Background

This is the first entry in a three-part series about the past, present, and future of social and medical service referral in the United States.

The social safety net is inefficient and ineffective. Admittedly, that’s not a particularly novel or actionable observation, but did you know that the United States spends more than $100 billion every year just in the time it takes to connect people in need with social and medical services?¹ (That doesn’t include the cost of actually providing such services.) To put this into perspective, for about $100 billion, the United States could pursue a wide variety of notable programs.²

It’s actually worse than that. The $100 billion figure cited above includes only professionals in the social service, healthcare, and education sectors: it does not include social and medical service referrals made by police officers, firefighters, attorneys, and other public service professionals not included in our survey. Moreover, it does not fully capture referral-related administrative duplication that exists across these sectors.

Because there does not yet exist a sufficiently comprehensive and reliable directory of social and medical services, public service professionals must rely on word of mouth recommendations, online search engines, and printed paper directories as primary sources of information.³ Such inefficacy is harmful to those in need and those who serve them: a feeling of professional inefficacy is one of three primary dimensions of burnout, a widespread occurrence among nurses and social workers. As a result, many nonprofits create their own in-house directories, resulting in significant duplication of administrative efforts. Benetech, a MacArthur Genius-led nonprofit technology company, studied eleven such directories in and near the San Francisco Bay Area. Here is what they found:

Meanwhile, despite tremendous investments of time, talent, and treasure, many are struggling. Over one in five American children live in poverty, over 21 million Americans experience addiction, and over half a million Americans are homeless.

Why hasn’t this been solved? Various groups (such as 2-1-1, Aunt Bertha, and Healthify) have attempted to collect and share information about social and medical services. However, maintaining large or detailed directories is technically challenging and expensive: fundamentally, the only way to reliably verify information about a service provider is by asking them directly, typically via a phone call. Benetech estimates that it costs as much as $140 to collect information about just one service provider. Freely shared information faces free-rider pressures, and paywalled information competes with “free” resources previously mentioned: word-of-mouth recommendations, online search engines, and printed paper directories.

The good news is that it doesn’t have to be this way. In our next post, we will describe how Johego has designed, developed, and validated at scale an innovative data pipeline for collecting and verifying information about social and medical services — one that is reducing the time required to make service referrals as well as the need for creating in-house directories. Until our next post, if you want to know more about our work, you can follow us on social media or sign up for our email newsletter:

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As always, thank you for your support!

– Michael

Sources & Calculations:

1.) $100B+/yr Referrals. In 2017, Johego surveyed 24 professionals from the social service, healthcare, and education sectors who, as a regular or occasional part of their work, refer people to social and medical services. We asked them to report the number of people they typically refer to social and medical services each week as well as how much time they typically spend making such referrals. The following is a summary of their responses:

Sector	n = 24	People/Week	Hours/Week
Community and Social Services	11	12	6.5
Healthcare	7	9.4	2.9
Education	6	1	1.5

Then, using Bureau of Labor Statistics data, we determined the number of professionals in each sector as well as the median wage of professions within each sector, as follows:

Category	Occupation	Count	Median Wage
Community & Social Services	Social Workers	649,300	$22.07
	Health Educators and Community Health Workers	115,700	$21.08
	Mental Health Counselors and Marriage and Family Therapists	168,200	$20.77
	Probation Officers and Correctional Treatment Specialists	91,700	$23.73
	Rehabilitation Counselors	120,100	$16.54
	School and Career Counselors	273,400	$25.8
	Social and Human Service Assistants	386,600	$14.82
	Substance Abuse and Behavioral Disorder Counselors	94,900	$19.22
	Social and Community Service Managers	138,500	$30.54
	Clergy	48,250	$21.27
	Childcare Workers	1,260,600	$9.77
	Personal Care Aides	1,768,400	$10.09
Education	Preschool Teachers	441,000	$13.74
	Preschool and Childcare Center Directors	64,000	$21.96
	Kindergarten and Elementary School Teachers	1,517,400	$26.23
	Middle School Teachers	627,500	$26.86
	High School Teachers	961,600	$27.5
	Postsecondary Teachers	1,313,000	$34.84
	Postsecondary Education Administrators	175,100	$42.59
	Special Education Teachers	450,700	$27.31
	Instructional Coordinators	151,100	$29.94
	Career and Technical Education Teachers	231,800	$25.38
	Adult Literacy and High School Equivalency Diploma Teachers	77,500	$24.17
	Teacher Assistants	1,234,100	$11.97
	Librarians	143,100	$27.35
	Library Technicians and Assistants	210,700	$13.43
Healthcare	Medical and Health Services Managers	333,000	$45.43
	EMTs and Paramedics	241,200	$15.38
	Home Health Aides	348,400	$10.54
	Licensed Practical and Licensed Vocational Nurses	719,900	$20.76
	Medical Assistants	591,300	$14.71
	Medical Records and Health Information Technicians	188,600	$17.84
	Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners	170,400	$50.36
	Nursing Assistants and Orderlies	1,545,200	$12.36
	Physician Assistants	94,400	$47.2
	Physicians and Surgeons	708,300	$90.
	Psychiatric Technicians and Aides	145,200	$13.61
	Recreational Therapists	18,600	$22.06
	Registered Nurses	2,751,000	$32.45
Total	Public Service Professionals	20,569,750	—

With such information, we were able to estimate the total number of professionals in each sector as well as the average median wage within each sector. Then, assuming that our survey respondents are typical of their sectors, we calculated the total baseline wages required for social and medical referrals made each year. Finally, we multiplied the total baseline wages required by 1.4 to account for benefits, payroll taxes, and general organizational expenses associated with such labor.

2.) $100B+/yr Equivalent. The Marshall Plan cost ~$103 billion over four years (~$26B/yr). The Apollo Space Program cost ~$107 billion over twelve years (~$9B/yr). Providing improved water and sanitation throughout the globe would cost ~$23B/yr. Eliminating homelessness in the United States would cost ~$5B/yr. Doubling federal expenditures on academic research and development (R&D) would cost ~$39B/yr. Taken together, pursuing these programs would cost ~$102B/yr, which is ~$4B/yr less than our conservative estimate of the annual cost of social and medical service referrals in the United States.

3.) Referral Sources. In 2017, Johego surveyed 24 professionals from the social service, healthcare, and education sectors who, as a regular or occasional part of their work, refer people to social and medical services. When asked to identify the primary source(s) of information for completing such referrals, 21 respondents (88%) selected word-of-mouth recommendations, 18 respondents (75%) selected online search engines (e.g. Google), and 14 respondents (58%) selected printed paper directories. These were the three most commonly selected categories.

In order to better inform the public about some of the difficulties involved with navigating the social safety net, we are collecting stories from people who, in their personal or professional capacity, have struggled to connect themselves or a friend, family member, or colleague with social or medical services. If you have a story you can share, we would like to hear from you!

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Celebrating a Successful Year

It is with a joyful heart that I share my reflections on everything Johego has accomplished over the last twelve months. The 2017 calendar year began with renewed focus: Johego had recently completed our first contract, a $6,052 interdisciplinary research project for Missouri Foundation for Health, and I had just finished a 10-week entrepreneurship training program through Square One at the Center for Emerging Technologies:

Being in the Right Place

Through Missouri Foundation for Health’s “Healthy Communities” program, community organizers and health literacy experts organize coalitions of medical and social service providers around community-led initiatives to improve health outcomes in their region. In January, the Healthy Communities coalition in Hannibal, MO initially decided to focus on increasing awareness of the medical and social services already available in their region, by creating a paper-based directory they could hand out to their colleagues and clients. One of Johego’s allies happened to attend that meeting and told them about the technology Johego had been developing. Intrigued, the coalition invited Johego to give a presentation at their next meeting, ultimately deciding to pay us $4,732.26 to pilot our technology in their community instead of relying on a more traditional, paper-based approach. After several months of design, development, and testing in conjunction with our on-the-ground partners, Johego officially launched our smartphone application on iOS and Android in September, which got picked up by local and regional media:

Earning Institutional Credibility

A few weeks later, based on the success of our pilot program in Hannibal and our robust business plan, Johego was selected as a winner of the prestigious Social Entrepreneurship and Innovation Competition at Washington University in St. Louis, out of an initial field of 154 participants. Meanwhile, we continued to work with our on-the-ground partners to better understand their needs, including at Project Community Connect, my favorite event of the year:

Gaining a Huge Opportunity

Shortly thereafter, I was given the opportunity to present Johego’s vision to senior personnel at Missouri Foundation for Health, an organization that is focused on addressing health issues of underserved Missourians from a systemic perspective. The result of that conversation was a $268,392 contract that will enable Johego to:

• Add 18 additional counties to our coverage area, allowing nearly 1.1 million Missourians to access our services.
• Create a browser-based equivalent of our smartphone application so that anyone can search our directory using their laptop and desktop computers, including police officers in their squad cars.
• Provide information about the hours of operation, financial requirements, and documentation requirements of services listed in our directory, enabling our users to more efficiently obtain the help they need.

Although Johego still has a long way to go in order to actualize our vision of making connecting people in need with medical and social services as easy as finding showtimes for movies, this contract represents a major, if somewhat unbelievable, step forward for us. In the coming weeks and months, I will be introducing you to the newest members of our team, including two additional full-time staff members, and I will be sharing updates about our work as well as opportunities to get involved. In the meantime, I can’t thank you enough for your support.

– Michael

Want to support Johego or learn more? Follow us on social media & let us know what you think:

In the previous post, we discussed the resources that will be required to finish our app and expand its geographic coverage nationwide. In this post, we will describe what you can do to help make that happen.

Volunteer

One of the best ways to help Johego is to volunteer your time and talents. To that end, Johego is excited to announce three opportunities to join our team! If you are interested in applying for any of our volunteer positions, please click on the corresponding image below or visit our Volunteer page for more information.

Johego is looking for volunteers to serve on its 2016 Board of Directors. We are especially looking for individuals who are experienced with one or more of the following disciplines: finance, fundraising, human resources, information technology, legal matters, marketing, and public relations. If you would like to take a leading role in our efforts to revolutionize community development, please do not hesitate to apply!

Johego is looking for individuals with a strong background in programming and/or mobile application development to assist with finishing our app and expanding its coverage nationwide. If you have a knack for this kind of work and want to contribute to community development in an innovative way, please do not hesitate to apply!

As a 501(c)(3) charity still in its infancy, Johego is looking for individuals with significant fundraising and/or marketing experience to assist with developing a sustainable base of financial support. If you would like to help out with this critical endeavor, please do not hesitate to apply!

Donate

Another way you can help Johego is by making a financial contribution. As we indicated in our previous post, Johego is trying to raise $160,843.13 in order to pay for staff, subcontractors, and IT infrastructure during the coming year. To date, Johego has been supported almost entirely out of our personal savings, which is not a sustainable model.

Although we do our best to minimize our expenses and to seek out charitable grant opportunities, your support is essential for building on our existing work and bringing this project to scale. We especially appreciate automatic monthly giving, since that provides us with a greater degree of confidence about future revenues.

If you are interested in making a donation, please click on the button below or visit our Donate page.

As a reminder, because Johego is a 501(c)(3) charity, your donations are tax-deductible! Moreover, every new donor, no matter how small his or her contribution, broadens our base of support, which is an important metric we can show to charitable foundations and other large donors. With that in mind, please visit our Donate page and make a donation if you are able.

Donate

Raise Awareness

Perhaps the easiest way you can help Johego is by spreading the word about what trying to do. In particular, if you know anyone who may be interested in helping Johego revolutionize community development, we encourage you to facilitate an introduction. In the meantime, if you haven’t done so already, please connect with us on social media:

With that in mind, please share this post on whatever platform(s) you are active. The coming months will determine whether we can generate enough momentum to finish our app and expand its coverage nationwide. Thank you so much for your support!

– Michael

Want to support Johego or learn more? Follow us on social media & let us know what you think:

In the previous post, we explained why we think our smartphone application will be an efficient and effective vehicle for increasing community engagement. In this post, we will be describing the resources required to (1) finish our app and (2) expand its geographic coverage nationwide.

How did we develop our estimates?

Our method for estimating resource requirements was simple, yet rigorous: first, we identified the major tasks that will be required to finish our app and expand its coverage nationwide; next, we categorized these tasks by profession (e.g., programming, marketing, etc.) and subdivided each task into specific action items; then, we interviewed various subject matter experts to develop a low-end and high-end time estimate for the completion of each action item. For example:

After that, we looked at how many hours will be required to complete the tasks associated with each profession. Then, based on the number of labor hours required, as well as the typical hourly wage for such labors, we determined whether it will make more sense financially to hire someone full-time to complete those tasks or to utilize a subcontractor.

Based on this analysis, we believe that we will be able to finish our app and significantly expand its geographic coverage in under one year with a three-person team of full-time professionals: a programmer/mobile application developer, a fundraiser/marketer, and an executive director. During this period, we are planning that data science, data entry, software security, legal, and accounting tasks will be completed by a variety of volunteers and subcontractors. In the longer term, as we expand our coverage nationwide and begin to perform large-scale data analytics, we anticipate bringing on a full-time data scientist.

How much will it cost to finish the app?

We do not expect to obtain the resources Johego needs overnight. Therefore, we anticipate completing our three-person team of full-time professionals over the next several months. Based on that assumption, we estimate that we will need $160,843.13 during 2016 and that our monthly costs will be as follows:

Specifically, we estimate that, with a three-person team of full-time professionals, our annual expenses will be as follows:

How much will it cost to expand the app’s coverage nationwide?

This is much more difficult to confidently estimate, since there are a greater number of uncertainties involved. Nonetheless, here is our approach:

As has been mentioned elsewhere on this website, the social service providers currently listed in our beta app are located in the Washington, D.C. area only. We were able to include these providers by collecting publicly available data from the Internet. Moving forward, we have identified approximately fifty other web-based resources that, if incorporated into our database, will provide geographic coverage of more than 90% of the United States, including Alaska, Hawaii, and Puerto Rico. Each of these resources differs in its size, complexity, and quality, so it is difficult to generalize the level of effort required to incorporate all of this information, especially because we do not yet know what economies (and diseconomies) of scale might occur from that effort. Nonetheless, based on our experiences with the Washington, D.C. data set and others, we put together the following chart to illustrate the potential effects of scaling on our efforts:

Based on this analysis, we believe that, as we expand and sustain our coverage nationwide, we will need to add a full-time data scientist to our team. This will become all the more critical as we begin to perform large-scale data analytics for the purpose of optimizing volunteering engagement.

All things considered, however, we can achieve nearly nationwide coverage by working with a relatively small number of web-based resources. Moreover, once a particular resource has been incorporated into our database, it will become that much easier to work with that resource whenever it is updated. For these reasons and others, we believe that we can bring Johego nationwide on a relatively short timeframe.

In the meantime, stay tuned for the next post, in which we will share some specific ways you can help make that happen.

– Michael

Want to support Johego or learn more? Follow us on social media & let us know what you think:

Currently, there are more than more than 45 million people in the US living in poverty. However, only one quarter of Americans volunteered in their communities last year. Faced with those challenges, why are we convinced that our application will make a big impact on both?

In a recent survey of 135 countries, Americans were more likely than any other nationality to help strangers, with nearly four in five survey respondents having done so during the previous month. Compared to the level of volunteerism in the US, this finding suggests that there is a profoundly underutilized willingness among Americans to become more involved with community development. Fortunately, we increasingly understand the factors that make people more willing to participate in community-building activities:

• When people feel like they can make a meaningful impact; and
• When people have a personal connection to a particular cause, or to those supporting the cause.

We will be leveraging both of these factors with our application, and the opportunities for scaling are tremendous:

• More than 98% of Americans are “connected to high-speed wireless Internet — surpassing any point in our nation’s history.” In addition, there are more than 180 million smartphone users throughout the US. This means that there are millions of opportunities to increase participation in community development using a smartphone application.
• Furthermore, nearly three in four Americans have a social network profile. By integrating our application with some of the most common social media networks, we will be able to increase the scale and the rate at which our app is utilized.

For these reasons and others, we believe that a well-crafted smartphone application can increase community engagement and, in turn, help build stronger communities through the US. In future posts, we will be describing specifically what will be required to bring our application nationwide and how you can help make that happen, so stay tuned!

– Michael

Want to support Johego or learn more? Follow us on social media & let us know what you think:

In a previous post, we discussed an article from Harvard Business Review, which identified four essential elements of a successful social movement. In this post, we will focus on the fourth of these elements as it relates to Johego: connection to the mainstream.

What We Do

Every successful social movement requires a meaningful connection to mainstream values and interests. For a start-up like Johego, social media can provide an efficient method for nurturing and sustaining that connection. To date, Johego has been using social media to provide updates on our progress and to post content that may be of interest to our supporters. Here are some of the content areas we have been focusing on so far:

• Data Science: Data science being used for good, especially as it relates to community development / poverty reduction. [Example]
• Smartphone Apps: Smartphone apps designed for community development / poverty reduction. [Example]
• Innovation: Other innovative products and services for the poor, especially from small- to medium-sized organizations. [Example]
• Policy: Novel policy approaches to community development / poverty reduction. [Example]
• Poverty: The extent of poverty in the U.S. as well as the personal challenges associated with living under poverty. [Example]
• General Interest: Actionable information for supporters about how to improve their lives: productivity, inspiration, etc. [Example]

Why Your Actions Matter

Ultimately, our success depends on your input. Your actions, even if they may seem inconsequential, actually do make a difference. For example, when one person ‘Likes’ a post on our Facebook page, it indicates to us what types of posts some people want to see. In addition, it increases the number of Facebook users that will see that particular post. To that end, the following plot shows how individual ‘Likes’ have increased the number of people that have seen our posts during the last few weeks:

How You Can Help

Here are a few easy things you can do that will increase our outreach and improve the content we send your way:

• If you haven’t started following us on Facebook, Twitter, Google+, and LinkedIn, please do so.
• If you are already following us, and if you believe in what Johego is trying to accomplish, invite members of your social networks to follow us as well.
• If you like a particular post, then let us know by ‘Liking’, ‘Sharing’, etc. that post.
• If you want to comment on a particular post, publicly or privately, please do so.
• If you would like to see something different that is more relevant to your interests, please do not hesitate to contact us. We really do listen.

That’s it for now. As always, thank you for reading!

– Michael

Want to support Johego or learn more? Follow us on social media & let us know what you think: