A Common-Sense Approach to Helping People Age in Place

Before 68–year-old Ms. V became involved with the CAPABLE program (described below), she was living with chronic bronchitis, depression and painful arthritis in a two-story row home in Baltimore with her home-bound husband. It was difficult for Ms. V. to walk more than two blocks due to shortness of breath. Like many row homes in Baltimore, hers had no railings for her marble steps. Inside, her flooring was loose or torn in many areas and there was no railing on the stairs leading to her second floor.  As if this didn’t make caring for herself a huge challenge, Ms. V also is the primary caregiver for her husband who is recovering from several strokes.  
When she was healthier, Ms. V had loved walking around a nearby reservoir for daily exercise. But when we met her, she rarely walked or went anywhere due to inability to get down the stairs.  
Luckily, she recently became part of a research study testing  CAPABLE (Community Aging in Place, Advancing Better Living for Elders) which provides $1,000 of home safety repair and modifications, $200 in assistive devices, up to six occupational therapy visits and up to four nurse visits. Each of these resources is entirely directed by the participants based on her or his functional goals. 
In Ms. V’s case, she wanted to be able to walk for exercise and to go to church.  Although it is in the medical system’s interest, the neighborhood’s interest and, most importantly, in Ms. V’s interest to be able to be as functional as possible, traditional medical care tends to focus just on the issues like bronchitis and arthritis. It ignores the ways that her housing—and ability to function within it—affect and are affected by those conditions.   
CAPABLE is based out of the Johns Hopkins University School of Nursing www.nursing.jhu.edu/capable currently funded by the Robert Wood Johnson Foundation, the National Institutes of Health. and the Centers for Medicare and Medicaid Services. Ms. V is part of a group testing the services to see whether this resource-intensive program saves money over time. Through CAPABLE, she had her flooring fixed, railings put on her outside and inside steps, management for her pain medication, and strength and balance exercises. She is now better able to take care of herself and her husband.  
One thing we know for sure: People like Ms. V are starting to move more safely around their homes and neighborhoods because we are addressing their housing and health at the same time. Healthy housing is an important component of aging at home. 
Sarah L. Szanton, PhD, CRNP, is an associate professor at the Johns Hopkins University School of Nursing and a Robert Wood Johnson Foundation Nurse Faculty Scholar.

Meet Shakétta Denson: GHHI Family Advocacy Attorney

The Green & Healthy Homes Initiative (GHHI) helps break the link between unhealthy housing and unhealthy children. By providing family advocacy, legal services, outreach and education, public policy and legislative advocacy, lead hazard reduction, and technical assistance nationwide, GHHI addresses the challenges families and communities face to ensure children are able to live, learn and play in safe and healthy homes. It is on the legal services team that its staff attorney Shakétta Denson makes a difference.
Shakétta, a Maryland native, keeps at top of mind creating safer homes for children and families. She received her Bachelor’s in Paralegal Science/Pre-Law from Villa Julie College, now Stevenson University, and received her law degree from the University of Baltimore School Of Law, focusing on Advocacy and Litigation.
For eight years, Shakétta worked as a Social Security paralegal, and after graduating and passing the bar, earned a position at the same firm as a Social Security attorney. After passing the bar, Shakétta began volunteering with the Pro Bono Resource Center, Maryland Volunteers Lawyers Services and The Homeless Persons Representation Project, all organizations she still works with.  In addition, Shakétta is co-chair of the Public Service Committee of the Young Lawyers Section of the Maryland State Bar Association and participates and plans volunteer outings to help other young lawyers use their station to give back to the Maryland community.
She said “My job as a SSD attorney was no longer filling my need to give back and help people. I became a lawyer to make a difference in people’s lives and I did not feel like I was doing that anymore. I saw my current position as an opportunity to do just what I wanted, helping children and low-income families, using the law."
In working to break the link between unhealthy housing and unhealthy children, the staff has since 1994 developed 27 pieces of successful legislation to set standards for enforcement, prevention and education.
“The work of GHHI is important because it gives families hope and confidence. Being able to intervene in a child’s life and knowing that in some small way our work can help prevent reading issues, aggression issues, and nutritional issues is major,” commented Shakétta.
So, what’s a day in the life like for the family advocacy attorney at the Green & Healthy Homes Initiative?
Shakétta relays, “When families call that have issues in their house involving lead and/or threats to health and safety, I meet with them to come up with a plan on how to get the issues fixed.  I am there to help as little or as much as the family needs.”
She continued, “The court system can be confusing and frustrating for most tenants.  They do not know their rights and the landlord’s obligations.  I help ease the process by explaining step by step what is going to happen, how it should happen and what they should and should not be doing.  I also explain to them what the landlord can and cannot do.”
Lead poisoning is not the only barrier that some clients face in achieving a healthy and safe home.  There is not legislation that currently exists in Maryland to tackle other home hazards. Shakétta would like to change this.
Shakétta said, “We need laws to deal with mold remediation and radon.”
She finds it rewarding when a client says to her “thank you we don’t know what we would have done without GHHI.”

What a Difference a Year Makes

What a difference a year makes. Last year, the Maryland General Assembly passed – and Governor O’Malley signed – key pieces of legislation aimed at further protecting our state’s children from the tragic consequences of lead poisoning. As they have done many times, Maryland leaders helped set the standard for other states to follow in regard to lead poisoning prevention.
Sadly, this kind of courage and leadership are lacking this year. Many of the bills currently in front of the House of Delegates Environmental Matters Committee related to lead will provide the rest of the nation with a blueprint for what not to do. There are bills being considered this year that, if implemented, will undermine the progress we have made and put thousands of Maryland’s children and families at risk.
We have made enormous headway in Maryland over the past two decades to reduce the rates of childhood lead poisoning by 98% (based on previous CDC guidelines of 10 µg/dl) by focusing on primary prevention and common sense legislation that provides protection for our children while not imposing undue burdens on property owners. The bills sponsored this year by Delegates Niemann, Stein, and Beidle, in particular, threaten to reverse this trend line, putting the interests of property owners and landlords above the interests of children.
Here’s just a sample of what some of our elected officials are trying to do this year to undermine efforts to eradicate childhood lead poisoning:

One bill (HB924) will actually overturn a piece of legislation passed last year (HB644) that all but one of the sponsors voted to support that requires rental properties built between 1950 and 1977 to receive lead treatment, inspection and educational information. (NOTE: 60% of children poisoned in Maryland live in rental properties constructed in this period.)

HB923 sets lead poisoned children up as a “separate class” and creates a new hurdle for lead poisoned children to overcome in order to seek compensation for the damages they suffer in housing with lead hazards;

HB754 proposes to reinstate practices that have been deemed unconstitutional by the Maryland Supreme Court (the “Qualified Offer”), undermine the Fair Housing Act and privacy protections afforded to families by federal law, and impose a predetermined value on the life of a lead poisoned child.
We encourage you to read more about the impact of these ill-conceived pieces of legislation and contact your state delegate and senator and urge them to vote “no.”
More information about the bills noted above, as well as the bills we and our advocacy partners support, is available at here.

Meet Donitra Scott: DWEJ Green Jobs Training Program Graduate

Creating jobs and training the next generation of “green” workers is a fundamental focus of the Green & Healthy Homes Initiative (GHHI). With a grant from the Open Society Foundations’ Poverty Alleviation Fund, GHHI has provided funding to nine sites to provide training programs and job placement services for under-employed and unemployed workers and formerly incarcerated individuals. In Detroit, the grant is implemented via the Detroiters Working for Environmental Justice’s (DWEJ) Green Jobs Training Program.
DWEJ works with communities to create cleaner, healthier and safer neighborhoods. The Green Jobs Training Program, which runs for 12 weeks, transforms the lives of Detroiters and their communities through sustainable, environmentally just and green job practices. One of its graduates, Donitra Scott, is just one of the lives enriched by the program.
A longtime member of the Bricklayers and Allied Craftsman Local 1 Union, Donitra is the owner of Dee’s Impressive Décor and More, a tile installation company. Family members encouraged her to take part in the Green Jobs Training Program.
Here students are encouraged to think past bricks and mortar. The initial weeks of the program focused on self-evaluation exercises.
Donitra relayed, “We conversed about things that we don’t talk about in daily life. I wasn’t expecting this since it was a construction-based program. This [component] was something to make you look at yourself differently. Where do you see yourself in a few years? How do you feel about spirituality? Things that help define you as a person. We covered things that necessitated deep conversation.”
During the program, Donitra earned her state lead and asbestos licenses, First Aid certifications and learned the basics of construction, just to name a few of her accomplishments.
“The lead and asbestos trainings were very important,” Donitra shared. “I have been in a union for seven years and they are [just] implementing these standards now. I feel like I got a head start. It makes you a more valuable asset to a company to have these types of trainings. Overall, the certificates and licenses that I earned are very important to me and added to my career. ”
She had been working in the construction field for some time before the DWEJ program. But, according to Donitra, the program “opened doors for me as far going down a different path and doing it on my own.” She found it gratifying when a classmate who has owned his own construction business for two decades complimented her on her tile installation work.
Ever one to pay it forward, Donitra hired one of her DWEJ classmates as her apprentice.
She said, “It meant a lot to be able to help someone else. He helped with a little bit of everything as an apprentice to a journeyman in the field.”
Apart from beautifying places and spaces, Donitra is doing her part to create a better Detroit in another fashion.
Her apprentice is also her business partner in her Better Days Global nonprofit, which is a charity that she founded to instill good morals and values in the kids that she hopes to reach.  Donitra said, “The main focus of the charity is that the kids learn to respect themselves first, and then they will learn to respect their community and people around them. “
Given her background in construction, Donitra doesn’t imagine her life would be much different had she not been in the DWEJ program. But it did make an indelible impact on her personally.
“The program gave me more depth and made me think a little differently. It made me realize that there are other opportunities out there and I can seize them if I put my mind to it. You’re able to meet people who have faith in you.”
As what’s next for Donitra, her company will not be far from her mind but she is also going to focus more on her nonprofit. This Donitra says she is “more passionate about.”
She said, “I want to get my company up and running. But the nonprofit is where my heart is.”

Advancing Healthy Housing – A Strategy for Action: An Interagency Report

At a press conference in Washington, DC this morning the leaders of the Federal Healthy Homes Workgroup announced the release of the 2013 Strategy for Advancing Healthy Housing. In it, GHHI is recognized specifically by HUD as a key partner in this work.
"We applaud the work of the Federal Healthy Homes Work Group for its vision and commitment to using housing as a platform to address the health and well-being of our most vulnerable families as articulated in the “Advancing Healthy Housing – A Strategy for Action” released today,” said Ruth Ann Norton, President & CEO of the Green & Healthy Homes Initiative (GHHI).

“We are very pleased that HUD has recognized GHHI as a key partner in the work to inform intervention and policy strategy, particularly as it relates to the medical cost savings. Hundreds of communities across the nation are doing the evidenced-based work that is showing how the health of our homes protects the health of our children and families,” continued Norton. “And, by focusing efforts on training contractors to become partners in preventative health care, as we do through our 16 GHHI sites, we will collectively advance housing as a critical factor in our evolving health care model. We look forward to continuing to work with the Healthy Homes Work Group and all of our local and philanthropic partners to move this Strategy forward to improve the health, economic and social outcomes for children and families."
Full report available here.

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