November 1, 2017

Niles Friedman worked with the State of California to establish an Office of Innovation for the California Health and Human Services Agency (CHHS). That included creating a staffing model and a plan from the ground up, and most importantly, building an innovation movement among the complex web of 12 departments and three offices within CHHS. The resulting impact: CHHS departments are investing in transformative ways to better serve and support their customers. Departments are demonstrating this focus by creating user-driven digital services to address what programs need to best service their customers, using knowledge and insights from data to inform better decision-making, investing in procurement options that more effectively support department priorities, and incorporating human-centered design approaches to improve the delivery of services.

California Health and Human Services Agency (CHHS), one of the state’s largest agencies, aims to make California residents among the healthiest in the nation. Over the past several years, CHHS focused on increasing public access to health-related data, operating with greater levels of transparency and embracing more innovative approaches to its operations. To that end, CHHS is aiming to revitalize the way services are delivered and promoted throughout the state, as well as to improve operations among its offices and departments.

With that goal in mind, CHHS brought in FUSE Fellow Niles Friedman in 2015 to build an Office of Innovation for the agency and to initiate a movement to support a culture of innovation.

Managing the creation of the staffing model and office was part of Friedman’s primary role as a fellow. Threaded throughout every initiative and strategy was building a movement that embraced innovation at the core of the department’s function. To do that, Friedman had to get alignment on what exactly “innovation” meant to CHHS, and how that could translate into concrete actions that departments could take to transform service delivery and ultimately the lives of Californians.

CHHS is a large, complex web of departments each with its own distinct mission and personality, including the Department of Public Health, Social Services, and Rehabilitation. Friedman wanted to encourage collaboration across departments, and find areas where incubator projects might serve more than one department and create agency-wide impact.

Transforming Service Delivery

Friedman worked with department stakeholders to understand how they defined innovation and what it meant to their programs and services. “The overarching message is getting back to what users — who are our customers — need,” Friedman said. “Not necessarily sitting in a boardroom and thinking about what they need, but actually getting out there and asking them. And then starting to create structures and approaches and processes that can be a catalyst to get something off the ground.”

Improving service delivery, addressing customer needs in transformative ways, and creating digital services were a few issue areas ripe for reimagining. To build momentum for these ambitious initiatives, Friedman quickly narrowed a list of 25 proof-of-concept projects down to an initial cohort across three departments. These innovation teams served dual purposes: incubating the ideas aimed at improving department services, as well as demonstrating that innovative ideas and approaches can be scaled and translated into other projects and programmatic outcomes. To date, two-thirds of departments have incubator teams, a few examples include:

• Creating a user-centered digital application with predictive analytics, where end-users participate in the agile product development process and ultimately use what they helped to create for improving consistency with licensing investigations. This is an example of a user-centered design approach that was initially prototyped for one program with the vision of broader utilization and impact.
• Creating a transformative eligibility model that facilitates same-day expedited enrollment in vocational services for individuals with disabilities. Those who request enrollment in services are now assumed eligible, rather than having to wait a prerequisite number of days. This empowers counselors to create a more customer-centric environment from the first point of contact.
• Collaborating across three departments to improve child-hunger program enrollment rates by challenging assumptions with data and analytics and targeting local outreach with geo mapping tools and resources.

Experimentation, Testing and Iteration

For ambitious projects like these to succeed, you have to start somewhere. To that end, an initial group of over 100 change agents has been experimenting with the incubator projects, not waiting for the perfect work plan to come along. “One of the things I pushed to each of these teams from the beginning is when you are being different and progressive in your thinking, you’re going to have failures,” Friedman said. “We want an environment that encourages experimentation, testing, and iterating on versions of a product, service or program.”

Part of building an environment friendly to innovation meant not being afraid to fail, a mindset that the Undersecretary of CHHS, Michael Wilkening, encouraged across departments. In a way, encouraging failure was redefining how a government agency, which usually tried to avoid all failures, defined success.

“Being willing to try different approaches and changing the focus from programs to people receiving services does change everything,” Wilkening said. “Being willing to try something that you might not succeed at — if you start out small and if you do fail — you can learn lessons from it and move forward from that new space.”

The biggest shift has been to challenge the existing disposition, Wilkening said. “A lot of it is mindset. People think you have to do things a certain way because of legacy. And it takes a while to show why it’s okay to try new approaches.”

And that’s where Friedman came in, challenging the status quo, asking why things were done in certain ways, finding new approaches, working across departments and helping to bridge them, Wilkening said.

Though Friedman’s deliverables throughout his fellowship offer concrete evidence to what’s possible, he hopes the lasting impact has a broader scope. Through the principles, approaches, and infrastructure he helped to create, Friedman said he was able to emphasize what users really need from government, and why it exists in the first place.

“Though Californians will directly benefit from the progressive investments across CHHS to establish an Office of Innovation, the approaches to initiate an innovation movement can apply to many government settings, which presents tremendous possibility to further improve and transform service delivery across cities and states,” Friedman said.

After his FUSE fellowship ended, Friedman stayed on with CHHS as an Executive Advisor on Innovation and Chair for the Agency Innovation Subcommittee.