Bread for the City

>Background: Bread for the City’s Legal Clinic exists to ensure better access to justice for low-income individuals in our nation’s capital. The Legal Clinic provides front-line civil legal services primarily in three areas of law: housing, family, and public benefits. Our Housing Law practice includes defending tenants against complaints for possession of real estate, affirmative litigation on behalf of tenants and tenant associations, representation at administrative agencies, and advice and counsel in a variety of housing-related matters.

Position Description: The Legal Clinic in our Southeast Center is seeking one attorney with 1-3 years’ experience for our Housing Law practice. Specifically, we seek one attorney to work in the new Court-Based Legal Services Project. The attorney will work one or two days per week in an office at the Landlord/Tenant Branch of D.C. Superior Court, providing immediate representation to referred clients in emergency matters. Many of those cases will then be retained by our clinic for continued representation by the court-based attorney. The attorney will also maintain a caseload of other housing matters that come through the clinic’s regular intake procedures, and conduct advocacy, education and other outreach activities. This project is in collaboration with other legal services providers.

Qualifications: A J.D. degree, excellent research and writing skills, outstanding oral communication skills, strong organizational skills, a high degree of flexibility, an ability to work collaboratively with other staff, as well as self-motivation. Some knowledge or experience in housing law is a plus. The candidate must also be adept at interacting with a wide variety of people, and comfortable working in a busy, open, noisy work environment, with no private offices for staff. A demonstrated commitment to social and economic justice is a must, as well as a sense of humor. Seriously. Prior experience in a public interest and/or grassroots setting is highly desirable. Fluency in Spanish is strongly preferred for these positions. The candidate is expected to either be a member of the D.C. Bar, or be eligible to waive into the D.C. Bar. 2010 graduates need not apply.

Salary: Bread for the City’s legal clinic offers competitive salaries, based on experience, and a generous benefits package.

To apply: Bread for the City encourages all interested persons regardless of race, gender, sexual orientation, religion or disability to apply immediately. Qualified candidates should submit a letter of interest, resume, short writing sample, and a list of 3 references to: Vytas V. Vergeer, Legal Clinic Director

>This is excerpted from testimony delivered by George A. Jones to City Council, regarding the proposed elimination of the Medical Liability Captive Insurance Agency, which provides malpractice insurance to community health centers like Bread for the City. Click here to hear Councilmember Mary Cheh discuss this issue with journalist Pete Tucker on “Spectrum Today,” WPFW 89.3 (6-7pm) last week.

Thank you for the opportunity to testify today in support of the continuation of the District of Columbia’s Medical Liability Captive Insurance Agency (The DC Captive).

The DC Captive was established in 2008 largely as a replacement for the DC Free Clinic Medical Assistance Act which, from 1986 to 2008, essentially provided malpractice coverage to the staff and volunteers of 4 DC nonprofit clinics: Bread for the City, La Clinica del Pueblo, Whitman Walker and Washington Free Clinic. This ensured that otherwise cost-prohibitive malpractice insurance would not prevent us from providing free primary care to tens of thousands of uninsured DC residents.

During the 20 years that the DC Free Clinic Act was in effect, not one time was a malpractice suit brought against any of the Clinic’s indemnified by the Free Clinic Act.

Still, some 3 or 4 years ago, the DC Government informed the clinics covered under the DC Free Clinic Act that it no longer wanted to have the unsecured risk associated with the Act. Instead, the DC government wanted to develop a special insurance product that would be funded by the government and would continue to provide DC’s nonprofit clinics with medical malpractice protection at little to no cost.

It was understood by the clinic community that the DC Government was making a firm commitment that this replacement, the DC Captive, would be sustained permanently.

Now, less than two years later, the DC Captive which we worked so hard with our government counterparts to establish, is threatened with no discussion or real notification given to the clinics or our patients. The DC Government seems prepared to renege on its promise to indemnify the community clinics, threatening the ability for tens of thousands of DC residents to receive free or affordable primary medical care.

I want to make it clear that the clinics are not here to beg for a public handout. When one considers the uncompensated care and private resources the community clinics bring to the DC healthcare system, it’s easy to see that it is in the District Government’s best interest to preserve our ability to provide healthcare to DC resident.

Please consider the following simple analysis of the return on the District’s investment:

Over the past 5 years, Bread for the City has provided an average of 8,000 medical visits to about 2,700 unique patients each year. Our average cost per patient visit was $122 in 2009 (when we provided 9,100 visits).

Of those 9100 visits, 51% were members of the DC Healthcare Alliance, which reimbursed us $95, or $27 less than it cost us to provide the care; 20% were Medicaid visits, which paid us on average $40 per visit, or $82 less than our actual cost; and 29% of our patient visits yielded no public or third party compensation, thus costing us the full $122 per visit. In short, BFC provided close to $600,000 of free care to District residents last year alone. That care is paid for with private funds that BFC raises at no cost to the District or our patients.

Patients like Ms. C who works in a liquor store and lives in the apartment above the store. She takes 7 different medications for her diabetes, hypertension and thyroid disease. She and her husband have a combined income that makes them ineligible for the DC Health Care Alliance. Without the free primary care provided by Bread for the City, this family would simply have no access to the medical care and medications they need to remain active, working adults.

Were it not for our primary care clinic, these patients might otherwise turn to local emergency rooms for matters like the flu, or a sprained wrist, or other non-emergency ailments. Compare our average cost of $122 with the emergency room’s estimated $1,000 average cost for non-emergency visit, i.e. those not requiring an overnight stay.

I feel confident the other nonprofit clinics included in the DC Captive could provide similar numbers and patient stories that expand on the level of value the District and its citizens receive through our efforts.

At the end of the day, our cost-effective model, our high quality of care for these patients, and the fact that not one claim has ever been made against the Free Clinic Act or DC Insurance, all represent ample reasons for the Council to restore the funding for the insurance that sustains our operation.

Again, thanks to the Council for allowing me to present this testimony this afternoon. I would be happy to address any questions the committee members might have.

>After two successful dry-runs, Client Choice recently went live for an entire week at our Southeast Center, and these experiments have made one thing perfectly clear: our clients love the ability to choose what food they receive from our pantry. This alone makes it a priority for us to implement Client Choice as a permanent feature of our food program.

Permanently instituting Client Choice is going to take time and work. Our average “cycle time” (the total time it takes for a client to receive a bag) is a lean 4 minutes in the regular pantry setup; during the choice experiments our cycle time averaged 6.7 minutes. That’s not bad, but we do want to keep our pantry as efficient as possible — so we intend to tinker with the pantry’s layout, adding new tables that mimic a grocery store experience.

We are also developing a volunteer training module, breaking out everything step-by-step, so that experienced volunteers can easily train first-timers, and staff have the help they need to carry the extra workload.

Even with increased cycle times, however, we find that most clients don’t mind the extra waiting. As one client explained, “I don’t mind waiting if I get to shop for what I like. This is fun!” This sentiment is music to our ears. But despite this, we want to be sensitive to people’s schedules. Sometimes a client needs to make a job interview, catch a bus, or pick up their kids from school. So we intend to offer a choice for choice. If clients need to rush out, pre-made bags will be ready and waiting for them.

Client Choice embodies the very mission of BFC: identifying opportunities to meet people’s needs in an environment of dignity and respect. For people who often have little control over their circumstances, we believe it is important to establish an opportunity for them to decide what food they need from us. With that in mind we will continue our choice experiment and make improvements until it becomes a permanent feature of our pantry.

>The DC Fiscal Policy Institute reported yesterday that, given the passage of national healthcare legislation, the District is taking an early advantage by opting-in to a major expansion of Medicaid.

DC has already become a nationwide leader in the push for healthcare reform: our locally-funded DC Health Care Alliance helps ensure that almost 95% of our residents are insured, the second-highest percentage in the nation.

This expansion will therefore be especially beneficial for us: with Medicaid newly available to residents with incomes below 133 percent of the federal poverty line (including childless adults), DCFPI cites estimates that 35,000 to 40,000 DC residents will transfer out of the locally-funded Alliance and into Medicaid next year.

With the passage of reform, the District can cut costs of their coverage by almost one half. The potential benefits of this development were also reported last week by the Washington Post. (But the Post article was misleading in one important respect. Tim Craig’s reporting suggested that the Alliance only covers childless adults and undocumented immigrants. In fact, the Alliance also covers many immigrants who legally reside in the U.S. but are ineligible for Medicaid due to a 1996 federal law that drastically restricts the Medicaid eligibility of lawfully residing immigrants.)

With the significant savings that DC stands to yield from Medicaid expansion, our city has a great reinvestment opportunity. The city could expand Alliance benefits for prescription drugs and specialty care to match those available through Medicaid. (As DCFPI notes, the Alliance does not currently provide strong mental health coverage.) And we could further expand eligibility for still more low- and moderate-income District residents.

This reinvestment would ensure that in the midst of sweeping healthcare reform, DC will remain at the forefront of the national trend towards universal health coverage.

>Although we support the environmental objectives of DC’s new bag tax, we also can’t ignore the cumulative effect of a 5c per-bag fee on our clients. Clients are already turning to us because they fell short each month — so even seemingly small extra fees do have an impact on them.

This also means that Bread for the City can be a critical gateway point for efforts to mitigate the regressive effect of this law. So we are pleased to report that since the passage of the Bag Bill, Bread for the City has received more than 8,000 reusable bags to distribute to our clients.

We are keeping track of every bag we hand out, and encouraging clients to bring back their bag next time. Early indications suggest that our clients are adapting quickly. Clients are already coming back with our reusable bags in hand, as well as others that they’ve received elsewhere.

So a special thanks goes out to these large donors: D.D.O.E.(5,500 bags), Whole Foods (2,000 bags), Giant (200 bags), and Target (100 bags).

As impressive as 8,000 bags sounds, it leaves us far from our goal of one reusable bag provided to each client. Even before the passage of the law, however, Safeway pledged to donate a large amount of reusable bags. By fulfilling its pledge, Safeway would put us considerably farther along down the path to a bag per client.

While we wait for Safeway to come through, we’re continuing to search for more bags for our clients. That’s why we are kicking off a reusable bag campaign: now you can help!

Put those dozens of idle bags lying around your house to good use. Set up a bag drive at work, or your community group. Contact me at jwankel@breadforthecity.org to make arrangements.

Thanks to all of our generous supporters!

>The following is excerpted from Stacy Braverman‘s testimony before the Department of Human Services budget hearing on April 19, 2010:

Applying for Social Security can take years: applicants may have to collect and submit medical records, be examined by doctors Social Security chooses, wait for a decision, and request reconsideration and fair hearings on the initial decision. The people who are the most disabled, and thus the most qualified for Social Security benefits, are often the least able to quickly navigate the process. Interim Disability Assistance (IDA) provides up to $270 a month in cash assistance to low-income District residents who await decisions on their Social Security disability benefits.

IDA is therefore a lifeline, a true safety net for disabled District residents patiently embroiled in Social Security bureaucracy.

One Bread for the City client told us he used his IDA towards subsidized rent, a cell phone, and toiletries. Before receiving IDA, it was difficult to contact him and hard for him to keep in touch with the Social Security Administration. When IDA provided him a measure of stability, he was better able to pursue the SSI application process. This winter, Bread for the City represented him in a fair hearing at the Social Security Administration. Many legal service providers and pro bono attorneys do similar work, and are overwhelmingly successful in achieving benefits for their clients. The man we represented won his case and received a sizable back payment—part of which will be returned to the District to cover the amount he was given in IDA. His income increased from $270 a month in District-funded IDA to $674 a month in federal dollars—dollars that benefit both him and the District as a whole as he spends them here.

So IDA provides a bridge to federal funds. The small amounts that IDA pays each month are also a shield that keeps recipients from requiring more costly services. For example, my client Mr. N is on the IDA waitlist. He actually received IDA before he came to Bread for the City, but he struggled with the Social Security process, his application lapsed, and his IDA ended. We helped him reapply for SSI and IDA, but he is currently receiving neither. When I asked Mr. N how his life was different when he got IDA, the first thing he mentioned was that he used to be able to pay the co-pay for his prescriptions. Now, he tries to borrow money from friends and he asked for credit at the pharmacy. Once, his doctor paid for him. Sometimes, he goes without for a time, which leads to medical consequences that can be expensive to unravel.

There are hundreds of people who, like Mr. N, qualify for IDA but are not receiving it. DHS has not taken anyone off the waitlist in many months. Many people I speak to are wary of applying for IDA, because they know benefits will be slow to arrive and that they will face long waits and overburdened staff when they apply.

>Today, the Washington Informer reports on the expansion of food stamps in the District, as celebrated here at Bread for the City last week in a press conference with Councilmembers Michael Brown (I-At Large) and Mary Cheh (D-Ward 3).

The actual implementation of the Food Stamp Expansion Act (introduced by Brown and unanimously approved by the Council) was way delayed, but finally an additional 4,800 DC residents are eligible for food assistance. It’s good news at a time when the low-income residents of DC need more of it. We are proud to have partnered on the push for this policy with Councilmember Brown’s office and DC Hunger Solutions.

But can we just take a step back to last week, when the Washington Post covered this story? (I know it’s lame to blog about something that’s like a whole week old; yet it was a busy week around here, and there’s something about the Post’s article that really sticks in the craw.) Check out how WaPo’s Tim Craig caps off his article with an out-of-nowhere conclusion:

“Still, for some residents both inside and outside the city, the fact that city officials are bragging about increasing the District’s food stamps rolls is sure to generate debate, and reinforce conservatives’ criticisms of the District government’s priorities.”

Okay — hold on. Is that a fact that Craig is reporting? Is such a debate actually happening somewhere? Would any District resident really think it’s a bad idea for our city government to claim federal funding (free money!) that will both alleviate miserable hunger and stimulate $1.73 of local economic activity for every $1 of food stamps? Or was this paragraph written because the practice of journalism demands that the ‘other side’ get its say, regardless of reason, morals, or even presence?

We are not journalists, so maybe we just don’t understand. But we do think that Craig could have put this precious column space to better use by, say, reporting on the fact that Councilmember Mary Cheh has another food stamp expansion bill in the works, one which will bring relief to 4,000 more District residents (working families, homeless people, and self-employed individuals) and is already unanimously-supported by Council. That sounds like news to us.

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We are pleased to share with you the transcript of the speech given by Bread for the City’s legal director, Vytas V. Vergeer, upon acceptance of the DC Bar Foundation’s 2010 Jerrold Scoutt Prize:

Ronald Wilson Reagan….Arnold Alois Schwartzenegger… Jesse “The Body” Ventura… Al Stuart Franken… Vytas Varekojis Vergeer. So begins, and hopefully ends, a long list of light entertainers who somehow became recognized for other accomplishments.

Seems to me that there are basically two ways to get the Scoutt prize: being great at what you do for a pretty long time…or not completely sucking at what you do for a reeeeally long time. I’m glad to see the Scoutt prize covers both this year. (Yay! I don’t really suck!)

I’m going to tell a little story a few people have heard before. A few days after I took the final in my law school professional responsibility class, the professor saw me wandering around campus. She flagged me down and gave me one of the best compliments I have ever received – a compliment I have pretty much always tried to live my life by. She said, “Vytas, not only was your exam the best in the class, but it was really funny.” I consider this award to be a continuation of that compliment, and a true reflexion of the wonderfulness of this legal services community for both allowing me to do the work I do and to be the person I am.

I’m not much into recognition and awards. That’s not why I, or anyone I know in this community, do the work I do. But I consider the Scoutt prize to be my hall of fame. And I got in without using any performance enhancing substance other than Mountain Dew. But seriously, when you look at the list of people who have gotten this award before, and with, me – the people I so admire in this community — my mentors — my idols — the absurdity and incredible honor of my getting this award really hits home.

Speaking of my co-recipient, I couldn’t be more pleased to receive this award with Eric. I must confess he expressed concern that his speech would not be as funny as mine. I want to say now that that concern was well-founded. But Eric has been an incredible advocate for the poor in this community and a fantastic partner in the many battles we’ve fought to improve the legal rights and representation for our clients. Thank you, Eric, for all the ways you’ve helped me and this community. And I’m not just saying that because you’re my wife’s boss.

Since I’m well over my allotted two minutes, I’ll get to the thanking part and the finale. So thank you, most sincerely, to the following people and/or entities, in no particular order. Zuckert, Scoutt, and Razenberger for having this prize in the first place, the DC Bar Foundation for actually giving it to me. To all the judges. Well, not all the judges. You know who you are. My incredible wife, Bonnie and my children, who have tolerated my late hours, bad moods, and low pay for years and years. Jeannine Sanford, my true partner at Bread, who was dumb enough to hire me…twice. George Jones, the Director of Bread for the City, who’s supported just about anything I’ve ever asked for. Rebecca Lindhurst and Su Sie Ju, our two most veteran and competent attorneys who tolerate my “leadership style” and are the ones who really make Bread’s legal clinic work. Every other attorney and employee at Bread’s legal clinic and Bread in general, who work their asses off to help DC’s poor. I’ve got nothing but clichés, but they are simply an incredible group of people to whom I’m eternally grateful. Thanks to Mark and Maureen and all the pro bono lawyers who’ve helped us. And thank you to the clients – I say that I hate them – not true, actually, I love them. God help me, I love them. They have taught me more about life, law and myself than I could ever have imagined. It’s been such a privilege to work for them and for Bread and for and with this community. Thank you.

I could and should talk in inspirational fashion about our work now. I don’t have time. Too many jokes. I will say this: I so, so, so wish our work was ended. Alas it is not.

Ok, I led with a joke. Check. I told a story. Check. I thanked everyone. Check. So now I must end with a quote. I was thinking of singing this, but I’ll spare you. I leave you with some musings of the great Lyle Lovett.

I’ve had an excellent time so far.
There’s only one thing that I fear.
I’ve been up so long on this lucky star.
It could be all downhill from here.

Thank you. Very, very much.

—V3

>The Food Stamp Expansion Act of 2009 is finally going into effect, bringing much-needed assistance to thousands of DC residents who are struggling to make ends meet but also previously did not qualify for food stamps. We’re proud to have worked with DC Councilmember Michael Brown, DC Hunger Solutions, and other community leaders to enact this smart legislation.

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WHAT/WHO: Councilmember Michael A. Brown, will be joined by Councilmember Cheh, and representatives from local government agencies, and Bread for the City, DC Hunger Solutions, and other local advocacy and service providers to celebrate the implementation of the Food Stamp Expansion Act of 2009. The event will highlight the new changes in eligibility that took effect on March 15th and the forthcoming changes in benefits under the bills “Heat and Eat” provision. There will also be discussion regarding the new bill that Councilmembers Michael Brown and Mary Cheh recently introduced further strengthening the local food stamp program.

BACKGROUND: In March of 2009, Councilmember Michael A. Brown authored and introduced the Food Stamp Expansion Act of 2009 with the support of the full council. The bill was passed as part of the Fiscal Year 2010 Budget Support Act making the bill effective October 1st 2009. The law creates two separate initiatives which are aimed at expanding eligibility and increasing the benefits of our federally funded food stamp program by utilizing existing mechanisms within the federal regulations.