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Aug 8, 2016

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Mapping Colorado’s human-services landscape

by | Aug 8, 2016

Research and Policy Analysis

Human-service programs ensure that Colorado communities have the building blocks for a prosperous future, such as food, health care, child care and financial assistance. But not all Coloradans who qualify for these essential programs get the assistance they need.

Funded by various combinations of state revenue and federal dollars, Supplemental Nutrition and Assistance Program (SNAP), Women, Infants and Children (WIC), Colorado Child Care Assistance Program (CCCAP), Colorado Works (Colorado’s TANF program) and Medicaid all provide resources so that Coloradans get support to maintain a solid foundation throughout their lives.

But according to the newly released Human Services Gap Map, these programs aren’t reaching many people who could potentially benefit from them.

Developed by a group of Colorado nonprofit organizations working to align human service programs, the Human Services Gap Map provides a window into how effectively Colorado counties are delivering the basic building blocks needed for lifelong health and well-being. It lets stakeholders identify which counties are performing well and explore the factors influencing that performance.

Using the most current fiscal, administrative and census data available, the Human Services Gap Map offers a county-by-county comparison of enrollment, funding levels and costs for SNAP, WIC, CCCAP, Colorado Works and Medicaid.

The project was led by Colorado Center on Law and Policy with support from The Bell Policy Center, Colorado Consumer Health Initiative, Colorado Covering Kids and Families, and Hunger Free Colorado. CCLP gathered and analyzed current data, and worked with partners to develop content.

Key features of the dashboard include:

  • Caseload data for each program by county with estimates of how many people may still be eligible for these basic needs programs.
  • Fiscal data displaying how taxpayer dollars are spent on these programs, as well as benchmarks for efficiency.
  • Performance data for programs funded by federal block grants and analysis tools for determining the true costs of serving eligible families.

Here are some findings that we think are worth noting:

* There is a significant gap between the people who are eligible for basic-needs programs and those who actually get assistance in many counties throughout Colorado. Some counties have a much larger gap than others. The size of a gap might signify a missed opportunity to meet residents’ needs or more efficiently use available resources.

* Some counties are spending more than what the state provides in funds for human-service programs while others are under-spending such funds. Overspending may indicate that a county needs additional state funds to support its residents while counties that under-spend might be leaving money on the table that could help people in their communities.

* Federal block grants used to fund CCCAP and Colorado Works are falling far short in providing necessary services to help Coloradans build strong foundations for health and well-being. In fact, even if counties spend 100 percent of their allocations in these programs, they can seldom help even half of all eligible families in their communities.

It’s imperative to promote and align key human-service programs to support the health and well-being of low-income Coloradans and ensure that they can meet all of their basic needs. This project is intended to foster transparency, accessibility and efficiency.

The project began coming together in 2015, when a national organization provided Hunger Free Colorado with funding to collaborate with other organizations to improve access to and the effectiveness and integration of core health and work-support programs in Colorado.

Together, with CCLP, The Bell Policy Center, Covering Kids and Families and the Colorado Consumer Health Initiative, they developed a data dashboard that melds the particular subject matter and population focus for each organization.

CCLP and its partners hope the Human Services Gap Map will be an important and useful tool for helping administrators and decision-makers improve the effectiveness and integration of these programs.

– By Bob Mook

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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.