Only Anecdotal

I have surprised my own self with the title of this little piece.

I hate when rules bog people down, and make it next-to-impossible to get anything done. I hate rules even more when they seem created to keep people out, rather than to devise a logical way to let them in.

I think about that question of entry, access, everyday. As I said in my last article, I may be feeling optimistic by an extraordinary ability in my present job to gain access to needed paperwork, documents–most often a passport. But it is a powerful thing, a passport, granting permission to enter, to cross, to leave.

My last jobs have not been so easy in this respect. Canadian passports require an extraordinary number of checks, I think–it often seems to surprise people here in the United States, who are not so accustomed to actual reference checks, or very specific photo requirements. A MassHealth application, though, requires a lot of documentation, as does a SNAP application for food stamps. There may well be no reference checks, but the systems in these two institutions are often kept ambiguous by overwhelmed staff who are most likely paid not enough to meet the high standards of customer service that are absolutely obligatory to meet the need well. Are there examinations that TANF employees must pass to have access to a database? I do not think so. Does MassHealth go beyond an initial training period to verify that employees really do understand their responsibilities, as well as their limitations? I am quite sure this is impossible.

And yet, when immersed in the trenches of people in need, we learn a lot. We learn, for example, that recipients of Supplementary Security Income (SSI) through Social Security automatically receive MassHealth Standard. We learn that permanent residents who are entitled to MassHealth nonetheless cannot receive all benefits for five full years–and this can be devastating to individuals with disabilities who are in need of long-term services and supports. We learn that immigrants who do not have green card status may well receive no or very few MassHealth benefits at all… and it is hard not to advise a parent, for example, to apply for permanent residency, for example, for their children who need more than a safety net.

The only problem with this sort of trench-learning is that sometimes we are wrong. Sometimes we have heard enough to make ourselves dangerous, and assume that the understanding we have gained in our own bureaucracy has made us experts in all others. We would do so better to embrace the complexities and build relationships with our expert colleagues in other systems. But this seems a difficult concept to achieve.

Now… I know I seem to be straying from my original defence. Do I like monotonous paperwork, and complicated regulation? Well, no. Hell no. But then, I think about it a bit more… The rules sometimes are complex from the start, due to the legislation that created the program. But really, this is rarely the case. More often, I believe, the system becomes more complicated as we consider the individual within it. We consider just one person who does not fit a certain mold, but still needs something, and we make an exception. Complication #1. Another individual happens into the system, and needs something else. Complication #2. An individual to whom complication #1 applies has other resources that cancel the real need for the program in question: complication #3. And so it goes. A community complains about the high level of X, and we face complication #4, 5, and 6, sometimes all at once. It is easy to create institutions, and we must create them, I believe. But making them fair is even more essential. And this is where the bureaucracy begins. It is a real shame when we do not expect excellence in our public servants’ understanding and administering of this bureaucracy. Perhaps if we had that, these systems would not have such a terrible reputation.

I do believe that most people who work in these systems want to be helpful. In a customer service-oriented environment, “making a difference” is the true motivation for most employees. Hard to say what happens in translation there. A crappy database? Bad management? An utterly impossibly large number of clients to handle with that crappy database? Rules that are created more to micromanage underpaid employees than to give employees tools to help clients? Who knows?

But I think of the last week, for example. A woman who may have been considered quite foreign in appearance arrived at our office requesting assistance with her children’s Canadian passport applications. As I reviewed her documents, I asked her a bit more about her children, and their citizenship, to see if they had other documents for travel. They were Canadians, yes, born there. The parents were not. The parents were, in fact, US citizens who had lived abroad for years. They had adapted the lifestyle and customs of another country, and came back to North America to study, work, research. But both parents were born in the US.

The mother told me that she wanted MassHealth for her children, and was instructed by a MassHealth agent to apply for permanent residency for them. Children of US-born citizens.

The children, in reality, ARE US citizens. They need proof of citizenship, not permanent residency.

The cost of green card applications is enormous. The mother later took my advice to verify her children’s status with an agent at the US Citizenship and Immigration Services office. She learned, first, that her permanent residency application fees would not be refunded. She learned also that she did not have to resubmit paperwork for proof of her children’s US citizenship. Finally, she learned that her children were US citizens–yes! it was true! Upon receipt of their US citizenship certificates, they will be entitled to all privileges as American citizens, and without a five-year wait for full benefits under MassHealth.

In the meanwhile, I encouraged her to contact MassHealth once more. Unfortunately, in so many bureaucracies, the individual in need does not have access to an individual within the system. So, reaching anything more than a badge number or the next available staff is nearly impossible. I suggested that she could try going to a community health center, where an employee could access MassHealth as a professional, and perhaps find something more through that gateway… Another layer here to that system–that virtual gateway accesible to whom?? To hospitals.. to community health centers… to some provider agencies, advocacy agencies. It is a difficult system, fluid, and not smooth to sail. I hope her children can get what they need quickly here. They are entitled to it.

I defend bureaucracy, though I understand why we hate it. We hate it, because it is so hard to navigate through institutions that veer from their frameworks to try to be fair to all. We hate it, quite rightly, because it sometimes IS ridiculous, and more focused on preventing fraud than on the original mission. But try we must, and understand we must.

For, our understanding, in reality, is understanding the very complexity of our humanity, and the responsibilities of our government to provide fair treatment to the human beings who depend on it.

And do not be fooled by notions of self-sufficiency: we ALL depend on our government to do things for us. And we all are only human.