Policy and Practice | December 2022

Progressing Through Partnership

The Current Landscape The COVID-19 pandemic clearly illuminated the glaring inequities 6 in our current health and human services systems—inequities that our nation has long failed to confront or address. Across the human services ecosystem, we see the impact of structural racism and bias highlighted at a systems level, calling us to shift power dynamics in order to realize the full force of a unified health and human services sector working in partnership with communities. Over the past few years, we have also witnessed firsthand how quickly we can adapt and innovate when system leaders work together, and act on community priorities and insights. We have a shared imperative to meet ongoing, immediate commu nity needs while also working toward transformative, systems-level change. In other words, we must ask how we can foster these transformations and ensure they are used to prepare today’s human- and social-sector leaders for the challenges not just of the present, but for the future as well. Together, across our networks, we believe we can equip a new leadership paradigm that supports a more equitable healthcare and human services system. We recognize that this paradigm shift is not an easy one nor one we can make overnight. It requires deep reflec tion on how our systems work today, a willingness to be open and vulner able to what people and communities experience when they interact with our sector, and an authentic curiosity for what we as leaders must do differ ently to truly center community and eliminate the structural and systemic bias baked into our programs and service delivery. Social Current and APHSA share a collective commitment to, once again, join in meaningful col laboration to ignite an effort to more intentionally partner with community. We must address the financial chal lenges but work beyond them to unlock the power of communities. By working together on identifying community needs and aligning vision across public and private sectors, we hope to build and strengthen relationships that not only foster trust with community, but shift the power dynamics so that com munities are always in the driver’s

an estimated 70 million individuals, and APHSA, a national network of public (state and county) agencies administering health and human services, represent two legs of that stool and offer the pathway to connect to the fourth—communities. With support from RWJF, representing the philanthropic sector, we represent and connect the entire human services eco system, including community voices and those with lived experience. It’s no secret that the United States outspends its peers on healthcare while massively underspending on human and social services. 3 This imbalance does not lead to better healthcare outcomes. In fact, a 2021 Commonwealth Fund study 4 ranks the United States last among economi cally developed nations in key health outcome metrics, including life expec tancy, infant mortality, and deaths from complications or preventable diseases. While there are clearly other factors driving our nation’s dispro portionality in healthcare spending, the relationship between ignoring the social determinants of health and negative health outcomes has become increasingly apparent. This lack of investment in social services has led to challenges for the human services sector, particularly among nonprofit CBOs. They include a troubling financial state for the sector, with nearly one in eight CBOs reporting they were technically insol vent; many experiencing operational shortcomings; and capacity limita tions, including little to no capital for investment in technology and talent. 5 Instead of a “health and human services” system, the United States has a broad-based health system operating alongside an untapped human services system that is made up of a group of organizations, both public sector and CBOs, that have not yet fully achieved our potential impact nor have unified as one voice. The human services system sits in proximity to the populations most marginalized, and yet is rarely seen as a whole system that has the structural power to work effectively in partner ship with healthcare and public health systems to advance health and well being and help eliminate inequities.

In 2018, APHSA joined forces with the Alliance to quantify and illustrate the value of community-based orga nizations (CBOs) working alongside public agencies in addressing social determinants of health and improving overall health and well-being. The research and resulting report, A National Imperative: Joining Forces to Strengthen Human Services in America 2 significantly advanced learning around the state of the sector, pointing to a human and social services sector that is woefully undervalued in the United States. The report defined the human services ecosystem as a virtual three legged stool, comprised of human services CBOs, public agencies, and the philanthropic community, who all work together to build the capacity of communities and to deliver critical services to individuals in families within them. Today, we would add a fourth leg to that stool—communities and individuals with lived experience whose voices we must elevate, as recip ients of services and vital partners in determining needs and solutions. Social Current, a network of 1800+ social services organizations serving

TracyWareing Evans is the President and CEO of the American Public Human Services Association.

Jody Levison Johnson , PhD, LCSW, is the President and CEO of Social Current.

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