Monday, July 31, 2017

Innovative integration of housing and health in Portland, Oregon

by Janet Viveiros, National Housing Conference

During a recent meeting of NHC’s Housing and Health Working Group in Portland, Oregon, group members learned of the exciting work in Oregon to integrate housing into that state’s focus on health in the state Medicaid program. As described by Enterprise Community Partners, one strategy to address the health and well-being of low-income Oregonians is to use the Flexible Funds Pilot program, which authorizes Medicaid funds to be used on non-clinic services in order to address social determinants of health. The program supports the health of individuals by offering services such as short-term rental assistance and security deposits to improve the housing stability with of Medicaid enrollees.

The Center for Outcomes Research and Education (CORE) will evaluate the impact of this use of Medicaid funds on the health of enrollees. If found to be effective, the hope is that other states will work with the Centers for Medicare and Medicaid Services to seek more flexibility in using Medicaid funds to address social determinants of health. Other research by CORE has found that helping Medicaid enrollees access affordable housing has a significant, positive impact on their health.

Oregon is also experimenting with the use of Medicaid funds to support the use of traditional health workers who apply a deep understanding of the culture of their community and focus on health equity to their interactions patients and help them navigate the health care system and address the social determinants of their health.

Oregon’s use of Coordinated Care Organizations, health care provider networks that offer a comprehensive approach to health care and the flexibility to address social determinants of health, are another avenue used in the state to better address the complex health needs of low-income residents with an integrated approach to well-being.

Even as efforts to repeal or change the Affordable Care Act stall in Congress, states are still focused on how to create health systems that achieve better health outcomes at lower costs. Oregon’s strategy of integrating care and seeking flexibility in the kinds of services Medicaid can fund provide an example for how other states may be able to reform their health systems to serve low-income residents more effectively. 

Let’s improve the fair housing process, not abandon it

by Ethan Handelman, National Housing Conference

Recently, HUD Secretary Dr. Ben Carson stated his intention to reinterpret the department’s rule defining the obligation to affirmatively further fair housing. That statement rings alarm bells for many housers, in part because of his 2015 op-ed characterizing the proposal as “social engineering” likely to fail. However, there is potential to improve HUD’s fair housing rule, which would be a far better outcome than the outright repeal some congressional Republicans are calling for.

HUD’s 2015 rule implementing the Fair Housing Act of 1968 is a planning exercise, primarily. It requires states and localities receiving HUD grants to examine patterns of housing segregation, the sources of that segregation and propose improvements they will pursue. HUD provides data and a process to help by way of a creation of the assessment of fair housing (the output of the five-year review), and the department encourages states and localities to include their own data too. HUD doesn’t mandate particular actions, but rather gives states and localities the tools to improve their own housing policies in ways that work for their communities.

There are certainly legitimate complaints about HUD’s fair housing enforcement. It shouldn’t get in the way of developing new affordable housing, nor should it add significant costs to housing development or operation. The department should encourage a regulatory culture that we often find at the state level, where regulators aim to help development occur both smoothly and with the right qualities: desirable, affordable homes in places of opportunity.

HUD’s easiest path to improvement is through the rule. The department could use the federal notice and comment process to solicit suggestions based on the first cycle of assessments of fair housing and propose improvements to the regulation. It can’t simply repeal the rule without notice and comment, nor should it, especially since the Supreme Court recently opined on the importance of fair housing law. Legislative changes to the Fair Housing Act seem unwise, especially since this is an issue of calibrating regulation, not a time to change our national commitment to end discrimination and segregation in housing.

When it comes to income, lives and potential, segregated housing is costly, and not just to those who live in it, but to entire communities as well. The local, state and federal policies that led to segregated housing still exist in many places. Letting those policies go unexamined would just be bad governance, so it behooves housing stakeholders, community members and HUD to ensure there is an effective process for reviewing and changing housing policies.

Thursday, July 13, 2017

Should members of Congress receive housing stipends?

by Janet Viveiros, National Housing Conference

In a recent interview with The Hill, Rep. Jason Chaffetz (R-Utah) advocated for a housing stipend to help members of Congress afford housing in D.C. According to Chaffetz, who retires at the end of June, the $174,000 salary for members of Congress is insufficient to allow them to pay for homes in both their home districts and in D.C.

NHC’s Paycheck to Paycheck database shows that in order to own a median-priced home in the Provo-Orem metro area, which falls within Chaffetz’s district, his household would have to earn nearly $75,000 a year. To rent a typical two-bedroom home in the Washington, D.C., metro area, Chaffetz’s household would have to earn almost $65,000. Few would dispute that residents of the D.C. metro area face high housing costs. But given the $174,000 salary of members of Congress, Chaffetz theoretically would be able to afford the combined cost of owning a home in his district and renting in the D.C. area.

Some members of Congress may find it harder to juggle the costs of two households if their home district has high and rising housing costs like that of San Francisco, where owning a median-priced home would require a family to earn over $275,000. This raises the question of how people who are essential to the running of our federal, state and local governments afford housing in costly areas on much lower salaries than congressmen and congresswomen.

Instead of pursuing housing subsidies for special groups, such as members of Congress, we should think more broadly about strategies to promote access to quality housing that is affordable to Americans at all income levels.   

Monday, July 10, 2017

Summer forecast

by Chris Estes, National Housing Conference

With our Housing Visionary Award Gala and Annual Policy Symposium behind us, NHC has much work planned for the last six months of the year.

NHC will continue its active participation in the Campaign for Housing and Community Development Funding to advocate for housing funding at HUD and USDA through the remainder of the budget process. Congress continues to work through the appropriations process in hopes of passing a budget before the September 30 end of the fiscal year, making the next few months important for budget advocacy.

To put similar focus on the housing policy discussion, NHC brought national housing and community development organizations together this spring to launch Strong Voices for Housing. We are currently working with this group of more than 35 national organizations to develop messages that all of us can use to more consistently and coherently position housing as a vital issue area for government support.

Solutions for Affordable Housing 2017, NHC’s national housing policy convening, is set for November 29 at the Ronald Reagan Building and International Trade Center. Following up on last year’s look at what was ahead for housing in the Trump administration, this year’s convening will connect potential policy action from the agencies with solutions emerging from practice and opportunities in the legislative environment. Plenaries and breakouts will provide opportunities for engagement with the administration, policy makers and leaders in the field. This convening will be an important opportunity to learn from and connect with colleagues, and is a great opportunity to sponsor a high-profile national convening. Visit our website to sign up for updates. I hope you’ll plan to attend.

As part of our continued effort to support our members and raise the national profile of housing, NHC has joined Our Homes, Our Voices for a national week of action that anyone, anywhere can participate in. What began as a single-day event has now expanded into a National Housing Week of Action, July 22-29, calling for increased federal investments in affordable housing and community development. To date, local housing advocates have planned 29 events in communities across the U.S. Visit the website to learn about the Week of Action and the campaign.

In September, NHC will release “Paycheck to Paycheck 2017,” a report and database comparing the median wages of over 80 occupations with the housing costs in over 200 metro areas across the country. This year’s report will analyze the impact of housing costs on fast-growing occupations in the health care sector.

Change where you live

by Ethan Handelman, National Housing Conference

Is ZIP code destiny? However you answer that question, the frame behind the question shapes how we think about policy. In a housing context, connecting where you live to your life outcomes can lead to a too-quick conclusion that people should just move (if they can afford to). But “change where you live” means two things: to move to a new home, and to make where you live now a better place. Too-high housing costs limit both of those options.

In the popular press and policy circles, the ZIP code-as-destiny concept is a common point of debate. Some focus on evidence that your neighborhood shapes your educational achievement, health and economic success. Others focus on your individual choices as key. President Obama used the idea as a springboard to talk about the Fair Housing Act. Still others look for ways to make place matter less, such as online work and education. Much of the discussion started with research from the Equality of Opportunity project.

I was recently at a roundtable, “Building Healthy Communities: How to Support States in the Development of Community-Based Solutions and Sustainable Infrastructure,” convened by the National Governors Association and attended by a mix of housing, environment and health experts. The ZIP code-as-destiny concept came up a few times, mostly from the health experts. Some from the health field think in detail about how to improve homes and neighborhoods, particularly experts in lead contamination. But many are quick to ask for housing policy change to help people move to better neighborhoods, as are advocates from other fields.

In America, 6.3 million poor people live in places of concentrated poverty (out of a total of 14 million people living in those places). Practically speaking, most of those people aren’t likely to move, nor should they have to. And in America, they should have a chance to better their own lives and those of their children.

But the vast majority of poor households spend far too much of their income on housing. They’re stretched just to afford where they live now, and homelessness is just one minor crisis away. People at higher incomes are stretching, too, and are finding their range of housing options shrinking.

Changing where you live has to mean giving everyone more and better choices. Making housing less expensive, helping communities thrive and ensuring some help for those who need it most are all part of changing where you live.