The Districts Dime

More DC Residents Have Health Insurance, New Census Data Show

September 13th, 2016 | by Jodi Kwarciany

For the second year, the share of District residents without health insurance got smaller, according to data released today by the U.S. Census Bureau. Just 3.8 percent of DC residents lacked health coverage in 2015, compared with 6.7 percent in 2013. While there’s still progress to be made, that’s equivalent to about 17,000 more residents having health coverage.

District leaders should be applauded for leading the way in providing affordable insurance options for nearly all residents, resulting in DC having the second highest rate of insured in the country, behind only Massachusetts. Much of DC’s success can be attributed to its array of insuranStock Photo 14852ce options that have expanded as a result of federal health reform. DC’s Medicaid program now covers nearly all adults with incomes below 200 percent of the poverty line (less than $40,320 for a family of three). Nearly a third of DC residents get their health coverage from Medicaid, including two out of every three children. In addition, low-income DC residents not eligible for Medicaid can get coverage through the Healthcare Alliance program, and others may qualify for subsidies to pay for private insurance through DC Health Link, the city’s health insurance exchange.

There is no doubt that having health insurance makes a difference, according to a growing body of research. Having Medicaid coverage improves health, increases use of preventive care and screenings, and reduces financial hardship. It also improves children’s long-term educational outcomes and earnings as adults.

Despite these gains, there are 25,000 District residents who still lack health coverage, and there are steps the District should take to reduce that number over the next year. We previously noted that certain individuals are more likely to lack insurance, such as people who live outside, face language barriers, or have less than a 9th grade education. In addition, many residents face challenges in applying for or renewing benefits, especially in the Healthcare Alliance. The Alliance’s restrictive eligibility processes appear to have led thousands of eligible residents to go without health insurance. More work is needed not only to reach those who remain uninsured, but also to reduce the potential barriers that prevent them from enrolling, re-enrolling, and ultimately accessing care.

The 2015 health insurance coverage estimates are the first of two data releases from the U.S. Census Bureau this week. For more information on poverty trends in the District, tune in to the District Dime this Thursday for our extended commentary.

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How to Build Affordable Housing Without an Expiration Date

September 12th, 2016 | by Claire Zippel

A promising new policy can help preserve DC’s disappearing affordable housing – by requiring that all housing built with government support be kept affordable forever, instead of only for a set number of years, as is often the case right now. Last week, DC area housing leaders discussed the how’s and why’s of “permanent affordability” at a roundtable convened by Enterprise Community Partners, Urban Institute, the Coalition for Smarter Growth, and DCFPI. District leaders should adopt this forward-thinking permanent affordability policy to break the cycle of building affordable housing, only to risk losing it when affordability requirements expire.

Photo/Aimee Custis for Coalition for Smarter Growth

Photo/Aimee Custis for Coalition for Smarter Growth

Today, affordable housing built with public dollars usually comes with an expiration date. Programs like DC’s Housing Production Trust Fund require the housing it supports remain affordable for a set number of years, after which the owner is free to convert to market-rate housing. The terms can be short as 30 years for rental housing and 5 years for homeownership housing.[1] When entire buildings of low-cost housing are lost, low-income residents are displaced from their homes and communities, and it is expensive and often impossible for the city to rebuild the lost housing.

But what if affordable housing built with public dollars had no expiration date? Housing officials from Boston, Massachusetts joined DC housing leaders to discuss their policy of requiring all projects receiving public subsidy to stay affordable permanently. Boston did this after seeing its past housing investments evaporate as affordability terms expired. The city ensured its permanent affordability requirement worked financially, by putting in more dollars up-front so buildings can stay in good condition long-term, and by pledging to step in if buildings run into trouble.

The District has adopted permanent affordability for some of its housing programs – affordable housing built on land sold by the District, and inclusionary zoning units remain affordable as long as the building stands – but not for all of its housing programs.

The District will get better bang for its buck by adopting a permanent affordability requirement like Boston’s. The city is investing record amounts in affordable housing, yet that housing may not be there for future generations of DC residents if it’s allowed to expire after a certain number of years. DC’s housing leaders should build upon the productive discussions at the roundtable last week, and bring permanently affordable housing to DC.

[1] 30 years: National Housing Trust Fund. http://dhcd.dc.gov/sites/default/files/dc/sites/dhcd/publication/attachments/FY17%20National%20Housing%20Trust%20Fund%20Allocation%20Plan.pdf

5 years: DC Housing Production Trust Fund (pending final regulations on “distressed areas.”) See: http://www.dcfpi.org/testimony-of-jenny-reed-policy-director-at-the-public-hearing-on-b20-604-affordable-homeownership-preservation-and-equity-accumulation-act-of-2013

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DCFPI Welcomes Simone Holzer to Our Team!

September 8th, 2016 | by DCFPI Staff

The DC Fiscal Policy Institute welcomes Simone Holzer as our new Communications, Development, and Outreach Assistant.

headshot2 Simone graduated from Kenyon College in May 2016 with a B.A. in sociology, which allowed her to study various aspects of inequality and social change. In particular, Simone is interested in the structural causes of inequality and the best ways to address these issues on both a small and large scale.

Simone comes to DCFPI through AVODAH, the Jewish service corps, which works to strengthen the Jewish community’s fight against poverty in the United States by placing Corps members at a diverse range of anti-poverty organizations.

Originally from the DC area, Simone recently moved back to the District to be part of AVODAH, and she is excited to become more immersed in DC’s anti-poverty fight through her work at DCFPI.

In her spare time, Simone enjoys cooking and doing pottery.

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Back to School: Focusing on Mental Health

August 31st, 2016 | by Jodi Kwarciany

Many DC students came back to school this month with mental health or emotional needs that could get in the way of their success this year. The needs are especially great among students who face the stress of poverty. The District’s public schools provide many services to address students’ mental health challenges, but most schools do not have a full-time mental health clinician. With a new school year starting, and a search for a new DCPS chancellor underway, improving school-based mental health services should be a top priority.

About one in six DC children have emotional, behavioral, or developmental conditions, and one in six youth have considered attempting suicide, according to a recent report. In particular, children who grow up in poverty are exposed to high levels of trauma and stress, which hinders dBack to Schoolevelopment of skills necessary for learning, like attention and memory. Children facing toxic stress are also more likely to have problems in school, be absent, suspended or expelled, or drop out.

But the need for services doesn’t always match the supply: although most children live in Wards 4, 7, and 8, mental health resources for children are concentrated around Ward 2. Young Black and Hispanic adults receive much less outpatient mental health and substance abuse care than their white counterparts, even when controlling for factors like income and health insurance coverage, according to one recent national study.

Schools are a critical provider of mental health services and a logical place to identify students with mental health needs. Children are more likely to engage in services when housed in a school setting, and students who receive school-based mental health services see improvements in test scores, attendance and grade point averages as well decreased behavioral problems and improved social functioning.

DCPS provides a variety of services to assist students with mental health needs, including school social workers and psychologists at the majority of DCPS schools, although psychologists focus primarily on special education. And a new pilot program at two high schools will expand behavioral support services. Yet only one-third of DCPS and public charter schools have a full-time mental health clinician through the School-Based Mental Health program despite a goal that all schools be covered by this school year.

The District can better meet the mental health needs of students in the following ways:

  • Expand the number of schools with mental health clinicians focused solely on mental health services.
  • Expand “positive behavior intervention and supports” to all schools, which has been shown to reduce discipline issues and referrals to counseling and special education services.
  • Create trauma-sensitive school environments in all schools, giving staff the tools to understand trauma, how it impacts children, and how to respond appropriately so that children feel safe.
  • Increase the availability of school social workers and psychologists in areas where the number of students per social worker and/or psychologist is above the recommended threshold.

Strengthening the District’s mental health services in school settings is an important part of helping students overcome barriers to learning and unlocking their full potential. When students are back in school, we should get back to focusing on their mental health.

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Thanks to DC’s Paid Sick Leave Law, Fewer People Are Getting the Flu

August 30th, 2016 | by Ilana Boivie

The District’s efforts to ensure that everyone gets paid sick leave from their job—adopted in 2008 and strengthened in 2014—have led to reduced flu infections citywide. That’s great news as the flu season approaches.

States and cities that require employers to offer sick leave to employees have seen a drop in flu infections, according to a new study from the National Bureau of Economic Research, based on Google Flu data. The study finds that incidents of flu infections fell:

  • 5.5 percent in states that require employers to provide unpaid sick leave to workers;
  • 6.5 percent in states that require employers to provide paid sick leave to workers; and
  • 2.5 percent in the District after its paid sick leave law was initially passed, with the likelihood of even larger declines in the future, due to the law’s expansion (see below).

Paid sick leave benefits are important both to workers and to public health. All of us get sick sometimes and need to take time off from work, but that should not lead to a loss of income that makes it harder to pay bills. Without paid sick leave, many workers go to work when they shouldn’t, where they are more likely to infect their coworkers. When workers have access to paid sick leave, by contrast, they are more likely to stay home when they are sick, reducing the spread of contagious illnesses like the flu.

DC’s Accrued Safe and Sick Leave Act (ASSLA) requires employers to give workers at least 3-7 paid sick days per year, depending on the size of the business and whether the worker is tipped or not. Sick leave can be used for personal illness, medical appointments, care of an ill family member, or absences associated with domestic violence or sexual abuse. Employees are protected from employer retaliation for using their sick leave benefits.

Researchers believe that flu infections will fall further in DC as more recent data is collected. This is because DC’s paid sick leave law was strengthened in 2014 to cover more workers. The initial law passed in 2008 required workers to be on the job a year before accruing benefits, and it excluded tipped workers and bar employees. The 2014 changes cover all workers, and allows them to accrue starting on their first day of work.

As summer starts to wind down and the new school year begins, it’s good to know that a law aimed at improving working conditions for city workers has made us healthier as a city.

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