Policy Statements
Preamble to Human Services Alliance Policy Statements
The Human Services Alliance (HSA) is a group of nonprofit agencies meeting the human service needs of the people of Boulder County. Human service agencies are experts in the underlying causes of, and contributing factors that impact the various missions to which they are committed, be they early childhood education, domestic violence, healthcare needs, homelessness, or others.
The agencies also experience the "real world" impact of public policy and legislative changes, since many agencies either directly or indirectly utilize governmental support or serve clients impacted by changing public policy. These changes may include funding decisions, eligibility issues or fundamental changes in how we as a society view those who are disadvantaged or have special needs.
Additionally, the nonprofit sector is an important segment of the business community employing many people, leveraging a variety of funding sources, and providing venues for volunteerism and philanthropy. The success of nonprofits also directly impacts the utilization of other governmental resources necessary to address the consequences of unmet human needs. Without successful nonprofit support, more public resources are needed to address issues such as remedial schooling, juvenile and adult justice systems, and higher acuity healthcare, to name a few.
The HSA agencies share a broad social justice vision, equally applicable to all agencies, of equal opportunity, fundamental fairness and respect. Thus, HSA believes it is imperative that agencies share both their particular expertise and their social justice vision with policy makers through shared resources, educational efforts, development of policy statements and active political advocacy.
The goals of the HSA Advocacy Initiative are to:
1) develop broad guiding principles that address major human services issues.
2) utilize the resources of the individual agencies to develop more specific policy statements, action items or initiatives, as relevant.
3) advertise the availability of our expertise to public policy and legislative bodies.
4) proactively intervene in a timely manner when compelling human service issues are presented at either the local, county or state level.
Boulder County Human Services Alliance
Public Policy Statements
Policy Statement on Homelessness and Affordable Housing
Value Statement
We believe that all people deserve the basic necessities of life including safe, affordable shelter.
Problem Statement
Affordable housing provides the foundation from which full personal and community development is accessed and the economic and cultural diversity of Boulder is strengthened and protected.
On January 24 th of 2005, the annual Point-in-Time survey counted over 1,500 people that were homeless in Boulder County. According to the City of Boulder's housing authority, Boulder Housing Partners, if a qualified family were to join the waiting list for affordable housing in the City of Boulder, they would wait 13 years for housing.
According to the 2003 census, the average rent for a 2-bedroom apartment in Boulder County was $927 a month. Assuming 30% of a family's income is dedicated to housing expenses, a family would need an income of over $37,000 ($17+/hr) to afford market-rate housing in Boulder County.
Policy Statement
The HSA supports policies that promote:
- Safe, temporary shelter for everyone in our community who desires it
- Programs that promote and create pathways to independent, stable housing
- Adequate affordable housing stock and programs to promote a sustainable and diverse community
Health Care
Value Statement
Access to comprehensive preventive and illness-focused health care is an essential human need; therefore, the basic healthcare system must be available to all people.
Problem Statement
Our health care system is in a crisis. Numerous barriers to accessing primary and specialty health care exist including: age, gender, illness (e.g., mental health,) cost/affordability, and availability of providers accepting Medicaid/ Medicare or willing to provide services to people who are uninsured.
In our country, access to health care insurance is too often the determinant of access to health care services. Those who are uninsured are more likely to delay or avoid seeking treatment, be less able to comply with recommended treatment, lack access to prescription drugs, or wait until their health situation reaches a crisis and seek treatment at hospital emergency rooms. This results in poorer health outcomes and shifts the cost of those services to those who are insured or can otherwise pay for healthcare.
People without health care insurance are often precluded from access to specialty care, medications, surgical procedures or necessary laboratory work which interferes or prevents treatment for chronic illnesses and other ailments. Community health centers provide primary health care, but may have limited access to specialty care. There is a growing need for collaboration among health care providers, specialists, including mental health and oral health providers, and local hospitals within our community to treat people with chronic and acute illnesses. Improvements in health information technology are available, but expensive and generally not coordinated on a local or state-wide level.
Low income, elderly and disabled adults and children who rely on government-sponsored insurance such as Medicaid and Medicare often have limited choices of health care providers. Providers who accept government sponsored insurance programs often face demand that exceeds capacity. In addition, government-sponsored insurance programs traditionally do not reimburse providers for the cost of providing care, resulting in the need to look for additional and alternative sources of funding when few exist and placing the burden of providing this care on the providers themselves.
The current system of private insurance reimbursement for healthcare is inefficient, onerous, bureaucratic, confusing and expensive. In addition, the majority of health care providers, insurers and pharmaceutical companies are for-profit and must make decisions based on profitability rather than providing good healthcare for all. Thus, a significant portion of dollars that are spent on "healthcare" are not actually spent on healthcare, but instead are spent on administrative matters such as billing services, dividends, marketing, and compliance issues.
The high cost of professional liability insurance premiums is dictating how the business of medicine is conducted, restricting physician flexibility, encouraging defensive medical practice which ultimately increases the cost of services. It can dictate what services can be offered not based on the provider's expertise, but instead on whether malpractice coverage is available. This decreases the overall number of providers, services offered and increases the cost of services provided.
Lack of education and lack of access to healthcare results in patients who access healthcare providers only when ill or infirm. It is more effective to proactively prevent illness with healthy lifestyle choices and by accessing preventive health care that can diagnose problems early when most easily and effectively treated. However, preventive healthcare and comprehensive health care education are inadequately funded and undervalued. Many adults in America share unreasonable expectations of what the medical profession can economically and realistically provide, and refuse to take individual responsibility for achieving and maintaining their own health.
Policy Statement
The HSA supports state and local policies that ensure:
- All people have access to affordable health care including oral health, mental health, preventive care and comprehensive health education;
- Scientifically-based, medically accurate public health education that is culturally sensitive and available to all;
- Incentives for adults and children to encourage responsibility for achieving and maintaining their own health as much as possible;
- Availability of age-appropriate substance abuse treatment;
- The development of a collaborative health care model that encourages efficient, effective use of healthcare resources, both financial and professional;
- Facilitation of transitions between Medicaid and Medicare and employer-provided or private health insurance
- Recognition of the interrelationship between physical health, oral health and mental/emotional health and development of holistic healthcare models;
- Recognition of the impact of social, political and economic factors on people's health and development of collaborative models that combine resources from a variety of sources to address these factors;
- Provision of transition from health care to other corollary services when needed, such as mental health services, transitional housing, home care, and other ongoing support services;
- Development of reasonable tort reform legislation that encourages high quality medical practice balanced with economic reality, protects providers from frivolous litigation, requires that insurance premiums decrease commensurate with decreased liability exposure, but ensures adequate compensation to people injured due to medical negligence;
- A healthcare financing system that is efficient and adequately reimburses healthcare providers for the reasonable cost of the care provided.
- A healthcare system that rewards wellness and preventative care.
The Boulder County Strategic Plan supports the following strategies:
• Increase the availability of low-cost or sliding-scale medical care aligned with people's ability to pay
• Support access to medical care, including dental, and mental health services, for those least able to afford it
• Provide targeted programs that address the health needs of special population
• Embed wellness care, physical activity, nutrition and positive life choices in all health care activities and strategies
• Provide convenient locations for families to obtain information about children's health
• Provide services to build resiliency and reduce risk for youth in Boulder county
• Implement strategic plan “Creating Vibrant Communities in Which We all Age Well
• Expand public education and awareness mental health issues
• Provide health information in multiple languages and in culturally appropriate formats
• Increase levels of support for substance abuse prevention and sobriety maintenance
Hunger
Value Statement
All residents of Boulder County should be assured access at all times to enough food to fully meet basic needs for an active, healthy life, in socially acceptable ways.
Problem Statement
In Boulder County, children and adults go hungry and chronic, mild under nutrition occurs when financial resources are low or uncertain. The mental and physical changes that accompany inadequate food intakes can have harmful, and lasting, effects on learning, development, productivity, physical and psychological health, and family life.
Hunger is defined as "the uneasy or painful sensation caused by lack of food," as well as the recurrent and involuntary lack of access to sufficient food due to poverty or constrained resources, which, over time, can lead to malnutrition.
Policy Statement
The HSA supports state and local policies that promote and ensure the critical importance of a visible, organized, comprehensive and responsive food "safety net" system in Boulder County, to prevent chronic hunger from occurring as well as significantly reducing episodic hunger that can occur with a changing economic climate. To ensure such a "safety net" system, policies that focus on maintaining and improving all aspects of a seamless coordination of food assistance are needed.
Safety and Well-Being of Children and Youth
Value Statement
Every child and family in Boulder County should have a safe and permanent home in order to promote the health, safety, and well being of children, and to build a better future for families and create a more caring community.
Problem Statement
An estimated 903,000 children across the country were victims of abuse or neglect in 2001, according to national data released by the Department of Health and Human Services. The statistics indicate that 12.4 out of every 1,000 children were victims of abuse or neglect in 2001, a rate comparable to the previous year's victimization rate of 12.2 out of 1,000 children.
The data released are based on information collected through the national Child Abuse and Neglect Data System. The data show that child protective service agencies received about 2,672,000 reports of possible maltreatment in 2001. There were 903,000 substantiated cases of maltreatment of children – the majority of which involved cases of neglect. About 1,300 children died of abuse or neglect, a rate of 1.81 children per 100.000 children in the population.
Almost 9/10 of the victims of child maltreatment were maltreated by at least one parent. Longitudinal studies on the cycle of violence show that being abused or neglected as a child increases the likelihood of juvenile arrest by 59%, adult arrest by 28%, and for a violent crime by 30%. What's more, abused and neglected children are involved in delinquency and criminality earlier, commit more offenses, and more often become chronic or repeat offenders.
Many abused children also have lower IQ's and reading ability, higher rates of unemployment, more low paying jobs and higher rates of suicide attempts.
Boulder County is not immune to those statistics. In 2003, 3,190 cases of suspected child abuse and neglect were reported to the Boulder County Department of Social Services (DSS). Of those reported, 1,578 were investigated: 166 for sexual abuse, 492 for other (physical, emotional, etc.) abuse, 920 for neglect. Following substantiation of child maltreatment in 2003, there were 179 Dependency and Neglect (D&N) petitions filed with the Boulder County Juvenile Court on behalf of child victims.
Child abuse and neglect cost our society, not only in terms of the trauma caused to the maltreated individuals, but also in economic terms. Economic costs include the funds spent each year on child welfare services for abused and neglected children (direct costs) as well as the large sums dedicated to addressing the short- and long-term consequences of abuse and neglect (indirect costs).
The long-term consequences of childhood maltreatment are often regarded as “merely psychological” and therefore frequently dismissed as essentially inconsequential in terms of physical health and economic costs. Recent research, however, has identified significant impacts on physical health as well as dramatically increasing an individual's risk for costly disabling mental disorders such as major depression and suicide. It is now documented that childhood maltreatment and related adverse childhood experiences make a substantial contribution to many of our leading public health problems. U. S. Surgeon General Richard Carmona said, “While child maltreatment has traditionally been thought of as a criminal justice issue, it is also very much a public health issue….from the public health side we need to emphasize prevention. The wrenching mental and physical health effects of child maltreatment continue for that child long after he or she is placed in a safe environment.” Among these are drug and alcohol abuse, AIDS, tobacco use (heart disease and lung cancer), and major depression.
Child abuse and neglect have known detrimental effects on the physical, psychological, cognitive, and behavioral development of children (National Research Council, 1993). These consequences range from minor to severe and include physical injuries, brain damage, chronic low self-esteem, problems with bonding and forming relationships, developmental delays, learning disorders, and aggressive behavior. Clinical conditions associated with abuse and neglect include depression, post-traumatic stress disorder, and conduct disorders. Beyond the trauma inflicted on individual children, child maltreatment also has been linked with long-term, negative societal consequences. For example, studies associate child maltreatment with increased risk of low academic achievement, drug use, teen pregnancy, juvenile delinquency, and adult criminality (Widom, 1992; Kelly, Thornberry, and Smith, 1997). Further, these consequences cost society by expanding the need for mental health and substance abuse treatment programs, police and court interventions, correctional facilities, and public assistance programs, and by causing losses in productivity. Calculation of the total financial cost of child maltreatment must account for both the direct costs as well as the indirect costs of its long-term consequences.
As a community, we need to address child abuse and neglect issues with prevention and early intervention for at-risk children and their caretakers, as well as programs for children currently in the social services system.
Policy Statement
H S A supports policies that promote:
• Adequate funding for the Boulder County Department of Social Services that allows for the Boulder County best practices in returning children to their homes when appropriate and safe;
• Early intervention for families who are at-risk for child abuse and neglect;
• Safe, nurturing, appropriate out-of-home placements for those children where home is no longer a safe place for them;
• Support for community-based adoptive and foster parents and group homes when it is not safe to return a child to his family;
• Access to affordable, effective treatment programs for children and youth for mental health issues and substance abuse issues;
• Adequate support programs for birth, foster, and adoptive parents
• Adequate screening and treatment for children living in violent homes to determine if there is cause for intervention or removal.
Social Justice and Nonviolence
Value Statement
All residents of Boulder County deserve the protection of full dignity and human rights.
Problem Statement
Each year, an average 1,700 related to domestic violence are filed in Boulder County. If FBI estimates are correct and only 1 in 10 cases is reported, then an estimated 17,000 cases of domestic violence warranting police intervention are taking place in our community each year. Typically, violence within an intimate relationship escalates in frequency and severity over time, and may result in death or permanent injury if intervention does not occur. On average, more than three women are murdered by their husbands or boyfriends in this country every day (Bureau of Justice Statistics Special Report, 2001). Twenty-three domestic violence-related deaths have taken place in Boulder County in the last five years.
In addition to fear and isolation, battered women must confront significant economic barriers. With the average cost to buy a house in Boulder at $486,678 (Boulder Area Realtors Association), the monthly rent for a two-bedroom apartment at $930, and the wait for subsidized housing lasting up to three years, many battered women find themselves forced to choose between abuse at home and life on the streets. As a result, domestic violence is the third leading cause of homelessness for families in the six-county Denver Metropolitan region (Colorado Department of Human Services, 2001).
Women and children of color, and battered immigrant women are further isolated by racism, anti-immigrant sentiments, and lack of language accessible or culturally relevant services.
Domestic abuse can also have a devastating effect upon children. The U.S. Advisory Board on Child Abuse and Neglect has identified domestic violence as a major precursor to child abuse and neglect fatalities in this country (1995). A study by D.S. Elliott (1994) revealed that children who experience family violence are at a 40% greater risk for violent behavior themselves.
Policy Statement
The HSA promotes policy and advocacy efforts that:
- Promote the dignity and human rights of all people;
- Promote equal access to services and assistance, regardless of citizenship status;
- Promote prevention and education efforts intended to impact the root causes of violence/injustice and the beliefs/attitudes that condone them;
- Recognize the interconnectedness of various forms of injustice (i.e., poverty, racism, classism, sexism, etc.) and the need for an integrated approach to social justice that promotes equity and respect for all people;
- Provide resources and support for those impacted by injustice and violence, and the groups and organizations working with them;
- Support community-based, collaborative efforts that reflect an integrated response to intimate personal violence, family violence, and community violence, and which build on the unique strengths of diverse communities;
- Support services for at-risk teens, recognizing that they may be both victims of and perpetrators of violence, with special attention to reduction of gang influences;
- Resources to prevent and address sexual abuse of people of all ages;
- Recognize the needs of ex-offenders for training, jobs, and housing and reintegration into the community;
- Assist accommodation and access of people with disabilities in the criminal justice system.
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