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Affordable Housing Conference Call, Privatizing Mental Health Services & Trans Fat Bans

Affordable Housing Conference Call, Privatizing Mental Health Services & Trans Fat Bans

Thursday, November 29th, 2007

http://www.progressivestates.org/dispatch

Growing-Economy

Promoting Affordable Housing Conference Call

When subprime mortgage scandals led to broader economic problems across the economy, Progressive States Network highlighted how bad policy at the federal level fed the predatory lending bubble, but also highlighted state policies that could improve consumer rights against the predatory lenders. But the core of the problem remains that families turned to such bad deals because of the lack of affordable housing. This policy failure to provide for affordable housing hasn't just hurt the pocketbooks of working families, but has had broader social effects. As we highlighted in our Affordable Housing as Smart Growth Dispatch, as families have been forced to move further away from their jobs in search of cheaper housing, we have seen longer commutes, wasted energy and community-destroying sprawl.  

To assist state lawmakers and advocates, we highlighted key policies in Promoting Affordable Housing through State Policy and have released today a companion summary of policies, State Policy Options for Promoting Affordable Housing.

Next Wednesday, December 5th at 4:00pm EST, Progressive States Network will be hosting a conference call for state legislators and state policy advocates to share the best state policies being used to promote affordable housing that serves communities and ultimately protects the environment through smarter development and community planning.

On the call, we will have Senator James Condos from Vermont and Rep. Mark Miloscia from Washington State, both of whom have been great affordable housing advocates in their states, speaking about recent efforts in their respective states on affordable housing.  Also on the call, will be Kalima Rose from PolicyLink, Jeffrey Lubell from the National Housing Conference, John McIlwain from the Urban Land Institute, and a representative from ACORN. Kalima Rose will speak about inclusionary zoning, which ties afforable housing to private development, as well as PolicyLink's Louisiana recovery work, collaborating with others to shape equitable rebuilding of New Orleans and Louisiana. Jeffrey Lubell will discuss the National Housing Conference's current state and local efforts, John McIlwain will speak about the Urban Land Institute's recent conference on green affordable housing, and a representative from ACORN will highlight ongoing efforts to limit exploitive predatory lending.

Conference Call: Promoting Affordable Housing
Wednesday, December 5th
4pm EST/1pm PST
1-800-391-1709 (Conference ID# 70 94 24)
Please RSVP at http://snipr.com/housingconfcall

Please join us to participate in this discussion about how states can promote affordable housing policies that are not only equitable but environmentally sound.

Strengthening-Communities

BY Adam Thompson

Nevada May Repeat Other States' Mistakes in Privatizing Mental Health Services

Nevada is exploring privatization of its mental health services, citing the difficulty of finding psychiatrists for its state-operated psychiatric hospital and a shortage of mental health care services in rural communities. Yet, privatization is not the easy fix it's often sold as and raises concerns of accountability and quality inherent in contracting out public services to private firms.

In 2006, Nevada's mental health care services earned a D-grade from the National Alliance for Mentall Illness (NAMI), the nation's largest mental illness advocacy organization. The group, however, praised the state for its candidness, transparency, and other efforts to address the problems in its mental health care system, which largely stem from underfunding of programs and a lack of service infrustracture. This indicates that the culprit is funding, rather than public administration. NAMI does not offer privatization as a solution for Nevada's system, rather it urges lawmakers to focus on improving access to services for mentally ill people in rural areas, reducing the burden on emergency rooms for treating and housing mentally ill patients, and increasing housing for the homeless mentally ill.

Lessons in Privatization from Michigan and North Carolina:  Opinions on privatization vary, but experiences in a few states serve as a warning for lawmakers considering privatization of mental health care services. NAMI's Michigan chapter in 2002 cited years of privatization of the state's mental health services as a key reason for a dysfunctional, inefficient and unaccountable system:

...a policy of decentralization and privatization has resulted in a shifting of responsibility and control from the state to the local community mental health programs, and in turn to contracting agencies. This has produced multiple layers of administrative overhead, duplication of efforts, fragmented and ill-defined programs and loss of control over the management of public funds. The management of these funds is thereby removed from public scrutiny otherwise enabled by the Freedom of Information Act, the Open Meetings Act and competitive bidding.

The Michigan chapter made a laundry list of recommendations for improving the mental health system that centered around increased state oversight, management and accountability. 

Six years ago, North Carolina began a broad reform of its mental health services that hinged on outsourcing services and management to private firms. Recent news regarding the reform, however, are cause for concern. A consultant's report found that the neediest patients are falling through the "safety net privatization was expected to provide" and recent state audits show that privatization has led to overbilling the state by millions of dollars amid a breakdown of oversight. The audits found that up to 185 private firms providing direct care to patients as part of the community-support services (CSS) program overbilled taxpayers to the tune of $45 million since March 2006. Compounding the problem, ValueOptions, the private firm hired to run the CSS program and determine eligibility, has been cited by critics as failing in its management duties. Mismanagement resulted in thousands of residents, many of whom were children, waiting for treatment.

All of this led the Daily Advance of Elizabeth City, North Carolina, to editorialize:

Privatization of mental health services is a disaster. It's time to reform the reforms. 

In related news, North Carolina took a significant step forward this year to ensuring access to health insurance coverage for mental health illnesses by enacting mental health parity, which requires insurance companies to cover mental health needs the same way they cover physical needs. 

Nevada should look to these lessons before it repeats the mistakes of other states by buying into the idea that privatization is a simple solution to much deeper problems of funding and reform of its mental health services.

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Strengthening-Communities

BY Adam Thompson

Banning Trans Fats in Restaurants

According to the Associated Press, 15 states have considered banning artery-clogging trans fats from restaurants this year, although the bans have only been enacted in local jurisdictions so far. Trans fats, which are linked to obesity, heart disease, and diabetes, are commonly found in fried foods and commercially baked goods, like doughnuts. According to Harvard researchers, 2 grams of trans fats per day are acceptable for the typical American diet. However, a 9-piece order of Burger King Chicken Fries with a side order of medium Onion Rings will saddle you with 7 grams of trans fats.  These higher levels of trans fat consumption can increase risk of heart disease by 23%.  

Cities are taking the lead on banning trans fats from restaurants. New York City enacted the first ban of the dangerous cooking oil and Philadelphia soon followed suit, although it later exempted bakeries after complaints that alternative oils yield a shorter shelf-life for pastries. This seems to be a weak argument, however, given that even a Twinkie, with a possible shelf-life of 30-years, surprisingly has zero trans fats. (The Twinkies' longevity likely earned it space in the nation's millenium time capsule in 1999.) Elsewhere, Montgomery County, MD, and Albany County, NY, have passed trans fats bans and the Louisville, KY, Metro Council is pursuing a ban along with a consumer education campaign. 

Opposition to banning trans fats has been driven by the National Restaurant Association, which has helped keep the state proposals off the books. Although the Association says outright bans are too difficult for restaurants to comply with, New York City's over 10,000 restaurants have already made the switch to safer cooking oils, like canola oil, with relatively little fanfare or protest. States where bans have been proposed include: California, Connecticut, Illinois, Maryland, Massachusetts, Michigan, New Hampshire, New Jersey, New York, Ohio, Rhode Island, South Carolina, Tennessee, Vermont and Hawaii.

The Center for Science in the Public Interest (CSPI) is leading the fight against trans fats in our foods. Several lawsuits by CSPI have prompted national fast-food chains to switch to safer cooking oils, including McDonald's, KFC, and Starbucks. CSPI recently filed another lawsuit to force Burger King to make the switch.

Broader Policy Implications for Health Disparities:  Eliminating trans fats from restaurants is a key policy goal to reducing rates of obesity, diabetes and heart disease. This is especially important in low-income communities and communities of color where access to healthy food options is limited, compared to white and higher income communities. A comprehensive report, Healthy Food, Healthy Communities: Improving Access and Opportunities Through Food Retailing, by the non-profit research and action institute PolicyLink documents the racial, ethnic, and economic disparities in access to healthy food options. One multi-state study found that wealthy communities had 3-times as many supermarkets as low-income communities and predominantly white neighborhoods had 4-times as many markets as African-American neighborhoods.  Although the report focuses on food retailing, it makes clear that low-income communities and communities of color have less access to healthy food. These problems are compounded when limited access to mass-transit and other transportation needs of low-income communities are factored in.

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Research Roundup

The Sloan Work and Family Research Network has released State Policy Makers: Supporting Low-Income Working Families, a menu of policies proposed or passed in states to expand access to services, better target economic development subsidies, or strengthen fair wage policies for low-income families.

A couple of new reports examine the economic strains facing middle class working families:

  • While many families have the income to look "middle class", most lack the financial assets to protect their families if crisis hits, often due to a  lack of health insurance, or face escalating housing costs beyond their financial means.  These findings are highlighted in By a Thread, a new report by Demos and researchers at Brandeis University that creates a new "Middle Class Security Index" to highlight the factors that endanger the economic well-being of many families.
  • A new Commonwealth Fund report, Overburdened and Overwhelmed: The Struggles of Communities with High Medical Cost Burdens, finds that an estimated 38% of people in the United States are saddled with high medical cost burdens relative to their income, the result of lack of insurance or poor benefits that leave many families often on the brink of bankruptcy.

On the immigration front, new reports continue to highlight that new immigrants come to the United States to work and contribute to our society, not to use social services:

  • In Working for a Better Life: A Profile of Immigrants in the New York State Economy, the Fiscal Policy Institute finds that immigrants added $229 billion to the New York State economy in 2006 with immigrant entrepreneurs playing a key role in creating jobs throughout the state.  Over time, most immigrants have learned English, bought homes and added to the cultural diversity and economic strength of the state.
  • Undocumented immigrants from Mexico and other Latin American countries are 50% less likely than U.S.-born Latinos to use hospital emergency rooms in California, according to a study by researchers at UCLA's Center for Health Research, published Monday in the journal Archives of Internal Medicine. As emphasized by a separate report by the Center, Immigration, Health & Work: The Facts Behind the Myths, all evidence shows that new immigrants are not coming to the U.S. to take advantage of our health care services.

Please email us leads on good research at research@progressivestates.org

Resources

Nevada May Repeat Other States' Mistakes in Privatizing Mental Health Services

National Alliance for Mental Illness - Grading the States 2006

NAMI-Michigan - Resolution on Michigan Mental Health Care Reform

North Carolina Psychiatry Association - There is Not Enough Money for Mental Health

Banning Trans Fats in Restaurants

New York City Department of Health - Report and Notice of Adoption of Trans Fat Ban

Center for Science in the Public Interest - Trans Fats

Ban Trans Fats - The Campaign to Ban Partially Hydrogenated Oils

US Food and Drug Administration - Revealing Trans Fats

PolicyLink - The Influence of Community Factors on Health: An Annotated Bibliography

Masthead

The Stateside Dispatch is written and edited by:

Nathan Newman, Policy Director
J. Mijin Cha, Policy Specialist
Adam Thompson, Policy Specialist
John Bacino, Communications Associate

Please shoot us an email at dispatch@progressivestates.org if you have feedback, tips, suggestions, criticisms, or nominations for any of our sidebar features.

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