Friday, January 12, 2018

CONTINUING EDUCATION IN HOUSING AND SUPPORT

Advanced Courses in Public Administration and Disability

Supported and Affordable Housing: 
Toward Inclusive, Equitable and Sustainable Communities

Posted: (c) 2013, January 12, 2018

Julie Ann Racino, Cornell University and Syracuse University
Community and Policy Studies 

COURSE SYLLABUS

Fall Semester 2018

Class 1: Introduction to the Course, including Assignments and Syllabus
  • Introduction to Disability Policy and the Universalizing of Public Policy
  • Housing for All and the Americans with Disabilities Act
  • Inclusive, Sustainable and Equitable Communities

Class 2: Housing and Support Status in Disability in the US
  • Deinstitutionalization, Transinstitutionalization and History of Congregate Facilities
  • Community Support and Independent Living Movements in US
  • Trends and Milestones in Community Services (e.g., Smaller Homes, Homeownership,      Families and Employment)
  • Public and Low Income Housing vs. Mixed Income Housing Approaches
  • Housing and Community and Economic Development
  • Sustainable, Equitable and Inclusive US Developments
   
Class 3: Service System Delivery: Disability and Aging Systems in the US   
  • Categorical Service Delivery by State Departments and Unified Housing  Departments    
  • Unified Aging System Exclusive of Disability at Younger Ages
  • Housing, Public Health and Social Services Departments
  • Facility-Based Service Delivery Systems in Disability to Decategorizing, Debundling, Braiding and Service Packages
  • Categorical Service Delivery by State Departments and Unified Housing Departments

Class 4: New Approaches to Community Supported Housing in the US
           
Compared to New and Older Health Facility Approaches
From intermediate care facilities to institutional reclassification, assisted living facilities, nursing facilities, and rehabilitation facilities; home health care and personal assistance services; visiting nurses and practitioner programs; speech, communication, physical and occupational therapy, medication management, behavioral health services; case management

Service Typologies, Continuum Critique, and Olmstead Most Integrated Standard
From group homes to apartments and home services, supported housing and supportive living,      independent living, cooperative apartments and associations, and villages and retirements communities; user-directed approaches and community service options; family support and education; after school activities; transitional housing; integrated apartment clusters
                 
Class 5: Housing and Support: The Ideal Proposed in the 1990s  
  • Person-Centered Plans and Support Services (see, also, Great Britain)
  • US Demonstrations on Money Follows the Person
  • Family Cash Subsidies and Consumer-Controlled Budgets
  • Choice, Empowerment and Self-Determination- The Basics: Selection of Own Home,  Providers or Assistants, Portable Services
  • Disability Categorical, Community Support, and Housing State and Local Planning
  • ADA and Accessible Housing, Assistive Technology and Accommodations       

Status in US Policy and in Europe: Developing Countries and Families
         
Class 6: Home Ownership and Rental in the US 
  • Harvard Joint Center on Housing and Public Policy and the National Council on Disability: State of the Nation's Housing
  • Housing, Affordability, Housing Cost Burdens and Worst Case Housing Scenarios
  • Local Communities and Public Housing, Home Ownership Program
  • Role of Nonprofits in Housing: e.g., The Case of HELP
  • Federal, State and Local Roles, including Poverty and Community Building
  • Special Populations and Housing (e.g., HIV-AIDS, psychiatric disabilities, criminal backgrounds)
  • Home ownership, Income integration, income disparities, and neighborhoods          

International: Home and Land Ownership and the Status of Women
         
Class 7: Mid-Year Class Assignments

Class 8: Financing of Housing and Support in Disability
  • Community and Development Block Grants
  • Community Development Corporations
  • Corporations for Supported Housing 
  • Commission on Affordable Housing and Health Facilities 
  • Housing Financing: Low income tax credit, National Housing Trust Fund, tax      exempt bond financing, mortgage tax credit, housing choice vouchers, Section 8 construction, rehabilitation section 515, delinquent property tax collections
  • Support Services Financing/Social Services Financing
  • Health Care Financing (e.g., Home and Community-Based Medicaid Waivers)

General Accountability Office, USA, 23 new reported programs

Class 9: Residential Segregation, Fair Housing and Discrimination
  • Literature on Residential Segregation, Fair Housing and Discrimination in Housing 
  • Fair Housing Laws and Discrimination: Landlords Tenants, Developers

Disability: Fair Housing
  • Title VI of the Civil Rights Act of 1964
  • Section 109 of the Housing and Community Development Act of 1974
  • Architectural Barriers Act of 1968
  • Rehabilitation Act of 1973 (Section 503 and 504)
  • Title IX of the Education Amendment Act of 1972      

Class 10: Inclusive Communities: Asset and Capacity-Based Approaches to Community Development
  • John McKnight, Northwestern University, and Studies in Neighborhood, Residential  and Housing Integration
  •  Inclusionary Zoning in the US (Department of Housing Preservation and Development)
  •  History of Site Selection in New York State and US
  •  Housing Integration in the US, Inclusion and Democracies, and New Gated Communities
  •  Sustainability and Green Initiatives in Housing, Transportation and Equity
  •  Worldwide Residential Segregation Studies of Cities: Waves of Immigration & Housing  
  •  Capacity-Building and Social Networks in  Local Communities and Neighborhoods  (also, Negative Support)

Class 11: Housing Alliances and Coalitions: Legislation, Regulations, Financing, State and Localities
  •  Governmental Focused Alliances: Partnership for Sustainable Communities, US, 2012
  •  Government Officials - e.g.,National Association of Housing and Redevelopment Officials
  •  New Groups: Housing and Support Alliance, Great Britain, 2012
  •  Community Groups and Processes: Community Development Plans
  •  Longstanding Coalitions: Low Income or Affordability Coalitions
  •  Categorical Coalitions for Housing: National AIDS Coalition 

Class 12: Quality and Evaluation of Housing and Support in US
  • Quality Indicators in Housing and Services, National-USA
  • Annual Housing Reporting and Statistics: US Housing and Urban Development Department
  • Household Surveys, Disability Surveys, and State, Federal and Local Evaluations
  • Real Estate and Housing Construction Industries

Class 13: Housing Laws in the US and their Administration

          Partial List of Applicable Laws: Joint with School of Law
          1949 Housing Act, Housing Act of 1959
          1974 Housing and Community Development Act
          1986 Tax Reform Act
          1990 Cranston-Gonzalez Affordable Housing Act
          1990 National Affordable Housing Act
          1994 Continuum of Care and Homeless Funding
          1998 Quality Housing and Work Responsibility Act
          2000 Stewart B. McKinney Homeless Assistance Act
          2009 American Recovery and Reinvestment Act
          2009 Obama: Helping Families Save their Homes Act
          2009 Protecting Tenants at Foreclosure Act
          2010 Frank Mellville Supported Housing Investment Act
        
Class 14: Class Papers
Report on Class Projects and Final Paper Submission

References

Allard, M. (1996). Supported living policies and programs in the USA. In: J. Mansell & K. Ericsson, Deinstitutionalization and community living. London: Chapman & Hall. 

Allen, M. (2004, March). Just like where you and I live: Integrated housing options for people with mental illness. Washington, DC: Bazelon Mental Health Center. 

Americans with Disabilities Act, 1990, PL 101-336, 42 USC, Section 12101 et seq., 2008 Amendments

Anthony, W.A., Cohen, M., Farkas, M., & Gagne, C. (2002). Service systems. Psychiatric rehabilitation, 231-270. Boston, MA: Center for Psychiatric Rehabilitation, Trustees of Boston University. 

Biklen, D. (1991). Small homes. In: S. Taylor, R. Bogdan, & J. Racino, Life in the community: Organizations supporting people with disabilities. (pp. 94-104). Baltimore, MD: Paul H. Brookes. 

Boss, P., Doherty, W., LaRossa, R., Schumm, W.R., & Steinmetz, S.K. (2004/2009). Sourcebook of family theory and methods: A contextual approach. NY, NY: Springer.

Braddock, D., Hemp, R., & Rizzolo, M. (2008). Supportive living, family support, personal assistance assistance and supported employment. State of the states in developmental disabilities. Washington, DC: American Association on Intellectual and Developmental Disabilities

Bratt, R.G. (2012). Homeownership policy in the US. In: R. Ronald & M. Elisinga, Beyond homeownership: Housing, welfare and society, 130-145. London: Routledge.

Carling, P. (1992). Housing, community, support and homelessness: Emerging policy in mental health systems. New England Journal of Public Policy, 8(1): 281-295. 

Carr, J.H. & Kutty, N.K. (2008). Segregation: The rising costs for America. NY, NY: Routledge. 

Carvelli, A. (2016, February 16). Letter to County Executive Anthony Picente from Commissioner of Finance on delinquent property tax collections. Utica, NY: Oneida County Offices, County Legislative Chambers.

Consortium of Citizens with Disabilities. (2012). Housing task force: Final report 2012. Washington, DC: Author. 

Cuomo, A. (2014). Chapter 3: HELP.  In:  A.M. Cuomo, All things possible: Setbacks and successes in politics and life  (pp. 80-136). NY, NY: Harper Collins Publishers. 

Galbraith, S.A. (1999). A home of one's own: what housing and social services can do to afford people the dignity and supports for personal housing. Washington, DC: President's Committee on Mental Retardation, Administration on Children and Families, US Department of Health and Human Services. 

Habitat for Humanity. (2012). International housing statistics and research. Atlanta, GA: Author. Retrieved in October 2012 from:
http://www.habitat.or/print/how/why/intl_status_research.aspx

Hagner, D. & Klein, J. (2005). Home ownership for individuals with disabilities. Journal of Disability Public Policy Studies, 15(4): 194-200.

Hemingway, L. (2011). Disabled people and housing: Choices, opportunities and barriers. Bristol, UK: Policy Press, University of Bristol.

Herbert, C.E, Belsky, E.S., & Apgar, W. (2012). Critical housing finance: Challenges for policy makers: Defining a research agenda. Boston, MA: Joint Center for Housing Studies, Harvard University. 

Hernandez, B., Balcazar, F., Keys, C. Hidalgo, M. & Rosen, J. (2006, Autumn). Taking it to the streets: Ethnic minorities with disabilities seek community inclusion. Community Development: Journal of Community Development, 37(3): 4-25. 

Kretzman, J. & McKnight, J. (1993/2005). Discovering community power: A guide to utilizing local assets and your organizations's capacity. Evanston, IL: Asset-Based Community Development Institute, School of Education and Social Policy, Northwestern University. 

Lakin, K.C. & Stancliffe, R. (2007). Residential supports for persons with intellectual and developmental disabilities. Mental Retardation and Developmental Disabilities Reviews, 13: 151-159. 

Mace, R. (2001). Dedication to Ron Mace. In: W. Preiser & E. Ostroff, Universal design handbook, iii. NY, NY: McGraw Hill. 

Massey, D., Condura, G.A. , & Denton, M.A. (1987). The effect of residential segregation on black social an economic well being. Social Forces, 66: 29-56. 

National Council on Disability. (2010). State of housing in America: A disability perspective. Washington, DC: Author. 

O'Brien, J. & O'Brien, C. (1994). More than a new address: Images of supported living agencies. In: V. Bradley, J. Ashbaugh, & B. Blaney, Creating individual supports for people with developmental disabilities. (pp. 109-140). Baltimore MD: Paul H. Brookes. 

O'Hara, A. & Day, J. (2001). Olmstead and supportive housing: A vision of the future. Washington, DC: Center for Health Care Strategies, Inc. 

Pynoos, J., Feldman, P., & Ahrens, J. (2004). Linking housing and services for older adults: Obstacles, options and opportunities. London: The Haworth Press. 

Racino, J. (2013). Housing and disability: Toward inclusive, equitable and sustainable communities. Public administration and disability: Community services administration in the US. (pp. 123-156). NY, NY: CRC Press, Francis and Taylor. 

Racino, J., Walker, P., O'Connor, S., & Taylor, S. (1993). Housing, support and community. Baltimore, MD: Paul H. Brookes. 

Rogers, E.S., Farkas, M., Anthony, W.A., Kash, M., Harding, M., & Oschewski, A. (2008). A systematic review of the supported housing literature, 1993-2008. Boston, MA: Center for Psychatric Rehabiltaiton, Boston University. 

Schwartz, A. (2006). Housing policy in the US (2nd edition). NY, NY and London: Routledge. 

Seekins, T. (2006). Introduction: Disability and community development. Community Development, 37(3): 1-3. 

Targett, P.S. & Smith, M.C. (2009). Living in the community. In: P. Wehman & M. Smith, Autism and transition to adulthood. (pp. 233-250). Baltimore, MD: Paul H. Brookes. 

Technical Assistance Collaborative. (2012). Resource Center on Supported Housing. Boston, MA: Author. 

Turner, M.A., Herbig, C., Kaye, D., Fenderson, J., & Levy, L. (2005, June). Discrimination against persons with disabilities: Barriers at every step. Washington, DC: Urban Institute. 

US Housing and Urban Development. (2007). Estimated assisted housing parameters using American housing survey data. US Housing Market Conditions, 5-12. 

Walker, P. (1991). Anything's possible. Project Rescue, Georgia. In: S.Taylor, R., Bogdan, & J. Racino (Eds.), Life in the Community: Case Studies of Organizations Supporting People with Disabilities (pp. 171-183). Toronto, Canada, NY, NY, and Sydney, Australia: Paul H. Brookes.

Watson, S. (1986). Women and housing or feminist housing analysis? Housing Studies, 1(1): 1-10. 

Zola, I. (1989). Toward the necessary universalizing of disability policy. Milbank Quarterly, 67 (Supplement 2 Part 2), 401-428. 

Additional references available upon request. Also, see, wikipedia, supportive living, supported housing, family support and community integration in addition to housing and housing policies.



Monday, January 1, 2018

NATIONAL PUBLIC SERVICE AWARD: NOMINATION OF THE CONSORTIUM OF CITIZENS WITH DISABILITIES

NATIONAL PUBLIC SERVICE AWARD
2017-2018
American Society for Public Administration

Award Nominee 
CONSORTIUM OF CITIZENS WITH DISABILITIES

The Consortium of Citizens with Disabilities, representing 100 voluntary organizations, was founded in 1973. CCD is the largest coalition of national organizations working together to advocate for federal public policy that supports self-determination, independence, empowerment, integration, and inclusion of children and adults with disabilities in all aspects of society. 

Founding Executive Director
Paul Marchand, Arc-US

Governmental Affairs, Public Policy
 Marty Ford, Arc-US

Currrent Task Forces: In 2017, CCD hosts the following working taskforces and sections with additional information on its website: Developmental Disabilities, Autism and Family Support, Education, Employment Training, Financial Security, Health and Housing, Long Term Services and Supports, Regulation and Reform, Rights, Social Security, Technology and Telecommunications, Poverty and TANF, Transportaiton and Veterans.  The task forces actively engage iin current proposed legislation and its effects on individuals with disabilities and their families, and in proposing national leadership directions to federal levels. 
info@c-c-d.org

Nominating Statement of Julie Ann Racino
Member, American Society for Public Administration 

The Consortium of Citizens with Disabilities (CCD) supports federal policies for the Nation's 
Science Centers in Disability, for advocacy and empowerment organizations, for critical policies 
for local communities and financial security, and to address the governmental affairs at the 
federal-state levels which range from the US Congress to Executive Departments, and the federal, national policy and research initiatives.

The nominating party was pleased to meet with Paul Marchand and Marty Ford in Washington, DC as part of the Task Force structurres of CCD in areas ranging from health, housing, and long-term sevices and suupports. All task force members representing diverse constituencies (e.g., mental health/illness, traumatic brain injuries, learning disabilities, deaf blindness, independent living) worked diligently to collaborate on shared, coherent public policies in the "true tradition" of public administration. 

This nominating party also worked individually in states in the US with members of the Association of University Centers for Excellence in Developmental Disabilities (Current Chair) as "the Center on Human Policy, Rehabilitation Research and Training Center on Community Integration". Current contact (CCD liaison) for these Centers is Kim Musheno, Current Chairperson, Association of Univeristy Centers of Excellence in Developmental Disabilities, 1825 K Street, NW. Suite 1200, Washington, DC 20006 (202-783-2229 and 202-534-3731).

Selected Resume (Award Acceptance): Marty Ford, Arc-US
Marty Ford is Senior Executive for ove 30 years for the Arc-US offering leadership in public policy.  The Arc-US indicates that Marty Ford served as Chairperson of the Consortium of Citizens with Disabilities for three years and currently serves as Co-Chair of the Task Force for Financial Security. Marty Ford servies on the Board of the National Academy of Social Insurance and has served on the American Bar Association Commission on Law and Aging. 

Marty Ford is a staunch supporter of community services, quality health care, and income security for individuals with disabilties, families and seniors.  As part of the Arc-US Executive Team, she led the way in community development throughout the US, more populatly known  in the 1980s as group homes (e.g., Nordic community emblem), secured the support of legislative and Executive groups, and developed and modernized the 1940s local and state chapters in the US. 

Marty Ford obtained her J.D. from George Washington University Law Center, Master's in Communication Design at the Pratt Institute, and BA from the University of Virginia. She has testified before US Congress on numerous occasions, "corresponds regularly through CCD", and provides testimony to the Ways and Means Subcommittee, House and Senate Appropriations Committee, and Senate Finance Committee, among others. 

Marty Ford's Biography can be found at:
www.thearc.org/who-we-are/staff/marty-ford

Marty Ford was part of the Executive Team under Arc-US Director Alan Abeson, who was part of a university Consortium of University of Minnesota, Syracuse University, and University of Illinois-Chicago with funding from the National Institute on Disability Research and Rehabilitation. She currently serves at the Arc-US under the leadership of new Executive Director Peter Berns. Marty Ford worked at the Consortium of Citizens with Disabilities with Allan Bergman who represented United Cerebral Palsy-US in the 1980s and also served (with Julie Ann Racino) as Formation Co-Chair of Public Administration and Disability at the American Society for Public Administration, 2015-2017. 

Marty Ford and Paul Marchand have been cited in the new book, Public Administration and Disability: Community Services Administration in the US (Racino, 2014).

Nominating Date: October 18, 2017 for ASPA Awards in Denver, Colorado

Nomination Received: Williams Shields, Jr., Executive Director, American Society for Public Administration, October 18, 2017

Saturday, December 30, 2017

BOOK REVIEW: PUBLIC ADMINISTRATION AND DISABILITY: COMMUNITY SERVICES ADMINISTRATION IN THE US

   Book Review:  Public Administration and Disability: 
Community Services Administration in the US: 

From 2014 to 2017 in a Changing World  

     In 2017, the US is in its first term of  the Republican Trump Presidency having re-elected President Barack Obama, a Nobel Peace Prize Winner, to a historic second term.  In spite of the Affordable Care Act (ACA) of 2010, the health care of Americans (universal) continues to be held in the balance. Historic international environmental and trade accords are being challenged or overturned (e.g, Sustainable Development Goals and the Paris Climate Change Agreements in 2015).

      Today, as we meet with our international colleagues through the American Society for Public Administration (ASPA), North Korea is launching repeated nuclear missile tests and Eastern Europe's Ukraine was over run by the Russian government. Our United Nation's agenda is being led by Nikki Haley, a young appointee of President Trump who moved through the Governor's Chambers of the South, the UN Convention on the Right of Persons with Disabilities together with a universal right to health care remain top of the agenda on the 21st Century.

    The book, Public Administration and Disability: Community Services Administration in the US (Racino, 2014), reflects an approach to public administration reflective of the now 100 year young inception of Good Government and moderately to ASPA's Governance of the growing alternative provision of public goods (Castellani, 1997). In particular, the book describes the advent of caring administrations and laws addressing OECD's (Organisation for Economic Cooperation and Development) estimated  at 14% of most Nation-state populations.

    Public Administration and Disability reflects the diversity of approaches to issues of poverty, quality of life, economic and social well being, long term services and supports (LTSS), civil rights, theories and principles in government (Chapter 1), and "take-for-granted" housing, income security and family support. These administrations are involved in Executive leadership, intergovernmental fiscal relations, conflict and social change, pubic personnel administration, performance management, education, disability and inclusion, government regulation and administrative law, international community development and rehabilitation, and "democracy and other forms of government" (Chapter 13).

     The book takes on the multi-decade issues of residential and housing integration, often under the rubric of housing for all (Chapter 6), introduces the voluntary sector organizing on behalf of individuals with disabilities and their families (Chapter 4), and challenges the reader on why individual and family support per capita exhibits such variability across the states and stability versus growth in the past three decades (Chapter 5). Joining Julie Ann Racino of New York are her colleagues from the University of Minnesota (Larson, Hewitt, Sedlezky, & Blakeway) describing the status of the new Direct Support Professional and US Direct Support Services Workforce.

     The author also thanks Steven E. Brown, whom she met in the 1990s at the World Institute on Disability (invitation from Judith E. Heumann, international disability advisor, originally from New York), for his national and international contributions. Julie Ann Racino's newest book, subsequent to Policy, Program Evaluation and Research in Disability, is available internationally, and is online on mobile devices, androids, tablets and desktops at http://www.crcpress.com/authors

     Additional information on individual and public budgeting (Chapter 9), comparative service systems (Chapter 8), disability policy research (Chapter 11), and employment and personnel administration (Chapter 7) are being shared at the ASPA Conferences from Chicago, Illinois to Seattle, Washington, and Atlanta, Georgia.

Castellani, P. (1997). Managing alternative approaches to the provision of public goods: Public, private and non-profit. In J.J. Gargan, Handbook of local government administration (pp. 47-70). NY, NY: Dekker.

Heumann, J. (2010, May 26). Judith Heumann to join U.S. State Department in fulfillment of a Clinton-Obama pledge. Washington, DC: Author.

Organisation for Economic Co-Operation and Development. (2003). Transforming disability into ability: Policies to promote work and income security for disabled people. Paris, France: Social Policy Division of the Directorate of Education, Employment, Labour, and Social Affairs.

Racino, J. (2014). Public administration and disability: Community services administration in the US. NY, NY, Boca Raton, FL, and London: CRC Press, Francis and Taylor.

Racino, J. (2015, December). Environment and climate change: From Earth Summit world leadership to today's Sustainable Development Goals of the United Nations. Newsletter of the Section on the Environment and Natural Resources (SENRA), American Society for Public Administration, pp. 1-4.

United Nations. (2006). United Nation's Convention on the Rights of Persons with Disabilities. NY, NY: UN ENABLE.



Tuesday, October 3, 2017

A WORD TO THE WISE ON PUBLIC BUDGETING, FINANCE AND SPECIAL POPULATIONS

A Word to the Wise on Public Budgeting, Finance and Special Populations 

By Julie Ann Racino, Member of American Society for Public Administration
October 3, 2017 

     In the middle of the 2017 election campaigns, which today have new northeast woman Mayors running and winning small to medium size city offices, and new black Mayors, both men and women, in cities in the South and Mid-West such as Houston, Texas (on news, this week; kickoff by Gwen Ifill, 2009, now deceased), we will take a minute to examine Public Budgeting and Finance.

    The term Special Populations as opposed to general populations, usually refers to sub-population groups, for example in disability fields from broad mental health populations, to populations with heart disease, intellectual and developmental disabilities, or sensory impairments (e.g., visual, hearing, sense of smell). Special populations may also refer to clients of a department or program, though that is often a misnomer - child abuse and neglect, criminal justice and offenders with disabilities, low income or below poverty thresholds. Why? That's the origin of disability as distinct from the General Population, and also as part of the general population (e.g., Marcuse, 1989, issue of housing).  Community integration (see, wikipedia, federal use) is based upon assumptions and beliefs about "special populations", in addition to research related to the General Population.

     In areas such as employment and hiring (Human Capital), the term "protected classes" under human rights laws is less popular in 2017, and many people who never understood affirmative action in the first place, were then a bit taken aback by needing to be colorblind!  Why? Well, who writes about protected classes as a chosen or designated job is usually, the protected class members (See, composition of EEO, 2016)! Is it still true today after the Obama Presidential election and second term? Yes and no. For example, when there is women in public administration next to minority (male, black) public administration at public planning, is it surprising that America remains as a segregated and divided society (Carr & Kutty, 2008, Segregation: The rising costs to America)?

    Now, I have just examined the three issues of Public Budgeting and Finance (2017), and already the lead issue authors almost separated into one issue of woman leadership! And as our feminist authors (e.g., Fine & Asch, 1988; Traustadottir, 2006) would "not state", writing not as women (a peculiar thought according to the "other women" who have not had their consciousness raised by "their sisters"), but as "male job peers" in an unjust society. Yet, all striving for "equal pay and benefits" to their gender counterparts discounting the factors of social class and, surprisingly, then merit (from an Ivy!). Thus, this author's first personal essay on the subject after Junior Achievement Treasurer of the Year (Indiana, 1967- "mixed gender" or "co-ed") and real hospital and entrepreneur, business budgets!

       In these 2017 issues, however, the themes revolve around public borrowing "for private organizations" and municipalities, public pensions as a liability in the new "public bankruptcies", special district financing, the new role of tax and expenditure limits (e.g., on property taxes),  municipal bonds versus new municipal purchases, "subnational debt in Mexico" (e.g., Smith & Benton, 2017) and "Italian regulation", the role of insurance and underwriting, banking and transportation infrastructure, case study of New York budget process, casino taxes and future revenue expectations (e.g. Srinivasan & Lambert, 2017), and fracturing, taxes and the environment. Interesting are the authors, who for example, recommended commercial over development banks, and long-term debt management plans (for government to carry high debt) which have also led to bankruptcies.

      At the American Society for Public Administration, we now have a new LGBT (lesbian-gay-bisexual-transgender) Section and the standing Women in Public Administration Section (SWPA), and Women Section Chairs and Presidents of the Association. However, disability has been ushered to its Special Population Associations other than as part of the general association itself (e.g., ASPA as Non-Voluntary Governance, all federal categories, and as Federal, Local and State Governments). That brings us back to the Nothing About Us Without Us (Charlton, 2000- as the Association enters domains of international world order, rule of law, decades of worldwide NGO growth (e.g., women, disability, ethnic), and "involuntary care" hidden from the public eyes.

    With the growth in health care and health care financing, and "publicly approved" designations of human service NGOs as health care organizations, the role of communities, advocacy, independent and supportive living (See, wikipedia), supported housing and supported employment, non-profit human services, and governance are changing considerably, especially post-911 (e.g., Racino, 2015, ASPA. Chicago, Illinois).  The shifting of US budgets-personnel and government- to an extra-ordinary health care system, together with privatization of essential government functions outside the public eye, has raised the importance of these matters to the health, well being and futures of local individuals, families and communities in America (and worldwide).

References
Carr, J. & Kutty, N. (2008). Segregation: The Rising Costs of America. NY, NY: Routledge.

Charlton, J.I. (2000). Nothing About Us Without Us: Disability Oppression and Empowerment. Berkeley and Los Angeles, CA: University of California.

Fine, M. & Asch, A. (1988). Women with Disabilities: Essays in Psychology, Culture and Politics. Philadelphia, PA: Temple University Press.

Ifill, G. (2009). The Breakthrough: Politics and Race in the Age of Obama. NY, NY: Doubleday Publishers.

Marcuse, P. (1989). The pitfalls of specialism: Special groups and general problem of housing. In: C. Hartman & S. Rosenberrry (Eds.), Housing Issues in the 1990s. NY, NY: Praeger.

Racino, J.A. (2015). Community Financing in the 21st Century: The Rise in Health Care Financing in the Community. Chicago, Illinois: American Society for Public Administration. [Budget and Finance Section Member]

Smith, H.J.M. & Benton, A.L. (2017). The role of metropolitan cooperation and administrative capacity in subnational debt dynamics: Evidence from municipal Mexico. Public Budgeting and Finance, 37(2): 58-82.

Srinivasan, A.K. & Lambert, T.E. (2017). The impact of stagnating casino revenues on state and local governments tax receipts. Public Budgeting and Finance, 37(1): 26-46.

Traustadottir, R. (2006). Disability and gender: Introduction to the special issue. Scandinavian Journal of Disability Research, 8: 81-84.

Wikipedia. (2012). Community Integration, Supportive Living, Supported Housing

Saturday, September 16, 2017

Contributions to Client-Centered Therapy and the Person-Centered Approach

Contributions to Client-Centered Therapy and Person-Centered Approach

Julie Ann Racino, MAPA, BA

September 2017

        In 1977, after working for two years after graduating from Cornell University, I headed for my first choice of our Nation's clinical psychology programs- Northwestern University Medical School. Located off the shores of Lake Michigan,  in downtown Chicago, it was there that I met Nat Raskin, whom I later learned worked with the illustrious psychologist, Dr. Carl Rogers, in encounter groups in the US and Europe. Dr. Nathaniel Raskin later became Department Head for Social and Behavioral Sciences, and in his 2004 book he describes his inauguration in 1978 as President of the American Academy of Psychotherapists. 

      My primary relationship with Nat was with a one semester course in which he taught non-directive counseling, my first semester in medical school (clinical psychology). His 2004 book is exactly about that course and work, and indeed I was unbelievably delighted as Dr. Carl Roger's work was my favorite of all the leading psychologists (e.g., R. D. Laing, Sigmund Freud, Gordon Allport, Carl Jung, Kurt Lewin, B.F. Skinner, Alfred Adler) taught at Cornell University, Liberal Arts Program. Non-directive (client-centered) clinical counseling  was "right on" with Dr. Roger's unconditional positive regard, and scientifically-based therapy, clearly superior as an approach for healing and professional helping in the office and clinical settings in which clinical psychologists often work. Later, I would transfer my course credits, together with others, to my Maxwell MPA degree, predating the now joint MPH-MPA degree programs. 

        Nat's book, which is highly referenced to his and Roger's work for decades, includes his "landmark study of six differing therapeutic orientations" which Dr. Roger's believed deserved much more attention. Nat himself took courses from Rogers his first year in Chicago, with his term paper appearing in the Journal of Consulting Psychology on non-directive attitudes versus the concentation on non-directive techniques.  He also describes congruence, as one of the three necessary and sufficient conditions for success in the psychotherapeutic process. The book is a must read for proteges of Rogerian psychotherapy, and I would argue for all community psychologists offering services to the public. Subsequent to Cornell University, my thesis was on the development of generic, community approaches such as family support.

     My career, of course took another path in which I was involved in the development of the first community programs in mental health, first in New York State in the 1970s.  Later, I would move on to the development of programs in related fields (e.g., intellectual disabilities, traumatic brain injury) and in other sectors and roles (e.g., Executive, Education, Research, Development) and Non-Profit, Governmental, and the Corporate and Business Sectors in the US and internationally. My path, of course, would cross many other leaders and contributors, but always, Rogerian and non-directive counseling approaches, would be core with "existential psychology" undergirding the world gates. All counseling, other than group, dyad or family therapies, tend to be person-centered approaches which is one of the reasons I enjoy clinical work.

     I was lucky to meet with Nat while I was in Chicago for the International Association of Persons with Severe Handicaps, where I was chairing a new Committee on Housing (with Elaine Ostroff, who later edited a world book on universal design), and a panel on our national federal center on community living research and developments in the US. He also would write to me when Carl became ill and had a visual impairment before he passed, with Nat having worked with the American Foundation for the Blind earlier in his career in New York City. Carl and Nat claimed each other as friends, and I claimed myself as honored to have met Nat!  In 1985, while I joined Syracuse University and the federal Rehabilitation Research and Training Center's network, Nat was teaching courses on clinical interviewing and empathy, and visiting South Africa as part of an international  team; Carl Rogers, on the team, was 83 years old!

     This month, now 2017, I read Nat Raskin's The first 50 years and the next 10 in which he appraised the person-centered approach; it was published in the Person-Centered Review, 5(4): 364-372 in November 1990.  It was the period to which we contributed decades to the dominance of "positivistic" approaches, which at Syracuse University, unwittingly included Bogdan's and Taylor's positivistic evaluation research and social acceptance theories published as part of the work of the national Center on which I served as Deputy Director. Nat cites the Roger's leading book, On becoming a person (1961) which introduced me to him at Cornell undergraduate days, and indicates that his publications with Carl date way back to 1949 on coordinated research in psychotherapy! The next generation is now publishing about Nat and Carl, and I find the interweaving of the generations to be both right and intriguing.

     We will miss our colleagues and leaders as we move to the next decades, but positivism is not for just a few decades, but a mainstay to the future for a good planet (i.e., Sustainable Development Goals) and good lives in the "galaxies" (the Star Trek generations). Nat and I respectively in our distinct careers, approved a range of theories (e.g., personality development) and thus, community and university practices in the US. However, in my conversations with Nat, both of us are in our own practices, at the clinical effectiveness of Rogerian therapy and similar foundational sciences to support good personal and societal outcomes. Today,"anti-behaviorism" becomes critical to "purge" the growth in "bad" (e.g., nuclear warfare, growing terrorism and police interventions),  societal and personal outcomes that can and do occur in the US and world. Looking forward to reading the transcripts and the further work conducted, published and released!! 

References
Bogdan, R. & Taylor, S.J (1987). Toward a sociology of acceptance: The other side of the study of deviance. Social Policy, 18: 34-39. 

Bogdan, R. & Taylor, S. (1990). Looking at the bright side: A positive approach to qualitative policy and evaluation research. Qualitative Sociology, 13: 183-192. 

Hall, C.S. & Lindzey, G. (1957, 1970). Theories of personality. NY, NY and London: John Wiley and Sons, Inc. 

Racino, J. (1979). Education of supervisors and managers in community programs in Central New York and New York State.  Syracuse, NY: Transitional Living Services of Onondaga County, CNY Training Coalition, and NYSACRA.

Racino, J. (1986). Panel presentation on community living research and development. Chicago, IL: International Association of Persons with Severe Handicaps (TASH). 

Racino, J. & Ostroff, E. (1990). Housing that people want and control. TASH-International. Syracuse, NY: Syracuse University, Division of Special Education and Rehabilitation.  

Racino, J. (2014). Public administration and disability: Community services administration in the US. NY, NY and London: CRC Press.

Raskin, N. J.  (1985, February 12). Letter to Julie Ann Racino, Syracuse, NY. Chicago, IL: Northwestern University Medical School, Department of Psychiatry and Behavioral Sciences. 

Raskin, N.J. (1990). The first 50 years and the next 10. Person-Centered Review, 5(4): 364-372. 

Raskin, N.J. (2004). Contributions to client-centered therapy and the person-centered approach. Ross-on-the-Wye: PCCS Books. 

Rogers, C.R. (1961).  On becoming a person. Boston: Houghton Mifflin. 

Rogers, C.R. (2004).  A personal message from Carl Rogers. In N.J. Raskin, Conbtributions to client-centered therapy and the person-centered approach (pp. v-vi). Ross-on-the-Wye, Herefordshire, UK: PCCS Books. 

Rogers, C.R., Raskin, N.J., et al. (1949). A coordinated research in psychotherapy. Journal of Consulting Psychology, 13: 149-220.

      

Thursday, September 7, 2017

AARP's PROFILES OF LONG TERM SERVICES AND SUPPORTS

AMERICAN ASSOCIATION FOR RETIRED PERSON'S 
PROFILES OF LONG TERM SERVICES AND SUPPORTS
9th Edition, 2012


     In 2012, I was absolutely delighted to obtain a copy of the AARP's Profiles of Long Term Services and Supports (LTSS) with Older Americans represented by this illustrious voluntary sector, non-profit organization in areas from US legislation to health care financing. Are you invited to join AARP as an Older American? Yes you are!

     In its American Public Policy Institute, AARP concluded:
* 4  Many older Americans live below 250 percent of the poverty line, and are likely to qualify for need-based long-term services and supports and other publicly funded services.
* 5  The bulk of Medicaid long term services and support dollars still go to nursing facilities rather than home and community-based services.
* 2  The older population is racially and ethnically diverse and is projected to become even more diverse as our multicultural society grows.

     Now, what did this author find as critically, relevant statistics "for use with legislative, executive and financing" bodies? 
* AARP states that "In 2010, one out of every five people 65+ was nonwhite or Hispanic, a percentage that is increasing and will continue to do so in the future. By 2060, it is projected that 46% of the age 65+ population will be people of color." The reasons for such demographic changes, according to Julie Ann Racino of the American Society for Public Administration, typically are differential birth rates among the populations and immigration policies, and that these changes vary by region and migration patterns in the USA.

* Very popular home health services are reported as part of LTSS by states in the Nation
(e.g., Alabama, Colorado, Maine, Mississippi), together with "similar workers" as personal and home care aides, assisted living and residential care units and facilities, health maintenance task delegation, and congregate and home delivered meals. These services and workers are called home and community-based resources. In contrast, nursing facilities (beds, facilities, occupancies) are reported with quality and oversight on physical restraints, residents with dementia, high risk and low care need residents with ombudsman programs.

* Long Term Services and Supports are still Long Term Care Financing, similar to the Public Policy Institute hosted by President Obama. In particular, the state-by-state analyses indicate a marked increase in Medicaid LTSS spending through MR/DD waivers (plus 54%) between 2004-2009 with growth in personal care services and other HCBS services (67%), nursing facilities (12% growth), HCBS 1915 waivers (77%), and intermediate care facilities for mental retardation (8%); aged and disabled waivers varied by state (e.g., plus 58% in Alabama; 89% increase in Idaho; 1,237% in Tennessee), including decreases (minus 5%, Maine; minus 56%, New York). The charts indicate in intellectual disabilities either a transfer of Medicaid packages to this reporting for older Americans, or indeed a marked new increase in funds toward this population group (may or may not include dementia; marked increases over age 85).

      This author recommends use of this document to review your own state (e.g., exorbitant institutional costs), to compare to others (why not in our state?), to increase "service typologies" for homes and communities (e.g., we like more hours available in home health instead of large nursing facilities), to obtain information on family caregiving and its economic costs (AARP at state legislatures for funds for family caregiving), and information on "living arrangements" including care for grandchildren and those over age 75 who may live alone. On the latter, few of us are truly alone, though increasingly families may have relocated out-of-state, and plans may involve neighborhoods or governments of "birthplaces" (e.g., institutions, had "place of origin"). In particular, the tables indicate a need for awareness on "cognitive difficulty" and "self care difficulty" which may be reasons a home health aide, a personal care aide or home care may be contacted or requested post-age 65 versus adult ages (18-64). The US has new disability and aging coordinators which are to be there to assist in decisions and resources.

        For those who wonder about the "formal and informal support" studies, the findings were that "instrumental support" is provided by neighbors and friends (e.g., coffee or lunch; "check in"; "voluntary telephone calls"), and broadly speaking, "more difficulty caregiving" (e.g., bathing, "toileting") does indeed "fall" to families (e.g., of birth), spouses (yes, gay marriages, too) and newly created families (e.g., children). Independent living has long supported a system of independence from families in living in homes and communities, and have advocated for the aides (e.g., see, also, US Direct Support Workforce, 2014, e.g., "psychiatric aides", "home aides"), income, decision making and supports to do so. The report also describes Long Term Care Insurance which is a new marketplace product.

      Thank you to the authors of the AARP report on Long Term Services and Supports, Ari Houser, Wendy-Fox-Gage and Kathleen Ujvari. AARP is on the web at www.aarp.org and has state offices throughout the US (e.g., Oklahoma, South Dakota, South Carolina, Rhode Island). The Public Policy Institute report was from 601 E. Street, NW., Washington, DC 20049.

By Julie Ann Racino, September 7, 2017