An Open Letter to Congress

Senior Employment Training Needs to be Restored

An Open Letter to Members of Congress:

RE: Title V Cuts of the Older Americans Act

Dear Member of Congress:

The Northeast Ohio Coalition for the Homeless is proud to be one of the thousands of host sites in the United States providing skills upgrades to seniors as part of the Senior Employment Act (Title V of the Older Americans Act). We have been one of the host sites for over a decade. The seniors who participated in the program enhanced their computer skills, office administration, and all were able to develop a tremendous amount of knowledge on homelessness.

As you know, this program was strongly supported by the late Senator Kennedy. He nursed this program and saw it grow over the decades. It is shameful that upon his death the program was cut so drastically. The program was funded at $825.4 million in Fiscal Year 2010, and then cut to $449 million for Fiscal Year 2011—a 46% cut. Even using the pre-stimulus funded allocation of $691.9 million in 2009, there was a 35% cut in a time of a extreme need for additional government jobs to stimulate the economy. In a time of huge downturn when seniors are already struggling, we do not understand how cutting funds from seniors can be viewed as a positive.

These decisions have real impact on seniors across America. I wanted to give you some idea of how this is impacting our senior trainees. Our two current trainees had their hours cut by 20%. While these are small amounts for each individual, it could mean going without a prescription drug or electricity for a month. One of our members has had to delay serious dental care, because of the cut in his hours. Another of our members will not be able to replace his car that was recently stolen because of the cut in the program. This wonderful employment program supplements the income of seniors while they also refresh their skills.

We need someone to take up the gauntlet from Senator Kennedy and become the champion for this program. America’s seniors need someone to work to restore the funding for Title V of the Older Americans Act to allow seniors in training to get back to the 20 hours a week. The work sites, most of whom are non-profits, are overwhelmed with people in need, and we need all the help that we can get. The mature members need the money to be able to meet the increasing cost of living for food, heating, prescriptions, that is often not covered by their fixed incomes.

We would love to sit down to talk to you about this issue. This is an extremely valuable program for senior citizens in the United States. The program was working well with many thousands of examples of positive outcomes. We urge Congress to restore this program in order to help seniors to re-enter the workforce. This program follows the proven model for training in which the individual is reimbursed for their time while participating in a training program. Finally, the thousands of non-profits working on homeless, hunger, tenant issues, and other human services benefit from the seniors working for social change.

Sincerely,
Brian Davis
Director of Community Organizing
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Voting Changes Coming to Ohio

How do you vote, when you can bring your residence to the polling place?
Photo by Cheryl Jones of the Grapevine Photo Project

Why Are We Making All These Changes?

Was the 2010 election corrupt in Ohio? Did we have long lines at the polling places? Did we have a flawed electronic voting system without a backup for verification purposes? Were there charges from either side that voters were casting multiple ballots? Were there problems with counting the ballots or with provisional voting? So, why did we change the procedure for voting Ohio with the passage of House Bill 194?

NEOCH has been involved in a lawsuit against the State of Ohio since 2006 that we finally settled in 2010. We have a 20 year history of working to assure that those without a traditional residence have a right to vote. We believe that it is critical to have homeless people participate in the electoral process under the thinking that they above other citizens need to vote for leaders willing to address the housing, job and healthcare crisis. These changes are especially troubling to groups that represent very low income individuals, and will make it difficult for our constituency to participate in democracy.

The leaders down in Columbus made changes to the procedure for voting with the passage of HB 194, and then two weeks later corrected the law that they had just passed. Strange, and it does not inspire confidence in the law if they needed a fix only two weeks later. So what are the changes and what will they mean?

• The size of the precincts will be changed so that they are larger, but for some reason only in urban communities. This will mean longer lines for those in cities where the majority of homeless people reside.
• Poll workers will not be required to tell people that they are voting in the wrong precinct, which will result in many more spoiled ballots and disenfranchised voters.
• Counties may not send out an application for early voting to registered voters. Large counties tried to encourage voting to cut down on lines by sending out notices to every registered voter, and paid for the return of the ballot to the Board. This new law will prevent counties from communicating with voters and prevents them from paying for the return of the completed request. This will result in more people voting in person thus causing lines.
  
• There are a whole series of changes that allow corporations greater participation in the election, which will bring more dollars into the election.
  
• The time to bring citizen petitions to a statewide ballot would be shortened making it harder to get ballot issues before voters to decide.
  
• Provisional ballots could be excluded from being counted for technical reasons. This was the settlement of the NEOCH vs. State of Ohio lawsuit that will be overturned. Homeless people often have to vote a provisional ballot because they move around so frequently. It was our position that if a poll worker makes the error the ballot should count. This new law would allow that a poll worker who suspects the voter to be casting a ballot for the other party they could make an intentional error on the processing of the ballot and it would not count thus benefiting the poll worker's party.
  
• They have taken away the ability to open early voting sites on Sundays and reduced early voting to 16 days (down from 35). This will result in longer lines for early voting and fewer people with the ability to vote early in person. Again, more people will be forced to vote in person on election day again resulting in lines.
• Long lines at the polling place cannot interfere with local surrounding businesses. I have no idea what this means or how it is can be enforced. Would the county sheriff or Ohio Highway Patrol shut down voting activities because it was interfering with a local bowling alley which happens to share a parking lot with a church polling place? Would the local police have jurisdiction to enforce this part of the law?
  
• There are new rules for when to take a voter off the voting rolls. This would allow the state to search databases and take a voter off the list of eligible voters. Often there is a conflict between two state databases due to clerical errors, and with this new law that could involve the individual being taken off the voting roles. The voter would then have to vote a provisional ballot and hope that it gets counted under the new rules.
  

These changes will be harmful to those who live in cities. They will make it more difficult to vote in person and by mail. They will fix problems that never existed in Ohio, and will reduce confidence in the election. Ohio had major problems with voting in the 2000 and 2004 Presidential election, but the only problem in 2008 election was with duplicate registrations. No one charged that there were duplicate voters or that Mickey Mouse voted in Ohio, just that ACORN paid people to register people and many of these canvassers made up registrations in order to get paid. Why would we want to go back to long lines and attempts to trip up voters by figuring out ways to disqualify voters? We should try to get as many people as possible to want to vote and make that process as easy as possible. Ohio is moving the wrong way in providing an efficient and trustworthy process for participating in democracy.

Brian
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Ohio A Dangerous Place for Homeless People

National Coalition Keeps Track of Hate Crimes

The Plain Dealer reported a hate crime against a resident of 2100 Lakeside Shelter this weekend. A group of teens attacked a homeless individual and stole his shopping cart. Ohio is always on the top of the list of states with a large number of hate crimes against homeless people put out by the National Coalition for the Homeless. Florida is by far the most dangerous state for homeless people in the United States with Ohio within the top five most dangerous states. NCH is right now preparing their hate crimes report. Look for it this fall.

County Prosecutor Bill Mason wonders at the end of the story why young people would attack a homeless person. Most readers were wondering the same thing. NEOCH believes that there should be additional penalties for those who target homeless people with violence. Mason's prosecutor lobby organization down in Columbus opposes adding homeless people to the hate crimes statute in Ohio. Mason also allowed the young people from Youngstown who came to Cleveland and attack homeless people with a stun gun to plead to misdemeanor charges and the teenagers only had to do community service. Maybe Mason will support a hate crimes statute in Ohio or will make an example of these teens to send a message that our society will not accept homeless people being easy targets after seeing the number of incidents increasing.

Brian
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Information on the Opening the Waiting List

Housing Choice Voucher List Opening

This August, the Housing Choice Voucher Program (HCVP) will be opening its waiting list with a lottery for the first time since 2006, and this time, the entire HCVP Waiting List Lottery will be conducted online.

Entries for the lottery will only be accepted online on the HCVP Waiting List Lottery website at

www.applycuyahogacounty.tenmast.com

There also will be a link to the lottery website from the CMHA website.

Seniors and persons with disabilities can contact:

There will be a call center open for assistance with submitting a lottery entry, but the application must be submitted online

Interested persons cannot access the lottery at any CMHA office or facility. Instead they should go to the library or to a social service provider. NEOCH will be offering help to homeless people at our offices at 3631 Perkins Ave.

The website and Call Center will go live on Monday August 1, 2011, providing helpful information about the HCVP and the lottery itself.

The actual lottery and waiting list will open mid-month for only five days.

After they close, a random computer draw will take place to create the waiting list with 10,000 names. Entry in the lottery and placement on the waiting list will not guarantee a household a voucher. All households will need to be qualified as eligible when they reach the top of the waiting list.

Brian
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Americans in Need of Housing

Housing Vouchers Are the Gold Pot at the End of the Rainbow?

As reported widely in the national news, thousands showed up in Dallas County Texas to get a spot on the waiting list for a housing voucher. For those who do not know a voucher will allow the household to pay only 30% of their income in rent and utilities and thus making housing affordable. The Dallas Morning News accurately described this as a sign of the instability in housing across the country.

"When, at 6 a.m., officials said it was time to form a line, a frantic rush ensued — the latest sign of people’s desperation for help in tough times. There were no serious injuries, but video footage of the chaos received national attention," wrote Kim Horner of the Morning News.

There were 5,000 who showed up in person and another 21,000 applied on line to get a space on the waiting list. Dallas had not opened up the waiting list for the last five years. The agency will select 5,000 of the names to be on the waiting list going forward.

In Parma Ohio earlier in 2011, they have a local housing authority that received over 20,000 applications for a couple of hundred vouchers using an entirely paper system. In Plano Texas, 8,000 people applied for 100 available housing vouchers. In Cincinnati, the Hamilton County Housing Authority did an entirely electronic application process and 19,000 people applied over one week for a 5,000 person waiting list. All of these numbers show a huge demand for housing in the United States.

Cleveland opened its waiting list back in 2006, and 40,000 people applied for 10,000 people on the waiting list. In Dallas county, they only have a total inventory of 3,800 households utilizing the vouchers. Cleveland has over 13,000 vouchers utilized throughout the county. The big news is that August 15 to August 19, the Cuyahoga Metropolitan Housing Authority will be opening their waiting list. We will be able to see how many people show up in need of housing during that week. We will only have electronic applications available, so that could keep the numbers down. The application will only be available online for that one week, and for the first time locally there will be no paper applications.

The Coalition and the Cleveland Tenants Organization will be available to help people with applications or they can go to a number of shelters or any library in the area. People should continue to check the CMHA website for details. The information will be available after August 1 for more details. It will be critical to get every low income household to apply for the voucher lottery, because the next opportunity will not be until 2016 or 2017 if we continue to have such a limited housing resource in the United States.

We should collect all these stories about the near riots in various cities, and the overwhelming number of people who need help with housing. It is a nationwide problem that was compounded by the financial downturn and the mortgage foreclosure crisis. HUD Secretary Donovan, Speaker John Boehner, Rep. Eric Cantor and Senator Harry Reid are you reading all these stories about the housing crisis in America?

Brian
Northeast Ohio Coalition for the Homeless
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Affordable Health Care Coming Soon

Photo by Pleasure Simmons

Health Care Forums: An Overview

I have provided an overview of each of the three UHCAN Affordable Care Act health care forums. Here is the summary of the first one, the second one, and last week we posted the summary of the last. I wanted to give a brief overview of all three together.

At the end of three highly detailed healthcare reform forums, I can say I am both more informed and confused about the coming changes. All forums seem to stress that there is potential for positive change, but that there are many obstacles to success, the largest one being that this is all a new system to the majority of patients and providers. Other concerns are: how consumers will fair purchasing their own insurance on the “exchange”; how providers will coordinating care in an equitable manner; and will there be an increase in primary care providers? We shall see how these all play out. More importantly will the increase in insured persons demand for services by 2014 when the Affordable Care Act is to be fully implemented be met with higher quality care or will overwhelmed care providers have to increase an already heavy work load? The coordination of care will likely be ineffective if there is not an increase in the work force to back it up. Dr. Richard Christi who spoke at the last forum voiced concerns about needing at least ten years to increase primary care providers due to the length of educational requirement.

Will the exchange be user friendly and if health insurance consumers are largely uniformed about the cost of medical services will individuals and businesses be able to appropriately purchase health care on the exchange? There are of courses great positives and no one at any of the three forums ever suggested that the changes in the United States healthcare system were not needed. Certainly more people being covered should in theory increase the health of Americans and reduce the crushing debt many incur due to medical bills. Increasing coordination and ease of services is beneficial to the consumer. However, change is coming and it is clear that participation in the delivery of care is going to require great effort from providers and patients to utilize the advantages and minimize the areas of concerns.

by Holly Lyon
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Cleveland Street Chronicle Out and Available

The new paper, the Cleveland Street Chronicle, is out and available on the streets of Cleveland. Typically, it is sold at the West Side Market and Downtown. A few vendors have been venturing into University Circle and other areas of the City, but you can guarantee a vendor anytime the West Side Market is open.

This issue has our "Facts on Homelessness," which has become quite popular over the last two issues. We have two editorial cartoons from two vendors of the paper. Have them autograph the paper when you buy a paper from Kim or Greg. They could be famous someday so don't miss your chance when they are signing autographs for free. We have about one third of the paper written by those who vendor the Chronicle.

Other items include two commentaries on the changes in voting. There is a look at the Cleveland Youth Forum that took place in May. We have a book review and a feature on a homeless woman who found her way off the streets. Finally, there is a story from the Washington DC Street Newspaper about becoming invisible when you become homeless. There is a center spread feature on the recent graduates of the Lakeside--General Education Development Program. As always, we have plenty of poetry and photographs in the paper. Pick one up today and support your local vendor who is always struggling with their housing.

Also, check out the Cleveland Street Chronicle on Facebook.

Brian
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Third Health Care Forum Overview

Health Care Reform and the Consumer

This is the third and last forum in a series of health care reform hosted by UHCANN. You can find our overview here and here and here on this blog. The last healthcare forum, National Health Care Reform Begins: The Delivery of Care Story took place June, 20 at Cleveland State University. This forum addressed how reform will effect the general public as consumers.

Speakers included:
Cathy Levine- Executive Director of the Universal HealthCare Action network of Ohio (UHCAN Ohio).
Gary Hartman- Director of Care management program for Uninsured for the MetroHelath System.
Peter DeGolia- Director of the Center for Geriatric medicine of University Hospital Case Medical Center and the Executive Director of McGregor PACE (program of all inclusive care for the elderly).
Aaron Smith- Emergency Medicine Doctor and assistant Medical Director for External Affair organizational effectiveness for Kaiser Permanente.
John Begala- Executive Director of the Center for Community Solutions.
Scheduled but could not attend Greg Moody Director of the Governor’s Office of Health Transformation. Monica Juenger- Director of Stakeholder Relations replaced Greg Moody from the Governor’s Office of Health Transformation.

This forum began with a presentation from a consumer talking about her terrible experience with lack of coordination in the current medical system. Pat Morgan, as a result has been left blind in one eye due to misdiagnosis and lack of follow up. She suffered needlessly after receiving surgery for a cyst in her ear, she was released with no prescription for antibiotics; had to fight to get the prescription and received no follow up information from the doctor after she had the surgery. This resulted in a severe infection. Personally she feels having an accountable care facility as a standard for medical needs would have alleviated many of the miscommunications and misdiagnosis that she experienced. She believes that an accountable care facility would have resulted in fewer tests, fewer doctor visits, shorter illnesses and would have lowered her cost of health care.

Ms. Juenger replaced Director Moody, and featured a powerpoint presentation called Medicaid Hot Spots. This slide show is available online at the Ohio Governor’s Office of Health Transformation (search under reports on their website. Ms. Juenger’s presentation was the same information that has been provided in the news in regards to the Governor’s plans for healthcare. The high cost of Medicaid being absorbed by the few and changing long term care. 96% of Medicaid recipients are low cost, while 4% utilize over 50% of expenditures. Sighting that Ohio per capita has a rate 52% higher in nursing home care and 12% higher in hospital care, but 8% lower in home healthcare than the rest of the country.

Also covered by Ms. Juenger’s presentation was Ohio’s poor performance in national ranking in regards to overall health and delivery of health care. The following are few of the highlights. Ohio is ranked 42nd healthiest state in the nation, 44th in avoiding Medicare hospital admission for preventable conditions, 44th most affordable Medicaid for seniors (6th from last), 40th in avoiding Medicare hospital re-admissions. Another key highlight was that while Governor Kasich plan is designed to save money and improve a fragmented system in order to provide a coordinated, efficient and ultimately better care system. But with regard to seniors and persons with chronic disease the goal is to reduce hospitalization and nursing care facilities stays in order to save money while improving care. Ms. Juenger pointed out that savings will not take place immediately, but will take a few years to actually see cost going down.

Cathy Levine Executive Director of UCHAN of Ohio said it will be important for consumers and consumer advocates to insure that patient center care is effective during this transition. This means transparency in delivery of service, changes in how providers interact with patients and most importantly leadership provided by consumer and consumer advocates. Patients will need to have a better understanding of their insurance, specifically pertaining to cost and coverage. Providers should not receive funds for “volume but quality.” Many Medicaid providers are paid for specific services they provide, this often results in unnecessary test as well as duplication of tests.

Gwyn Hartman discussed the MetroHealth medical home model that the organization implemented in 2009, which is a comprehensive onsite coordination of care program and is available at six of their locations. This program mimics the key components of an accountable care facility as described in the law. She stated that the number of uninsured patients continues to grow. At this comprehensive care program, all health care members who relate to a patient come together on a daily basis to share information. Care coordinator nurses work with high risk patients beyond their stay in the physical facility. This includes communicating with patients on daily or weekly basis. Hartman gave examples such as the diabetic that a care coordinator also schedules the patient with an eye exam in order to reduce emergency room visits and encourage preventative care.

Peter DeGolia discussed the PACE program and their comprehensive care provided to dual eligible seniors. Dual eligible refers to people who qualify for both Medicaid and Medicare. Peter provided the average medical needs of a baby boomer in a year time span:

• 1 in 10 have a chronic illness
• 77% has more than one chronic illness
• On average they attend 37 different doctors appointments annually
• They see 14 different doctors
• They fill 50 different prescriptions annually

DeGolia explained that hospitals are not the safest places for senior, as they can find the transitions disorienting and are exposed to various illnesses. Home care saves an incredible amount of money for the State. He did point out the problem with those physicians and nurses who currently provide care coordination are often not properly reimbursed under the current system. Sharing a personal example of a house call, (yes, Dr. DeGalio still performs house calls!) he went to a gentleman’s house and he treated him for pneumonia. DeGalio arranged health care aids to properly treat him and followed up with the patient in his home. He stated it was the right thing to do because he knew the patient would become disorientated in the hospital and risk the quality of his overall health. For this house call related to pneumonia he was only reimbursed $250. Had he had the patient admitted he would of had a plethora of tests to confirm he had pneumonia, and it would have cost the state thousands. DeGalio saved Medicaid and or Medicare substantial amount of money, but in many cases the best interest of the patient is not taken into account when these health care decisions are made.

Aaron Smith from Kaiser Permanente said that patients at Kaiser also receive service that replicate an accountable care facility. The most distinct difference is that Kaiser is a for-profit corporation. Smith was asked by an audience member if Kaiser being a profit based agency had anything to do with their model of care he replied, “Yes,” and went on to point out that from a fiscal stand point healthier patients save money. Kaiser Permanente currently covers 600 Medicaid patients.

John Begala focused his presentation on how health insurance differs from other products we purchase. The buyer and the provider often do not know how much the service that they are receiving actually costs. The bulk of medical costs are paid by somebody else; consumers rely on someone else to make choices for them with regard to the amount of care as well as the costs of that care. Begalia stated that the affordable care act is “Marvelous” in regards to expanding Medicaid (32 million will receive coverage with ACT; specifically 16 million will receive coverage under Medicaid.) However he is concerned that policy makers in DC do not fully understand what an accountable care facility is and is doubtful about the federal government’s ability to guide the implementation of something they seem to know little about.

I will evaluate the forum in a follow up posting.
Holly Lyon
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PBS NewsHour Highlights Cleveland

Photo by Cheryl Jones of the Grapevine Photo Project

Foreclosures and Clearing Land Focus of NewsHour Report

Last night was an excellent piece on the effort by the Land Bank and the City of Cleveland to clear some of the degrading housing stock as a result of the foreclosure tsunami. The usual suspects were featured including Gus Frangos of the Land Bank, Frank Ford of NPI, Councilman Tony Brancatelli, and Housing Court Judge Raymond Pianka. It was a nice touch to talk to Manfield Frazier about his vineyard in Hough. The piece was centered at Ground Zero of the foreclosure crisis in Slavic Village. They showed houses coming down as part of the thousands that we have destroyed over the last five years. Frank Ford did a good job describing the economics of this crisis with the reality that it costs$7,500 to take down a property while it can cost $100,000 to renovate that property with new electrical, new plumbing and new furnace.

There was a interesting discussion about the flipping of these homes using the internet, and the nasty practices of some of the banks (we are talking to you Deutsche Bank). They sold a property for $500 that was an eyesore, and then the new owner tried flipping it on the internet with a profit of $1,000 to an out of state buyer (sucker) with no intention of doing anything to the property. They are just hoping that the land value will turn around and they can make a profit. These vultures are just trying to earn money off of the misery of hard hit neighborhoods. It was a good piece. Check it out.

Brian
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National Speaker's Bureau

NPR Highlights Speaker Bureau

On Independence Day, NPR's All Things Considered featured a story on the National Coalition for the Homeless and the Speakers' Bureau. This was an excellent overview of the program, and its remarkable reach. The NCH program speakers go all around the country to speak, and are available for urban plunges in the nation's capital. Please check out the story here. Pam Fessler interviewed two members of the bureau, George and John. I really like how the guys focus on the dignity of everyone, and the desire for most not to be ignored:

Steve Thomas and George Siletti are also members of the National Coalition for the Homeless' speakers bureau. "Seemed like all of a sudden, people walked by me like I wasn't even there," Harrison tells the group. "I remember going into a restaurant to get what I called a 'two for one.' And the 'two for one' for the person experiencing homelessness is the warmth and the food for the price of the food. And so, I was optimistic. They took my order. But when they brought me my food, it was to go. Because that was the message. Go," he says.

"And those same people that used to walk by and say, 'Hey, Steve' everyday stopped speaking, just stopped even looking in my direction. And that kinda hurt," he says, his voice shaking. Thomas eventually got help from a volunteer group. He's been off the streets for more than three years.

The staff at NCH do a great deal of work with a limited amount of resources to put this all together. If you would like to schedule a speaker for DC or would be willing to pay for a speaker to come to your conference/school/church group you can contact NCH at 202.462.4822 or go to their website.

For speakers in Cleveland contact Larry Davis at NEOCH at 216/432-0540 ext. 103. We have a Street Voices program with trained volunteers with experience in homelessness. We do around 40 presentations a year mostly at area high schools, colleges or in front of religious organizations. We have both women and men, and until last week we had a high school student who would go out to do presentations.

Brian

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