COMMENTARY: CHHS Has Ambitious Agenda

COMMENTARY 

Government, out of necessity, divides itself into departments and programs. Our clients’ lives are not similarly segmented, and we must adapt to meet their needs. This simple concept is the guide for the cultural change we are driving at the California Health and Human Services Agency (CHHS) and our departments.

Three years ago, the CHHS began its open-data movement and innovation initiatives. In August 2014, the first of our departments established an open-data portal, and since then, we have built on our momentum and lessons learned to launch several new initiatives, including procurement reform and rethinking internal data usage. All of these efforts are components of changing the culture at CHHS — for staff, our partners and the public we serve.  

In our efforts to embrace and build a culture of innovation, we are fostering an environment that encourages experimentation, testing and iterating. Through our collective work, we are redefining success and encouraging intelligent risks that can positively impact those who depend on us. This strategy has involved many different initiatives. Each of these changes is important individually, but they have meaningful impact as a collective effort.

First in open data

In August 2014, CHHS became the first state agency to have an open-data portal. While we were clear that all 12 departments would participate, we started with departments that were enthusiastic and ready to post data, which built strong peer-to-peer interactions and relationships. Today, all 12 departments have a presence on our open-data portal, which has more than 230 data sets and nearly 10,000 visitors each month. We remain committed to improving the user experience with our portal and connecting with the communities that use and benefit from the data we supply.

Data-rich information

Like many governmental agencies, CHHS is data-rich and information-poor, but we are taking steps to change this. We established a data use agreement among our 12 departments that provides the framework for sharing data, and more importantly, the expectation that departments should be sharing data with each other — for appropriate purposes and with appropriate protections. As part of this effort, we have produced a data playbook to provide a set of repeatable, easily reproducible frameworks and guidelines that serve as resources to our departments.

Supporting culture of innovation

Our work across the last few years to establish an environment that supports innovation will help us design services with a user focus and more rapidly develop solutions to meaningful departmental priorities. Our collective goal is to sustain a culture of innovation to demonstrate how a government agency can, and should, be more responsive to the needs of Californians and create a rewarding work environment for state staff.

To support this innovative culture, two-thirds of our departments have invested in incubator teams to improve service delivery, address customer needs in transformative ways, create user-centered digital services, and replicate models and approaches to produce agencywide impact.

In addition, we are launching a CHHS Innovation Office, with active recruitment for a visionary director. The office will build on our successes and collaborate directly with departments to support a culture across CHHS that will improve program outcomes and better meet client needs. The team will directly partner with department and agency leadership on innovation investments and priorities. 

An eye for procurement

California’s IT procurement process, like most governmental IT procurement processes, is outdated, frustrating and confusing — both for state staff and vendors. Based on our experiences with large IT procurements, we can generally expect three things: It will cost more than estimated, it will take longer than projected, and we will not be satisfied with the final product. Vendors are incentivized to build to static requirements that take years to design, develop and implement. With constant changes in health and human services programs and the IT world, compounded by delays in procurement and development, by the time a product or technology is delivered, it is already out of date.

Even worse, all of this occurs in an environment that culturally and structurally works to limit risk. If failure occurs, additional checks and constraints are enacted, often on top of existing controls. While it is vitally important that we are careful stewards of the public’s money, there also must be an acceptable level of risk. In order to innovate and meet the needs and expectations of stakeholders, we must revise our risk tolerance.

Failure of a system costing hundreds of millions of dollars is, of course, unacceptable. With the reprocurement of the Child Welfare System, California is proving that an agile, user-centered approach to information technology procurement can work in state government. Breaking the large procurement into modules opens the field to vendors who have not traditionally bid on state projects. Moving to an agile approach — iterative and modular — requires more active involvement from state staff and end users, but also sets a higher bar by which vendors need to compete.  

Building meaningful partnerships

Building meaningful partnerships is one of the primary reasons we have been able to move quickly. We have benefited from those who went before us, such as New York and Illinois in open data. Civic technologists, such as Code for America and Code for Sacramento, have provided insights, inspiration and expertise. At the federal level, 18F and the U.S. Digital Service have lent their expertise and shown us a different way for governmental entities to operate. Research institutions are providing professors with skill sets and resources necessary for new approaches to analysis and utilization of data. And foundations — the California Healthcare Foundation, the California Endowment, Blue Shield of California Foundation, and Sierra Health Foundation — have generously provided resources necessary to get us started.

Keeping it sustainable

Sustainability is the trickiest part. The key to this rests with the approach we have used. In addition to emphasizing departmental buy-in, we built handbooks and guidance to provide tools to build on initial successes. We embedded these efforts in our governance committee, comprised of representatives from all 12 of our departments. This structure provides a means for peer review, and, importantly, means that continuation of these efforts is not reliant on any one individual.

The progress we are making in each of these areas is merely a piece of a greater movement. So where are we headed? It is about a cultural change at CHHS under which people are encouraged to be curious and to shift their focus from being program-centered to client-centered; a change in the expectations of our staff; and a change in how we communicate with our staff, the public and our clients.

It’s our hope that these efforts will continue to stimulate innovation, shape and improve public policy, and ultimately, improve services for our clients, making it easier to understand how to get benefits and how to use those benefits. Simply put, innovation is more than updating technology. We are committed to iterate with intention, in order to create a more rewarding environment for our staff, and most importantly, to improve the lives of our clients.

Michael Wilkening serves as undersecretary for the California Health and Human Services Agency.