Policy and Practice | August 2022

The Magazine of the American Public Human Services Association August 2022

Navigating Upstream Achieving Better Health and Well-Being Through Prevention

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contents

Vol. 80, No. 4 August 2022

features

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12

Aligning for Prevention Serving Young Families Better

Coordination of Child Welfare and Early Childhood Systems A Key Prevention Strategy

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20

We Can’t Be On the Sidelines The Role of Human Services in Advancing Environmental Justice

Looking Back to Accelerate Moving Forward Charting Our Next Course

departments

3 Editor’s Note

7 Technology Speaks

26 Association News

Moving Forward in the New Normal

Achieving Health Equity: Actionable Analytics Unlock Improved Outcomes

APHSA Announces Member Awards at 2022 National Health and Human Services Summit

5 From the Field

24 Race Equity Champion Connecticut Department of Children and Families, Racial Justice Change Initiative 25 Partnering for Impact Early Intervention Is Key to

Keys to Prevention: Wisconsin Explores Housing Interventions to Keep Children with Their Families

36 Staff Spotlight

Lynnea Kaufman, Associate Director of the National Electronic Interstate Compact Enterprise (NEICE)

6 From Our Partners

Moving Forward Together: Education, Early Intervention, and Prevention Services Save Lives

Supporting Families: How Health and Human Services Agencies Can Make the Connection

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August 2022 Policy&Practice

Strategic Industry Partners

APHSA Executive Governing Board

Chair Dannette R. Smith, CEO, Nebraska Department of Health and Human Services Vice Chair Rodney Adams, Former Director, Mecklenburg County (NC) Department of Community Resources Immediate Past Chair David A. Hansell, Former Commissioner, NewYork City Administration for Children’s Services Treasurer Reiko Osaki, President and Founder, Ikaso Consulting Elected Director Derrik Anderson, Executive Director, Race Matters for Juvenile Justice Elected Director Vannessa L. Dorantes, Commissioner, Connecticut Department of Children and Families

Elected Director Kathy Park, CEO, Evident Change Elected Director

DIAMOND

Terry J. Stigdon , Agency Head/Executive Director, Indiana Department of Child Services Elected Director Jennifer Sullivan , Senior Vice President for Strategic Operations, Atrium Health Elected Director Eboni Washington , Assistant Director, Clark County (NV) Juvenile Justice Services Leadership Council Representative Justin Brown, Secretary, Oklahoma Department of Human Services Local Council Representative Dan Makelky , Director, Douglas County (CO) Department of Human Services

PLATINUM

SILVER

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Policy&Practice August 2022

editor’s note By Jessica Garon

Moving Forward in the New Normal I t is hard to believe it’s been almost two and a half years since I first

in this new normal, there are many opportunities for the pandemic to serve as a catalyst for change and innovation. Recently, we were fortunate to hear from members, partners, and friends about many of these opportunities during our 2022 National Health and Human Services Summit—the first in person Summit in two years, making it an amazing occasion to reconnect, recharge, and learn from one another. In the pages ahead, you will find two special features that came out of our time together at the Summit. On page 20, APHSA President and CEO Tracy Wareing Evans shares her remarks from the Summit’s opening session, which highlighted and celebrated our past 90 years as an association. By reflecting on our past, we have the

chance to pave new and improved paths forward. And on page 16, APHSA Policy Associate Chloe Green, and our friends at Mathematica, reflect on the unique opportunity to deepen our col lective understanding of the ways in which human services and environ mental justice intersect and what that means in our pursuit of a more equi table future for all. We hope to connect, reenergize, and continue learning from one another at our remaining upcoming events this year (see below). In the meantime, you can continue learning from our resilient network of members and partners in the stories that follow, and I also invite you to be in touch (via jgaron@aphsa.org ) if you, too, have a story of your own to share. Be well and see you soon!

mentioned the COVID-19 pandemic in our April 2020 issue and how it was impacting you—our members and partners—as well as other front-line workers, essential businesses, and communities as a whole. Times were uncertain and I don’t think any of us would have guessed how long the road ahead would be—or how bumpy! However, with the unexpected came new perspectives and realizations, adaptable solutions, and unyielding drive. We saw the health and human services field (amongst many others) bend without breaking, doing all they could to support and strengthen the communities they serve in a new normal. And as we nowmove forward

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August 2022 Policy&Practice

Vol. 80, No. 4

www.aphsa.org

Policy & Practice™ (ISSN 1942-6828) is published six times a year by the American Public Human Services Association, 1300 N. 17th Street, Suite 340, Arlington, VA 22209. For subscription information, contact APHSA at (202) 682-0100 or visit the website at www.aphsa.org. Copyright © 2022. All rights reserved. This magazine may not be reproduced in whole or in part without written permission from the publisher. The viewpoints expressed in contributors’ materials are the authors’ own and do not necessarily reflect the policies or views of APHSA. Postmaster: Send address changes to Policy & Practice 1300 N. 17th Street, Suite 340, Arlington, VA 22209

President & CEO Tracy Wareing Evans Communications Director/Editor- in-Chief Jessica Garon jgaron@aphsa.org

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Editor Amy Plotnick

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Policy&Practice August 2022

from the field By Molly Tierney and Wendy Henderson

Keys to Prevention: Wisconsin Explores Housing Interventions to Keep Children with Their Families

T he eviction moratorium during the COVID-19 pandemic led to a significant decline in safety reports and family separations in the State of Wisconsin. This phenomenon prompted child welfare leaders to explore housing assistance as a means of reducing unnecessary and traumatic removals. Accenture’s Molly Tierney spoke with Wisconsin’s state child welfare director, Wendy Henderson , about the innovative work underway. Molly Tierney: First, what is your point of view on child welfare as primary prevention? Wendy Henderson: Other social services agencies are better suited to delivering primary prevention. Child welfare should provide secondary prevention. Too often, though, child welfare removes children from their homes because their families are in poverty. In Wisconsin, we are focusing on making sure the system involves the “right” families—those that come to us truly because of an allegation of abuse and/or neglect. We want to keep the “wrong” families—the ones who are simply struggling with poverty— out of the system. Tierney: What guided your thinking about where it might be possible to divert the “wrong” kids from secondary prevention? Henderson: We always start with data, and a couple of powerful data points kicked off our thinking. First, we analyzed what we call our “short stayers,” the kids we remove from their families for 30 days or fewer. On

paper, that is a short separation, but it changes that child and family forever. The damage is difficult or impossible to undo. Second, we looked closely at the overlay of poverty and child welfare. In Wisconsin, as in many places, there is a straight line between poverty, race, and child welfare. They are just inex tricably intertwined. We started to ask, “What can we grab hold of?” That is when housing came to the front. It became even clearer as we looked at the relation ship between the COVID-19 eviction moratorium and the reduction in removals based on housing.

We challenged ourselves to find new ways to work with families who should not be in the child welfare system. At the same time, we are revising our safety model since that is the mecha nism for starting the process. Tierney: How are you starting to bring this idea to life? Henderson: It is still early days, but we are calling the initiative “Family Keys” and developing it in partner ship with Casey Family Programs. Wisconsin already has a federally funded program that provides more

See Keys to Prevention on page 28

Photo by Cottonbro/Pexels

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August 2022 Policy&Practice

from our partners

By Karen Snyder

Moving Forward Together: Education, Early Intervention, and Prevention Services Save Lives

G rowing up, my grandmother always told me to be kind to people as you never knowwhat a person may be going through and howmuch a smile or a kind word could help someone. Little did I know that I would dedicate my career to health and human services, working to make positive impacts on the lives of people and families facing adversity. One thing I have learned is that prevention services and activities come in many shapes and forms—from a smile and kind word to evidence-based practices and programs, delivered by states, counties, schools, or community-based organizations. Our world continues to evolve. There are more than 400,000 children living in foster care. More than 5.9 million individuals are unemployed; and more than half a million individuals are homeless. Individuals and families continue to change and face adversity, and as a society we have a respon sibility to adjust and meet people where they are. We need to speak to the unique needs of individuals and families that make up today’s world. As leaders, we must continu ally review our systems’ foundations and frameworks to determine the need to refocus, reshape, or rebuild. We need to relentlessly pursue a deep understanding of the barriers that prevent individuals from realizing their full potential; and tap into the ideas and experiences of families and human services professionals. Moving forward, we must keep in mind lessons learned over the years and re-empha sized through the COVID-19 pandemic: 1. Education plays a key role in prevention

few. Health and human services orga nizations, including community-based organizations and religious groups, inform the public of programs and services available to individuals and families. These programs and services can, ultimately, prevent significant stress, homelessness, substance use, and even child abuse. Early intervention can prevent more severe consequences. During COVID 19, interventions such as wearing masks and social distancing were imple mented to prevent or slow the spread of the disease. Providing an intervention and interceding for an individual with a substance use disorder can prevent an overdose and lifealtering impacts. We have witnessed the success of a variety of early intervention programs, such

2. Early intervention can prevent more severe consequences 3. Prevention services and activities save lives Education plays a key role in pre vention . Throughout the COVID-19 pandemic, we continually learned new information and adjusted our practices and protocols accordingly. Education has always played a key role in prevention. For years, health prac titioners have shared the impacts of poor eating habits and lack of exercise, promoting healthy choices and thereby preventing a variety of illnesses and prolonging life. Public health officials have implemented a variety of vaccine programs through the years, including the Vaccines for Children’s program, influenza, pneumococcal, hepatitis, chickenpox, and shingles, to name a

See Moving Forward on page 28

Illustration by Chris Campbell

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Policy&Practice August 2022

technology speaks By Rob Waters, James Lukenbill, and Mylynn Tufte

Achieving Health Equity: Actionable Analytics Unlock Improved Outcomes

W ith health equity, part of the challenge is deciding where to start. States have built programs for improving specific social determinants of health (SDOH). But without data driven insights, it is tough to know how to prioritize and coordinate efforts. By applying analytics solutions, states can create a comprehensive roadmap to better health equity. We see big opportunities for change with solutions that include integration, scal ability, and partnerships. Rob Waters , with State Healthcare IT Connect, sat down with James Lukenbill and Mylynn Tufte from Optum to discuss achieving health equity through actionable analytics. Rob Waters: How should states be thinking about applying ana lytics to the challenge of improving health equity? approach to health equity. It has also focused attention on the public health infrastructure, IT, and data modern ization crisis facing state public health departments. Harnessing the power of integrated data sets across agencies, working with their federal, state, local and tribal partners will make a difference. It can help drive efficiencies that are difficult for one entity to achieve by themselves. Advanced analytics can help states improve access, better manage utilization of resources, and Mylynn Tufte: The pandemic forced us to take a more holistic realize better health and quality outcomes for their population. James Lukenbill: Analytics do not just point out problems. They let states

identify their greatest opportunities for leveling the playing field. With the right insights, states can choose how to dedicate resources. They can plan budgets and plot interventions. Waters: How can states realize the full potential of analytics to affect health equity? Tufte: First, they need good quality data, and then they need a lot of it. When I ran the North Dakota Department of Health, we had access to multiple data sets, but few of them talked to each other and I did not have access to the breadth of data across multiple data sets or the ability to apply a data-driven approach across those data sets. The ability to apply a data driven approach across data sets from transportation, housing, or Medicaid would have allowed for more targeted

interventions to address health dispari ties. When you can get large data sets together, that is when you can make a difference in achieving health equity. You can design and deploy programs best suited to your population and increase feedback. Lukenbill: Collaboration is also essential, for example, in public– private partnerships. With support, states can build on the SDOH work they have already done and expand it. Partnerships tie to data access, too. They allow for data exchange, which increases the amount of acces sible data. The more data, the more we know about a population, and the more likely programs will be designed to match needs.

See Health Equity on page 30

Image via Shutterstock

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August 2022 Policy&Practice

Aligning for Prevention Serving Young Families Better By Meg Dygert and Mary Nelson

M

illions of children in the United States live with parents aged 18–24. These young parents, jointly navigating adulthood and parenthood, face such challenges as disruption in education, unemployment,

housing instability, and lack of access to quality child care. Despite these obstacles, young families are incredibly resilient. Young parents experience critical phases of development as new parents and adolescents grow alongside their children, who are also in an important phase of early-childhood development. Investing in young families during this critical time frame is a chance to maximize on two windows of opportunity, supporting parents and children in developing physical, social, emotional, and economic well-being.

Through the American Public Human Services Association’s (APHSA) System Alignment for Young Families (SAYF) Learning Academy, funded by the Annie E. Casey Foundation, six state and local cross-system human services teams, including young parent leaders, are targeting system alignment strate gies to break down silos and establish human services systems that work with and for young families. Using APHSA’s Working Together—A Roadmap to Human Services System Alignment for Young Families 1 each state and local team is working to create a System Alignment Plan that identifies systematic service gaps and establishes concrete action steps to close them. The SAYF Learning Academy has focused primarily on delib erate planning and communication with parents and human services leaders across programs and funding streams to identify practice shifts and long-term tactical planning. Emerging projects include estab lishing state-level young parent advisory committees to review policies impacting young families; implementing system-wide, county level assessments to better identify and coordinate services for young

families; and cross-training of front line staff to inform case management and system navigation for young parents. Throughout the process, however, clear policy questions have also emerged that impact young parents and their children. Examining policy levers that can be pulled alongside practice changes can serve to enhance cross-system efforts to support young families and ultimately prevent deeper system involvement. The emerging insights from the SAYF Learning Academy adds to the extensive body of work 2 focusing on better supporting young families. Human Services Must Support All Parents’ Ability as Caregivers Young families are incredibly diverse, in varied housing arrange ments and relationships. Yet, research supports that whatever the home arrangement, engagement with all caregivers promotes children’s social, emotional, and physical development. 3 n Incentivize participation of non custodial parents in education, work activities, and supportive services that promote long term family economic mobility. Supplemental Nutrition Assistance Program (SNAP) Employment and Training (E&T), 4 Temporary Assistance for Needy Families (TANF), 5 and Workforce Innovation Opportunity Act funds can be used for high-quality employment and training services targeted to parents with support orders. States can create policies to forgive child support arrears or otherwise modify child support arrangements for parents who successfully participate in such programs. For instance, the Maryland Department of Human Services’ Supporting, Training, and Employing Parents (STEP Up!) program supports noncustodial parents in Baltimore City with child support cases in overcoming employ ment barriers. Participants who successfully complete the STEP Up! program can earn forgiveness for child support arrears owed to the State of Maryland.

n Consider state flexibilities in child support cooperation requirements to promote family stability. States have flexibility to modify or remove child support collection require ments for several federally funded programs and supports. States can utilize allowable exemptions or good cause from cooperation where it would support the social, emo tional, and physical well-being of the family. For many states, some or all of these flexibilities are already in use, however, it is worth evaluating where there is potential for policy change to better support young families (see Chart 1). geting mothers. For example, the Connecticut Department of Public Health partnered with the organiza tion, Real Dads Forever, to promote the inclusivity of fathers in the Special Supplemental Nutrition Program for Women, Infants, and Children, including adding space for fathers’ names on forms and staff training on fatherhood engage ment. 6 In Georgia, the Department of Human Services’ Division of Child Support Services (DCSS) Fatherhood Program provides services to help fathers paying support to achieve self-sufficiency and improve parenting skills. DCSS also strategically partners to meet the needs of fathers who are homeless veterans and/or returning citizens. Human Services Should Align Housing Resources to Promote Family Stability It is estimated annually that more than one million children across the United States have a young parent that has experienced homelessness. Of the unhoused population, 44 percent of young women are mothers and 18 percent of young men are fathers. 7 Navigating parenthood during key developmental milestones for both parent and child are difficult without stable housing. Supporting young families in accessing afford able and stable housing is critical to n Invest in fathers’ social and economic involvement with families, particularly in programs traditionally tar

Meg Dygert is a Policy Associate for ChildWelfare and Family Well-Being at the American Public Human Services Association (APHSA).

Mary Nelson is a Policy Associate for Employment and Economic Well Being at APHSA.

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Policy&Practice August 2022

the Department of Human Resources and 30 organizations, establishing formal data-sharing agreements and a joint case management/enrollment system, to create the Campus of Hope. Campus of Hope is a one-stop shop where families can access a variety of resources throughout the community that are geared toward both parents and their children. By co-locating services, agencies reduce administrative burden for their staff while allowing for comprehensive screening, resource navigation, case management, and service delivery aimed at the needs of young families. Human Services Can Promote Employment Opportunities that Align with Young Parents’ Goals Young people’s employment goals and priorities reflect a growing interest in entrepreneurship and comfort with technology. Thirty-eight percent of the gig economy, including self-employ ment contract arrangements like Uber or Rover, is made up of young people ages 18–34. 9 At the same time, young people are increasingly adept at using technology, a trend that will enhance opportunities for young parents in the workplace and could serve to reduce barriers to employment. 10 n Support self-employment as a work participation option for parents. Federal law allows for self-employment to count toward TANF work requirements. States should ensure that young parents are aware that self-employment counts toward work requirements and accurately capture hours. States also can support parents’ entre preneurial interests by excluding business start-up loans from income determinations for TANF, child care, and other public benefits, and by providing training and education related to business ownership. 11 The Mississippi Community Education Center Entrepreneurship Education Program, which helps young people grow through hands-on entrepre neurship education, is an example of one such program. 12

Chart 1: State Flexibilities for Child Support Supplemental Nutrition Assistance Program (SNAP) • State option to require custodial and noncustodial parents to participate in paternity establishment and cooperation with child support. Temporary Assistance for Needy Families (TANF) Cash Assistance • Federal law requires families receiving TANF cash assistance to cooperate with child support and paternity establishment, absent “good cause.” States have flexibility in defining “good cause.” • States may opt to “pass through” all or some child support to the family, but may only waive a portion of the federal share. Medicaid • Federal law requires custodial and noncustodial parents to cooperate with paternity establishment and child support collection of medical support, absent “good cause.” Pregnant and postpartum women are exempt.

Child Care Subsidy • State option to require custodial and noncustodial parents to participate in paternity establishment and cooperation with child support.

family well-being and preventing further, more costly, interventions downstream. n Align rental assistance and local homeless services with eviction proceedings. For example, a 2021 report by The Pittsburgh Foundation 8 highlighted how Allegany County, PA could provide a wrap-around, mixed delivery of homelessness prevention and mitigation services. The mixed-delivery method empha sizes the importance of utilizing community-based access points and better aligning court-based eviction diversion programs and local homeless service providers. Agencies can further support pregnant or parenting youth at risk of homeless ness by increasing communication between housing agencies and court systems to coordinate and craft policies that delay evictions in favor of deploying preventive services before evictions become a reality. n Identify young families as a special population to keep the whole family together and pri oritize their needs. While there is a robust system aimed to elimi nate homelessness, services often focus on housing mother and child, excluding co-parents. Additionally, availability of services can be depen dent on if the parent is identified

as an “adult” or “youth,” causing confusion and forcing families into systems that do not meet the unique needs of pregnant or par enting youth. Local jurisdictions can list young families as a special population within their Continuum of Care Coordinated Community Plan and identify population-based needs, service gaps, and bench marks for pregnant and parenting youth populations. For example, both King County, WA, and the Santa Cruz County, CA, Youth Homelessness Demonstration Program Coordinated Community Plan identify young parents as a special population. In doing so, these jurisdictions hold themselves accountable for serving young families and create a clear pathway for providers to serve the population more effectively. n Co-locate economic and sup portive services with housing agencies. To reduce burden on young families seeking services and actualize access to the myriad programs offered within a commu nity, agencies should coordinate to co-locate economic support services with housing and community-based agencies. For example, in Alabama, the Housing Authority of the Birmingham District partnered with

See Prevention on page 37

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August 2022 Policy&Practice

Coordinating

Child Welfare & Early Childhood Systems

A Key Prevention Strategy

By Elizabeth Jordan

E

arly childhood and child welfare systems are both broadly increasing their investments in preventing child abuse and neglect. Both systems have initiated efforts to reduce maltreatment and avoid the harm caused by child welfare

involvement and family separation through foster care. Both are also striving to better support children and families of color who have been subject to long-standing and persistent inequities. My work at Child Trends, a nonprofit research organization, focuses on understanding policy opportunities to support children and families in early childhood and child welfare systems. A deeper understanding of the two systems can help leaders identify opportunities to weave the separate streams of work together to increase the efficiency and effectiveness of services, resulting in improved outcomes for children and families. In this article, I elevate salient points from our recent paper, “Alignment Between Early Childhood and Child Welfare Systems Benefits Children and Families,” 1 to help system leaders do just that.

identified as maltreatment victims, neglect is the most frequent allega tion (69 percent for children age 8 and younger). In all states, inadequate supervision, harm due to inadequate supervision, or failure to meet parent/ caretaker responsibilities is defined as maltreatment. Addressing condi tions that are linked to poverty, such as unaffordable or unavailable child care or housing, or other conditions related to extreme financial stress, can prevent neglect allegations. Opportunities for Coordination to Support Prevention of Maltreatment Our paper suggests several approaches for collaboration for prevention. n Connect primary prevention strat egies across systems. State child welfare systems are increasingly focusing on primary prevention— i.e., services designed to avoid any need for child welfare inter vention. For example, Thriving Families, Safer Children: A National Commitment to Well-Being 6 —a joint partnership between the federal Children’s Bureau, Casey Family Programs, the Annie E. Casey Foundation, and Prevent Child Abuse America—focuses on helping systems prevent the separa tion of families through foster care. Federal funding sources, including Title IV-B 7 and Community Based Child Abuse Prevention 8 can be used for prevention services such as Developmental Understanding and Legal Collaboration for Everyone, 9 which provides holistic services to families with infants. n Coordinate on prenatal sub stance abuse supports to help families access the services they need. The federal Child Abuse and Prevention Treatment Act 10 requires child welfare agencies to create and implement Plans of Safe Care that describe the process for supporting children born with prenatal drug or alcohol exposure and determining the need for child welfare interven tion. System leaders can coordinate on developing and implementing these plans and partner with

families to access services in a non punitive, strengths-based way. n Promote programs and policies that allow children to qualify for dyadic therapeutic services with their parents. States vary 11 in how they use Medicaid to cover dyadic treatment 12 (a type of therapy that supports the young child and parent together) and models that focus on parents/caregivers, and on the process by which parents/caregivers can access treatment (e.g., qualifica tion requirements and whether a referral is required). The National Center for Children in Poverty’s PRiSM Initiative 13 features policy strategies for connecting families to dyadic treatment in Arkansas, Colorado, Connecticut, Florida, New Mexico, and Oregon. n Coordinate with state efforts to implement the Family First Prevention Services Act Title IV-E Prevention Plans. The federal Family First Prevention Services Act 14 allows states to use federal child welfare dollars for qualifying evidence-based preven tion services, 15 including mental health, substance use, and in-home parent skill-building programs for children at imminent risk of entering foster care. Home visiting programs approved by the Title IV-E Prevention Services Clearinghouse 16 are eligible for federal funding, so some states—Hawai’i 17 is an example—include early childhood stakeholders on implementation teams. Early childhood leaders have important and relevant exper tise due to their administration of the Maternal, Infant, and Early Childhood Home Visiting Program, which has similar evidence-based requirements. n Join efforts to reduce the number of child fatalities. Over three-quar ters of the 1,750 children who died 18 from child abuse or neglect in 2020 (likely an undercount) 19 were ages 3 or younger. State child welfare agencies are required to create plans to reduce these fatalities, building on the work of a federal Commission to Eliminate Child Abuse and Neglect Fatalities 20 and state policies

Early Childhood Is a Critical Time to Focus on Prevention Compared to older children, the child welfare system is more likely to identify young children 2 —especially infants under age 1—as victims of abuse or neglect. Young children are also more likely to be placed in foster care than older children. In fact, in fiscal year 2020, nearly two out of three children who entered foster care were age 8 or younger. Early childhood trauma 3 is very harmful for young children, because it can cause long-term developmental and physical challenges. 4 To be most effec tive, strategies to reduce or prevent long-term consequences 5 of trauma and enhance resilience must be coor dinated across systems, anchored in evidence, begin as early as possible, and be grounded in early child devel opment best practices. Coordination Can Improve Access to Prevention Services for Young Children and Their Families Because the child welfare and early childhood systems often serve the same populations, coordination can streamline service access for families, broaden workforce awareness of family supports, and ensure families’ access to a cohesive set of needed services, ultimately reducing the need for child welfare involvement. Particularly important is coordination around connecting families to economic and concrete supports. Among children

Elizabeth Jordan is the Director of Policy Communications and Outreach for Child Trends.

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promoting child fatality reviews. 21 The expertise of early childhood leaders can help make these plans more effective. n Educate mandated reporters, including early care and educa tion providers, on how to identify maltreatment when appro priate—and to avoid reporting when child welfare intervention is not appropriate. State policies vary in their specifications of mandated reporters 22 (i.e., which groups of individuals are required to report suspected child abuse or neglect). Child care providers are mandated reporters in 49 out of 52 states (including Puerto Rico and Washington, DC). However, at least 30 states do not require training for them. States’ definitions of abuse and neglect 23 can be complicated, 24 so training early childhood providers to understand reporting requirements may not only identify when child welfare intervention is appropriate, but also prevent unnecessary inves tigations. Organizations like Evident Change have been supporting states in updating and revising mandated reporting policies and trainings. 25 n Include members of both systems in race equity efforts. To increase equity for families of color, both the child welfare and early child hood systems must come to terms with their respective histories and deconstruct systemic racism. A joint equity agenda—such as the one laid out in the Center for the Study of Social Policy’s “Supporting the First 1,000 Days of A Child’s Life: An Anti-Racist Blueprint for Early Childhood Well-Being and Child Welfare Prevention” 26 —could be one strategy to advance this work. The blueprint includes both guiding principles and questions to help leaders find common ground and a unified path forward. n Authentically engage parents working to reunify, relatives caring for children, young parents who were in foster care, foster parents, and kinship caregivers in early childhood equity efforts. These stakeholders can help shape policies that truly address families’

needs, because they understand the challenges created by system involvement for themselves, their children, and the children for whom they care. Engagement should be meaningful and in a safe and acces sible format, and participants should be compensated for their time. Early childhood stakeholder groups may be able to coordinate with existing groups of parents and caregivers, such as the Illinois Statewide Foster Care Advisory Council. 27 n Invest in data that allow states to set goals toward more equitable access to services and a more equitable child welfare system, and use the data to regularly monitor progress and adjust course when needed. Connecting data between systems is useful for understanding how children are faring, and for learning which efforts are working for children and families. However, many states struggle with data integration. 28 Exploring how data can inform a key policy question, such as whether children in foster care are accessing high-quality child care, can be a helpful first step. Federal projects such as the Child and Caregiver Outcomes Using Linked Data Project 29 and state efforts, such as Rhode Island’s, 30 work to understand child care access issues for young children who have expe rienced maltreatment, show how connecting these data can help leaders better understand and meet the needs of families. alignment-between-early-childhood-and child-welfare-systems-benefits-children and-families 2. https://www.acf.hhs.gov/sites/default/ files/documents/cb/afcarsreport28.pdf 3. https://www.nctsn.org/what is-child-trauma/trauma-types/ early-childhood-trauma 4. https://www.nctsn.org/what is-child-trauma/trauma-types/ early-childhood-trauma/effects 5. https://www.nctsn.org/resources/ resilience-and-child-traumatic-stress 6. https://www.acf.hhs.gov/ media/press/2020/ Reference Notes 1. https://www.childtrends.org/publications/

first-its-kind-national-partnership-aims redesign-child-welfare-child-and-family 7. https://www.childtrends.org/wp-content/ uploads/2021/01/Title_IVB_SFY2018.pdf 8. https://www.childtrends.org/ wp-content/uploads/2021/01/ Other-federal_SFY2018.pdf 9. https://cssp.org/our-work/project/dulce 10. https://www.childwelfare.gov/pubs/ factsheets/about 11. http://www.nccp.org/wp-content/ uploads/2017/03/text_1164.pdf 12. https://www.nccp.org/dyadic-treatment 13. https://www.nccp.org/prism-project 14. https://www.childwelfare.gov/topics/ systemwide/laws-policies/federal/ family-first 15. https://www.childtrends.org/publications/ applying-the-research-and-evaluation provisions-of-the-family-first-prevention services-act 16. https://preventionservices.acf.hhs.gov 17. https://humanservices.hawaii.gov/ wp-content/uploads/2021/10/Family First-Hawaii_FFPSA-Plan_Final-May21_ PDF-2.pdf 18. https://www.acf.hhs.gov/sites/default/ files/documents/cb/cm2020.pdf 19. https://www.gao.gov/products/gao-11-599 20. https://www.acf.hhs.gov/cb/report/ within-our-reach-national-strategy eliminate-child-abuse-and-neglect fatalities 21. https://www.ncsl.org/research/human services/child-fatality-legislation.aspx 22. https://www.childwelfare.gov/pubPDFs/ manda.pdf 23. https://www.scanpoliciesdatabase.com 24. https://www.childtrends.org/ wp-content/uploads/2022/02/ ChildWelfareDataCompanionGuide_ ChildTrends_March2022.pdf 25. https://www.evidentchange.org/ blog/keeping-children-safe-everyones mandate#:~:text=Evident%20 26. https://cssp.org/wp-content/ uploads/2021/02/Supporting-the-First 1000-Days-of-a-Childs-Life.pdf 27. https://www2.illinois.gov/dcfs/ lovinghomes/fostercare/Pages/ com_ communications_statefpadv.aspx 28. https://www.childtrends.org/ publications/2018-state-of-early childhood-data-systems-interactive-map 29. https://aspe.hhs.gov/sites/default/files/ documents/d8f17022f085efd79013d33d81 994e91/ccould-project-brief.pdf 30. https://www.rikidscount.org/Portals/0/ Change%20has%20developed%20 reporting,suspected%20child%20 abuse%20or%20neglect

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The Role of Human Services in Advancing Environmental Justice We Can’t Be Sidelines on the c By Chloe Green, Alex Bauer, Colleen Psomas, Shaun Stevenson, Anu Rangarajan, Matthew Stagner, and Jacque Gombach

limate impacts are not experienced equitably across communities in a given geography; rather, adverse weather and other environmental health hazards disproportionately affect populations that may be more vulnerable and less able than others to adapt or recover. For example, children, older adults, and those without access to cooling or heating systems may be more sus ceptible to harm from extreme weather such as heatwaves, floods, wildfires, and other natural disasters that can have serious implications for those living in high-risk areas without the financial resources needed for preparedness measures. And factors like systemic racism, redlining, and disinvestments can place com munities of color, those experiencing poverty or houselessness, and other disenfranchised groups at risk— in other words, many of the individuals, families, and communities that human services agencies are designed to serve.

“Somemight ask, why are you even talking about environmental justice if youwork at HHS? Inmany ways, we serve the same individuals. It’s the same families that will endup coming to us after the event of any disaster—for any resources, or any support.”

– Shavana Howard, Assistant Secretary, Louisiana Department of Children and Family Services

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A number of additional factors further contributes to climate vulner ability for these same populations, including limited availability of infor mation and resources; less ability to rebuild after a disaster; higher levels of existing health risks in comparison to other groups; decreased reliable access to food, adequate housing, and consis tent employment; and limited access to health care services. The data highlight these inequities. For example, take a look at the graphic on the next page, which illustrates how heat impacts the Medicaid population. In 2016, there were 971 heatwaves in 20 percent of the counties across the nation. Half of the Medicaid popula tion lived in a county experiencing a heatwave and nearly $15 million was spent on the Medicaid popula tion on illnesses resulting from heatwaves. Given that the Medicaid

population closely aligns with the populations served by human services agencies, one can infer that many individuals served will be affected by extreme heat. This is precisely why human services leaders need to embed themselves in the conversations surrounding climate change, environmental inequities, and securing environmental justice (EJ) that are already happening in other departments, such as public health. The Environmental Protection Agency defines EJ as the “fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies” and says, “This goal will be achieved when everyone enjoys: (1) the same degree of protection from environmental and health hazards; and (2) equal access to the decision-making process to have a healthy environment in which to live, learn, and work.” 1 Human services professionals are well positioned to serve as trusted messengers to help achieve that goal, supporting and engaging the individuals and families they serve, their peers, their community, and policymakers in the pursuit of EJ. It is now time for human services leaders

to leverage that position and proac tively engage with other departments, agencies, and community partners that are already committed to this work to pursue effective solutions together.

Taking the EJ Reins at the Federal, State, and Local Levels More recently, the connection

between EJ and human services has become a priority at the federal level, as illustrated in an infographic created by the U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Planning and Evaluation, which was referenced in APHSA President and CEO Tracy Wareing Evans’ October 2021 memo. 2 In January 2021, President Biden issued an Executive Order to spur climate action across all federal agencies. 3 In May 2022, the Administration established the Office of Environmental Justice (OEJ) within HHS to “better protect the health of disadvantaged communities and vul nerable populations on the frontlines of pollution and other environmental health issues.” 4 The President’s Fiscal Year 2023 Budget Request and the recently passed Inflation Reduction Act also have significant provisions to address climate issues and advance EJ efforts.

Chloe Green is a Policy Associate for Food and Nutrition Services at APHSA.

Alex Bauer is an Advisory Services Analyst at Mathematica.

Colleen Psomas is the Senior Communications Specialist at Mathematica.

Shaun Stevenson is an Advisory Services Analyst at Mathematica.

Anu Rangarajan is the Senior Vice President of Climate Change at Mathematica.

Matthew Stagner is the Vice President of Human Services at Mathematica.

Jacque Gombach is the Founder and CEO of Captuva, LLC.

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Number of heatwaves (U.S., 2016) Number of counties with 1+ heatwaves: 2,033

examples of strategies and tactics that agencies are either employing today, or actions they are considering taking, to engage in EJ efforts moving forward. Human services leaders can adapt these approaches to best suit their organiza tion, help prioritize EJ in their work, and navigate how to communicate about available resources to peers, clients, communities, and policymakers alike. Grow internal EJ awareness and education. To truly embed EJ at the core of an agency’s work and keep it a priority moving forward, buy-in from staff and leadership will need to be secured. Given that conversations sur rounding the intersection of human services and EJ are still in their early stages in many jurisdictions, inten tional education and awareness efforts are necessary to connect the dots for internal teams. This will help staff not only to understand how their existing work supports EJ efforts but will also spur them to start thinking outside the box for future solutions. To engage in EJ internally, human services leaders can consider the following: n Educate staff across all departments about EJ and regularly incorporate it into conversations at all levels of the organization to encourage understanding of how EJ is related to human services. n Incorporate EJ into strategic planning and budgeting and consider dedicating funding specifi cally to advancing EJ. n Develop new and/or realign existing roles and responsibilities to be dedicated to climate change and EJ, and help staff throughout the organization identify ways they can support EJ efforts through their existing work to minimize addi tional staff burden. Keeping staff engaged and on board. Staff is vital to successfully bringing any organizational EJ efforts to fruition, so it is necessary for human services leaders to involve their staff in this work early and often. This may look like: n Helping staff to balance workloads and competing priorities that may detract from an intentional EJ focus;

Number of heatwaves

0

1-2

3-4

5-6

7+

While this represents a strong federal model, more substantial change can happen when led by agencies at the state and local levels. APHSA and its partners, such as Mathematica, recognize that state and local human services cannot sit on the sidelines as the conversation surrounding EJ—and the role human services agencies need to play in this space—is taking shape. With their deep community roots, they are better situated to advocate and assure fair treatment for constituents affected by climate change. Now is the time to collaborate and bolster the work hap pening at the intersection of EJ and

human services. Now is the time to recognize and embrace the urgency behind what Roderick Bremby, former Secretary of the Kansas Department of Health and Environment and Commissioner of the Connecticut Department of Social Services, says of EJ: “EJ is central to the work of the 21st century human services sector, because climate change is the chal lenge of our lifetimes.” Human Services and EJ in Action State and local human services agencies are already engaging with EJ to varying degrees. We share some

“Together with APHSA, we see the need for human services leaders to come together to share best prac tices, lessons learned, barriers to overcome, and opportunities. As these leaders look to meaningfully apply an EJ lens to their policies and operations, it’s necessary for all to fully examine how they show up for the communities they serve to ensure that no one is subject to inequities arising from where they live or how climate events impact them.”

See Environmental Justice on page 32

—MATT STAGNER, VICE PRESIDENT OF HUMAN SERVICES AT MATHEMATICA

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