Feb 14, 2018

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How are we meeting Colorado’s basic needs? The Gap Map has answers

by | Feb 14, 2018

Human service programs ensure that Coloradans have the building blocks for a prosperous future, such as food, health care, child care and financial assistance.

Due to a number of reasons, access to these important programs varies from county to county. Wide enrollment gaps are evident in the first major update of the Human Services Gap Map, an interactive dashboard that aggregates county-level data to provide a window into how effectively Colorado is delivering the basic building blocks needed for health and well-being.

Funded by various combinations of state and federal dollars, the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Colorado Child Care Assistance Program (CCCAP), Colorado Works (Colorado’s program for Temporary Assistance to Needy Families) and Medicaid all provide resources so that Coloradans can maintain a solid foundation throughout their lives. Unfortunately, many of these programs face funding cuts in Washington, or conversion to “block grants” that would further undermine their availability to people who need them.

Developed by Colorado Center on Law and Policy (CCLP) and Hunger Free Colorado (HFC), the Gap Map is intended to spark a dialogue among human service directors, their staff, advocacy organizations and community leaders about the most effective strategies for closing gaps in enrollment vs. eligibility, allocation vs. spending and improving the overall effectiveness and efficiency of the limited resources that are available.

Using the most current fiscal, administrative and census data available, this tool offers a county-by-county comparison of enrollment, allocations and costs for SNAP, WIC, CCCAP, Colorado Works and Medicaid.

What’s notable about Gap Map 2.0:
  • For many reasons, gaps in program access vary in all five programs across all counties. Some counties have a much larger gap than other counties between the number of people who are eligible for basic-needs programs and those who actually receive assistance. The size of the gap may point to a missed opportunity to meet residents’ needs or more efficiently use available resources.
  • For child care assistance (CCCAP) and Colorado Works, the access gap is largely, but not exclusively, a function of funding limitations. Across the board, the Gap Map provides a powerful visual example of how block-granted programs fall short in providing necessary services to help Coloradans build strong foundations. This is worth noting as members of Congress push to extend the use of block grants in Medicaid and SNAP.
  • The Gap between SNAP and Medicaid access has grown substantially in Colorado across all counties. Access to food assistance through SNAP still lags behind Medicaid access in most counties despite the fact that a high percentage of Medicaid recipients would also be eligible to receive food assistance. This gap has critical health implications. Food security is an important determinant of overall health and well-being.
  • Some counties overspend their allocation resources while other counties underspend. Overspending may enable a county to more fully meet the community needs for assistance and may signal that the county needs additional state funds to support its residents. Meanwhile, counties that underspend their allocation might leave money on the table that could help address the needs of their residents and stimulate the economy.
CCLP and HFC developed and update the Gap Map with the goal of encouraging stakeholders throughout the state to increase accountability, transparency and planning in order to improve access, effectiveness and integration of core health and work-support programs.
– By Michelle Webster

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HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.