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.”
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
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 >>
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 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.
“The NHS stands on a burning platform — the model of acute care that worked well when the NHS was established is no longer capable of delivering the care that today’s population needs. The need for change is clear, but finding the resources and energy to deliver change while simultaneously providing safe patient care can seem near impossible.” (p.4)
This statement raises the fundamental question of whether the current model of the NHS is,’ fit for purpose’? The NHS since its formation has always had both a good and bad press. Since its inception it always been short of resources. Changing times bring with them new demands which can make established health care delivery structures obsolete and no longer capable of delivering optimal performance. One important NHS developing health care trend is the need to keep pace with a growing elderly population with more complex health needs along with other trends. Continue reading →
PACAC, the House of Commons, (Public Administration and Constitutional Affairs Committee) has just published its analysis of the PHSO’s, (Parliamentary and Health Service Ombudsman ) second report into the tragic death of Sam Morrish, a three year old child whose death from sepsis was found to have been avoidable. PACAC is composed of MP’s (Members of Parliament) and its remit includes considering matters relating to the quality and standards of administration provided by civil service departments which includes the Department of Health. PACAC also examines the reports of the PHSO.
The PACAC report is very thorough and detailed and really gets to grips with the issues surrounding NHS (National Health Service) health adverse incident investigation. It addresses very clearly the current challenges and opportunities in this area and puts forward some major concerns which need to be fully addressed by the NHS before it can be said to have a listening and learning culture. It is clear from reading the report that the NHS has a very long way to go before it can be said to be even close to reaching its listening and learning culture attainment goal.
The PACAC report also identifies what could be regarded as some muddled thinking by the Department of Health on the concept of the ‘safe space’ in NHS investigations and identifies some important patient safety policy gaps.
I am happy to announce our “Global Genes, Local Concerns Symposium on Legal, Ethical and Scientific Challenges in International Biobanking” to be held at the University of Copenhagen (DK) on 16 March 2017, 08:00-18:30. Among the many prominent experts speaking at this conference we find the PFC’s very own Glenn Cohen and several speakers with a PFC “history” or close PFC links, such as Bartha Knoppers, Tim Caulfield, Nicholson Price and Jeff Skopek.
A detailed program and further information is available here and here.
This Symposium marks the final phase of the Global Genes-Local Concerns project. In accordance with the goals of this large cross-faculty project, the Symposium deals with legal, ethical and scientific challenges in cross-national biobanking and translational exploitation. Leading international experts and invited speakers will discuss how national biobanks contribute to translational research, what opportunities and challenges regulations present for translational use of biobanks, how inter-biobank coordination and collaboration occurs on various levels, and how academic and industrial exploitation, ownership and IPR issues could be addressed and facilitated. Special emphasis will be laid on challenges and opportunities in addressing regulatory barriers to biobank research and the translation of research results, while at the same time securing ethical legitimacy and societal interests.
These issues will be dealt with in 4 main sessions covering (1) BIG DATA AND MODES OF COLLABORATION; (2) PATIENT INVOLVEMENT; (3) TRANSLATIONAL MEDICINE & TECH TRANSFER, as well as (4) GUIDELINES & GOOD GOVERNANCE.
Bartha Knoppers, Mc Gill University (Canada)
Glenn Cohen, Harvard University (US)
Timo Minssen, University of Copenhagen (DK)
Tim Caulfield, University of Alberta (Can)
Michael Madison, University of Pittsburgh (US)
Jeff Skopek, University of Cambridge (UK)
Brian Clark, Director, Human Biosample Governance, Novo Nordisk A/S (DK)
Jane Kaye, University of Oxford (UK)
Anne Cambon-Thomsen, INSERM, Toulouse / CNRS Director (Fr)
Klaus Høyer, University of Copenhagen (DK)
Aaro M. Tupasela, University of Copenhagen (DK)
M. B. Rasmussen, University of Copenhagen (DK)
Åsa Hellstadius, Stockholm University (Sweden)
Peter Yu, A&M Texas University (US)
Esther van Zimmeren, University of Antwerp/Leuven (Belgium)
Nicholson Price, University of Michigan Law School (US)
Karine Sargsyan, BBMRI/Head of Biobanking-Graz (Austria)
Eva Ortega-Paino, BBMRI, Lund University (Sweden)
Nana Kongsholm, University of Copenhagen (DK)
Klemens Kappel, University of Copenhagen (DK)
Helen Yu, University of Copenhagen (DK).
For participation in the event please use this registration form no later than Friday, 10 March 2017, 12:00 at the latest.
We are looking very much forward to welcoming you in wonderful Copenhagen on 16 March 2017.
In the UK, the Department of Health (DH) have just published a consultation paper on introducing fixed recoverable costs in lower value clinical negligence claims. The document contains some controversial proposals which many claimant, patient lawyers are very concerned about. They feel the proposals will make it much harder for patients with lower value claims to find a solicitor to fight their case .The publication of the consultation paper comes in the wake of criticism that some clinical negligence claimant lawyers, solicitor firms , make excessive and unreasonable costs demands. The NHS LA (The National Health Service Litigation Authority) which manages negligence and other claims against the NHS in England states:
“Claimant costs for lower value claims are disproportionate and excessive. For claims where compensation is less than £10,000, claimant lawyers recover almost three times more in costs on average.”(p.10)
The DH Consultation Paper begins by stating the annual cost of clinical negligence in the NHS. It has risen from £1.2bn in 2014/15 to £1.5bn in 2015/2016.Legal costs were 34% of the 2015/16 expenditure.The consultation paper states that the current system of claims resolution is often lengthy and adversarial. This creates what can be termed a dual problem. Delaying possible learning of lessons from incidents and also escalating the costs of litigation when claims are brought. Continue reading →
Some interesting local-level developments in housing, equity and law last week. Here’s our round-up of the news from last week, February 6-12, 2017:
What would happen if we stopped thinking about our home as an investment? Conor Dougherty of the New York Times argues that if we treated houses like we treat microwaves, the economy will improve and inequality will reduce.
Cleveland shared its timeline for first citywide housing inspection for lead
New York City will devote $90 million to offer legal representation for low income tenants in housing courts. This is a big victory for the “civil Gideon” right-to-council movement, via Gothamist.
The US Treasury and the Tennessee Housing Development Agency come together to provide funds for first time homebuyers down payments in Nashville, via NextCity
Did we miss any big housing, law and equity stories this week? Let us know!
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:
Two bills are attempting to abolish the Affirmatively Further Fair Housing rule of the Obama administration. A review of Fair Housing, the rule, and the proposed bill in the context of a tradition opposing desegregation, via City Lab
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.
Few believe that new HUD leadership under Ben Carson will continue to pressure cities to pursue the affirmatively furthering fair housing (AFFH) rule. However, some cities, like Philadelphia, are already on course
The National Health Service (NHS) in England’s quality regulator, the Care Quality Commission (CQC) has recently published a highly critical report on the way patient deaths are investigated in the NHS. The investigation follows events at the Southern Health NHS Foundation Trust where a number of failings were identified in the way patient deaths were identified and investigated. Certain groups of patients including people with a learning disability and older people receiving mental health care were far less likely to have their deaths investigated by this Trust. The Secretary of State for Health called for a CQC investigation into how acute, community and mental health NHS facilities across the country investigate and learn from deaths. The findings of the report are not good and major improvements in this area are needed across the NHS.
There are failings in openness, transparency and missed opportunities to learn important patient safety lessons. Families of patients and carers told the CQC reviewers that they often have a poor experience of investigations and are not always treated with kindness, respect, honesty and sensitivity. The CQC states that across their review they were unable to identify any NHS healthcare facility that could demonstrate good practice across all aspects of identifying, reviewing and investigating deaths and ensuring that learning from the events is implemented. Continue reading →
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.
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!
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.
The CQC (The Care Quality Commission) is the independent regulator of health and adult social care in England. They make sure that health and social care services provided to people are safe, effective, compassionate, high-quality care and they encourage care services to improve. The CQC inspects health facilities and they have important statutory regulatory powers and sanctions.They have recently produced a report on neonatal care and on providing care for infants in the community who need respiratory support. As well as some positive findings, the report does reveal a number of major patient safety risks and failings.
In England, one in every nine babies is born needing care from neonatal services and this is on the increase. The care process here can be challenging with sick babies with complex health needs receiving hospital care and then care at home and in the community. The care of the baby traverses’ distinct pathways or care areas and sometimes problems can occur:
“A lack of consistency in care and communication across a pathway can result in poor outcomes for both babies and parents.” (p.3)
The report looks at current practice in three different aspects of care: Continue reading →
Our children are our future and we need to look after them well. There is however a lot of evidence to suggest that we are failing our children in a number of key health areas. UNICEF in a report put the UK in 16th position – below Slovenia, the Czech Republic and Portugal – in a league table of child well-being in the world’s richest countries. The report considers five dimensions of children’s lives – material well-being, health and safety, education, behaviours and risks, and housing and environment – as well as children’s subjective well-being.
There are a number of health and other child well-being challenges for the UK to meet. The UNICEF report provides some useful context from which to view the recently published Care Quality Commission (CQC) report on the arrangements for child safeguarding and healthcare for looked after children in England.The CQC is the independent regulator of health and social care in England.Whilst the report does contain some positive findings, when read as a whole, these seem subsumed by the large number of negative findings, some of which are very worrying. Continue reading →