Beth Lester
Helping Commissioners Serve Their Constituents
Fellowship at the US Department of Health and Human Services
Project Brief
The Office of Business Management and Transformation (OBMT) was asked by one of the HHS strategic committees develop a new office within the Administration for Children and Families (ACF). Our team, consisting of myself, OBMT's innovation and design strategist, and an undergraduate business student, was brought on to lead a human-centered design approach to the project and to then provide the committee with a strategic blueprint for the proposed office.
Roles I played
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Developed discussion guides
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Conducted user interviews
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Created and tested prototypes
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Generated actionable insights
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Outlined strategic plan
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Presented insights and research to client via "paperpoint" prior to the strategic blueprint's development
Project Process
Our team conducted one-on-one phone interviews with state commissioners, state-level agency directors, and other players in the health and human services space across 7 states. Though we reached out to additional states for participation, many were skeptical of our intentions and did not want to participate, or outright did not respond. States chosen to reflect a range of access to funding, enmeshment of health and human services, and state legislature support for health and human services programming.
Using a say/do/think/feel model to build out themes and insights, we were able to understand discrepancies in policies and practice and discover where the system was failing users at all levels. We created low-fidelity prototypes and tested feasibility and desirability using a range of reactionary and co-creation activities.
Key Learnings
Commissioners of health and human services departments across the US were reluctant to take risks in developing new programs and services for their state. While many wanted to try new ideas, few of these made it past a theoretical existence. These same commissioners were also unsure how to navigate existing laws to receive funding while also best meet their specific state's needs, leading to further stalls in innovation. Commissioners' job security depended on their states' access to funding, and a program that did not meet grant criteria would likely mean financial losses and reprimand from the federal government, regardless of lessons learned. It was safer to stick with status quo than get slapped on the wrist or lose access to funds, even if it meant dealing with structural problems rather than attempting to fix them.
Project Outcomes
The initial deliverable of this project was a "paperpoint" presentation, some artifacts of which are pictured on this portfolio, in which I delivered our research, findings, and initial strategic recommendation to the director of ACF. Because of the federal government's reluctance to accept new methodology, we chose to present with Sharpie-written "slides" on printer paper. The goal of this method was to invite conversation and communicate that this project was on-going; we were not handing down a final decree, but rather were in the process of building a service with ACF's input.
Once finalized, OBMT delivered a strategic blueprint to the HHS committee detailing key activities for the office to execute, specific activities and messaging to avoid in the interest of maintaining users' trust, and personnel qualifications and character recommendations. The strategy focused on integrating programs, measuring outcomes, promoting collaboration, and providing commissioners with tools to innovate without fear of repercussions.
