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This blog is dedicated to distribute current information about the Coalition for the Homeless in Cleveland or poverty or the state of homelessness. Entries are written by board or staff of the Coalition. The opinions contained in this blog reflect the views of the author of the post. This blog features information on shelters, affordable housing, profiles, statistics, trends, and upcoming events relating to homelessness. We welcome comments, and will remove offensive or inappropriate messages. All postings are signed by the author.

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Sunday
Apr122015

When is Drug and Alcohol Treatment Going to Advance?

This American Life over the weekend (Episode 554--"Not It") had a feature on Puerto Rican residents being flown to the cities within the continental U.S. and dropped in unlicensed treatment facilities.  The reporter and the host seemed surprised over all of this, but I kept waiting for something shocking.  The Alcohol and Drug treatment folks have done an awful job of helping people deal with their addictions for decades.  They have focused on the punitive approach and avoided the healthcare and behavioral health aspects of addiction.   They have a one size fits all approach to the addiction (12 steps), and have not changed for 70 years despite a 90% failure rate. They set up artificial barriers to participation and then dismiss the majority of the people seeking help.

This program interviewed an HIV positive citizen of San Juan who was promised a better life in Chicago.   When he got to Illinois, he failed out of the program and now does not speak the language and does not have access to his HIV medicine.  He is homeless and none of the things promised materialized.  These promises were made by the city health officials in San Juan and what is the equivalent of our state government.  He was not told that these facilities he was going to were not licensed by the City or the State of Illinois.  He was not told that if he cannot maintain his sobriety he would be on the streets in a rough climate, and he was not told that he would have to find his own way back home.   It is radically different to be homeless in the tropical island of Puerto Rico compared to the mean, cold streets of Chicago.  The government and agency officials that the reporter talked to were not sympathetic.  They said that there is such a huge problem with addiction that they can not handle the number of people who need help. 

They governor of Puerto Rico said that he would welcome his brothers back, but did not see a huge problem with this strategy.  Most seemed to believe that these big cities would be able to handle the problem.  There was not the embarrassment or deer in the headlight moment of, "Mr. Wallace, you caught me--now get out!" Instead, we got a big shrug from all the officials.  The person in both Chicago who received these refugees and the program director in San Juan both spoke openly about the program.  They were not making money off the shipping people off the island.  They did not see the harm.  They felt that the people who failed were weak or irresponsible. 

In my 20 years of working at NEOCH, this is what I have seen up and down the Alcohol and Drug system.  They screen most people out because they don't want the negative element to contaminate the whole bunch, and then most of the people fail out of the program.  Never does anyone say, "This is not working, lets change our strategy."  There is no medicine or combination of medicine and treatment to help people with this brain disorder.  There is the 12 steps and nothing else.  Those that fail out are punished with homelessness and alienation from their family.  They are viewed as toxic and shunned for fear of their "disease" spreading.  There are waiting lists for help, and then everything revolves around talk therapy.  The day the addicted individual is ready to stop drinking, they have to have money or insurance or they wait for detox and treatment.  We lose so many people who go back to drinking because on the day that they make the decision to quit there is no space and so they go back to the streets and drink. 

Why haven't we come up with alternatives to 12 steps and making people homeless if they fail out of a 12 step program?   We could clean up 60% of the problems associated with homelessness if we just had some effective treatments for the behavioral health problem known as addiction.  If we treated it as a health concern and not a lifestyle choice, we could begin to make progress.   This casting people to the wind and hoping that they get better is only surprising in how far they had to travel in the This American Life radio story, but it is no different than evicting people from transitional programs to live on the streets of Cleveland.  Or kicking people out of their suburban home because their addiction is out of control.   I know how difficult family members are who are spending all their money on drugs or alcohol or those who cannot take care of their kids because they are drunk every night.  I just refuse to believe that our advanced society has not come up with an answer that does not involve homelessness and sleeping on the streets of Chicago or Cleveland to deal with addictions. 

Brian Davis

Posts reflect the opinion of those who sign the entry.

PS Our staff person Joyce, will be on the WCPN series Cleveland Tough this Thursday morning.  Tune in for the Brian Bull stories about individuals who have overcome so much.  Many of these stories are struggles to overcome addiction.

 

Sunday
Apr122015

Medicaid and Voter Suppression in State House

The State House of Representatives is releasing their budget this week. There is good news in the budget released by the Governor in February and then his transportation budget veto in March.  The Governor is supporting an expansion of Medicaid in the budget for 2015 to 2016.  This has not received much criticism despite the tricky way that it was passed into law in 2013.  If you remember the Medicaid expansion was bypassed by the legislature and the Governor slipped it into the Controlling Board budget.  There was so much rhetoric about overturning "Obamacare" and not expanding Medicaid. So far in the first two months that this budget has been out we have heard very little about Medicaid expansion.  There is no controversy it seems even though the State will have to pick up 10% of the cost in 2016. 

Why is there no there controversy?  The cost of dismantling Medicaid expansion would be enormous for the State.  All of these 200,000 people who now are getting prescription drugs would need to be provided some alternative.  All the hospitals in rural communities that are benefiting from the federal government reimbursing them for care would have to find alternatives.  In the South, those hospitals are struggling to stay alive or closing because there was no way to pay for cost of care to the poor.  The expansion of clinics and new health care facilities in Cleveland, Columbus and Cincinnati would close down and the communities would have to deal with the loss of health care jobs.  The Health Corridor in Cleveland would shrink to a couple of facilities.  The emergency rooms would again be packed with many uninsured residents, and cities would have to scramble to find additional health care money for their citizens.  Elected officials will be faced with coming up with funds for more EMS trips, more psychiatric problems, and more involvement with law enforcement because of out of control health issues. 

The other bit of good news was the Governor Kasich issued veto of the unrelated bit of voting restrictions slipped into the transportation bill.  This would have forced students to register their car within Ohio if they change their residence to Ohio.  They would have 30 days to register their car after they change their residence to Ohio in voting.  This would be very difficult for the local boards to enforce, and would dissuade students from changing their residence for voting.  Governor Kasich recognized all the problems and the potential lawsuit and vetoed this short sighted proposal.  Why don't legislators want to encourage student voting and encourage students studying in Ohio to remain here?  Why are they trying to put up all these barriers?  Why do they continue to try to encourage voting lawsuits? Thanks to the Governor for turning back further voting restrictions.

Brian Davis

Posts reflect the opinion of those who sign the entry.

Sunday
Apr122015

Faith Says Very Little Good in Ohio Budget

Bill Faith attends a Medicaid Expansion Rally in Columbus. Photo from COHHIO.org Bill Faith, executive director, of the Coalition on Homelessness and Housing in Ohio, spoke to the April Cuyahoga Affordable Housing Alliance meeting.  He brings a wealth of information about the State of Ohio budget and its impact on housing and homelessness.  Bill focused on the budget that the Governor submitted, which are subject to House and Senate approval.  Many of the Governor's proposals are destined to be slashed because the Republican dominated Ohio Legislature does not want to ever ever ever raise taxes anywhere, never upon pain of death.  Here are some highlights of his speech:

  • The National Housing Trust will most likely now have funds in 2016, but it looks as though Ohio will only get about $10 million or less to preserve or expand affordable housing. The Ohio Housing Finance Agency will develop an implementation strategy similar to priorities set by the HOME program.  These funds are no where near the level of cuts at the federal level to Public and Housing Choice Voucher over the last few years.
  • The State will receive additional funds to help build additional housing for disabled individuals in conjunction with State Medicaid and Drug and Mental Health Boards (only 508 disabled individuals selected throughout the state).
  • Bill talked about the horrible job the state did in renewing people on Medicaid as part of the Obamacare expansion.  There was a very long application with confusing details on where to return the form and thousands did not respond. 
  • Maybe additional PRC funds through the welfare department for job placement and retention assistance.  This is the proposal by COHHIO to counter the huge proposal to put huge funds into a new case management system at the local welfare offices. 
  • Massive cut to the income tax which benefits the richest people in the state the most.  These $4.6 billion in the two year budget could do so much for improving infrastructure, local governments, increasing the housing trust fund, and public transportation. But sadly a missed opportunity.
  • No controversy so far about expanding Medicaid because there are so many now on the program and benefitting from the service.
  • There may be an expansion of the childcare assistance from those below 200% of poverty to those under 300% of poverty income.
  • May be an increase in funds for Developmentally Disabled. This came about because of a series of lawsuits that showed that the system is overly reliant on institutional care for the developmentally disabled.
  • The State may allow more of the Recordation funds go to the State Housing Trust Fund to go to a Housing reserve funds.
  • COHHIO wants the state to do more to preserve mental health and recovery housing in the state as well as figure out a way to bill Medicaid for more of the supportive services offered at Permanent Supportive Housing buildings in the state.
  • There is a toxic bill that would gut the fair housing regulations (SB 134) in the State of Ohio and make it more difficult to file a claim of discrimination.  COHHIO fighting this potential regulation.
  • The state agency that distributes tax credits is making some big changes this year to correct some of the problems from the previous year.  COHHIO will weigh in on these changes.
  • The Hardest hit funds for those in foreclosure is over and the funds to renovate shelters in the State was a one year allocation. 

Next meeting is May 4 with First Call for Help and the State of Fair Housing at 1:30 p.m. at HUD lower level in Cleveland.  The meeting is open to all.

Brian Davis

Posts reflect the opinion of those who sign the entry.

Wednesday
Apr082015

The Importance of Healthcare for the Homeless

Mayor Jackson attends the new clinic ribbon cutting in March 2015. Photo by KenThe local health care for the homeless and public housing resident's Clinic under the Direction of Care Alliance had a ribbon cutting in March 2015.  This brings a free and low cost health care facility to the Central neighborhood. This will be a big boost to those at Cedar Extension Apartments and the new units being developed across from Tri-C.  Those lower income tenants at Arbor Park and the many others around Sterling Library have a health care home now.  Why is this so important for a community? And the other question this important in the era of the Affordable Care Act or Obamacare?

It is tremendous to have this expansion of health insurance in Ohio with the Medicaid expansion, but if the closest clinic is 60 blocks away there is still a hole.  Transportation is a huge barrier to maintain proper health care.  The elderly and fragile disabled populations served by these health clinics cannot travel long distances for health care.  They will if forced to, but will make better health choices if the clinic is convenient.  Those in need of healthcare will wait until things are serious before they see a doctor.  They will not want to wait in the emergency room for something that is not debilitating, but may walk over to the clinic to get it checked out. 

These Care Alliance clinics also have oral health care which is often overlooked, but can become serious.  It is often a sign of serious health issues or can start in the mouth and infection can spread to other parts of the body.  Oral health can make it difficult to process food, and can make it difficult to find stable employment.  This may mean that the individual is not taking in protein or able to eat healthy.  It may then spiral into an inability to get to sleep and the body begins to shut down.   It is a sad reality but with a glut of labor in the core city, employers often make the decision on whom to hire based on appearance.  The women without front teeth no matter how qualified is going to have a harder time getting a job.  We had a formerly homeless guy who regularly came to our office and refused to talk to groups of three or more.  Then he got healthcare last year with the ACA and all the rest of his teeth were taken out because of neglect and a gum disease.  After a couple of months, he was fitted for dentures so that he could digest food and now is regularly talking to larger and larger groups about his experiences. 

This facility has pediatrics care and a women's clinic as it opened on April 1, 2015.  We have had people who stay outside in need of care and would not go to the emergency room that received help from a Care Alliance doctor.  Outreach workers do find people living all over the city in places not fit for human habitation, and can stop into one of their clinics for help. Care Alliance offers a medical home to those displaced and wandering throughout the city.  This new clinic features a pharmacy as well.  It will only help to sign people up for health care insurance and maintain their eligibility.  This will be especially important if the State of Ohio keeps kicking people off the Medicaid Program, because they did not answer a long re-determination questionnaire. 

It is a beautiful facility which will help get homeless and low income people access to health care.  This will contribute to a healthier community. 

There is a nice article in the Plain Dealer today.

Brian Davis

Posts reflect the opinion of those who sign the entry.

Tuesday
Apr072015

Donations Still Needed

We made it through the horrible winter.  We had a report of one person suffering from frost bite and losing fingers, but no reports of people freezing to death.  We have to thank Community West Foundation for helping with all the donations and helping with putting people into motels during the extreme weather.  It was tough, but outreach teams, St. Pauls, Labre and Metanoia did a ton of work keeping people safe.  

It is spring and still a dangerous time.  Hypothermia is still a threat because people get wet and then it gets cold at night.  They may have prepared for the winter and the snow, and may let their guard down for the spring.  They may not have as many blankets or plastic or clothing as they had for the winter.  We are still collecting and distributing items. We have updated our flyer for the spring and that is available to print out and distribute. We give out items to the outreach teams every week. 

Flyer to print out and distribute