Musings from Yoxi Executive Director, Kaz Brecher
In our Field Notes series, we share perspectives and insights as we take a closer look at the work being done by Yoxi explorers on their inspiring journeys of discovery. We appreciate that Aunt Bertha has been lauded as a success by many in the social impact sphere but is not yet a household name. Founder Erine Gray embodies the humility and dedication that has driven their steady drumbeat towards impacting more lives and resulted in meaningful growth. Putting their money where their morals are, Aunt Bertha is a Certified B Corporation with a mission to make human service program information more accessible to those in need, helping more people reach self-sufficiency. Picking up “where Uncle Sam leaves off” by making it easy to find assistance, Aunt Bertha does something decidedly unsexy, in an age of sizzle and 140 character pitches. But by organizing the world’s human service program information, people can find which programs they qualify for in a matter of seconds, which can save lives.
You Don’t Know What You’ve Got Until It’s Gone
We are living through a time of unprecedented innovation while too many of the best minds and too much of our limited resources are directed at solving the wrong problems. A company that will pack your suitcase and deliver it to your hotel? An app to analyze the quality of your French kissing? The list is almost so long that it’s hard to know whether to laugh or cry. And, despite traditional measures indicating a strong economy, almost 40% of Americans can barely make ends meet. We can argue about quality versus quantity of jobs, stagnation, the minimum wage or almost any other consideration for those of us outside of Silicon Valley (and plenty who are in it), but the daily challenges many struggle to solve are much less glitzy than those most venture capitalists consider funding.
In the United States, there are 89,000 government organizations, over a million public charities and more than 300,000 congregations. Many of these offer programs designed to help people with the critical basics: food, healthcare, employment, housing or education needs. But learning about what’s out there and navigating the available information to see if you even qualify can be intimidating to say the least — too often resulting in people giving up and falling further into crisis. Enter Aunt Bertha, a tech company building a better way to connect people looking for help with organizations that offer help — by building the world’s most comprehensive human service database, they believe that free-to-use, well-organized, accessible program information can help people avoid preventable poverty.
Poverty-alleviation can be framed as both under- and over-funded, depending on the approach and vested interests, but Aunt Bertha founder Erine Gray asks what we might be able to do with technology to intervene earlier. This new frame for an entrenched and growing crisis hews closer to the foundational admonition of design thinking: look for need. So often, we don’t know what we don’t know. If a simple Google search doesn’t turn up help in a moment of crisis, a situation can quickly spiral from bad to worse.
Whether it’s parents struggling with rising rent in big cities, family members caring for their elderly in rural locations, or Fortune 50 healthcare employees juggling overwhelming caseloads, who hasn’t experienced (or knows someone who has) an illness, divorce, job loss or even eviction? At a time when career security is about as anomalous as flying pigs, weekly budgets often force choices between nutrition or medication. And with the reality of the “gray tsunami” becoming clearer, it’s unsurprising that so-called pink-collar jobs are some of the fastest growing segments in demand.
But we also face a swelling invisible profession, unpaid but critical to keeping families together, as Ai-jen Poo of the National Domestic Workers Alliance notes. “We’re experiencing a major generational shift in the United States, with 10,000 boomers turning 65 every day, and millennials having 4 million babies per year. We need more child care and elder care than ever before, but we have less of it. It’s creating a lot of pressure on the ‘sandwich generation’ that is squeezed between the pressures.” And what happens at home often impacts our offices, schools, and beyond.
In the summer of 1992, when Erine was 17 years old, his mother caught a rare disease. After a harrowing series of events to get her emergency care, she went into a coma and, though she’d survived, suffered brain damage. With her memory largely wiped out — no memory of Erine or his younger sister — his mother was released after 3 months into the care of her family. “Obviously you don’t get a certification for these types of things. Nobody is ever really prepared,” Erine shares. “She recovered, to some extent, but she suffered from seizures on a regular basis — they would sometimes knock her out for the day. My dad did the best he could to take care of her, for nine years…We didn’t know what services were available. And when we did find programs, it was difficult to get through the application process.”
Erine went off to college and studied computer science, ultimately getting his degree in economics. Some years later, his mother began to develop early-onset dementia, and his father asked for help. So, while juggling his work as a contractor in Texas, Erine moved his mother and became her legal guardian. But he was still faced with trying to figure out how to navigate a byzantine system for somebody who needed help on a number of fronts. The story of how Aunt Bertha came to be has been recounted on stages and in articles, but it’s the way Erine connected the dots between very real needs and his capacity to use basic technology to solve them that gives us hope — an example of the blinding insight design thinking practitioners view as the Holy Grail.
An Early Hint of Humanity-Centered Design
It is often said that the personal is political, but, in this case, it was revolutionary. Erine dug into his own family’s needs and the nagging sense that there had to be a better way. Moving intuitively beyond the limitations of human-centered design, where one “user” drives the shape of innovation, Erine examined the entire system. In what is now being recognized as humanity-centered design — the interplay between different actors and stakeholders, as well as the context of their capacity and living conditions — reveals opportunities and, perhaps, simple solutions.
Of course, simple is rarely easy, but it’s a start. Take, for example, the new Treo, a razor from Gillette designed for the elderly and people with disabilities, who need assistance with shaving. The company took a bold leap and looked at the increasingly common dynamic of grown children helping their aging parents. The product itself reflects needs that are both practical and emotional. This razor’s designers put dignity on par with efficacy as a measure of success.
Similarly, there are hints from PatientsLikeMe, where people struggling with health challenges show up to not only contribute to on-going research that might improve the lives of others but also learn from each other and find comfort in community. Indeed, there have been services popping up which help people simplify, strategize around and find guidance through major life challenges, from concierge medical programs to end of life directive parties.
But the repeating pattern in every new situation is that people try to orient, find support, and discover solutions, since they are starting from scratch, even if the conditions occur commonly. Very often, we see people post to Facebook or community boards, in a moment of crisis, asking if anyone else has navigated what’s coming, followed by an onslaught of ad hoc crib sheets passed around. When my father was heading into knee replacement surgery, a friend sent a 20-page document which he had cobbled together when his own father went through the process — with questions to ask the doctors, critical guidance on which HIPPA forms to have in-hand before surgery, medication contraindications that often get missed, and tips and tricks for recovery.
All of this begs the question of why these critical needs, arising so frequently and largely in predictable patterns, are so woefully unmet. Why don’t hospitals or insurance companies put these guides together? And how could we support the well-meaning in-take and recovery staff, who are overwhelmed but don’t know what to do other than hand over a brochure, which may as well be in a foreign language to someone experiencing a medical emergency for the first time? One avenue is to reduce friction.
We have myriad public and private social systems which have been built precisely to support people like Erine’s mother and her family. But if people don’t know they exist and they’re opaque and impossible to navigate, in the very moment when capacity is compromised, the systems fail even before they are engaged. As Erine experienced the frustrations from the perspective of someone disabled, he gleaned insight into where some of the breaks in the system really are. So, he went back to graduate school and got a masters in public policy, working for the state of Texas on how to improve the way people find out about social services like the food subsidy program or welfare programs in the US.
He also examined how people apply for these programs, and the role call centers play in enrollment — because we know finding help is just the first step in a long process. The economic downturn from 2006 to 2010 revealed an urgent need for another critical stakeholder in the system. Enrollment levels for programs grew significantly in Texas, and the state didn’t have the capacity for such rapid growth. So, while analyzing incoming calls, Erine realized that many people were ringing just to ask, “Hey, did you receive my application for food stamps?” or “I sent you a fax, can you confirm you got it?”
With a fairly simple redesign, a self-service menu was created, so that callers could get answers in 30 seconds instead of waiting on hold for 30 minutes. Some have rightly lamented the social cost of swapping humans for automated systems, like self-check-out at supermarkets or check-in at airports. In this case, it has had a tremendous benefit. The number of calls and the amount of time spent taking them went down. These efforts turned the project into an operation that could scale, helping more people get their needs met quickly and leading Erine to his light bulb moment.
Possibilities and Considerations in the Realm of Self-Service
Erine began with the premise that if you could visualize data for complex programs like food stamps, more self-service options in social services could be cheaper to implement and less frustrating for the person in need. The Aunt Bertha website quickly provided positive signs, and an implementation in New York hints at the potential for reaching seekers in different contexts.
LinkNYC is part of the massive city-wide broadband rollout, with WiFi-enabled kiosks. Described as “Yelp for social services” initially, Aunt Bertha’s robust database of food pantries, emergency housing, childcare, healthcare, transportation assistance, and financial aid programs located within each zip code became instantly available for New Yorkers to tap into. A 2015 study by the city comptroller’s office found that roughly 813,000 households (nearly 26 percent citywide) lacked broadband access at home; 510,000 don’t have a computer. The majority of these disconnected households, as is the case in many cities, are surviving below the poverty line and could benefit enormously from access to services like those Aunt Bertha surfaces.
“People in need are almost always grappling with interrelated problems…so easily accessible powerful technology tools that provide useful options in one place are key,” Steve Lee, a managing director at Robin Hood, a New York City anti-poverty agency, said in a statement around the launch of LinkNYC. Powered by data coming from all tiers of government, large nonprofit agencies, and neighborhood groups — the sorts of resources otherwise buried across thousands of websites and pamphlets that can require hours or days of sifting to find — a kiosk experience has to be seamless and easy to use, which is the beauty of how Aunt Bertha has done the heavy lifting of connecting dots and streamlining information behind the scenes.
That said, as digital citizens are becoming more and more keenly aware, our data has value and our privacy matters, especially as searches can be used against us if leveraged by dishonest actors. With new laws being implemented from Europe to California, Aunt Bertha surely had to consider implications for searches relating to often sensitive needs. Indeed, people search for everything from HIV testing services to survivors of incest support groups, so the service has ensured that all searches are completely anonymous. And, with a core design principle around providing an experience which affords its seekers dignity, the Aunt Bertha team believes that anonymity can help underpin an experience that doesn’t add a layer of shame.
But, it becomes clear that the searches themselves have a latent value that might help cities and states provide services more proactively. Erine explains, “For any ZIP code in the United States, you’ll see at least 600 listings. Some areas have more programs than others, but we are rapidly expanding. So say you’re in Austin. You type in a ZIP code, and in a couple of seconds, it’s pulling in all of the national programs, state programs, county programs, city programs, and then programs that cover just your neighborhood. If you type in “food pantry,” it pulls in the food pantry programs, organized by how close they are to you. You can filter for other variables — say “seniors.”
As you drill in, you get the hours and location, and so on. You can also search by eligibility: put in a family size — let’s say I have two kids under 5 and I make $700 a month. What comes up is the Texas Supplemental Nutrition Assistance Program — SNAP — what used to be called food stamps. I know, based on publicly available rules, that a family of this makeup would likely get somewhere around $458 a month in benefits.” So, even while keeping specific user data anonymous, the searches themselves reveal potential gaps in the safety net at large.
For policy makers and advocates, Aunt Bertha’s real-time analytics platform reveals what people search for, pointing to opportunities to address gaps in the services in their community. In any county in the U.S., search data can be mapped to view the concentration of searches (with any date range, a history of searches in that region can expose the growth of need by neighborhood) which allows visibility into how residents of a given zip code might benefit from additional support or programs. All of this is done anonymously but is incredibly valuable as it’s up-to-the-minute data.
There is still real work to be done in interpreting what underlying need those searches represent, but Aunt Bertha makes clear that solving the information problem is the critical first step to increasing efficacy of social services. Consider this use case: policy makers and city workers notice that many people are searching unsuccessfully for assistance with “light bills.” The Aunt Bertha team has learned that it might mean the need itself hasn’t been addressed in their database or, as was true in this case, they didn’t anticipate the term the seeker might use. Once that’s clear, they can add it as a synonym to their taxonomy and redirect people to what they need, which would be utility assistance programs in this case.
Without good data, or any data at all, there is only so much a solution like this can do. And, while on-ramping more providers and programs from more zip codes into the platform is an active and everyday effort, the frustrating reality is that sometimes there just aren’t services. But even exposing that kind of gaping hole has value. And this is a key focus for Erine and the team. Step-by-step, they have been wading into the nuance of need. Imagine a world where you can see, in real time, that your neighbors (anonymously, of course) don’t have enough money for tampons. And this is a real search. If we know someone needs something, in that moment, might we then move the conversation towards how we could more seamlessly fill that need? Could someone just buy that person some tampons and have it delivered anonymously and securely so she doesn’t have to worry?
Finding Beauty in Bits and Bytes
While what’s known as “tech for good” has been growing over the past decade, something about the way in which Aunt Bertha has been built from its earliest days inspires us uniquely. The fact that Erine Gray isn’t a household name is evidence of who he puts at the center of every decision — the “seeker” benefitting most from this platform. Erine embodies the understanding that the myth of CEO-superheroes is damaging our culture, and too many tech companies confine their values to posters. Aunt Bertha operates from these core values:
1. Seekers first
2. Solve today’s problems
3. Do beautiful work
Everything about these enlivens us, as Yoxi looks for beauty in the way all of our entrepreneurs approach the challenges they choose to tackle. We appreciate how unlikely it may seem to find beauty in the binary code of an information search and closed-loop referral platform. But this is precisely the point. Reframing each bit of data, each search, as an expression of a real human need or an offering which might mitigate a pain point, gives technology a purpose that too many venture capitalists overlook.
By making search data available to policy makers, researchers, universities and so on, Aunt Bertha can help them, and us, better understand where the hurt is hiding in our communities. And they have taken the bold stance that society could make huge strides by using what already exists in better ways rather than chasing newfangled mirages. Of course, it’s worthwhile to deeply examine the social determinants of health and poverty, but simplifying search and discovery and optimizing matching of needs may ultimately lead to compounding alleviation.
It’s true that the entire field benefits from experiments with how devices and capabilities might be harnessed in new ways, with apps like Papa, which allows seniors to effectively book time with “grandkids” on demand. But Erine has seen firsthand that technology doesn’t need to be whiz-bang to have transformative impact — it just needs to be brilliantly, and beautifully, applied. And that orientation is beginning to appear in other complex fields, as we explored in looking at how Project Drawdown is positioning itself on the frontline of climate change making sense of what is already available instead of chasing new solutions.
Remarkably, the commitment to doing beautiful work extends all the way into the foundations of Aunt Bertha. Erine originally considered incorporating as a non-profit, but he got the insightful advice that they wouldn’t want to be competing for donations with their customers, who would largely be other non-profits, foundations and government entities. He was challenged to come up with a scalable model that would keep the doors open, and they arrived at developing paid products — essentially providing enterprise tools for large teams of social workers, case managers and care coordinators — to which the large entities subscribe as a monthly service.
Aunt Bertha also provides, completely free, a suite of tools for Community Based Organizations (CBOs) to meet their intake management needs. This also has a hugeimpact, as many non-profits don’t have easy ways to accept applications online, so seekers end up standing in line rather than submitting digitally. These seemingly trivial services make it possible for seekers to quickly apply for services, and each agency can customize as they see fit.
Embodying rigor and integrity, it’s no surprise that Aunt Berthadecided to become a Certified B Corp, with the aim of using business as a force for good across a number of dimensions. Even as for-profit organizations, B Corps are accelerating a global culture shift to redefine success in business and build a more inclusive and sustainable economy. They meet the highest standards of verified social and environmental performance, public transparency, and legal accountability to balance profit and purpose. And the Aunt Bertha platform has crafted a user experience that does everything possible to reduce barriers to accessing information, implementing the highest levels of accessibility, navigation in over 100 languages, and a fully-responsive interface that can be easily used from any desktop, tablet or mobile device.
The Cost of Not Connecting Dots
The central innovation with Aunt Bertha is found in identifying and connecting the stakeholders in a three-sided marketplace, rendering the logistics challenges invisible and frictionless. Other platforms like Amazon and eBay have also done this brilliantly. But social services are a case where the cost of not connecting the dots isn’t just inconvenience but has significantly more dire consequence to both individual seekers and society at large. And, crass as it may sound when lives and quality of life are on the line, cost can’t be taken lightly as we are seeing trends in ballooning healthcare expenditures in the U.S. while overall life expectancy is declining.
There are indeed more private care facilities and concierge options, but these benefits are financially unattainable for most. And, when things go from bad to worse and people fall through the cracks, all too often, people end up homeless, in the prison system, or, if they’re lucky, in a facility that can take care of them. Already underfunded and stretched, human service organizations are being quickly overwhelmed.
Aunt Bertha is able to help frontline workers administer programs better by offering easy-to-use web-based intake management software — with tools that make it simple to make and manage referrals, empower clients with self-service functionality and coordinate with other community providers in the area to close-the-loop. And, while offerings like nutritional assistance and transit support may not seem like lifesavers, when social needs are met, a person’s health improves — which reduces hospital readmission rates and costs, children are less likely to miss school, older students are less likely to drop out, and prison recidivism rates decline. Working with hospitals and most major health plans means Aunt Bertha can close the gap.
And the more organizations who plug into the platform, the more effective it becomes. For example, the Austin Independent School District recently joined, so students across affiliated programs will have access to the services — expanding the ways in which guidance counsellors and administrators can support their student population. Or, as an example of how network effects can be increased, Aunt Bertha also started working with United Way Austin as a customer, joining forces with their team and the local 211 Call Center. This is win-win-win because realigning as collaborators helps each organization succeed, as well as benefiting seekers above all. So, while plugging myriad social care organizations into a platform sounds far from glitzy, it has created something that is so much more than the sum of its parts. If you are interested in bringing Aunt Bertha to your city, please reach out to them.
