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Local
alerttop story
HUD plans to reduce notice given before inspections, but advocates are unimpressed
A plan recently announced by the agency doesn’t address its much-maligned scoring system, despite recommendations drafted in 2016 by senior department officials.

This article was produced in partnership with ProPublica; The Southern Illinoisan was a member of the ProPublica Local Reporting Network in 2018.

In 2016, senior officials from the U.S. Department of Housing and Urban Development drafted recommendations to fix the agency’s broken inspection system for publicly subsidized housing after a series of scandals revealed deplorable living conditions across the country. Chief among them was a proposal to revise the agency’s much-maligned scoring system to put a greater emphasis on health and safety concerns facing tenants inside their units, such as severe infestation, mold and peeling paint that could contain lead.

More than two years later, HUD has yet to take that step.

Instead, late last month, HUD announced plans to reduce the advance notice that is provided to property managers about pending inspections from up to four months to a maximum of 21 days. In a statement, HUD Secretary Ben Carson said reducing the notice time of a pending inspection would prevent landlords from “gaming the system.” HUD also said it would hold “listening sessions” on other proposed improvements.

And on Monday, in his proposed fiscal year 2020 budget, President Donald Trump proposed deep cuts to HUD, including eliminating a fund that helps pay for major repairs at aging public housing complexes and asking people living in poverty to contribute more toward rent in federally subsidized apartments.

Tenants and advocates were unimpressed by Carson’s plan to improve HUD’s oversight of properties, particularly as the administration has proposed cutting funding to programs that would improve living conditions.

Michael Kane, director of the National Alliance of HUD Tenants, a tenant-led organization that represents renters of privately owned, federally subsidized apartment complexes, said the announced change may do some good, but doesn’t get to the heart of the system’s flaws.

“It doesn’t solve any of the more structural problems of the scoring system,” he said. “And it doesn’t address our recommendations for consulting with tenants and involving tenants in the process by asking them what’s really going on at their apartment complexes.”

“I don’t know why it’s taking so long,” he added.

Last year, The Southern Illinoisan and ProPublica examined how deep flaws in HUD’s inspection system resulted in dangerous properties receiving passing grades, which can leave vulnerable families trapped in unsafe conditions, sometimes for years. The news organizations also examined how the 20-year-old inspection system, coupled with federal funding shortfalls for subsidized housing, has led to a culture of score chasing and cosmetic fixes that may result in passing grades while neglecting the most serious health risks facing families.

Nationwide, about 30,000 federally funded properties are subject to HUD inspections, with poorer performing properties inspected more often. These properties are owned either by local housing authorities or by private or nonprofit entities that enter into contracts with HUD to provide subsidized housing to about 2 million American families.

In October, Carson announced via Twitter that he had directed a “wholesale reexamination” of how the department conducts inspections shortly after he took office in March 2017. HUD had not mentioned anything about it in the intervening year and a half, including when The Southern began asking HUD about problems with its inspection system in October 2017, a year earlier, because of oversight failures in Cairo, Illinois’ southernmost city.

NBC News also published its own investigation a short time after Carson’s October tweet. HUD repeatedly declined to provide details as to how Carson’s reexamination differed from the 2016 effort that took place in the final year of the Obama administration.

Over the last three years, HUD has quietly implemented some recommendations of the 2016 task force, including telling inspectors to issue deficiencies when they find shoddy repairs, and clarifying in a notice last October that property owners must maintain their properties in accordance with local codes.

That latter change came more than a year after tenants in Hartford, Connecticut, organized to take on their absentee landlord and HUD because of the rampant mice and mold infestations in their homes.

Their apartment complex never failed a HUD inspection, but the city of Hartford had cited it for dozens of code violations. Though HUD inspectors had cited the property for mice, mold and other problems, it passed by performing well on assessments of its grounds and building systems. HUD eventually ended the landlord’s contract last May. Since then, HUD has pulled contracts from two other private owners in Hartford’s North End. Those buildings also had recently passed HUD inspections.

Cori Mackey, the leader of a Hartford-based neighborhood advocacy organization that helped the residents organize, said the change reducing advanced notice before inspections is not “getting at the root of the problem at all.”

Mackey said the biggest issue she sees is not the notice landlords have of a coming inspection but rather a scoring system that favors them. Currently, while landlords can receive up to 120 days’ notice, many receive just a few weeks’ heads-up.

Property owners and HUD inspectors, most of whom are contractors, also said changes to the advance notice present logistical challenges the agency isn’t prepared to address.

“That’s impossible,” said Kay McIlmoil, a HUD inspector based in Virginia. As a full-time inspector, McIlmoil said she’s typically booked at least three months out. She conducts inspections up to six hours away from her home and plans multiple inspections for one trip.

Under the new directive, inspectors are required to call exactly 14 days out to tell a property owner the date they are coming for an inspection. But then the property owner can request an extension of up to seven days. McIlmoil said that would throw her schedule into chaos if she had to return the following week. More inspectors will drop out, she said. Inspector recruitment and retention has already proven to be an issue for HUD.

In recent years, HUD fell significantly behind in inspecting properties. The agency blamed delays on technical problems and a shortage of contract inspectors. For many inspections, certified inspectors bid for jobs in a reverse auction, with the job going to the lowest bidder.

Between January and April 2018, the agency did not receive bids for more than 100 of the 640 public housing property inspections, or roughly 16 percent, according to a 2018 report to Congress.

HUD also was unable to bid out inspections for about 40 of 1,500 privately owned, federally subsidized properties. Of those, more than half were for inspections of properties in Montana, “where inspector recruitment and retention has proved difficult,” the report stated.

Shelly Spiller, housing director of a small nonprofit that manages HUD-funded housing in Georgetown, Ohio, said the department isn’t considering that property managers also have full schedules, particularly at small agencies. Seven employees at her organization oversee public and private subsidized housing in two counties.

“I hate to say it, but is Mr. Carson able to change his schedule with a two-week notice?” Spiller said. HUD repeatedly declined to answer follow-up questions about how the scheduling would work under the new plan, or to make anyone available for an interview.

According to attendees of the first “listening session” in Philadelphia, senior officials acknowledged that it does present a challenge, but said they are moving forward with the change regardless.

At the same listening session, HUD said it plans to test out dramatic changes to its scoring system with a two-year pilot in a handful of states, according to a PowerPoint presentation. Nationwide implementation isn’t expected until at least 2021.


Carbondale
alerttop story
Memorial Hospital of Carbondale
Carbondale hospital was 2nd state-designated trauma center in the U.S. Now, it seeks to regain that status.

CARBONDALE — To understand important gains in the treatment of trauma patients, Dr. Eduardo Smith Singares, trauma medical director at Memorial Hospital of Carbondale, said you must go back to the 1950s.

Provided by Southern Illinois Healthcare 

Dr. Eduardo Smith Singares

“If you were injured in any kind of accident or hurt in type of violence, you’d be taken to the nearest hospital because that was the standard of care,” Smith Singares said. “At the time, your nearest hospital might not have physicians who were qualified or trained to deal with the peculiarities of trauma. That means your survival was different.”

Memorial Hospital of Carbondale is preparing to apply for status as a Level II trauma center. The Carbondale hospital was one of the first trauma centers in the state. With changes to trauma center requirements over the years, the hospital eventually lost its status. But the hospital is making an effort to again be designated a trauma center, the only one in the state south of Springfield.

“The first trauma center designated in the country was at Cook County Hospital,” Smith Singares said.

He added that there is an interesting piece of trivia in the history of the Illinois Trauma Program.

“Five minutes later, this hospital got designated. We were the second in Illinois and the second in the country,” Smith Singares said. “I am excited to resurrect what is clearly a pedigree trauma line."

Cook County Hospital developed a trauma unit in 1966, and Illinois was one of three states to capitalize on new federal programs funded by the National Highway Safety Act of 1966. The others were Maryland and Florida.

Illinois created a landmark statewide trauma system in 1971. The first four trauma centers were designated the same day: Cook County, Doctors’ Memorial in Carbondale, Franciscan in Peoria and St. John’s in Springfield. Smith Singares said they were Level I trauma centers.

According to several articles published in The Southern Illinoisan in 1988, a total of 50 hospitals were designated trauma centers in 1971. Those designations expired on June 30, 1988.

The state revamped the program in 1988 and named new trauma centers. Memorial Hospital of Carbondale was named a Level I trauma center in September 1988.

To become a Level II trauma center, a hospital has to have certain staff available in the hospital and other specialists on call with the ability to arrive at the hospital within 30 minutes. Level I status requires more staff to be immediately available at the hospital. Smith Singares said volume of trauma patients also plays into the equation.

George Maroney, former administrator at Memorial Hospital of Carbondale, remembers one requirement in the 1980s was having a trauma surgeon available at all times. In those days, the surgeon could not take general surgery cases.

“The biggest problem with a real trauma center around here, is I couldn’t afford and find surgeons to staff it,” Maroney said.

He said he believes that 1988 designation was short-lived. With the revamped state rules, centers were required to apply every two years.

Maroney added there are a lot of parts that go with trauma center status, like transportation.

Arch of Illinois covered the hospital out of their Sparta base, but Maroney could not convince them to open a Carbondale location.

“Prior to Arch, we operated with our own nurses using an (Illinois Department of Transportation) chopper,” Maroney said.

Arch opened a new base at Southern Illinois Airport last week, and held an open house on March 6.

Mike Navrkal, regional director for Air Methods, the parent company of Arch, said the base's new Eurocopter 135 is equipped to carry neonatal, STEMI heart, stroke and trauma patients.

Kris Whitlock, clinical supervisor, called the helicopter a “flying intensive care unit.”

Both Maroney and Smith Singares said treatment of trauma patients, as well as Illinois Department of Public Health rules, have evolved.

With all the needed pieces in place, Memorial Hospital will submit its application for Level II status on April 1. They expect the state to answer by Oct. 1. Smith Singares said the hospital will offer full trauma services within a month or two.

“It’s time that we go back to our roots,” Smith Singares said.


PROVIDED 

Memorial Hospital of Carbondale provides top-notch care to residents of Carbondale and from throughout Southern Illinois.


State-and-regional
breakingtop story
Changes to 2020 census could make some Southern Illinois communities even harder to count

Editor’s Note: This is the second in an occasional series of stories from Capitol News Illinois about the 2020 census. Future stories will look at efforts at outreach to specific hard-to-count communities, and pending state legislation.

SPRINGFIELD — With up to two Illinois congressional seats and $1 billion or more in federal funding on the line if Illinois’ population is not correctly counted in the 2020 census, nonprofit groups warn that changes to the census format this year could exacerbate an undercount in already hard-to-reach communities.

According to the U.S. Census Bureau, 16 percent of Illinoisans live in “hard to count,” or HTC, communities, which require greater resources for the Census Bureau to reach and are the most likely to be undercounted.

While HTC communities can be found across the state, they each have defining characteristics that make an undercount likely, and include rural, low-income, high-immigrant and homeless populations, as well as children, renters, and ethnic or racial minorities.

These communities are prevalent in large pockets of Chicago and surrounding Cook County; urban centers around the state including Peoria, Springfield, Bloomington-Normal, Decatur and Metro East; and more rural areas, especially in Southern Illinois, like Carbondale, Cairo and various southern counties, according to an article by Shawn Healy, head of the Robert R. McCormick Democracy Program.

Advocates warn that a number of national factors — including moving the census online and adding a question about a resident’s citizenship status — could make full participation even more difficult to achieve.

The census goes online

In 2020, for the first time, the U.S. Census Bureau will accept responses online. While every household will still be sent mailings, 80 percent of them will be invitations to complete the census online, rather than census forms to fill out and send back.

More traditional outreach methods, including mailed forms and in-person visits, are planned for the other 20 percent.

Griselda Vega Samuel, an attorney at the Mexican American Legal Defense and Education Fund who also sits on the state’s Complete Count Commission for census outreach, said lack of internet access and fear of data breaches could make online participation less likely across the state, not just in hard-to-count areas.

“Given our current climate, people are really scared to put their personal information online. And in the more rural parts of the state, broadband is an issue,” she said.

Samuel’s fears seem to be corroborated by a City University of New York study which shows 18 percent of Illinoisans have no internet or have only dial-up access.

In Southern Illinois’ Pope County, for example, 41 percent of residents have no or poor internet access. While only 54 percent of county households returned initial census forms in 2010, an internet-based census could further limit response rates, depending on how the Bureau approaches mailings there.

This will increase the need for outreach in Southern Illinois, said Anita Banerji, director of the Democracy Initiative at the nonprofit Forefront, which is leading a coalition of more than 40 local and statewide organizations on census outreach in Illinois.

“We need to focus a little more on central and Southern Illinois for these reasons,” Banerji said, adding that Chicago already has some “groups and lawmakers that are really in the fight” against an undercount.

Still, for those who do get it online, “there are thousands of cybersecurity risks that are out there as well,” Banerji said. “The bureau needs to spend time making sure the data is well protected and safe.”

That’s a tall task, Banerji added, considering the Census Bureau’s funding has been flat or underfunded since 2010, causing the cancellation of two out of three test runs for the online format leading up to the real thing.

The citizenship question

Since communities with high immigrant populations are often considered hard to count, the potential addition of a question asking about a resident’s immigration status is another obstacle to full participation.

“The question causes fear in many immigrant communities, mixed-status families, and communities of color,” Banerji said. “And not just in Chicago, either. Think about the orchard fields in Carbondale, the undocumented communities around Peoria — those folks will be impacted too.”

Two federal judges have already ruled against the Trump administration’s inclusion of the question on the 2020 census, and the U.S. Supreme Court is set to hear one of these cases on April 23.

While this will likely decide the matter, Banerji said until the decision is final, it is difficult for her group to plan specific outreach efforts in communities that will be most adversely affected by low turnout numbers.

“Forefront would not like for the question to be on the form,” Banerji said. “But we need to know what those questions are, sooner rather than later, so that communities are armed with the right and the best information.”

Still, Banerji said, “there’s a huge mistrust of government, and that sentiment across the country is so strong,” so outreach efforts will need to focus on the fact that personal data, including citizenship status, is mandated to be kept private under law.

The state’s own census outreach commission also acknowledged this problem in its first report from November 2018, saying that “the need to clarify that participation in the census will not result in the further investigation of an individual’s life is the greatest obstacle facing the commission and its members.”

Other factors

National factors are not the only thing threatening an undercount of Illinoisans in 2020. According to Vega Samuel, the top three HTC communities, in general, are renters, children ages 0-5, and low-income families.

“So that’s a big chunk of the state,” she said. “And it doesn’t matter if you’re in Chicago or the southern parts.”

According to Banerji’s data from Forefront, about 100,000 children up to age 5 were not counted in the 2010 census in Cook County alone. This matches up to the U.S. Census Bureau’s own data, which says 4.6 percent of children aged 0 to 4 were missed in the 2010 census nationally.

“When they get the census form in their household, a lot of folks don’t always think about the children being accounted for,” Banerji said. “They don’t think about everybody that’s under that roof — they usually think it’s only themselves and their significant other.”

Other communities, including racial and ethnic minorities and young mobile persons, have been historically undercounted as well. In 2010, for example, the Census Bureau estimates that 1.5 percent of African-Americans were not counted.


THE SOUTHERN FILE PHOTO 

Children from the wait for candy during the 58th annual Pope County Deer Festival parade in November. Experts say changes to the 2020 census will make hard-to-count communities, especially in rural Southern Illinois, even more difficult to count. Children also are often are undercounted in the census, with about 4.6 percent of children 0 to 4 missed in the 2010 census.


Washington
AP
Trump's record $4.7 trillion budget banks on strong growth

WASHINGTON — President Donald Trump proposed a record $4.7 trillion federal budget for 2020 on Monday, relying on optimistic 3.1 percent economic growth projections alongside accounting shuffles and steep domestic cuts to bring future spending into promised balance in 15 years.

The deficit is projected to hit $1.1 trillion in the 2020 fiscal year, the highest in a decade. The administration is counting on robust growth, including from the Republican tax cuts — which Trump wants to make permanent — to push down the red ink. Some economists, though, say the bump from the tax cuts is waning, and they project slower growth in coming years. The national debt is $22 trillion.

Even with his own projections, Trump's budget would not come into balance for a decade and a half, rather than the traditional hope of balancing in 10.

Still, Trump contended the nation is experiencing "an economic miracle." He said in a letter to Congress accompanying the plan that the country's next step must be "turbocharging the industries of the future and establishing a new standard of living for the 21st century."

Presidential budgets tend to be seen as aspirational blueprints, rarely becoming enacted policy, and Trump's proposal for the new fiscal year, which begins Oct. 1, sets up a showdown with Congress over priorities, including his push for $8.6 billion to build the U.S-Mexico border wall.

Titled "A Budget for a Better America: Promises Kept. Taxpayers First," Trump's proposal "embodies fiscal responsibility," said Russ Vought, the acting director of the Office of Management and Budget.

Despite the large projected deficits, Vought said the administration "prioritized reining in reckless Washington spending" and shows "we can return to fiscal sanity."

The budget calls the approach "MAGAnomics," after the president's "Make America Great Again" campaign slogan.

Some fiscal watchdogs, though, panned the effort as more piling on of debt by Trump with no course correction in sight.

Maya MacGuineas, president of the Committee for a Responsible Federal Budget, said Trump "relies on far too many accounting gimmicks and fantasy assumptions and puts forward far too few actual solutions." She warned the debt load will lead to slower income growth and stalled opportunities for Americans.

Perhaps most notably among spending proposals, Trump is reviving his border wall fight. Fresh off the longest government shutdown in history, his 2020 plan shows he is eager to confront Congress again over the wall.

Trump's budget proposes increasing defense spending to $750 billion — and building the new Space Force as a military branch — while reducing nondefense accounts by 5 percent, with cuts recommended to economic safety-net programs used by many Americans. The $2.7 trillion in proposed spending cuts over the decade is higher than any administration in history, they say.

The budget imposes work requirements for those receiving food stamps and other government aid as part of the cutbacks. The Department of Housing and Urban Development faces a 16 percent cut and for Education, a 12 percent reduction.

Trump's budget would re-open two health care battles he lost in his first year in office: repealing "Obamacare" and limiting future federal spending on Medicaid for low-income people. Under the budget, both programs would be turned over to the states starting in 2021.

The top Democrat on the Appropriation Committee, Sen. Patrick Leahy of Vermont, said the budget is "not a serious proposal."

By refusing to raise the budget caps, Trump is signaling a fight ahead. The president has resisted big, bipartisan budget deals that break the caps — threatening to veto one last year — but Congress will need to find agreement on spending levels to avoid another federal shutdown in the fall.

The Democratic chairman of the House Budget Committee, Rep. John Yarmuth of Kentucky, called the proposed cuts to essential services "dangerous." He said Trump added almost $2 trillion to deficits with the GOP's "tax cuts for the wealthy and large corporations, and now it appears his budget asks the American people to pay the price," the Democrat said.

In seeking $8.6 billion for more than 300 miles of new border wall, the budget request would more than double the $8.1 billion already potentially available to the president for the wall after he declared a national emergency at the border last month in order to circumvent Congress — though there's no guarantee he'll be able to use that money if he faces a legal challenge, as is expected.

The budget arrives as the Senate readies to vote this week to terminate Trump's national emergency declaration. The Democratic-led House already did so, and a handful of Republican senators, uneasy over what they see as an overreach of executive power, are expected to join Senate Democrats in following suit. Congress appears to have enough votes to reject Trump's declaration but not enough to overturn a veto.

The wall with Mexico played a big part in Trump's campaign for the White House, and it's expected to again be featured in his 2020 re-election effort. He used to say Mexico would pay for it, but Mexico refused to do so.


Provided by Southern Illinois Healthcare 

Dr. Eduardo Smith Singares