Safety Net

How the U.S. Can Prevent a Fire Like Grenfell Tower

At least 80 people are missing and presumed dead after a devastating fire in Grenfell Tower, a high-rise apartment building in London. It’s the deadliest fire in Britain in more than a century.

This fire is, unequivocally, a tragedy—particularly because it was so preventable. Investigators say the root causes were lax regulation and an unwillingness to invest in basic safety features. Residents had repeatedly warned that their living conditions were dangerous, pointing out that the building didn’t have fire alarms, sprinklers, or a fire escape, and there was only one stairway for people to get out and one road for firefighters to get in.

The fire has been a wake-up call for British politicians about a dangerous lack of investment in safe housing. Unfortunately, Britain is not the only country that has underinvested in safe homes.

A report by the Federal Healthy Homes Work Group found that more than 30 million homes in the United States are putting their occupants at risk. Six million homes have moderate to severe infrastructure problems, such as substandard heating, plumbing, and electrical wiring. Another 23 million homes have lead-based paint hazards, and 6.8 million homes have dangerously high levels of radon exposure. This means that millions of families face increased risk of lung cancer from radon exposure, fire-related injuries, and lead poisoning.

So far, the Trump administration has stymied efforts to address these problems. The administration’s proposed $6 billion in budget cuts to the Department of Housing and Urban Development (HUD) would severely curtail efforts to provide safe and affordable housing.

At least $300 million in cuts would come from rental assistance programs such as the housing choice vouchers program, which means that 250,000 people could lose access to housing vouchers. Landlords participating in the housing choice voucher program commit to extensive property maintenance and safety standards that other private landlords serving very low-income families are often not required to meet. When families who cannot pay their rent are evicted, they often move into homes with more health and safety hazards, which is why children who are evicted are twice as likely to be in poor health.

More than 30 million homes in the United States are putting their occupants at risk

The Trump administration’s budget also calls for direct cuts to the HUD public housing Capital Fund, the program that funds repairs to public housing. The budget would slash the fund by more than half, so that 212,000 fewer units would receive the repairs they need next year. It also means that local public housing authorities—which rely on this funding to address fire hazards before they become disasters and address health risks like mold, lead, and rodent infestations—could be short on their budgets.

Even indirect cuts, such as the proposed elimination of the Legal Services Corporation (LSC), will put more people at risk. LSC funds civil legal aid organizations that help low-income households bring lawsuits against landlords who refuse to deal with potentially deadly living conditions. After similar cuts to legal aid in Britain, residents of Grenfell Tower were unable to afford legal advice when they had concerns about their building’s safety.

We’re not doomed yet. Fire deaths have been dropping across the United States due to stronger building safety codes. Most states ban the usage of flammable aluminum cladding in tall buildings, which contributed to the Grenfell Tower fire.

Still, the Trump administration has promised to dramatically cut back on important safety regulations. Trump’s recent executive order that requires eliminating two regulations every time a new one is created forces agencies to choose which life-saving regulations they should prioritize to comply with the rule. Congress is now considering the Regulatory Accountability Act, which would add so many hurdles to the regulatory process that companies that produce dangerous products could delay regulations indefinitely. The Environmental Protection Agency faced similar roadblocks when it tried to ban asbestos—a known carcinogen—more than 25 years ago. Asbestos manufacturers used hurdles in the regulatory process to their advantage and blocked the agency from removing this toxic substance from commerce. Since 1999, at least 12,000 Americans have died every year because of asbestos exposure. Under the Trump administration, long-awaited asbestos regulations and many other critical protections may never be implemented.

In a chilling letter written just months before the building caught fire, residents of Grenfell Tower warned that “only a catastrophic event will expose the ineptitude and incompetence of our landlord, the KCTMO, and bring an end to the dangerous living conditions and neglect of health and safety legislation that they inflict upon their tenants and leaseholders.” Americans shouldn’t wait for a tragedy of this magnitude. Investing in the health and safety of low-income Americans begins with the funding decisions Congress will make this year.

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Culture

The Media Narrative Around Families Is Racist and Homophobic. It Needs to Stop.

Last week, David Brooks wrote an article about “Why Fathers Leave Their Children.” In a piece that largely focuses on the perceived moral failings of low-income families, where women are “bossy” and men are “disreputable,” Brooks lays out a plan for how to get Americans to live in “the stable two-parent family…we want.” This plan includes waiting to have sex, creating a couple’s budget, and “a few economic support programs and a confident social script.”

This goal—and the plan for how to get there—are bullshit.

Let’s talk about the goal first: a stable two-parent family. Brooks is feeding the narrative that there is an ideal kind of family—one that does best, one that is how people should be. It’s a family with two married parents. It’s a family in which people have children and mostly women raise them. It’s a family in which no one dies or is infertile or is incarcerated. It’s a family in which no one decides to stay single or childless or get divorced.

It is, in short, not reality. And making policy around this idealized vision of family has very real, often terrible consequences.

First, there is the emotional toll. When there is one ideal, people are crucified for falling short. They are blamed and marginalized. Their families are vilified and demonized. We have seen this with black single moms during welfare reform, gay parents during the same sex marriage movement, and now families with disabilities as policymakers seek to cut benefits. This helps no one.

Second, policies that focus on this idealized family, which account for less than one-fifth of American households, leave out the needs of tons of other families. We saw this last fall, when the Trump campaign floated a paid leave plan that only applied to birth mothers. The plan not only left out adoptive parents and male parents, it also ignored the needs of people caring for aging or disabled loved ones, sick children, their partners, or themselves.

Third, it can waste a ton of money. Jennifer Randles’s work reveals that though the nation has spent close to a billion dollars on programs that promote marriage over the last two decades, “couples who took government-funded relationship skills classes were neither more likely to marry or stay together nor to improve their financial situations.”

Fourth, policies aimed at keeping people married can trap people in dangerous relationships—even kill them. Perhaps the starkest example is the dramatic changes in women’s well-being after the passage of no-fault divorce. Research by Betsey Stevenson and Justin Wolfers shows that in states that passed no-fault divorce laws, suicide rates among wives decreased by 8 to 16 percent and domestic violence rates fell by 30 percent.

The policies he mentions would fall short of what any kind of family needs.

Even if we set Brooks’s dubious two-parents-a-dog-and-a-white-picket-fence goal aside, the policies he mentions would fall short of what any kind of family needs. His proposals to “help” families focus on changing individual choices without mentioning the systems that override them. Brooks fails to mention how America’s incarceration system is dividing families, particularly black families. He doesn’t address the fact that our nation’s immigration policies are literally ripping families apart. He does not discuss the importance of health care, good jobs, or reproductive care—all of which have been linked to strong and stable families. A few programs and a social script are not going to cut it.

Instead of this harmful, narrow vision of family, we should be looking for ways to value and support a whole range of healthy, stable families. Some are single parents. Some are couples without children. Some are brothers taking care of sisters, grandparents caring for children, extended chosen families. All of these families deserve support and appreciation.

When you have a broader vision of family, you can make the kind of policy choices that actually support everyone. And you can also make clear to all kinds of families that they are not less than or inadequate—and they deserve to have their needs met.

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Culture

What People Get Wrong When They Try to End Homelessness

When my mother was diagnosed with Alzheimer’s disease in 2007, she asked me to promise I’d never move her into a nursing facility.  I promised, although I wasn’t sure how I’d keep my commitment.

I pulled out of a four-book editing contract and moved in with her.  I learned from a social worker that I could receive 20 hours a week of help from home health aides, as well as SNAP benefits and cash assistance to help compensate for my decreased work income.  It was enough for us to get by.

About a month after I moved in with her, we returned from grocery shopping to find a state trooper standing outside of our front door. He handed me a court summons:  My sister had sued me for custody of our mother.  She wanted to place her in a care facility.

The court denied my sister’s request and named me our mother’s legal guardian, but it appointed my sister as guardian of her property.  In 2009, when my mother passed away, my sister evicted me.

The day I was scheduled to move out, I stood in a convenience store, dazed, as I stared at microwaveable meals.  These would be my new staple when I moved into the motel room.

My phone rang—my sister.  She told me she needed me out of the house in a couple of hours—she was a real estate agent and a client wanted to see the house.

“No hard feelings,” she said.

*            *            *

I was homeless for less than six weeks, a relatively short time compared to most.

The reason I fared better than many suddenly homeless people is because I was already in the social services system in Ocean County, New Jersey due to my mother’s illness.  Social services simply reopened my case and quickly provided temporary emergency housing.

For most people, emergency housing is just a port in the storm, since it only gives you six weeks to find permanent housing. It’s not easy to find a home—most landlords don’t want to accept housing vouchers for rent—but I was fortunate.  The woman who ran my church’s homeless outreach program vouched for me, so I was able to move into an apartment before my placement at the motel expired.

After my housing was stabilized, the trauma of familial conflict, loss, and eviction pummeled me like a tsunami.

The trauma of familial conflict, loss, and eviction pummeled me like a tsunami.

I was overcome with anxiety, convinced that things would never go right again.  Every time I heard a noise at night I would jump out of bed to check on my mother—worried that she was trying to get up and go to the bathroom by herself—before I remembered she was gone. In the mornings, depression made getting out of bed a struggle. Confused, I went to my local hospital where I was diagnosed with post-traumatic stress disorder (PTSD).  For three months, I participated in an intensive outpatient treatment program: three days a week I received cognitive mental health counseling, medication, and group therapy.

I came to understand that being solely responsible for my mother’s care for two years, combined with fighting to prevent her worst nightmare—losing her home and being forced into an institution—had been too much for me.  My brain and nervous system had been denied adequate time to recover from prolonged, severe stress.

It took me a couple of years, but I finally recovered—or at least adjusted to living with PTSD.  And I wanted to use my experience to help others going through the same thing.

*            *            *

At first I thought I could teach people how to successfully navigate the social services system like I had. But I quickly learned that my experience wasn’t necessarily transferrable to them. The fact that I had already been in the social services system, and had a key relationship through my community, made all the difference for me.

For example, someone contacted me to see if I could help find housing for a young man who was living in the woods.  When we sought emergency shelter through county social services, they turned him down because he’d been homeless for too long. They prioritized people who had been homeless for less than two weeks, and he’d been homeless for four months. Then we applied for Emergency Housing Assistance, but he couldn’t get to the mandated weekly career or substance abuse counseling. Those offices were across town, and out of reach of public transportation. Plus, the county requires documentation proving you are not currently receiving unemployment benefits and a letter from the Internal Revenue Service stating that no relatives are claiming you as a dependent—complete with a mailing address.

That young man spent another year in the woods before he was taken to a county mental health facility. Turned out he was autistic, and therefore eligible for permanent housing in a facility for persons with disabilities.  The county didn’t seem to understand the urgency of getting people housed quickly so they could begin their recovery.  There were too many pre-conditions and not enough affordable housing units to get the job done.

*            *            *

Since people clearly needed much more than the current system could offer, I explored a different avenue: Advocating for a County Homeless Trust Fund that would secure the monies needed for a shelter and real-time emergency housing assistance.

Unfortunately, advocates’ conversations with elected officials weren’t productive. In one meeting, a political representative charged with overseeing social services simply ticked off a series of negative stereotypes: “The homeless have always been here no matter how much money we spend trying to solve the problem… Nothing seems to work… I think many of them prefer to live like that.”

Clearly, she didn’t know any homeless people. In my half-dozen years working with people without homes, I’ve met very few individuals who wouldn’t prefer having a roof over their head, security, privacy, heat, running water, a toilet.  Nevertheless, this mischaracterization of the homeless is common—I’ve heard it from social workers, religious leaders, and agency heads. If you repeat a lie enough times, it gains currency.

Advocating for the Trust Fund reinforced the same feeling I had when I tried to advocate for people navigating social services: Unless policymakers and government employees enlist the involvement of people who have experienced this kind of struggle, they will not understand, support, or implement the solutions we need.

*            *            *

In one sense, I’ve now come full circle.  I’m volunteering at the same homeless outreach center that first helped me when I was evicted. We provide people with necessities like clothing, blankets, tents, heaters, and food, as well as services such as haircuts and laundry.  The center also creates a sense of community where people can lean on each other as they try to recover from trauma and find stability in their lives.

Now I’m also trying to connect our outreach community with opportunities that will help people achieve financial and housing independence.  A couple weeks ago I took a few young men and women to a farm where I used to volunteer, so they can hopefully earn some money and pick up some skills in a growing industry—vertical farming.

It was a diverse group. One woman was living in the woods and “here and there.” Another guy has emergency housing assistance and tons of energy—he skateboards everywhere—but no job. The third guy has been living without housing for more than five years and was looking for work.

They were given a tour of the operation and invited to fill out an application for a 60-hour summer work and training program. The manager also gave them her cell phone number and said to call her anytime to check on job openings.

Before we left town, we stopped at a restaurant where one of them applied for a job.  Then I took them to the beach on the other side of town—none of them had ever been there before.  For a little while at least, they were simply young people enjoying a beach, free from the burden of being labeled “disaffected homeless youths.”

These moments of normalcy—in a culture that constantly treats us as flawed and abnormal—are part of how we find our way again.

*            *            *

My experiences since my mother’s death and my eviction have taught me what we need to do to end homelessness in America.  If we simply invested in affordable housing—and committed to getting people housed quickly so they can begin their recovery—we would immediately see dramatic reductions in homelessness and an increase in people contributing to our communities.  On top of it, we know that this approach would save our nation money.

But it doesn’t matter how many studies demonstrate that this is the direction we need to go.  What is lacking, still, is political will.  And that will only change when our elected representatives begin listening to—and taking seriously—those of us who have lived this struggle.

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Media and Politics

If the Media Keeps Ignoring Health Care, We’ll Lose It

There is a giant scandal in Washington this week—and it’s not the one blaring from your television screen. Largely without media scrutiny, the United States Senate is quietly getting ready to pass their version of the House bill to repeal the Affordable Care Act. If it looks anything like the legislation the House passed last month—and by most accounts, it does—the bill could take away health care coverage from millions (the House-passed American Health Care Act would take away health insurance from 23 million people in 10 years).

The Senate’s stealth strategy here should come as no surprise: They learned from the House.  After the Congressional Budget Office (CBO) found that 24 million people would lose health care under the initial version of the AHCA bill, constituents responded by flooding House offices with phone calls. Paul Ryan and Republican leadership were forced to cancel a vote in mid-March, because the public opposition to the bill made it impossible to secure the votes they needed. The House then went back to their members and passed a new version, with no CBO score or media coverage, in order to mask the effects of their bill.

That handed Senate Majority Leader Mitch McConnell the playbook he needs to get his bill passed.  The Senate companion to the House bill is being crafted under lock and key, foregoing committee hearings, mark-up, or any public debate. McConnell went as far as kicking all non-leadership staff out of secret discussions last month to prevent them from disclosing information about the bill to the public. Even rank-and-file GOP Senators—who control the chamber and will likely be tasked with sending the legislation to the president’s desk—claim not to know what’s in it. According to Axios, the bill will not be released publicly even once it is complete. Instead, Mitch McConnell plans to send the completed text to the Congressional Budget Office for review, without any public scrutiny.

What’s shocking is not that the Senate is attempting to pass this bill under a shroud of secrecy; it’s that the strategy is working. As Vox’s Jeff Stein has been chronicling, most mainstream media outlets have either ignored the Senate health care discussions or downplayed their urgency.

Scanning the front webpages of the New York Times, Wall Street Journal, Washington Post, and CNN on Monday revealed no mentions of the health care bill—and the same was true for much of last week. Even politics-focused outlets like Politico and the Hill have largely relegated their coverage of the health care fight to specialized newsletters or paywalled content.

Instead, lead stories focus almost exclusively on the Trump-Russia investigation. Attorney General Jeff Sessions’ testimony before the Senate Intelligence Committee last week dominated national news coverage. Later in the week, news that the FBI was investigating the president himself—and the president’s histrionic response on Twitter—crowded out any discussion of the health care bill.

The media have their excuses. Without senators willing to discuss the plans publicly, reporters have found it difficult to break news on the topic. Cable news has no compelling soundbites to play for their viewers because Republican Senators are not holding public hearings, committee mark-ups, or press conferences on the bill.

There has been little public outcry because there has been little sunlight on the Senate’s process

But, as newsworthy as Russia’s interference in the 2016 election is, a bill to take away health insurance from millions is, at the very least, equally worthy of public attention. The legislation Senate Republicans are currently discussing is likely to reinstate annual and lifetime benefit limits—even for employer plans outside of the ACA exchanges. This could be a death sentence for people who get sick and require expensive care to stay alive.  Recent analysis from the Center for American Progress (full disclosure: TalkPoverty.org is a project of the Center) revealed that up to 27 million Americans could face annual limits. And the Senate is planning to go beyond repealing the Medicaid expansion—which was part of the ACA—by imposing deep cuts to the traditional Medicaid program that helps seniors, kids, and people with disabilities in every state.

What the Senate is doing is an affront to democracy, but there has been little public outcry because there has been little sunlight on the Senate’s process or underlying legislation. For the public to hold their representatives accountable, they need to have accurate—or at least basic—information on what Congress is doing. Just as dogged journalism has revealed some of most critical details of the Russia investigation, it is the responsibility of the press to draw out the contents of the Senate’s health care bill—before it is too late.

Editor’s note: For more on the healthcare news that no one is talking about, take a listen to the latest episode of CAP Action’s Off-Kilter podcast here.

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Media and Politics

Maybe This Is the Article That Will Convince You Not to Cut Medicaid

My sister Maggie’s body attacks itself.

In 2010, she went to the eye doctor for difficulties she was having with her vision. She thought she needed a new glasses prescription. Instead, she was admitted to the emergency room because the ophthalmologist thought she was having a stroke or a brain tumor.

Many appointments and tests and anxious weeks later, she was diagnosed with multiple sclerosis (MS). MS is an autoimmune disease in which the body attacks the membrane around its own nerve fibers, causing scar tissue. A typical diagnosis requires two to three lesions on the brain; my sister’s brain had eleven. Because MS attacks the central nervous system, symptoms vary widely, ranging from fatigue and vision problems to seizures and paralysis. The worst part about MS is its unpredictability; one day my sister can seem healthy and the next day she can be overwhelmed with nerve pains, muscle spasms, and immobility.

At the time of her diagnosis, my sister was a 25-year-old stay-at-home mom to her 3-year-old daughter. Her husband’s insurance covered her then. But within a year of her diagnosis, they filed for divorce.

This is not uncommon for women diagnosed with serious illnesses. A 2009 study published in the journal Cancer found that a married woman diagnosed with a serious disease is seven times more likely to be divorced or separated than a man with a similar diagnosis. Among study participants, the divorce rate was 21 percent for seriously ill women and 3 percent for seriously ill men.

After my sister’s diagnosis, her husband withdrew from the family. He engaged in addictive and destructive behaviors. That left my sister in a position where her access to health care was tied to a marriage that was not good for her or her daughter.

The Affordable Care Act, a.k.a. Obamacare, made it possible for her to live as a single mom with a chronic illness.

It qualified her for Medicaid coverage in Montana. It ensured that she would not be discriminated against in the health care market because she had a pre-existing condition. And it let her choose which treatment plan would be right for her and her body.

For six years, she experimented with different medications, starting with the cheaper ones (which cost $1,000-$3,000 a month). Her symptoms did not improve: Sometimes she relapsed, sometimes she got sicker, and sometimes she had to take drugs to deal with symptoms caused by other drugs. Still, she felt it was worth it to try to slow the progression of the disease.

It would cost her $65,000 a year without insurance

Last year, she found a treatment that works: It’s called Rituxan and it would cost her $65,000 a year without insurance. It’s part of a chemotherapy treatment she does every few months. It leaves her feeling sick and unable to work for a few days, but it works.

Last spring, Maggie graduated from Montana State with a degree in social work. She recently got a part-time job at an assisted living facility, which is funded in part by Medicaid.

It’s a good fit for her, because full-time work would be incredibly difficult with both her MS and her current treatment plan. It’s also a good fit for her because Maggie is one of the most caring people I know. She works with some of the most marginalized people in our society—elderly individuals, people with mental illness, those with severe disabilities—all unable to work or care for themselves.

The Congressional Republican health care plan could change all of that.

Under their plan, my sister could lose Medicaid because her part-time, low-wage income would disqualify her.

Under their plan, my sister could lose coverage for Rituxan, the only treatment that has worked for her so far.

Under their plan, my sister’s pre-existing condition could be used as justification to raise costs on her medical insurance.

Under their plan, my sister’s mobility and opportunity would be more limited by her economic insecurity than they are by her MS.

This is what it means to be uninsured. It means you cannot live safely and comfortably in your own body.

Maybe, if one of them is sympathetic enough, we'll be taken seriously.

It is excruciating to have to determine the trade-offs your family can make to maintain your sister’s health care. It is even worse to make those choices, knowing they would become worse under all the new iterations of the conservatives’ health care plan. But the true hell is having to have to do it all in public: To have to write articles like this with personal testimonies, create heartbreaking GoFundMe campaigns, share that video of Jimmy Kimmel talking about his baby with tears in his eyes, in the hopes that they go viral. Maybe, if one of them is sympathetic enough, someone will look my sister in the eyes and decide her pain, and her life, should be taken seriously.

At the very least, today, I will be calling undecided senators in Congress so that they can understand the impact of their vote. But let it be known that it’s only one among hundreds of efforts my family, like so many others, undertake to get access to health care for the people we love.

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