Policy & Practice | Winter 2024

Unfortunately, the nation still faces significant challenges that require bold leadership from the Trump Administration. • In 2023, 36.8 million people (11.2 percent of the U.S. population) 1 lived below the official poverty measure and more than twice as many people are estimated to live in households that do not earn enough to meet the basic needs of food, housing, health care, transportation, and child care, despite working full time. 2 • Despite the impact of the nation’s nutrition programs, food insecurity remains at alarming levels , with 13.5 percent of households and 47 million people struggling to consistently put healthy food on the table in 2023. 3 • Nationally during FFY 2022, 3,096,101 children received either an investigation or alternative response with 558,899 children determined to be victims of child abuse and neglect and an estimated 1,990 children dying from abuse and neglect. 4 • According to the U.S. Bureau of the Census, more than 21 million renter households spent more than 30 percent of their income on housing costs in 2023, representing nearly half (49.7 percent) of the 42.5 million renter households in the United States for whom rent burden is calculated. • An analysis of the National Database of Childcare Prices across 47 states show s child care prices for a single child ranged from $5,357 a year for school-age , home-based care in small counties to $17,171 for infant center-based care in very large counties. These price ranges were equivalent to between 8 percent and 19.3 percent of median family income per child in paid care. We can address these profound challenges and fuel many of our national priorities by building on the success of the nation’s human services programs and making strategic policy changes and funding investments. The following paper provides an overview of the U.S. human services system, how human services contribute to achieving our national priorities, and the actions the new Administration can take to strengthen human services programs so that every resident can be safe and healthy with an opportunity to thrive.

Human Services System Overview Human services encompass the essential services and supports that every American needs to stay safe and thrive , including access to food ; health care , including mental health and substance use services ; child care/early education ; income support ; and workforce development services as well as child and adult protective services. Increasingly, the nation’s human services infrastructure also includes prevention services , including home visiting, aging in place services, and housing assistance. The human services system bolsters resilience during life’s inevitable ups and downs, and, when necessary, provides safety, wellness, and healing in the most familial, community based settings. Most human services programs are implemented through shared governance across levels of government. Federal laws authorize most programs, and federal agencies provide oversight and guidance to states responsible for their implementation. States have flexibility in how they administer human services, which creates a variety of delivery models , including delivery by state staff, county and city governments ; privatization where the primary responsibility lies with not-for-profit or faith-based organizations ; and hybrid approaches that combine one or more of these delivery channels. All of these organizational delivery models include the use of private agencies, typically not-for-profit organizations, for direct service delivery and rely on technology solutions to facilitate the work, report program metrics, and gather insights. Most human services are overseen at the federal level by the U.S. Department s of Health and Human Services, Labor, and Agriculture.

Human services programs serve a significant percent of the nation’s population, including:

85.6 million people receiving health insurance through Medicaid and the Children’s Health Insurance Program (CHIP) 42.2 million people able to purchase food through the Supplemental Nutrition Assistance Program (SNAP)

12.7 million children served through the child support system

2 million families served by the Temporary Assistance for Needy Families (TANF) program 1.3 million children in child care 745,000 children receiving payments for foster care or prevention services

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Courageous Imperatives for Human Services—The Connective Force: Driving Health, Well-Being, and Prosperity in America