CITY LIMITS: Aging Out of Foster Care Makes Eating Right a Challenge

Earlier this week, I wrote a story about nutritional deficits for young people in foster care as well as young adults aging out with limited social supports for City Limits. People who have experienced foster care speak about entering adulthood – 'the real world' – without the soft skills (cooking, hygiene, cleaning, using health insurance) that people with consistent family structures tend to take for granted. Guardians either model behaviors or remain readily available to share guidance about confusing adult topics. 

Young people who have been in the foster care system experience a higher rate of preventable health problems, like diabetes and hypertension, than their peers, even when compared to other low-income young adults who did not spend time in foster care. 

There are some supportive housing sites for young people who have aged out of foster care. They also receive priority for NYCHA vacancies. But many fall through the cracks, either neglected by foster agencies or eager to leave the system and never look back. That means people who spent time in the foster care system have a higher risk of becoming homeless and thus a higher risk for the related health problems.

Fusing Fitness With Mental Health Treatment in Supportive Housing and Related Settings

The New Social Worker magazine published a piece I wrote last summer shortly after earning my MSW in their Summer 2017 issue [Available for Download here].

Here is an excerpt: 

Four Attributes of an Effective Program

During the past year, I have identified four core attributes of the programs that effectively foster an atmosphere of health within the community and that enable individuals to attain their physical health, mental health, and recovery goals.

First, the programs provide preventive, holistic healthcare by addressing chronic health problems proactively—a key to improving quality of life and reducing emergency room visits.

Second, the programs fuse fitness with mental health in a setting that contrasts the traditional seated, face-to-face counseling experience. The transference experience is quite different when a client and worker chat while pedaling stationary bicycles next to one another. Individuals often seem more comfortable talking while exercising and frequently share information with me that they have not yet talked about with their social workers or case managers. For example, a client recently disclosed to me how his family dynamics influence his substance use while he rested between sets of 10 push-ups. I am able to discuss such experiences with clients and encourage them to share these issues with their social workers.

Third, clinical evidence indicates that exercise serves as an effective tool in the substance abuse intervention toolkit by affecting the brain’s reward system and serving as a positive, non-drug reinforcer (Smith & Lynch, 2012). In a practical sense, exercise provides a structured alternative to substance use during the period in which one prepares for and engages in it.

Fourth, exercise programs build community among staff and tenants and promote egalitarianism in the client-worker relationship. Typical barriers disintegrate when a case manager and client try to complete one last squat or shoulder press together.

When encountering panhandlers

Friends sometimes ask me what do when they encounter “homeless people” panhandling on the subway or street. Should they give money? Should they feel guilty about not giving?

I think it’s up to each individual to make that decision for themselves (so do other homeless advocates). I also inform my friends that not everyone asking for money is homeless. I have run into a few of my housed clients on the subway or the street before. Personally, I think your money would go further if you donated to a homeless services agency or a food bank. You could save up the money you'd otherwise hand out dollar-by-dollar to individuals and instead donate larger sums to the organizations working for homeless and poor people. Here are a few organizations to check out:

Now the guilt question. I don't think we need to feel guilty about not giving money to each individual who asks for it, but I think we probably should feel guilty that anyone in our rich-as-hell city needs to ask for money to survive. Every single day, I encounter panhandlers on the subway and it really sucks. I am crammed in this uncomfortable tube, the doors open and a person enters asking for money or food. Now I’m forced to consider social inequities, discrimination, mistreatment and indifference. I feel helpless. 

What if society ensured that everyone had what they needed to survive and thrive: a home, healthy food, medical care, mental health care, substance use treatment, jobs. What if we ended homelessness? What if we guaranteed permanent housing to all people? What if we valued social service organizations and budgeted enough federal, state and city money to enable them to serve those in need?

Maybe the best question is, How can we answer those other questions?

To start, I think we can identify some worthy organizations and donate money to them (not old crappy clothes, not boxes of pasta – money). Next, we can encourage our lawmakers to actually talk about poverty and homelessness. We can educate ourselves about solutions to homelessness (like MORE HOUSING and MORE HOUSING VOUCHERS). And we can elect leaders who will seriously work toward those solutions. 

Think of it this way: We'd sure have a more comfortable subway ride. 

Overpowering our convenient, default thought-processes

What did he do become homeless – What bad decisions? What drugs?

That is often still my first impulse when encountering a homeless person. I default to blaming the individual for his or her circumstances. And I’m a social worker!

I know that I’ve been conditioned to respond like that. I think we all have. It’s convenient and it offers a pat, comforting explanation for someone else’s horrible, complicated situation – They did it to themselves. Phew. Thus we cling to the easy narrative.  

It takes some education and experience to override that programming. I say “override” instead of “deprogram” because we can’t get rid of old neural pathways, we can only build newer, stronger, more appropriate ones that overpower the regressive, untenable ones.

The new, stronger pathway enables us to understand homelessness as a complex social problem that screws individuals, not an individual problem that inconveniences society.

I met a formerly homeless man the other day who told me he became homeless after years of "drinking, smoking weed and doing the wrong thing." For years, his brief, rehearsed story has likely served as a simple explanation to satisfy others.

How the hell does drinking and smoking weed explain homelessness? We all drink, smoke weed and do the wrong thing. Everyone of my friends and I would be homeless if all it took was binge-drinking. But we’re not homeless because we all have families with money [a safety net], an expectation of success [the benefit of the doubt] and a society set up to swaddle and coddle us [power].

It’s just a lot easier to tap into the narrative of ‘“irresponsibility” through substance abuse to explain homelessness. Dig a little beyond the superficial story to consider the real causes of homelessness and it gets depressing and uncomfortable.

That man could easily say, “I became homeless because society doesn’t consider housing a human right. My family was poor so I did not inherit wealth. I worked – I worked very hard for many hours – but did not earn a living wage. My income did not keep pace with my rent and the cost of living in the most expensive city in the country. When I could no longer afford to rent my apartment, I had to leave. I could not find another affordable apartment because thousands of people are trying to get the same tiny number of affordable housing units. I became homeless. I drank and smoked weed more when I became homeless because it was a cheap way to ease my anxiety and mood, which worsened because not having a home is fucking hard.”

This New Year’s Eve, I propose that we all resolve to overcome our convenient, default thought-processes when we consider homelessness. We can shake ourselves back to reality and logic when we catch ourselves tapping into the tired narratives that comfort us (“That person deserves to be homeless”).

To more easily accomplish this, we can start with the premise that housing is a human right and everyone deserves a home, regardless of their decisions (and then with the fact that we don’t even know what their decisions were).

 

"This is a home and that has to be communicated the second you walk in the door"

All new tenants at Urban Pathways supportive housing sites – including community affordable housing tenants in mixed-use buildings - move into fully furnished units that include linens, cookware, flatware, shower curtains and lamps in addition to a bed and furniture.

At other housing sites, tenants must apply for and receive a One Shot Deal from the Human Resources Administration to cover the cost of moving and furnishing an apartment beyond a a bare bed, table and chairs. Urban Pathways pays for furnishings exclusively through private donations – including from corporations that understand the economic benefits of the Housing First model. 

"This is a home and that has to be communicated the second you walk in the door," said Director of Development Nancy Olecki during a meeting this morning at a mixed-use supportive housing site in the Bronx (mixed use means supportive housing units for formerly homeless people with mental illness and "regular" affordable housing units are integrated in the same building).

We visited a tenant – a former construction worker – who moved into his apartment from the Ward's Island Shelter, a massive and notorious institution in the East River, next to the Triborough Bridge. The man said he spent the past several years moving from shelter to shelter and crashing on his brother's couch. During our conversation, he mentioned participating in a healthy cooking program, helping an elderly neighbor flee her room when the fire alarm rang and routinely checking on another neighbor who had returned from the hospital.

I asked him when he had experienced that sort of community before. 

"This is my first place," he said, holding his tiny dog against his chest. "I've never had community like this before." 

The Home Stability Support program would save people from becoming homeless

The HUD FY2016 fair market rent (FMR) for a 2-Bedroom apartment in New York City is $1,571. Yet, a 3-person family with children that earns Public Assistance only receives $400 in shelter allowance, about 1/4 of what they need. It's more or less impossible to rent an apartment for your family if you receive Public Assistance without some sort of additional (and rare) housing voucher like Section 8.

There are currently more than 80,000 people in New York State who receive PA and who pay rents 1.5x higher than their shelter allowance – including 21,000 who pay rents 2.5x higher. Home Stability Support is a statewide rental supplement that would enable New Yorkers at risk for homelessness to find an apartment and prevent eviction.

According to the Coalition for the Homeless, "HSS would cost $11,224 per year for a household of three in New York City – a mere fraction of the $43,880 it costs annually to provide temporary shelter to a homeless family."

New York State originally instituted the shelter allowance to pay the cost of housing for low-income individuals and families unable to otherwise afford rent, but the allowance has not kept up with rising rents in the past few decades since the law changed in 1975. 

Citywide, the rapid FMR increase has been significant for most people but crippling for low-income individuals. Consider Kings County (aka Brooklyn). In 1983, the FMR for a 2-BR apartment was $420 (the current shelter allowance wouldn't even cover that). Now it's $1571.  In 2008, 2-BR FMR increased by nearly 11%. In 1994, it increased by more than 20%. Last year, it rose by more than 6%. 

This problem isn't new. It's just exploding. An article in The New York Times  explored the very same issue more than 23 years ago:

Less than six weeks before Gov. Mario M. Cuomo must propose next year's state budget, his administration is considering pressing the Legislature for the first increase in rent subsidies for welfare recipients since 1988 . . .  The rent subsidy, which is known as the shelter allowance, is so low -- $286 a month for a family of three in New York City -- that many families on welfare have been forced into homelessness, lawyers and other advocates for the homeless say. The median rent in the city, according to a recent report on housing vacancies, was $475 in 1991.

Back in December 1993, when the article was written, there were  5,100 adults and 7,500 children in the city's family shelters. Today, the population has more than tripled.

Even if you typically oppose subsidies that lift low-income families with children out of homelessness and poverty, check your small-government impulses for one moment and use the other parts of your brain: New York City is already paying a billion dollars just to warehouse people in temporary, substandard municipal shelters. We would save hundreds of millions of dollars to subsidize permanent housing for families – and that's not including all the attending social benefits of housing, especially for homeless children who have zero power over or responsibility for their living situation.