Housing Equity Week in Review

Here’s the latest news in housing equity and law, from March 13-20, 2017:

  • Inspired by Matthew Desmond’s award winning book, “Evicted,” the Reinvestment Fund published research mapping eviction rates in Philadelphia. Now, the pressure on the city to act on eviction is piling up. Deborah Ross, the chancellor of the Philadelphia Bar Association, and Catherine Carr and Joseph A. Sullivan, co-chairs of the Association’s Civil Gideon and Access to Justice Task Force, wrote a letter calling on the city to fund legal representation for low income Philadelphians facing eviction. The Philadelphia City Council hosted a hearing Monday, March 20, about eviction following a resolution proposed by Council Member Helen Gym. Will Philly become the next city with free legal representation in housing court?
  • Dr. Megan Sandel has been on the front of advocating for housing as a public health solution for children’s illnesses. In an opinion piece this week in Stat News, Dr. Sandel criticizes the proposed cuts to HUD’s budget and asks Ben Carson to “Think of a stable home as a vaccine, something that can keep people healthy now and in the future.”
  • A new report by the National Low Income Housing Coalition came out about the benefits of affordable housing. Next City reviews the report in the context of the HUD budget cuts, saying that affordable housing have ripple effects.
  • Senator Cantwell (D-WA) and Senator Hatch (R-UT) re-introduce a bipartisan bill to increase the housing credit authority by 50 percent in Low Income Housing Tax Credit development, via RentalHousingAction.org

Webinars: ASPPH Two-Part Series on PHLR

CPHLR is joining forces with the Association of Schools and Programs of Public Health (ASPPH) for a free, two-part webinar series on public health law research and policy data evaluation.

Public Health Law Research Part I: Creating and Using Open-Source Policy Data for Public Health Evaluation Research
March 29 @ 12:00 pm – 1:00 pm
Will introduce participants to the practice of Policy Surveillance and the various law and policy datasets available through LawAtlas and other open-source portals.
REGISTER >>

Public Health Law Research Part II: Developing and Implementing a Policy Evaluation Using Open-Source Legal Data
April 12 @ 12:00 pm – 1:00 pm
Will introduce participants to the theory, design and implementation of a policy evaluation using policy surveillance datasets.
REGISTER >>

Housing Equity Week in Review

It was a national and international first week of March in housing equity and law. Here are some of the big stories from the field March 6-12, 2017:

  • On the campaign trail, Donald Trump promised to cut domestic spending. Now the administration is considering a $6 billion cut to the Department of Housing and Urban Development. This could have major effects on programs such as Section 8, which is already notorious for the long waiting period for vouchers. Story from the Washington Post.
  • The Washington Post also reports fair and affordable housing advocates call the proposed budget cut “devastating”
  • The struggle to create “affordable” housing is not only an American problem. Here is an update on what’s going on in Britain, via the Guardian.
  • What does gentrification look like in West Philadelphia? Jake Blumgart via Philadelphia Magazine.
  • The National Low Income Housing Coalition report on affordable housing is out! “The Gap: A shortage of Affordable Homes” shows that we are still 7.4 million units away from meeting the need for affordable rental units for low income households.

Did we miss any big stories? Let us know.

The Balancing Act Between Mental Illness and Gun Rights

Editor’s Note: This is an update of the post “Second Amendment Rights and Mental Illness,” originally published on September 1, 2015. 

By Mariam Ahmed, JD/MSPP

In September 2015, we offered a glimpse of the current landscape of laws addressing mental health and gun violence. Many of the laws addressed public safety concerns that arose from active shooters with mental illnesses. At both the state and federal levels, government officials continue to debate the relationship between gun violence and mental health issues. Questions of safety and stigma continue to be asked, and are leading to changes in the laws. Here’s where we stand now:

In July 2015, Congress introduced the Safer Communities Act of 2015, but after being passed around four different committees, it was never released to the House floor for a vote. If the bill had passed, it would have further clarified who is restricted from possessing a gun based on their mental health and treatment.

After the bill died in committee, agencies such as the Department of Health and Human Services (HHS) and the Social Security Administration (SSA) have passed regulations to further define reporting and restriction requirements for people with mental illnesses. On January 4, 2016, HHS finalized a rule that modified the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The modification allows HIPAA-covered entities to release personal information to the National Instant Criminal Background Check System (NICS) if the person has a “mental health prohibitor” on their record that limits ability to possess, transport, receive, or ship a firearm under federal law. The rule went into effect on February 5, 2016. Continue reading

Housing Equity Week in Review

Lots of questions and debate this week in housing equity and law. Here’s the latest for the week of February 21-27, 2017:

  • After a win for the Civil Gideon movement in New York, Next City asks if other cities could follow New York City’s lead and extend the right to counsel to low income tenants facing eviction?
  • There is a known racial wealth gap in the United States. Many attribute the wealth gap to the legacy of housing policies, such as redlining, that did not allow property of people of color to appreciate in the same manner as property of white Americans. Does that mean that today the solution to the wealth gap is in housing? Not necessarily argues Dorothy Brown of Emory University, via Forbes.
  • Diane Yentel, National Low Income Housing Coalition President and CEO, reflects on Mortgage Interest Deduction reform.
  • Bozeman, Montana cites city building and development code as a barrier to housing affordability. The debate on the effects of code continues politically, but is there evidence to back it up?
  • What does a Trump administration and large business tax cuts mean for affordable housing? Developers in California are concerned in the face of uncertainty as the Low Income Housing Tax Credit program might become less attractive to banks and investors, via the LA Times.
  • While the research community still debates the extent to which gentrification leads to displacement, a new study in Journal of Urban Health assess the health outcomes of those who stay. Analysis via CityLab, paper here.

Housing Equity Week in Review

This week was all about fair housing. Particularly, the Affirmatively Further Fair Housing rule and recent attempts to dismantle it. Here’s the round-up for last week, January 29 – February 5, 2017:

We’ve talked a little about fair housing before. In case you missed it, we interviewed Christopher Bonastia about his book, “Knocking at the Door” back in November.

Did we miss any big housing, law and equity stories this week? Let us know!

Housing Equity Week in Review

Last week, January 23-29, 2017, saw a mix of national and local-level housing news. Here’s our round-up for the past week:

  • Surprising some on the “Warren-wing” of the Democratic Party, Elizabeth Warren came out in support of Dr. Ben Carson as the 17th Secretary of Housing and Urban Development. In the confirmation hearing, Warren asked Carson if he can promise that no taxpayer dollar will go from HUD to developments’ of Donald Trump, then pointing out that it was a trick question since there was no financial disclosure,  no one knows exactly what how or what President Trump benefits from financially. However, due to promises to abate lead in housing and to protect from LGBTQ discrimination in housing markets, Warren decided not to stand in Carson’s way. Coverage via The Hill.
  • President Trump’s pick for Secretary Treasury, Steve Mnuchin, lied during his confirmation hearing about foreclosure practices of One West Bank while he was the chairmen and CEO, according to the Columbus Dispatch.
  • As the population ages, housing needs change. Are we keeping up with the new demand? New York Times opinion piece on the housing needs of the elderly.
  • Bay Area housing prices are going down due to building boom, via the Business Journal.
  • The National Low Income Housing Coalition released a statement in opposition of the Local Zoning Decisions Protection Act of 2017.

Did we miss anything? Let us know!

Housing Equity Week in Review

Here’s the latest in housing equity and law for the week of January 16-22, 2017:

Did we miss anything? Let us know.

Housing Equity Week in Review

We’ve rounded up the latest news from the past week, January 9-15, 2017, for housing law and equity. The HUD confirmation hearing was, of course, the biggest news, but a few other items of note:

Did we miss anything? Let us know!

Pharmacist Vaccination Laws, 1990-2016

Since the 1990s, there has been a growing movement to improve access to immunization services by giving pharmacists the authority to administer vaccines.

The newest map on LawAtlas.org explores state laws from 1990 to 2016 that give pharmacists authority to administer vaccines and establish requirements for third-party vaccination authorization, patient age restrictions, and specific vaccination practice requirements, such as training, reporting, record-keeping, notification, malpractice insurance, and emergency exceptions.

As of January 1, 2016:

  • Pharmacists were explicitly authorized to administer vaccines in 46 states and the District of Columbia.
  • Thirteen states and the District of Columbia permit exceptions to vaccination requirements for emergencies or epidemics.
  • Ten states grant pharmacists prescriptive authority to administer vaccines (i.e., pharmacists can vaccinate without a third-party authorization).
US map shows every sate except AL, MS, TN, WA have laws

As of January 1, 2016, every state except Alabama, Mississippi, Tennessee, and Washington had laws that authorized pharmacists to vaccinate.

The dataset was created by Cason Schmit, JD, Research Assistant Professor, Texas A&M University, and Allison Reddick, JD, MPH, Associate Attorney at Hill & Ponton, PA.

Check out the latest map and data at LawAtlas.org.

Mapping Emergency Suspension Powers

Together with the Centers for Disease Control and Prevention and Public Health Management Corporation, the Policy Surveillance Program recently released a new map addressing Emergency Powers laws.

Emergencies might involve dangers to public health, such as an outbreak of the flu; natural disasters, such as floods or earthquakes; or threats to security, such as acts of terror. In 41 states and the District of Columbia, governors are explicitly permitted to suspend laws that would interfere with an efficient, effective response to an emergency. Some states also permit governors to amend laws or create new ones during emergencies.

This new map covers laws granting broad powers to governors to manage emergencies in all 50 states and the District of Columbia.

PHLR spoke with the researchers, Kelly Thompson, JD, Law and Policy Manager at the National Nurse-Led Care Consortium, an affiliate of Public Health Management Corporation, and Nick Anderson, JD, ORISE Fellow at the Centers for Disease Control and Prevention, to discuss their work.

Read on for the full interview! Continue reading

Health Equity in Housing Book Club: “Knocking on the Door”

Q&A with Christopher Bonastia, PhD

This is the first in a series of posts we will share during our research for our housing equity project. Have a suggestion for what we should read next? Let us know.

In his 2006 book, Knocking on the Door: The Federal Government’s Attempt to Desegregate the Suburbs, Christopher Bonastia, PhD, reviews the federal government’s role in perpetuating residential segregation in the United States, and its fleeting attempts to desegregate the nation’s neighborhoods.

Dr. Bonastia discusses the active role federal agencies and courts have played in creating and perpetuating residential segregation. He points to the Home Owners’ Loan Corporation, the Federal Housing Administration, the Veterans Administration, and the US Department of Housing and Urban Development as significant players in segregation and desegregation.

Understanding the roots of segregation and policy attempts to desegregate is key to understanding housing as a social determinant of health. Empirical research has shown associations between black-white segregation and an increased black infant mortality rate, elevated rates of black mortality, black homicide rates, and other negative individual and public health outcomes. Addressing racial residential segregation is imperative when attempting to improve any of those health outcomes.

Christopher Bonastia is professor of sociology at Lehman College and the City University of New York Graduate Center, as well as associate director of the Lehman Scholars Program and Macaulay Honors College at Lehman. He is the author of Southern Stalemate: Five Years without Public Education in Prince Edward County, Virginia as well as Knocking on the Door: The Federal Government’s Attempt to Desegregate the Suburbs.

Our team read Knocking on the Door during our initial research period on housing, health equity and legal levers. Continue reading below for our interview with Dr. Bonastia about this book and ongoing research in this area.

Continue reading

Legal Levers for Health Equity through Housing: A New Research Project

Health equity in housing can be defined as the absence of disadvantage to individuals and communities in health outcomes, access to health and social services, and quality of health and social services based on a person’s dwelling or neighborhood.

Lack of housing access, poor housing conditions, and income or racial segregation all have been shown empirically to cause negative health outcomes. Law has a pervasive role in housing, and has for a long time. Law was instrumental in creating and maintaining segregation through mechanisms like red-lining, restrictive covenants and zoning. The Civil Rights movement brought an end to explicitly discriminatory policies, and new finance and inclusionary zoning policies helped create millions of units of affordable housing, but we still have a long way to go. As Matthew Desmond’s work shows, drastic improvements are needed in how governments enforce housing codes and balance the rights of landlords and tenants. The bottom line is that too many of our people have trouble affording decent housing in neighborhoods with the amenities for healthy living, and too many of our neighborhoods are still segregated.

Our team at the Center for Public Health Law Research has been selected as a research hub in the Robert Wood Johnson Foundation’s Policies for Action Program. For the next 20 months, we will be using empirical research and legal scholarship to analyze the housing crisis through the lens of law. We know that law shapes environments and behaviors, so we are searching for the links between laws, their intended and unintended effects on the housing market, and the health outcomes that follow. We will be bringing a focus on law and its mechanisms to a field rich in policy research. Our aim is to investigate how law influences health equity in housing, and offer recommendations about how it can be a lever for greater equity. We hope to engage the community of non-profits, advocacy groups, policy think-tanks, and social scientists who are working on identifying problems and finding solutions, as well as the community of legal scholars and litigators working on housing issues. In our recommendations we plan on both identifying steps to incrementally advance housing equity through existing law, and envisioning creative changes to the legal framework itself.

We are excited to engage the housing policy and the law community in a discussion about legal levers for health equity through housing. We also look forward to sharing our work with you as we go, here and on the Policies for Action website. Please stay tuned!

If you are interested in continuing this discussion please reach out to Abraham Gutman at Abraham.gutman@temple.edu

Biosimilars – In The Pipeline or Still a Pipe Dream?

By Jonathan Larsen, JD, MPP and Adrienne R. Ghorashi, Esq.

The US Food and Drug Administration (FDA) approved the first biosimilar for use in the United States in March 2015. The approval came after several years of regulatory process development authorized by the Biologics Price Competition and Innovation (BPCI) Act of 2009, a component of the Affordable Care Act.

Biosimilars are highly similar, but not identical, copies of FDA-approved biologics, known as “reference” products. Biologics are used to treat a variety of diseases and medical conditions, including cancer. For many years, biosimilar development was thought to be too complex and too costly to advance, and exclusivity patents for reference biologics prohibited developers from marketing competing biosimilars. Now that those patents have started to expire, biosimilar development can finally begin, at a potentially huge benefit to patients.

Continue reading

Updated Nurse Practitioner Scope of Practice Map

The Policy Surveillance Program staff has recently updated the Nurse Practitioner Scope of Practice Dataset on LawAtlas.org to include laws through May 2016.

Fifty jurisdictions and the District of Columbia have laws pertaining to nurse practitioners’ scope of practice. In general, scope of practice laws regulate the autonomy nurse practitioners are given within their practice to treat patients. State laws fall into two main categories: limited practice and full practice. In limited practice states, the law limits autonomy for nurse practitioners by requiring them to collaborate with, or work under, the supervision of another health care provider. By contrast, full practice states allow nurse practitioners to practice independently.

In total, there are 29 limited practice states. In those states, collaboration, supervision, or a combination of the two are required in performing activities such as prescribing medication, ordering tests, performing examinations, and counseling or educating patients, among other activities.

1map

– States with limited practice authority

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California the latest to pass a Death with Dignity law, 5th in US

Medical personnel are trained to “first do no harm.” In end-of-life treatment, that simple directive can be difficult to interpret, and the legal landscape has evolved in the United States over the past 25 years. In 1990, the US Supreme Court ruled that physicians and other health care providers could withhold medical treatment at the direction of a patient or the patient’s directed agent.

Most recently, a movement to provide patients’ help in dying has been termed “death with dignity” and “assisted suicide.” Federal law does not currently address euthanasia or “mercy killings” in terminal patients who seek a physician’s aid to end their own suffering. Rather, the patient’s right to obtain a physician’s or other health care provider’s help to end their life is established by state law. Continue reading

Prior Authorization Policies for Pediatric ADHD Medication Prescriptions

According to the Centers for Disease Control and Prevention, more than 6.4 million US children 4-17 years old have been diagnosed with attention-deficit/hyperactivity disorder (ADHD). The percentage of US children diagnosed with ADHD has increased by 3-5 percent per year since the 1990s. Relatedly, the percentage of children in this age group taking ADHD medication also has increased by about 7 percent per year from 2007-2008 to 2011-2012.

In response, some state Medicaid programs have implemented policies to manage the use of ADHD medications and guide physicians toward best practices for ADHD treatment in children. These policies include prescription medication prior authorization requirements that restrict approvals to patients above a certain age, or require additional provider involvement before approval for payment is granted.

In a new article published this afternoon in MMWR, CDC researchers compared Medicaid and employer-sponsored insurance (ESI) claims for “psychological services” (the procedure code category that includes behavior therapy) and ADHD medication among children aged 2–5 years receiving clinical care for ADHD.

The article references a newly released LawAtlas map that examines features of state Medicaid prior authorization policies that pertain to pediatric ADHD medication treatment, including applicable ages, medication types, and criteria for approval.

States with Medicaid programs that have a policy that requires prior authorization for ADHD medications prescribed to children younger than 28 years old.

States with Medicaid programs that have a policy that requires prior authorization for ADHD medications prescribed to children younger than 28 years old.

Continue reading

Variability of US State Workplace Wellness Program Laws

A team of researchers led by Jennifer Pomeranz, JD, MPH, Clinical Assistant Professor of the College of Global Public Health at New York University, have released a new set of resources that detail characteristics of laws related to workplace wellness programs and identify trends in these laws across the United States: interactive maps for public and private employers at LawAtlas.org and a paper published in the American Journal of Public Health.

Workplace Wellness Program Laws in US

A few key findings:

  • Thirty-three states and the District of Columbia have laws related to workplace wellness programs.
  • Four states (Georgia, Indiana, Maine and Massachusetts) provide tax incentives for work place wellness programs.
  • State laws addressed public and private employers differently, for example, five states permit rewards (e.g., discounts, rebates and waivers) by public employers, whereas 16 states expressly permit positive rewards for participation in programs by private employers.

The research was funded by the Robert Wood Johnson Foundation’s Public Health Law Research Program.

New Federal Employee Drug Screening Guidelines to Include Opioid Testing

By Jonathan K. Larsen, JD, MPP

There is no denying that the United States is experiencing an opioid overdose epidemic. Drug overdose deaths generally in the United States have been associated, at least in part, with increasing mortality rates among white non-Hispanics, which is counter to trends in other wealthy nations. The Urban Institute’s Laudan Aron recently posted about the underlying causes of our current epidemic, paying special attention to aggressive marketing of painkillers, the related spike in opioid prescriptions, and the closely correlated increase in opioid abuse. The issue has even made it into the current Presidential campaign, however briefly. President Obama has sought increased funding to address the issue, as well as a focused private, state, and local effort to tackle prescription drug abuse. While opioid abuse has been on the rise, it is not typically part of employee drug testing, when employers choose or are required to test. This may be changing.

The Substance Abuse and Mental Health Services Administration (SAMHSA), the federal agency responsible for drug testing standards for federal agencies, is poised to release drug screening guidelines (see page 4 (28104 in the Federal Register) that would expand drug screening for opioid abuse to federal employees, and could influence employee drug testing policies across the nation. The US Department of Defense has been testing for hydrocodone and benzodiazepines (used to treat anxiety and seizures among other things) since May 1, 2012. SAMHSA cites sobering statistics about opioid-related deaths now outnumbering deaths from illicit drugs, as it prepares to test for oxycodone, oxymorphone, hydrocodone, and hydromorphone, all classified as Schedule II drugs, or drugs with high risk of abuse, by the United States Food and Drug Administration (FDA). The proposed guidelines were released May 15, 2015, so the final rules should be coming soon. Continue reading