A Public Health Framework for Implementing Economic and Social Supports
April 2, 2020
The $2 trillion-plus Coronavirus response law, along with two other pandemic-related funding bills, provide for a vast array of new federally-funded programs and policies aimed at helping individuals and families battered by a global pandemic and harmed by the economic downturn precipitated by our broad-based public health response. An overarching public health framework can guide the shared work of federal, state and local agencies to implement these new policies and programs.
The following is an excerpt from an article written by Professor John Monahan, Senior Advisor for Global Health to Georgetown University and National Advisory Board Member to the Network for Public Health Law. The full article can be viewed on the O’Neill Institute website.
Now that President Trump has signed a $2 trillion-plus Coronavirus response law (along with two other pandemic-related funding bills earlier this month), attention will rightly shift to federal, state, and county agencies charged with implementing a vast array of new federally-funded programs and policies. These policies are aimed at helping individuals and families battered by a global pandemic and harmed by the economic downturn precipitated by our broad-based public health response.
While these massive bills improve access to testing and care (and much more needs to be done in future legislation, including mandatory coverage for COVID-19 treatment), these new laws provide the financial and in-kind supports necessary for Americans who have lost jobs and income, and who need to comply with strict public health measures, such as social distancing, sheltering-in-place, and staying home from work. This is not a counter-cyclical stimulus designed to get people and businesses back to work right away; instead we need people to double-down on physical distancing. This also is not a situation in which governments at any level can treat this as business-as-usual with each agency working in its own lane and at its own pace. Time and speed are of the essence to protect Americans living paycheck to paycheck, in poverty, or on the margins.
In considering this mammoth task, I recommend adopting an overarching public health framework to guide the shared work of federal agencies, including Agriculture, Housing and Urban Development, Health and Human Services, Labor, Education, and Treasury, and their counterparts in state and local governments charged with implementing these new policies and programs. Public health is about protecting and improving the health of people and their communities, ensuring that nobody is left behind. This is especially critical in a pandemic when we need every person to take individual actions in order to protect our entire communities from the spread of infectious diseases. Leaving some people out presents a risk to us all.
In fact, the collective measure of success for federal, state, and local agencies working to implement the workforce, health, nutrition, tax, and housing provisions of the coronavirus bills should be whether we are supporting as many Americans as possible in taking the public health steps we need to “flatten the curve” of COVID-19. This means using these new provisions to build on and strengthen elements of our fragile, torn, and uneven social safety net as quickly as possible – and to identify gaps that still need to be filled by future coronavirus legislative packages.
Specifically, this requires states and counties (especially in states such as California which have devolved many social programs to county governments) to quickly implement newly-created Coronavirus stimulus programs (e.g., special unemployment programs, child care, etc.) and coordinate effectively with complementary federally-administered policies (e.g., individual payments, tax preparation support, industry-specific recovery loans). At the same time, agencies need to utilize the flexibilities that exist in current programs (e.g., Medicaid, CHIP, SNAP, housing, WIC, etc.) to coordinate benefits and services as seamlessly as possible for families and households. Finally, states and localities will want to consider imposing special time-limited protections for essential services and family supports (moratoriums on evictions, utility shutoffs, internet cutoffs, etc.).
This also means prioritizing the best mix of policies and programs for at least four key populations whose relative security will be indispensable for sustaining the public health response: (1) economic stability for low-wage workers in industries profoundly impacted by public health measures (e.g., restaurant, hospitality, travel, retail, food service, etc.); (2) work supports like child care for people who need to continue working in essential industries (e.g., health care, first responders, caregiving, food, public utilities, etc.); (3) outreach to vulnerable populations people outside the workforce (e.g., people with disabilities, homeless, fragile families); and (4) engagement of immigrants, tribes, and other communities that warrant special attention (e.g., undocumented persons, refugees, mixed-status families, tribal institutions).