposed, funded, built, and launched EatFresh.org, the first nutrition website made specifically to help Food Stamp clients.
- And thanks to Trent Rhorer’s endless willingness to take risks on behalf of clients, HSA was the first human service agency in the country to build and implement a text messaging system for clients.
They did all of this in 2013. This is truly what it takes to put users first. So, thank you to HSA and the more than 2,000 staff who show up everyday to help San Franciscans live better, fuller lives.
Thanks to Alan and Cris for mezcal-fueled critiques. Thanks to Marc and Zavain for reading drafts. And thanks to our partners at SF HSA for building important stuff with us in 2013 and continuing to do such important work.
Don’t hesitate to reach out @lippytak with criticisms/stories/reactions.