U.S. Perspectives

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[edit] US Perspectives

[edit] State Differences

[edit] Government Sponsored Medical Insurance (Federal & NYS)

  • The Federal Government directly funds and sponsors Medicare and Medicaid.
  • The AIDS Drug Assistance Program (ADAP) is an extension of Medicaid.
  • New York State has created programs called Child Health Plus and Family Health Plus. It appears that Child Health Plus replaced "Children's Medicaid", but this is not explicitly stated anywhere on the related sites.

[edit] Medicare

  • To receive Medicare, you must be age 65 or older, deemed disabled by the Federal Government, or have end-stage renal disease (kidney failure).
  • A disabled person does not receive Medicare benefits until they have been disabled for two years.
  • Medicare can be administered directly as a fee for service, or you can join an HMO where your benefits will vary and be subject to the jurisdiction of the HMO.
  • Medicare Website

[edit] Medicaid

  • To receive Medicaid, your household income and resources must be below a certain level.
    • You can receive Medicaid and Medicare at the same time. When you are a Medicare recipient, you may receive a limited or full Medicaid benefit.
  • Medicaid can be administered directly as a fee for service, or you can join an HMO where your benefits will vary and be subject to the jurisdiction of the HMO. Persons without HIV are generally forced to join an HMO; persons who are HIV+ are exempt from having to join an HMO.
  • Joining an HMO under Medicaid can be extremely distressing because then the provider list becomes extremely limited, particularly in specialist categories.
  • There are HMO Medicaid Programs for people with HIV that are called "HIV Special Needs Programs", which are supposed to provide more appropriate benefits to patients with HIV, but they are still optional to join.
  • It is typically recommended you don't join an HMO under Medicaid if you can avoid it.

[edit] Medicaid Special Coverage Conditions

  • Women with breast or cervical cancer can receive Medicaid based on their diagnosis. The law allows states this option; all 50 states exercise it.
  • People with Tuberculosis (TB) can receive Medicaid based on their diagnosis. The law allows states to limit treatment to coverage of TB related services.
  • People with Sickle Cell Disease (SCD) can receive Medicaid benefits, but are not automatically entitled to receive Medicaid based on their diagnosis. (But states are not prohibited from it either?)

[edit] AIDS Drug Assistance Program (ADAP)

  • ADAP is available to persons with HIV
  • Financial requirements are an income of less than $44,000/year for one, and liquid assets of less than $25,000.

[edit] Family Health Plus

  • From the New York State Department of Health Website: "Family Health Plus is available to single adults, couples without children, and parents with limited income, who are aged 19 to 64, are residents of New York State and United States citizens or fall under one of many immigration categories."
  • The income requirements are still quite low, causing one to wonder how much lower could they be for Medicaid. This page shows a financial guide for who can qualify for Family Health Plus: Who Can Join
  • College students living at home would have their parents' income figured in their eligibility, but there may be ways around this or other stipulations that should not prevent the student from inquiring. FAQ about eligibility for FHP.

[edit] Healthy NY

  • Healthy NY is a state sponsored program where an individual or small business can purchase (presumably) low cost health insurance from a list of plans.
  • To be eligible, generally one must be employed but not have access to other health insurance. There is an online screening program located here.
  • Rates for Manhattan residents range from $248 to $320 as of 12/8/08, and the rates for all counties can be found here: Healthy NY Rates Rates would be expected to change on January 1 of each year.
  • If you do not have assets (cash, stocks or real estate) in excess of $5,000, please speak to a CPA before you buy health insurance if you are a generally well person without any chronic medical conditions.

[edit] GHI for CUNY Students

  • GHI offers a health insurance for CUNY students. GHI for CUNY students details
  • The rate for an individual is $221.70 per month, but it is billed quarterly. For a family the rate is $631.86, also billed quarterly.
  • A family plan, and enrollment for a domestic partner are available as well.

[edit] New York City Health Insurance Access Website

For New York City, there is a detailed website for the Office of Citywide Health Insurance Access

[edit] New York City Health Insurance Screening Tool

Find out if you qualify for a public health insurance plan.

[edit] Red-lining

Redlining is the unethical practice whereby financial institutions make it extremely difficult or impossible for residents of poor inner-city neighborhoods to borrow money, gain approval for a mortgage, take out insurance or gain access to other financial services because of high default rates. In this case, the rejection does not take the individual's qualifications and creditworthiness into account.

In other words, mortgage loaners etc would have maps of areas, particularly low income areas, and outline those communities in red, and they would purposely not give loans, mortgages or insurance to anyone within those red lines, because it was considered a risky investment. This caused racial profiling, discrimination, segregation, and the underdevelopment of many U.S. communities.


Causes of Redlining:

1- Home Owners' Loan Corporation (HOLC) – 1933 was a New Deal agency established by the Homeowners Refinancing Act under President FDR. Its purpose was to refinance homes to prevent foreclosure. However, HOLC is oft-cited as the originators of mortgage redlining. Recent research has suggested that the institution itself did not redline or discriminate on the basis of borrowers' race and ethnicity, but instead it was the racist undertone and language found in their appraisal sheets. Researchers also argue that HOLC caused redlining and disinvestment by sharing its color-coded maps.

2- Racial discrimination- Race of the loan applicant or the racial profile of the neighborhood?


Anti-Redlining Laws:

1- Title VIII of the Civil Rights Act – 1968

The Fair Housing Act

Prohibits housing discrimination on the basis of race, color, religion, sex, disability, familial status, and national origin

2- Laufman v. Oakley Building and Loan Company

3- The Home Mortgage Disclosure Act – 1975

Requires lending institutions to report public loan data, which in turn makes it difficult to redline

4- Federal Community Reinvestment Act - 1977

This further required banks to apply the same lending criteria to all communities. It was designed to encourage commercial banks and savings associations to meet the needs of borrowers in all segments of their communities, including low- and moderate-income neighborhoods.


Alternative Forms of Redlining:

1- Reverse Redlining- predatory lending

2- Covert forms of redlining to discourage buying- high interest rates, higher down payments


Consequences:

1- Disinvestment in urban communities can cause it to completely collapse from within

2- Deters the acquisition of small businesses in low income areas

3- Racial segregation


Redlining Bibliography

American Apartheid: Segregation and the Making of the Underclass By: Douglas Massey and Nancy Denton

Categorically Unequal: The American Stratification System By: Douglas S. Massey

The Possessive Investment in Whiteness: How White People Profit from Identity Politics By: George Lipsitz

Article title: Don't Let Banks Turn Their Backs on the Poor. Source: New York Times [0362-4331] yr.2004 pg.19

Kelly, Marvin. “Redlining myths and realities.” CPCU Journal, 01622706, Summer96, Vol. 49, Issue 2. <http://web.ebscohost.com/ehost/detail?vid=7&hid=109&sid=614e2743-682b-4300-bea2-8e209f2840ec%40sessionmgr109&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d>

Williams, Patricia. “Of Race and Risk”. The Nation. December 29, 1997. <http://web.ebscohost.com/ehost/pdf?vid=6&hid=109&sid=614e2743-682b-4300-bea2-8e209f2840ec%40sessionmgr109>

Immergluck, Dan. “Redlining Redux: Black Neighborhoods, Black-owned Firms, and the Regulatory Cold Shoulder.” Urban Affairs Review, 2002; 38; 22. <http://web.ebscohost.com/ehost/detail?vid=4&hid=109&sid=614e2743-682b-4300-bea2-8e209f2840ec%40sessionmgr109>

The Reach of Redlinging: Long-held Mistrust of Lenders Fueled Mortgage Crisis in Black Communities By: Mary Kane http://blog.lib.umn.edu/arras004/lfwproductions/2008/08/the_reach_of_redlinging_longhe.html

Aalbers, Manuel. “When the Banks Withdraw, Slum Landlords Take Over: The Structuration of Neighbourhood Decline trhough Redlining, Drug Dealing, Speculation and Immigrant Exploitation.” Urban Studies, Vol. 43, No. 7, Pgs. 1061-1086, June 2006. <http://web.ebscohost.com/ehost/pdf?vid=6&hid=113&sid=e967f0c3-ce89-4a05-bc8b-5c9d80b63fe8%40sessionmgr104>

Wyly, Elvin. Holloway, Steven. “The Disappearance of Race in Mortgage Lending” Economic Geography, Vol. 78, No. 2 (Apr., 2002), pp. 129-169. <http://www.jstor.org/stable/pdfplus/4140785.pdf>

Holmes, Andrew. Horvitz, Paul. “Mortgage Redlining: race, Risk, Demand.” The Journal of Finance, Vol. 49, No. 1 (Mar., 1994), pp. 81-99. http://www.jstor.org/stable/pdfplus/2329136.pdf Kantor, Amy. Nystuen, John. “De Facto Redlining a Geographic View” Economic Geography, Vol. 58, No. 4 (Oct., 1982), pp. 309-328. http://www.jstor.org/stable/143457

Harrington, Scott. Niehaus, Greg. “Race, Redlining, and Automobile Insurance Prices” The Journal of Business, Vol. 71, No. 3 (Jul., 1998), pp. 439-469. <http://www.jstor.org/stable/2353416>

[edit] Homeless Shelters and Resources

[edit] New York City Homeless Shelters and Programs

Introduction

I am researching the homeless population in New York City as well as looking at a few homeless shelters and programs that the city offers. I am focusing on The Bowery Mission which has been open since 1879. They offer numerous programs for men, women and children including food, shelter, ministry and counseling.

Resources

http://www.bowery.org/

http://www.nyc.gov/html/dhs/html/press/pr021205.shtml NYC Dept of Homeless Services

http://www.coalitionforthehomeless.org/

Smith, Daniel. "Profile of New York City's Street Population.



The Bowery Mission

The Bowery Mission is New York City's oldest homeless shelter. It was started in 1879 by the Rev. and Mrs. A. G. Ruliffson. The purpose of the mission, as stated on their website is, "to minister in New York City to men, women, and children caught in the cycles of poverty, hopelessness and dependencies of many kinds, and to see their lives transformed to hope, joy, lasting productivity and eternal life through the power of Jesus Christ."

Men's Programs at the Bowery

-Compassionate Care

-Outreach Program

-Discipleship Institute

-Transitional Center


Women's Programs at the Bowery

-Compassionate Care

-Outreach

-Women's Center at Heartsease Home


Kids with a Promise

-After School Program

-Leadership Academy

-Mont Lawn Camp

-Summer Day Camp



Statistics from the New York City Department of Homeless Services

Daily Statistics for November 26, 2008

Total Shelter Census: 35,220 people


Uniting for Solutions Beyond Shelter The Action Plan for New York City

In November 2003, Mayor Bloomberg convened an unprecedented group of public, private, and nonprofit leaders to develop a 10-year, multi-sector strategy to address these concerns and strengthen the city’s response.A 41-member coordinating committee, as well as hundreds of task force participants and experts convened from November 2003 through April 2004 to produce a nine-point strategy.


The strategy aims to:

1. Overcome street homelessness

2. Prevent homelessness

3. Coordinate discharge planning

4. Coordinate city services and benefits

5. Minimize disruptions to families whose homelessness cannot be prevented

6. Minimize duration of homelessness

7. Shift resources into preferred solutions

8. Provide resources for vulnerable populations to access and afford housing

9. Measure progress, evaluate success, and invest in continuous improvement


Below is an article from the Daily News with updates on Bloomerberg's Plan

http://www.nydailynews.com/ny_local/2008/08/07/2008-08-07_report_nyc_has_failed_to_reduce_homeless.html

The Coalition For the Homeless

The Coalition For the Homeless is "is the nation's oldest advocacy and direct service organization helping homeless men, women, and children. We are dedicated to the principle that decent shelter, sufficient food, affordable housing, and the chance to work for a living wage are fundamental rights in a civilized society. Since our inception in 1981, the Coalition has worked through litigation, public education, and direct services to ensure that these goals are realized."

The Coalition Provides:

-Crisis Services

-Housing Programs

-Youth Services

-Job Training


Myths and Facts about New York City's Homeless

http://www.coalitionforthehomeless.org/annualreport.html

[edit] In Pursuit Of Happiness

The subtitle is inspired by a movie the authors saw called “In Pursuit of Happiness” starring Will Smith where the main character struggled with his son to live in the shelters and in spite of all the tribulations, he managed to get out of the bad cycle and made something good of himself. Although this case was exceptional, I thought to myself that there must be a lot of people who need homes and not necessarily shelters because they have families and who do not have to be drug or substance abusers. Now meet Moises and Jennifer Cedano who expected to spend the next four to six months in a homeless shelter while they saved enough money for a deposit to rent an apartment. Today they happily watch two of their three children, Timothy and Francisco, jump with joy on a new bed in a new apartment and they didn’t even have to go to the shelter program. My researches first lead me to the Housing First program. It was developed by Pathways to Housing to meet the housing and treatment needs of the chronically homeless population. It was based on the belief that housing is a basic right on a theoretical foundation that includes psychiatric rehabilitation and values consumer choice. Here, consumer choice was key because it was in contrast with the Continuum of Care program that encouraged treatment as a precondition to housing. For the Housing First model on the other hand treated the homeless as a consumer and sought to address their needs. This meant they encouraged consumers to define their own needs and goals and if the consumer so wished, provide an apartment for the consumer without any prerequisites for psychiatric treatments or sobriety. In addition to the apartment, consumers were offered treatment support and services that included social workers, nurses, psychiatrists, vocational and substance abuse counselors who were available to assist consumers 7 days a week 24 hours a day. There were only 2 requirements which were to pay 30% of their income towards rent and participate in the money management program and to meet with a staff member a minimum of twice a month. While all the above may seem like a wish list, an experiment was conducted to track a sample group in the Housing First program and the Continuum Care program over a 2 year period.

The aim of the experiment was to

• Test the effect of consumer choice over control.

• Test which group would have greater residential stability

• Test which group would exhibit lower rates of homelessness.

• Test the rates of substance use

• Test the use of substance abuse treatments over time.

The results although not fully conclusive but were conclusive enough to conclude that consumers valued choice and that there was a relation between perceived choice and less psychiatric symptoms. Consumers in the Housing First program had more residential stability and lower rates of homelessness. Overall there was no difference between the 2 programs as far as substance use and the use of substance abuse treatments was concerned. The winner here was CHOICE especially perceived choice and PERSONAL CONTROL. According to Badger 2001, personal control is associated with greater controls of psychological well being. For the Housing First program this also meant allowing the consumers to refuse treatment.

The success of the Housing First program has eventually led it to transform to provide housing to not only drug and substance abusers but also regular homeless people in shelters with the aim of replacing the temporary shelter system with permanent housing. This move was not only good natured but also cost effective because the supportive housing systems costing between $13,000 and $25,000 were cheaper than the behavioral health systems costing between $30,000 and $150,000 per person per year. As we look for alternative long term solutions to homelesseness and shelters I think this is the way to go rather than the temporary shelter facilities. While there is a use for the shelter program it should not be the standard.

This brings us back to the Cedano family who could not afford to pay for the initial deposit to enter into an apartment and so in the meantime they were leaving with their mother. Now thanks to the Housing First program which is now becoming the next step after the shelter program they can now enter a house and pursue their happiness.


Resources

1. Housing First, Consumer Choice, and Harm Reduction for Homeless Individuals With a Dual Diagnosis.Preview By: Tsemberis, Sam; Gulcur, Leyla; Nakae, Maria. American Journal of Public Health, Apr2004, Vol. 94 Issue 4, p651-656, 6p, 1 chart, 4 graphs; (AN 12667292)

2. Decreasing Psychiatric Symptoms by Increasing Choice in Services for Adults with Histories of Homelessness.Preview By: Greenwood, Ronni Michelle; Schaefer-McDaniel, Nicole J.; Winkel, Gary; Tsemberis, Sam J.. American Journal of Community Psychology, Dec2005, Vol. 36 Issue 3/4, p223-238, 16p; DOI: 10.1007/s10464-005-8617-z; (AN 19300903)

3. Moving the homeless out of shelters, into homes 

	Alexandra Marks Staff writer of The Christian Science Monitor

August 20, 2007, Monday

4. Not just shelter, but home, for the homeless March 23, 2008 Sunday Bella English of Boston Globe Section: South; Pg. Reg10 Length: 922 words

[edit] The Action Plan

"In November 2003, Mayor Bloomberg convened an unprecedented group of public, private, and nonprofit leaders to develop a multi-sector strategy to end homelessness as we know it in New York City. From November 2003 through April 2004, a 41-member coordinating committee as well as hundreds of task force participants worked to produce the nine-point strategy outlined below." (taken from the website) http://nyc.gov/html/endinghomelessness/html/action_plan/action_plan.shtml

[edit] Welfare in NYC

Introduction

I am researching welfare in New York specifically New York City. My objective is to try and find out what programs are most popular here and what those programs provide for the people that need them. I want to try and find the specific qualifications that people need to fall under to receive the certain welfare programs that are available in New York. I am also going to look into what activist programs are in New York City and what those programs are doing to help push the issue of welfare. I am also going to look at Mayor Bloomberg's stand on welfare and what he has done while in office as mayor.


Topics

  • TANF in NYC
    • Work Requirements Under TANF program in the US:
      • Recipients (with few exceptions) must work as soon as they are job ready or no later than two years after coming on assistance.
      • Single parents are required to participate in work activities for at least 30 hours per week. Two-parent families must participate in work activities 35 or 55 hours a week, depending upon circumstances.
      • Failure to participate in work requirements can result in a reduction or termination of benefits to the family.
      • States cannot penalize single parents with a child under six for failing to meet work requirements if they cannot find adequate child care.
      • States have to ensure that 50 percent of all families and 90 percent of two-parent families are participating in work activities. If a state reduces its caseload below the FY 2005 level, without restricting eligibility, it can receive a caseload reduction credit. This credit reduces the minimum participation rates the state must achieve.
    • Activities that count towards a state's participation rate:
      • unsubsidized or subsidized employment
      • on-the-job training
      • work experience
      • community service
      • job search – not to exceed 6 total weeks and no more than 4 consecutive weeks
      • vocational training – not to exceed 12 months
      • job skills training related to work
      • satisfactory secondary school attendance
      • providing child care services to individuals who are participating in community service
    • Five-Year Time Limit:
      • Families with an adult who has received federally funded assistance for a total of five years (or less at state option) are not eligible for cash aid under the TANF program.
      • States may extend assistance beyond 60 months to not more than 20 percent of their caseload. They may also elect to provide assistance to families beyond 60 months using state-only funds or Social Services Block Grants.
    • Penalties - The Department of Health and Human Services (HHS) may reduce a state's block grant if it fails to do any of the following:
      • satisfy work requirements
      • comply with the five-year limit on assistance
      • meet the state’s Contingency fund MOE requirement
      • reduce recipient grants for refusing to participate in work activities without good cause
      • maintain assistance when a single custodial parent with a child under six can not obtain child care
      • submit required data reports
      • comply with paternity establishment and child support enforcement requirement
      • participate in the Income and Eligibility Verification System
      • establish and maintain work verification procedures
      • use funds appropriately
      • replace federal penalty reductions with additional state funds.

Funding In FY 2008, $16.5 billion is available for TANF.


  • NYC Welfare Statistics
    • Number of Persons, 2000 Census New York City: 8,008,278 New York State: 18,976,457
    • Number of Persons in Poverty: 1997 New York City: 1,661,584 New York State: 2,814,460
    • Poverty Rate: 1997 New York City: 22.4% New York State: 15.6%
    • Change in the Number of Persons in Poverty: 1995-1997 New York City: -80,832 New York State: -31,753
    • Percent Change in the Number of Persons in Poverty: 1995 to 1997 New York City: -4.6% New York State: -1.1%
    • Temporary Assistance Caseload,August 2001 New York City: 224,441 New York State: 314,728
    • Change in Temporary Assistance Caseload,December 1995 to August 2001 New York City: -258,222 New York State: -359,760
    • Percent Change in Temporary Assistance Caseload,December 1995 to August 2001 New York City: -53.5% New York State: -53.3%
    • Change in Temporary Assistance Expenditures,December 1995 to August 2001 New York City: -$109,217,000 New York State: -$160,286,213
    • Percent Change in Temporary Assistance Expenditures,December 1995 to August 2001 New York City: -52.4% New York State: -52.1%
    • TANF Cases Approaching Five Year Federal Limits,October 2001 New York City: 31,793 New York State: 37,554
    • TANF Cases Approaching Five Year Limits as a Percent of All TANF Cases, October 2001 New York City: 21.8% New York State: 18.3%
    • Annual Child Care Co-Pay - Three-person family with income at 150% of Poverty ($21,945), 2001 New York City: $1,463
    • Annual public assistance grant for a single parent with two children, 2001 New York City: $6,924
    • Welfare Benefits—Maximum Monthly Benefit (Family of Three, No Income):
      • 1996 (AFDC) New York $577 United States Median: $415
      • 1998 (TANF) New York $577 United States Median: $421
      • 2000 (TANF) New York $577 United States Median: $421
    • Ratio of Children Receiving Welfare to All Poor Children:
      • 1996 (AFDC) New York 70.1% United States 59.3%
      • 1998 (TANF) New York 64.1% United States 49.9%
    • Percent of All Children Without Health Insurance:
      • 1997 New York 11.2% United States 12.2%
      • 1999 New York 9.7% United States 12.5%
    • Income Cutoff for Children's Eligibility for Medicaid/State Children's Health Insurance Program (Percent of Federal Poverty Level):
      • 1996 New York 101.3% United States 123.8%
      • 1998 New York 185.0% United States 178.4%
      • 2000 New York 230.0% United States 205.1%
    • Income Cutoff for Children's Eligibility for Child Care Subsidy (Percent of State Median Income/ Federal Poverty Level):
      • 1998 (January) New York 63% / 202% United States 57% / 182%
      • 1999 (June) New York 61% / 194% United States 59% / 178%
    • (the following information is from 1994, I know a little outdated but still a very interesting article)New York state's welfare benefits are so high that a welfare recipient would have to work at a job paying nearly $45,000 to break-even, according to a study released today by CHANGE-NY, a statewide taxpayers organization with over 100,000 members. The CHANGE-NY study documents that the typical welfare recipient (a woman with two children) is able to receive a tax-free welfare-benefit package costing taxpayers $32,571 annually. This figure encompasses the most common and broadly used welfare programs in New York, including the AFDC basic cash grant, Medicaid health coverage, and subsidies for food, housing, and energy cost.To have after-tax take-home pay of $32,571 from a regular job, a welfare recipient would have to earn a salary of $44,900 annually, according to CHANGE-NY. By comparison, the starting salary for nuclear engineers with college degrees is $32,200. The $44,900 figure also is higher than the statewide median household income, almost four times the poverty level, and almost three times the annual unemployment-insurance benefits.
    • ASSISTANCE PROGRAM and ANNUAL AMOUNT: AFDC basic cash grant, $2,856; Medicaid, $13,664; Housing Assistance, $9,828; Food Assistance, $4,507; Energy Assistance, $1,716. TOTAL $32,571. Pre-Tax Equivalent of Welfare Benefit Level $44,900.


  • NYC Welfare Qualifications
  • Activist Programs
  • Mayor's Stand on Welfare
    • Michael Bloomberg believes in rewarding work and encouraging education as a means to helping people in need.


Resources

Websites

Articles

[edit] Foodstamps

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