True Government Efficiency (June 20th, 2026)

I have met just about weekly with my primary funder since we began working together, who has supported me in my work since I started as ED on loan to CTIPP over five years ago. Actually, we started meeting regularly about a half a year before that, though those meetings were not always one on one like they often are now. What interested her most in me, beyond honestly my mentor who she wanted to support me to be able to learn more from, was the project financing idea to sustain and scale trauma-informed efforts that I call Full Capital. 

Despite our hundreds of hours spent talking and working together over the years so far, this week, I shared with her how I was thinking about governance of both HEAL PA and The Change Campaign as I prepared for board meetings for each of them (HEAL PA is referred to as an Executive Steering Committee meeting rather than a board meeting, but same idea), and she shared how impressed she was with the evolution of my thinking about this. 

What really struck me was that I didn’t feel like I was saying too many things I hadn’t said to her before. The ways in which I think about the triangle offense of organizational structure, the work streams necessary to achieve the broad goals we are working toward, and the infrastructure needed to carry out those workstreams and how I plan to build the capacity to support that. I don’t say this to doubt that she had been paying attention before or was wrong, but rather to highlight that evolution of thought feels slow to the thinker, but can feel instant to the receiver. 

It didn’t feel like anything novel to me. I think about this stuff all the time. It can be frustrating to have such evolving thought processes and robust writings about how things can grow while the pace of change beyond my mind does not keep up, but that has been my reality for a while now. 

So when she said that to me I had two main thoughts: gratitude for her, the support she provides me both financially and through critical thought and conversations about the work I am doing; and the idea that I need to be willing to share things I feel like I’ve already said. I try not to repeat myself though I am sure to many people I do. I want to provide novel insights and strategies and historically, though this is certainly changing as I write these blogs, if I don’t feel I have anything new or valuable to share then I normally stay quiet. But perhaps there is more evolution of thinking than I recognize. And if not, then I guess I’ll just repeat myself. 

But the message of The Full Press (the comprehensive agenda that combines Full Capital and PressOn) bears repeating. I say this with the most humility possible, that I believe that it is the best articulated strategy that provides a framework for our society to evolve beyond the current crises we face. I feel okay saying that because it is not something I simply came up with, it is the conglomeration of many people in my life providing input to an evolving train of thought that has more than six years of clear development, and looser lines of thought for years before that. 

So I will try here to articulate The Full Press in simple, yet unapologetic terms. The long strategy can be found in my capstone, but the shorter pitch that doesn’t have the jargon of academic writing that can reach audiences the capstone won’t. This is a helpful exercise for some of the presentations I have coming up this week - from NIH to community coalitions - that I might just write about in next week’s blog, and maybe it’ll reach someone I otherwise would not have connected with about this who can help accelerate the work. 

In essence, The Full Press is working toward true government efficiency. As with many things this administration does, DOGE identified a real problem and addressed it with a fake solution. There was bloat for sure, but taking a hacksaw to government services, from life saving social services to regulatory bodies that ensured we worked toward something resembling liberty and justice for all (I recognize we have never achieved this but were certainly closer in the past than where we find ourselves today) is not true government efficiency. The idea that we are going to cut entities and services that attempt to promote wellbeing as a way to save our society money follows the same logic as stuffing cash under the mattress as an investment strategy. 

The Full Press articulates a vision for how we can create true government efficiency. We have seen the development of community-led, cross-sector coalitions play a really important role in laying the foundation for promoting wellbeing. It should be said that this is not the entire work, but just the first phase, but it is where the work lies as we work to develop and support such coalitions because it is the foundation that all the other work that must be done can be done in a coordinated fashion. But thinking back to my blog post with musings on what education system transformation could look like (or at least the beginnings of) as an example, that grows through the coalitions we are developing. Same with other efforts in different systems.

What implementation and integration in social change theory so often misses or forgets is the local buy-in necessary for ideas, no matter how good they are, to work in different contexts. Different communities have different populations, needs, resources, and desires. There cannot be a one size fits all model of what social change looks like that works everywhere. People like to be included in decision making and not just have things done to them, which feels incredibly human, as well as needing the local expertise to integrate new ideas in an existing social fabric. 

Local coalitions play a huge role in doing this. It provides the ability for democracy (notice we are talking here about small d democracy, routine civic engagement beyond a voting booth) to function and people to play both leadership and supporting roles in their communities. We do not live our daily lives in the context of a federal system, though it can feel that way sometimes, but rather in relationship with the people and spaces that surround us. Community coalitions allow biocracy to function on the ground to support communities in adapting to changing circumstances, whether that be a disaster or to reduce long standing traumatogenic forces.

So that is where we must begin. Reweaving the community fabric must be a priority so that fewer people fall through the cracks of our long (though highly accelerating) fraying social fabric. But our society does not exist just at a community level, of course, and while that is where people experience their daily lives it is not the only place that impacts people’s daily lives. The next level up that I will focus on deeply is county coalitions, though it should be noted that large municipalities would also fit into this, as could smaller municipalities, groupings of townships, and other sub-county regional coalitions depending on how communities are organized. 

But county coalitions are important because it is the first place that in all areas we begin to interact with government spending that is heavily impacted by promoting wellbeing. While in large urban areas the municipal government would also fit this, smaller municipalities don’t carry large social service spending, but rather hold costs that would likely remain mostly steady, with perhaps a police force and fire company, as well as maybe one or a few people who carry out the administrative tasks of the local government. Perhaps there is an evolution of thinking I must continue after this writing about local education agencies, but there is complexity there because of a separation of the school board from other aspects of local government. It is an example of fragmented systems that make this work difficult that I am recognizing as I write but don’t have a good answer to at the moment, so I will continue on with a discussion of county coalitions. 

At the county level, social service spending is deployed across education, health (across all of its forms), justice, and many other service areas. All of these have costs, some of which are fixed, or at least should be, so that the main functions of government can be accomplished, but others are not, and those are the ones we are looking to target. Variance in these costs are usually indicators of wellbeing - it is more expensive: the more alternative education system costs school districts must pay for because students get expelled; the more people require healthcare for downstream consequences of preventable mental and physical health conditions; the more people we incarcerate - and so promoting wellbeing here will save money. 

Again, we must not forget that we are focusing on wellbeing through community coalitions. So a part of the county’s role is to coordinate and support community-led coalitions not by deciding what they must do, that is the community’s to decide, but to be an accountability partner in this work, looking at data that is collected and identifying what might be working and where there might be areas for improvement, and connecting communities to learn from each other rather than needing to reinvent the wheel. But at the county level, we also begin to see how The Full Press is building capacity toward public-private partnerships, as the government must play an integral role in a functioning public financing model. 

We must recognize the challenging position that county and municipal governments are in right now. They are often the level of government that constituents most closely know the people at a personal level who administer functions and services, yet are disproportionately impacted by the decisions, especially around appropriations, of both federal and state governments. Therefore they receive a lot of the blame without as much of the control. Of course this is also true of people at the state level when talking about decisions made by the federal government, but there is an additional layer of decisionmaking that impacts their own. I was talking to a county executive in Pennsylvania a few weeks ago and they told me about their experience when both the state and federal government were late to pass the next year’s budget. It was already hard enough following DOGE as residents were impacted in a wide range of ways by massive cuts, and then they had to be on the frontlines of communicating the impacts of service stoppages. They had even leveraged reserves to not need to completely stop total functioning, yet that move was scrutinized. It was literally a no win position.

What we are building is critical in supporting local governments right now. Novel ways to fund social services are needed right now. It is beyond challenging trying to navigate the DOGE cuts while reconciling the massive needs that exist and in some places are growing. The extended rise in gas prices from this war with Iran has put more strain on food banks and other services that support basic household functions. The Full Press at first would not fund one for one the services that are being disrupted, we simply do not have the funds to do that. To build efficiency, we must explore system-level approaches to alter where preventable stress flows and redirect structures to promote better outcomes. This is where the community coalitions, which organize around mutual aid, can work with county coalitions, which organize at more of that system level, to consider new ways that services can be offered to improve outcomes. This is how we begin to drive government efficiency in new ways. Successful community efforts along these lines have included fixing street lights to change conditions that lead to criminal behavior and putting in a bus stop to increase transportation access to higher paying jobs. Both of these activities had huge impacts on the population, one by making the neighborhood safer which tightened community fabric and the other by altering one of the forces that perpetuates cycles of poverty.

As improvements occur, the budget constraints that local governments must face when setting their budgets each year will lighten. What this work actually does, by involving residents as the leaders of the work (this is what we mean by community-led) in changing trajectories, families and individuals feel a greater sense of agency in their wellbeing as well as their community’s, which over time and with the right education has shown to alter the ways they lead their private lives as well, without being forced to do so, which changes trajectories in massive ways, as far as having been shown to reduce ACE prevalence across a population. What this indicates is that while there are short-term benefits that exist, long-term benefits are exponentially greater when we look at the impacts of this work, which enables sustainability and scale over time.

State level operates similar to counties, just on a broader scale. The state will organize these county coalitions - which again are organizing community coalitions - to support the ways in which local governments are moving to support this cost avoidance. State governments are large, so in addition to greater data modeling to support the financing, there must also be greater work to support interagency coordination as we work to address fragmentation. Integration is key to healing at a systems level so that we can actually function in coordinated ways that best serve the people the government is supposed to serve. Systems have become so complicated that it can feel like we must serve the systems rather than the other way around. Interagency coordination allows us to start looking at things in new ways. I saw this first hand in my work with the Interagency Task Force on Trauma-Informed Care in the federal government.

This is not a new concept and there have been many efforts - ironically many of which are siloed from each other - to create greater interagency coordination. However, what has been missing is an incentive for agencies and officials that is greater than the inertia of their current jobs, which in fairness are already very busy. The alternative financing, especially given the constraints governments are currently facing, can serve as this incentive. What this starts to solve more deeply than Full Capital does alone, which I will get to in a bit, is the wrong pocket problem, where investments in one “system” produce returns in another, but the fragmentation of those “systems” leads to the returns not going back to the investment and initiatives stopping.

I put “systems” in quotes there because I believe that referring to them as different systems is a flaw in our conception of the public system. They are different systems in their own right in some ways, but I also believe that in working toward integration, we must recognize that they are all in service of a greater public system. I believe there is one public system that we live in, broken into component parts so that it becomes more manageable, but when we forget that it is really just one system in service of life flourishing, we harm people through its fragmented parts. I recognize that I am saying the same thing twice here a bit, but it leads to a core philosophy. We so frequently put the onus and burden of trauma on individuals and fail to recognize that trauma also impacts systems. One of the hallmarks of trauma at any level is fragmentation, as I’ve been talking about. At an individual level we may see fragmented narratives, while at a systems level we see trauma through the fragmentation outlined above. Traumatized systems perpetuate stress and adversity, disproportionately on marginalized people and groups of people, which then propels predictable outcomes systems must address further downstream. If fragmentation is a hallmark of trauma, then it makes sense that integration is a hallmark of healing. 

What we will likely find as this work continues at both the county and state level is that as systems improve, and as communities and constituencies become happier, government work will become more hopeful, perhaps even enjoyable. Most people I know who do government work, especially those at the state and local levels, though the same is true at the federal level, get into this work because they want to make a positive difference in people’s lives. They work incredibly hard in what has especially recently been thankless work - think back to my county executive story - and problems are becoming so great the work itself can feel helpless. So as we improve processes and outcomes, morale is likely to improve, which is likely to drive the improvement of processes and outcomes, feeding into the exponential growth over time.

The federal government fits into this similar to how states fit into the counties. Just as county governments are structured differently from one another, so too are state governments. But the federal government has the opportunity to fit into this by learning from states, both what states are doing themselves as well as what states are learning from counties, which should be informed by not just what counties are doing but also what counties are learning from communities, and synthesizing these findings to both inform policy and resource allocation, as well as sharing with states, counties, and communities to reduce reinventing the wheel. 

Interagency coordination would need to be done at the federal level like at the state level to align data collection and financial projections from investment to return to have a full view of where the government is becoming more efficient, but again this is true government efficiency. Our nation is nearing $40 trillion in debt without any clue as to how to reverse the trend. What I hope is clear is that this does not mean that there are no ideas as to how we can reverse that trend and someday find our ways out of this debt burden and crisis. As I said at the beginning of this piece, this is a comprehensive agenda that is informed alongside some of the smartest minds I know and have known, informed by the best policies we have seen. There is hope.

I hope that it does not continue taking so long to build capacity to implement The Full Press. I am currently working with multiple states, none more deeply than Pennsylvania at the moment, to implement The Full Press, but with no other staff and no capacity to fund the coalition work outlined above, what is already a tall order becomes increasingly daunting, but this piece is not being written to bemoan my current position. I am writing with the hopes of clarifying the vision of this work so that we can build capacity, not just financial capital, but also human and social and cultural capital, among others, so that this work can be done now and scale over time. 

The Full Press, as I briefly mentioned before in this piece, and less briefly in many others, consists of two main components, Full Capital and PressOn. Full Capital is the idea that we invest financial capital disproportionately into more financial capital without investing in human, social, cultural, environmental, intellectual, and other forms of capital. This is like trying to bake a pie with only one slice. If we invest in all forms of capital, the entire pie will grow, including the “slice” of financial capital, which can then be reinvested to sustain and scale growth over time. This will not be a linear growth curve, but as has been discussed above, will be exponential. That means that we may not see the returns immediately, we know that while there are some proximate returns there are many more in the intermediate term, with the greatest returns coming in the long term, but as the returns come they will compound many times over. This trajectory will continue for multiple generations as children born to healthier parents and in healthier communities experience the benefits of better epigenetic lineages as well as external environments in which to grow up, which then will create continued benefits for their children and so on. At some point on an exponential curve, there will be a plateau, but at that point there will be such a fundamental shift in resource availability as well as incentives on systems that future generations will be better positioned to create strategies that deal with problems that currently exist beyond the horizon of where present-day generations can see because of the vastness of the challenges we are facing. There is no silver bullet, so more innovation will be necessary, but The Full Press does position us on a long-term trajectory to be able to work down our debt by promoting wellbeing, which will strengthen our society in multiple ways. We cannot pretend that short term solutions can truly solve generational issues.

PressOn compliments Full Capital by coordinating and aligning across levels, back to the point of integration, with a focus on communities. It was the vision of my late mentor Dan Press, he argued but ultimately let us name it after him, that we worked on together as he became sick, and informed by the chaos of working to direct COVID stimulus funds and seeing the lack of coordination across levels of government. Put the two together and it creates the ability to align funding streams and data collection to reinvest dollars where savings are being driven, and supporting communities in driving innovation. The funder I mentioned at the beginning of this piece supported me to work alongside Dan and learn from him, which I will always be grateful for, as while there was so much more he had to teach me I sure did learn an awful lot. 

Clearly, there is still so much more to learn. I am going to need retry this because I don’t feel like I did a good job articulating clearly the vision, at least not better than I have done before. So I will keep trying. Like taking reps on the field. Good practice makes you better.