Jane’s husband left her after 10 years. She is raising three young children, seven, four and two years old, and has been staying home because day care is too expensive. Who will take care of the children while she looks for a job? How will she pay the rent? Is there someplace cheaper that she could live? Will it be safe?
Albert is 84, living on Social Security, and is about to lose his home because of a recent refinancing scheme. His car, his one link to groceries, medical care and socialization, is 10 years old and needs repair, and he is no longer sure what he owes to whom.
Jane and Albert, like many people in the United States, need help, or what we loosely call human services. But definitions of what that help may be, and the availability and accessibility of those services differ widely, particularly between rural and urban communities. We all would probably agree that “essential human services, especially for those who are least able to help themselves” (see About HHS) should minimally include necessary income supports, food assistance, child and adult protection, especially in a crisis. What about housing assistance, workforce assistance, and community development for preventive services? What about long-term support? Do they include only publicly funded services, or local private, non-profit services, as well?
We need a definition of human services for many reasons.
First, without a definition, “human services” are difficult to measure—how can we determine which we have, which are essential and which are simply desirable? To quote Tom Johnson, RUPRI Director of Academic and Analytic Programs, “We value what we measure.” Second, without a definition it is difficult to explain how these services should be provided (integrated? wraparound? “systems of care”?), and what they should include. Third, we have to be able to define and measure them in order to determine if they are available not only for those “who are least able to help themselves,” but to all who may become vulnerable at any moment. And we need to determine if human services are available in all communities, rural and urban, or only in urban centers.
Health services are clear and definable, and as a result measurable; because of this, we know when they are there and when they are missing. There are health professional shortage areas, and we can build hospitals and provide incentives for providers of health care to come to rural communities. However, how can we describe human services “deserts” if we can’t define them? The field of child welfare is an excellent example. States are required to provide a “service array” for children and families at risk of entering the system, but we know that in rural communities they may very well be missing. What is required to be available for Jane and her family so that her children can remain safe and stable in their own home? Are those services available and accessible to her if she lives in a rural community? If not, will she be required to leave her children unsupervised, to earn an income through dangerous or illegal activities, or to neglect her children? Will her family be traumatized because she happens to live in an area with too few people to be considered significant?
Defining human services is a lot like pinning Jell-O to a wall—which is probably why they remain largely undefined. Sometimes they are categorized by age group (infants, children, elderly), issue (behavioral health challenges, teen pregnancy, etc.) and/or facilities (hospitals, schools, nursing homes, etc.). More often, human services are described by their funding sources. They are thought of as SNAP or TANF, Child Support or Emergency Housing. But if we define human services by their source of funding, then integrating services becomes a matter of increasing the efficiency in applying for those services instead of assuring a positive impact on those in need, and the definition ignores partnerships with communities, non-profit and faith-based providers, formal and informal. Defining services by their funding sources reinforces “silo” delivery systems and tends to focus on interventions after crises occur instead of prevention.
It’s not enough to rely on funding-based and other types of category-based definitions. Perhaps it’s because that focus omits the most essential elements: the humans.
Jane and Albert may have some standard needs (food, income assistance, housing, etc.) but their circumstances vary, not only because of their personal strengths and challenges, but because of their situations, their communities, and even challenges related to the political or economic landscape. Albert was the victim of the current housing crisis. Jane could face unemployment or poor pay because of the current market. Human services need to be client- and community-focused if they are to do the job they are intended to do.
Even more importantly, Jane and Albert could probably benefit from the direct help of another human, not just in giving services, but listening and helping them sort through their challenges, strengths and personal resources to consider their alternatives. In fact, could guidance, the ear and expertise of another human being, have averted their crises? Could we have helped Jane in any way keep her family together, or been a resource to Albert, someone to come to for advice before refinancing his home? Human services can possibly link both Jane and Albert to other humans, i.e., social support, people who might be able to fix a car, or watch children temporarily.
Both Jane and Albert are right now at risk of entering more complicated and expensive systems, including child protection or nursing home care, although basic human services might have prevented the crises and could currently help them. Human services, then, must include the supports that promote well-being and help them live independently, must be client-focused, must be provided to them where they live without requiring them to move, and must have some sort of direct human intervention and support. The RUPRI Rural Human Services Panel is currently working to provide such a definition. It makes a difference to Jane and Albert and to all rural people.
Kathleen Belanger, Ph.D., is Associate Professor of Social Work at Stephen F. Austin State University in Nacogdoches, Texas, and is a member of the RUPRI Human Services Panel, co-chair of Child Welfare League of America (CWLA) National Advisory Committee on Rural Social Services, and recipient of CWLA’s Champion for Children award in 2005 for her work in rural child welfare. Belanger has published and presented on human services issues in a variety of publications and forums. In addition, she has worked for more than 20 years with rural communities, where she has helped found several non-profit organizations and advocated for rural resources.
Opinions expressed in this column are those of the author and do not necessarily reflect the views of the Rural Health Information Hub.
Back to: Fall 2010 Issue