In March, Congress passed much-needed relief for families and communities through a major economic stimulus package—the American Rescue Plan (ARP). The ARP supports a lifeline for families impacted by the pandemic this past year, like housing, utilities (including water and broadband), child care, and nutrition assistance. It also makes an important down payment toward an equitable recovery by including upstream investments in maternal and paternal health; community-based grants that support family well-being and prevent child maltreatment; aging and disability supports; increased access to quality child care; and asset-building through child tax credits, among many others.
Coupled with direct allocations to states and localities, including dedicated resources to invest in building the workforce and technology infrastructure, the ARP helps ensure that public agencies, and the community organizations they work alongside, can continue to meet the needs of people experiencing the most adversity while striving to repair past harms and lay new tracks that advance equity. Notably, many investments in the ARP will extend beyond the duration of the public health emergency and are explicitly designed to address the racial and economic injustices COVID-19 has exacerbated by positioning communities for a more equitable long-term recovery. Furthermore, if Congress ultimately passes one or more infrastructure bills, the impact of these investments could be greatly amplified.
For state and local health and human services leaders and, by extension, the team at APHSA, implementation of this legislation is very much top of mind. Leaders want to ensure agency services are meeting the immediate needs of people in the community and begin to advance the systemic change we collectively desire. What can we do?
The very nature of how the ARP came to be creates a tension point on how best to make good on both of those objectives. The ARP was passed through budget reconciliation, a vehicle explicitly designed to be transactional—not transformative—in nature. At the same time, the ARP is broad in scope with investments touching nearly all aspects of the social determinants that are foundational to health and well-being. As a result, multiple sectors are involved—public health departments, labor and commerce, regulatory authorities, and the people-serving systems that exist across health, education, housing, and human services. In sum, state and local agencies face a major short-term influx of funds across a multitude of agencies with decisions about if and how they can make long-term or permanent systemic improvements—not knowing whether there will be funding to sustain those changes.
There are many outstanding questions about who will make spending decisions, their timeline, and what exactly is allowed. For many parts of the ARP, states must first wait on guidance from multiple federal agencies. And the multiyear nature of the funds does not necessarily fit neatly into state annual budget cycles nor with state legislative session timelines. This is further complicated by the fact that some resources will flow directly to local communities. For both new and existing supportive services, the eligibility rules vary across programs that are administered through multiple state agencies. The timelines for obligating resources and fully expending the dollars also vary by funding stream—some requiring funds to be spent within the next two years and others extending through 2024 and beyond.
These are a just a few of the challenges. Health and human services leaders need to plan, prioritize, and act based on this complicated terrain. The path forward remains unclear.
Hence, it is critical that all levels of government run in the same direction and work to connect immediate pandemic relief efforts to longer-term systems-level change. Federal agencies need to provide quick, clear guidance to states to assure immediate, effective delivery of critical supports now and to make informed investments for the future. States must work with local jurisdictions and through public-private collaborations to support dollars getting into communities while working to modernize our delivery systems in ways that are human-centered and have impact for everyone. Congress also needs to be prepared to make mid-course adjustments as new needs or barriers arise. This is a comprehensive government and community effort. It will be critical to have strong communication channels for everyone to solve problems and co-create together.
We all have a role to play—and APHSA is committed to working alongside our members and partners to make the most of these investments. Leveraging our many platforms, including this blog series, we’ll share what leaders are doing now to strengthen the resiliency of our public health and human services infrastructure, and, in turn, substantially move the needle on social and economic mobility so families succeed for the long run.
What Can We Do?
We can make significant strides on pernicious issues by reducing child poverty, addressing health disparities, and closing wealth gaps, especially for the vastly disproportionate impacts of generational poverty and community trauma experienced by Black, Brown, and Indigenous communities of color. Through people-centered approaches that meet people where they are, we can embed preventive approaches that center families as the best architects of their future and equip them with what they need to prevent prolonged exposure to stress, help build resiliency, and adapt to adversity. Together we can help lift the weight of toxic stress that has been pressing down on families and communities.
We have the opportunity to use data and resources to connect with people and families before they reach a crisis. We can build capacity for the equitable use of data across systems, focusing resources to those hardest hit—not just from the pandemic but from historic structural bias and inequities. In particular, we need to account for the “additive impact” on people who have been most affected by the pandemic. We must collectively exercise the muscle of collecting and disaggregating data by race, ethnicity, gender identity, disability—and by other dimensions. It must become our standard practice to ensure a data-informed evidence focus that is human centered and equitable.
We can invest in technology and tools to modernize our delivery systems by engaging community members and the front-line workforce in the redesign to make systems work for people instead of the other way around. By tapping strategies already in our toolkit—like blending and layering funds across programs—we can leverage additional administrative dollars to make upgrades to integrated IT platforms creating seamless data systems available to individual consumers, staff, and partners. Beyond efficient online portals, we can leverage tools like virtual agents and telehealth models to meet families in ways that are least disruptive to their lives.
We can reinvent organizational structures and work environments. For example, the Oklahoma Human Services Department, in its Service First model, has closed dozens of its in-person service offices and has co-located in more than 150 programs across the state, including nonprofit organizations, sister-state agencies, schools, and law enforcement agencies. The department is now working on a plan to keep this model in place even after the pandemic.
We can accelerate intergovernmental efforts—both horizontal (across agencies) and vertical (federal-state-local)—as well as bolster public–private partnerships to tap the expertise from all sectors and partner for true impact. Building on the extraordinary innovations and collaborations witnessed across the country in response to COVID-19, we can broaden the impact and reach of services provided on the ground. And through these intergovernmental efforts, we have the opportunity to evaluate and document the long-term payoff of these investments across systems.
Read Additional Posts from the American Rescue Plan Series:
Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9