This past Tuesday, Bread for the City had a very successful Breast Cancer Awareness Brunch. With around 30 guests in attendance, it was an opportunity for camaraderie among fellow survivors of and supporters of those who had breast cancer.

It was also a great opportunity to learn. Speakers Cassandra Miller from the GWU Breast Care Center, Toroitich Cherono from the Smith Center for Healing and the Arts, and Bread’s own cancer navigator Etta-Cheri Washington, presented on the importance of screening mammograms, early detection, support and navigation through the healing process.

At Bread for the City’s Medical Clinic, biennial screening for mammography is recommended for women over the age of 50, as suggested by the U.S. Preventative Services Task Force. According to the American Cancer Society, regular screening discovers cancer at an earlier stage where survivability can be between 88-98%. (For more information about this and other guidelines from the USPSTF, please visit this link.)

In the course of the brunch, clients and their family members shared stores of their own fight against cancer. One woman in particular described the importance of her faith in her providers for bringing her through the journey of cancer survival. She emphasized early detection and the need for clients to visit their doctors to be screened and referred for a mammogram. Another client, a survivor of stage IV breast cancer (the most advanced stage of cancer) described how she was very lucky to be alive and grateful for the support she received in her recovery.

Offering a different perspective was a gentleman who had personally seen two close family members – his mother and an aunt – pass away from breast cancer. Having grown up in a time where breast cancer had a grimmer prognosis, he had not been in the presence of survivors. “I wanted to see what a breast cancer survivor looked like,” he said, and expressed happiness at hearing how the outcomes of a breast cancer diagnosis have changed for the better.

It has been a great month of awareness and we would like to extend a very gracious thank you to our donors, volunteers, benefactors and our guests or helping us hold a successful this great brunch event. A special thanks to Whole Foods Market for donating the nutritious food for our clients, Melissa Jones for the delicious frittatas and members of the Sibley Young Women’s Breast Cancer Support Group for donating to the event so we could provide gift baskets to the survivors at the event.

Stay pink — and talk to your doctor!

In recent years, Bread for the City has taken several important steps across the digital divide. (You might say that we’re building a bridge as we walk on it!)

Our computer classes, Health Resource Room, and even a computer referral program are all ways that we are connecting our clients to information that can improve their lives.

So we’re excited to host the first community event organized by the Broadband Bridge — a volunteer project that’s working to foster community through shared technology. So please join us for the Discovering Technology Fair at our Northwest Center (1525 7th St NW) this Saturday, from noon to 5pm.

We’re calling it the ‘DiscoTech’ for short. (Props to our Digital Justice Coalition friends in Detroit, who have been an inspiration.)

The DiscoTech will be all free, and open, and geared for people of all skill levels — anyone interested in ways that technology can improve our lives and our communities. You can come to get experience with computers and learn about the internet — and to help others do the same. We’ll have presentations on robotics, mobile apps, community wireless network-building, and more.

We’ll also have panel discussions — one panel about a new District government initiative to spread access to broadband internet in underserved communities through the DC Community Access Network (scheduled for 2pm), and another panel about the challenge and opportunity of community resource directories like 211 (scheduled for 3pm).

We hope this will be a lot of fun and rewarding for all. Would you like to join us to volunteer? To share your skills? To sponsor the event’s food budget? Learn more here, and RSVP here.

To close out the week that was National Celebrate Pro Bono Week, we invited another guest author to share some words on the experience of working pro bono for Bread for the City’s legal clinic. (See here for our previous post from Mark Herzog of the DC Bar Pro Bono Program.) Here is Brandon Jamison, an attorney from Covington & Burling LLP, who has just finished his stint working ‘on loan’ to us. Thanks, Brandon, for your work and your words!

There is no more passionate, energetic, competent and effective group of attorneys than those that work in the legal clinic of Bread for the City. Bread for the City’s attorneys work tirelessly in the areas of family law, housing law and public benefits to see to it that District residents are 1) fully-informed of their rights under the law and 2) that their interests are zealously protected in litigation and administrative proceedings.

As an attorney at Covington & Burling LLP, I have had few more rewarding experiences than participating in the Bread for the City part-time rotation offered by my firm. Designated a housing law attorney, I was able to not only witness Bread for the City attorneys save vulnerable families from eviction, but I was also able to contribute to such efforts. By aggressively prosecuting and defending legal actions and negotiating from positions of strength, Bread for the City attorneys see to it that where District residents fulfill their obligations as tenants, landlords fulfill theirs.

No one should have to live under a leaky roof, without hot water or without heat. Unfortunately, there are District residents who are subjected to such housing conditions — and Bread for the City attorneys have intervened countless times to see to it that these bare necessities are restored.

The impact that Bread for the City has on this community cannot be quantified and the hard work that its attorneys put in helps to protect the welfare and dignity of its clients. It was a pleasure working at Bread for the City and I wish its attorneys and its clients the best.

Says Bread for the City’s Lord High Legal Director, Vytas V. Vergeer: “Though Bread for the City’s legal clinic has grown considerably in recent years, we still rely heavily on the support of law firms.  Over the years, we have been blessed with having outstanding lawyers on loan to us from (or paid for by) local law firms.  These pro bono counsel help us greatly expand the scope of our services.  In short, we love, need, and deeply appreciate the quality pro bono help we get.” Thanks to Brandon, Covington & Burling LLP, and all of our ‘loaned associates’!

http://breadforthecity.org/HolidayDrives

Holiday Helpings Drives are what makes all of this possible — and they are fun ways to involve your whole community in the spirit of the holidays. They’re easy too, and we can help you through every step! We’ll even create a specialized donation page for your company or community group, complete with logo and custom message. (See the special page for our Holiday Helpings All-Stars, Dickstein Shapiro LLP, here.)

Get involved in Holiday Helpings today. Make your donation here now, and contact Emily Schneider to get more information about how to start a Holiday Helpings drive of your own (or just download all the instructions you need from this page).

Let’s get started!

This week, we’re participating in the National Pro Bono Celebration! We’ll stand with other service groups across the country whose work in underprivileged communities is made possible by countless hours of pro bono assistance.

On that note, we’re thrilled to feature this post by Mark Herzog, Associate Director of the DC Bar Pro Bono Program, which has convened its monthly pro bono clinic in our facilities for more than a decade — providing thousands of people with free legal advice and referrals in the process. The DC Bar Pro Bono Clinic is an essential complement to our own legal services, so we are pleased to feature them today. Much love to legal service providers, and check out the rest of the national conversation about pro bono service on Twitter! Now, here’s Mark:

The legal staff at Bread for the City is one of the most professional, talented and compassionate groups of attorneys practicing in the District of Columbia. They work tirelessly to advocate for the rights of tenants to live in decent and affordable housing; of those who are unable to work to receive necessary benefits to buy food and pay rent; and of families in crisis to retain whatever structure and support is available to help care for their children.

Yet despite their dedication to serving the low-income community, and those of all the other legal services lawyers in the District, the number of unrepresented litigants appearing in our courts is enormous, and likely to remain so. In the high volume branches – Landlord and Tenant, Child Support and Small Claims – more than 90% of litigants proceed without counsel.

Where can all these unrepresented litigants turn for help? Bread for the City, of course.

Since the mid 90′s, Bread for the City has hosted the D.C. Bar Pro Bono Program’s Advice & Referral Clinic. On the second Saturday of every month between 10:00AM and noon at both the NW and SE Centers, scores of volunteer lawyers serve over 100 clients by providing pro se assistance in civil matters governed by D.C. law. They provide legal information, help complete court forms and sometimes attempt to resolve disputes by calling opposing parties.

Our Advice & Referral Clinic volunteers always have been impressed with the space at Bread for the City. We marveled at how much we could accomplish – and how many people we could serve – in what felt like very intimate quarters. Yet, the space also presented some challenges. We would interview clients in all the vacant areas – next to the walk-in freezer, in the hallways and even in the medical exam rooms. And the conference room was not large enough to accommodate all our volunteers during the opening orientation.

But we could not have wished for better space… or so we thought. When our volunteers and clients walk through the new entrance to the expanded NW Center for the first time, you can see the look of total awe on their faces. Not only is it an architectural wonder, but now we are able to conduct our interviews in private offices or other space better suited for our services; the large conference room easily holds all our volunteers; and our staff have plenty of storage for our supplies and forms.

And this expanded space could not have come at a better time. On the second Saturday in August, we served more clients than ever before – over 140!

Unfortunately, the need for our services is only growing as more people face harsh financial times. But thankfully, we have a great partner in Bread for the City. We are so grateful for its generosity and hospitality over these many years, and to all those who supported and believed in the expansion.

This Friday our staff are gathering to review and make decisions about Bread for the City’s strategic plan. One of the five proposed strategic priorities is:

Institutionalize and strengthen regular, meaningful opportunities for client engagement.

You might be wondering what “client engagement” means, exactly. We’re still figuring it out ourselves. One of the steps we’ve taken is to ask our Client Advisory Board to define it. They didn’t agree on a definition at their most recent meeting on Monday, but started to map out some different aspects of the work. Here’s what they came up with, in no particular order:

- opportunities to give back to Bread
- make it easy for clients to support each other
- activities led or proposed by clients
- open dialogue with clients concerning improving existing services and providing new services
- support entrepreneurs
- activities that lead to long-term self-improvement and self-sufficiency
- leadership development
- art
- self-advocacy
- connecting clients with similar interests
- small groups sharing skills

The Client Advisory Board also considered a suggestion from me to focus their work through a Participatory Action Research (PAR) study of client engagement at Bread for the City. PAR is different from the typical research process for two reasons. First, it centers the experiences of people affected by the topic being investigated. The experts are those who know the issue most intimately. In this case it makes a great deal of sense for clients themselves to study the availability and effectiveness of BFC’s client engagement opportunities.

Second, PAR focuses on action. It is research that makes recommendations for solutions rather than merely studying problems. It’s political. PAR also recognizes that action that can be realized through the research process itself. For example, by asking clients about their awareness of or experiences with client engagement opportunities at BFC, participation in those very activities could increase.

This fuzzy but great cartoon from Praxis India demonstrates these two concepts better than I ever could:

Now what? How do we get started? It begins with a research plan, which sounds fancier than it is. The encyclopedia of informal education has a great overview of the process for action research, taken from the book Action Research by Ernest Stringer:

Look – building a picture and gathering information. When evaluating we define and describe the problem to be investigated and the context in which it is set. We also describe what all the participants (educators, group members, managers etc.) have been doing.
Think – interpreting and explaining. When evaluating we analyse and interpret the situation. We reflect on what participants have been doing. We look at areas of success and any deficiencies, issues or problems.
Act – resolving issues and problems. In evaluation we judge the worth, effectiveness, appropriateness, and outcomes of those activities. We act to formulate solutions to any problems.

Obviously, there’s much to be done to define client engagement and to support the staff and clients that have been doing it in big and little ways throughout the history of our organization. I look forward to future blog posts sharing our successes, failures, questions, and new relationships as we go.

In honor of Breast Cancer Awareness Month, Bread for the City is Going Pink on October 25th. We encourage everyone in our community to wear pink in honor of the survivors and remember loved ones who have fought breast cancer.

Also on October 25th, Bread for the City will be hosting its first ever Breast Cancer Awareness Brunch!

According to current studies, breast cancer affects 200,000 new women, claiming 40,000 lives each year. An estimated 1 in 8 women will develop breast cancer in their lifetime.

It is an extremely serious disease, but early detection saves thousands of lives. The average 5-year survival rate for the most common (and earliest) stage of breast cancer detected is 98.6%, while the overall survival rate is 89.1%.

Within these numbers, there is some demographic disparity in the risks of breast cancer. In D.C., the breast cancer incidence rate is almost 20% higher than the national average. The mortality rate is 16% higher. And while Caucasian women are more likely to develop breast cancer, African American women with breast cancer have a higher mortality rate. Especially in low-income communities, patients with cancer often grapple with fear and a lack of awareness of the resources that are available to them.

So we are lucky to have Etta-Cheri Washington as a part of our team here at Bread for the City.  She is the patient navigator at BFTC through Capital City Area Health Education Center and the DC Cancer Consortium. Etta-Cheri works with cancer patients and their caregivers; she helps to explain treatments, eliminate barriers, answers questions and provides support. She serves as a reassuring voice to help clients cope with their disease.

“The treatment of cancer is a complicated process — one of the hardest things to do in our healthcare system. That difficulty is even more severe for people with low literacy levels, other health complications, dealing with a system that historically lacks cultural competence,” says Etta-Cheri. “So my job as a navigator is to guide patients through the continuum of care. I help them get educated on the health care system and into a culturally appropriate medical home.”

Here at Bread for the City, Etta-Cheri works within a medical home, so she has resources to work with. “We have access to a whole range of services and resources that are essential to the health of a cancer patient. Anything from access to healthy foods and nutritional advice to legal assistance that helps people keep their housing. With those resources, we can pave a path to recovery,” says Etta-Cheri.

“For instance, I had one patient from Africa who simply could not have found her way around without guidance. Together, we found an oncologist, a culturally competent surgeon, and a facility where she would be welcomed.”

To raise awareness, the Health Resource Room and its volunteers have brought together local organizations to offer a Breast Cancer Awareness Brunch to Bread for the City. Special guests will include Cassandra Miller from the George Washington University Breast Care Center, who as a Breast Cancer Navigator will discuss the array of services available through GWU and the importance of regular mammograms and screening. Also joining us will be Toroitich Cherono from the Smith Center for Healing and the Arts. She will be talking about the different programs available through the Smith Center that are geared towards empowering individuals affected by cancer through the healing process.

Finally, a big thank you to Whole Foods Market for catering this event!

Please save the date: Join us on October 25th from 11:30am to 1:00pm for a morning of sharing and support!

One of our most active client leaders from our community, Michael Blue, approached us recently with a problem. (Michael serves on both our Client Advisory Board and our Board of Directors, so we hear from him a lot.)

For years, Michael has been a recipient of Medicaid — and so he knows that he must regularly recertify for the program. Last month, however, Michael found that his Medicaid insurance was canceled despite submitting a recertification form on time. And Michael’s not alone.

Over the past six months, Bread for the City has seen a dramatic increase in the number of patients whose Medicaid enrollments have been canceled because their recertification applications were not processed on time by the Income Maintenance Administration (the agency that manages the District’s Medicaid enrollment, among other public benefits like food stamps).

Here’s what Michael told us about his problems with Medicaid recertification at IMA:

This has been a problem that has gradually worsened over the past few years. In the past, I’d get a notice along with an application for recertification. I’d send in the completed application within the proper time, and then a few weeks later I’d get two messages in the same day. One warning me that I hadn’t yet completed my recertification, and the other saying that the recertification had been completed. And this was before things got bad.

Soon it got to the point where you’d fill out your recertification questionnaire, and all I would hear back in the mail was the notice that they hadn’t received it. So first thing in the morning I got up and went down to the Income Maintenance Administration at 645 H street NW, and there I’d find out there that they had in fact received my questionnaire.

This time around, I got no notification whatsoever. All I got was a new insurance plan booklet in the mail; so I thought that everything was okay! Mind you, this was in June. Without any warning after that, I went to pick up a prescription on August 31st, only to find out that my insurance had been canceled!

So I was without insurance for a couple weeks. And I was making calls, getting recordings that said they’d get back to me in 24 hours. I went through three of the emergency numbers that they told me to call; each one gave me a different number to call, and the last of the three? Directed me back to the first number!

So Bread for the City finally stepped in. They were able to get in touch with someone down at IMA, who cleared it up within 24 hours. That person acknowledged that they were short staffed, and admitted that it was inexcusable.

Once again, I thank God for Bread for the City. I consider myself very lucky; my worst damage is that my blood pressure went up for a few days. I’m sure there are other people out there who don’t have access to a place like Bread for the City, who aren’t so lucky, and who are having this come down on their head.

Bread for the City’s enrollment coordinator, Norma Amador, confirms that these problems are part of a real and worrisome trend: “It’s at the point where it’s easier for us to do new Medicaid applications. To just start from scratch. Then a person has to spend all day in line, and it takes another three weeks to get insurance — but it’s actually more reliable.”

Norma also points out that it takes more time for IMA to certify a new Medicaid recipient than it does to recertify one. So when recertifications are improperly processed, and people are forced to start from scratch, it only makes the problem worse. But we are increasingly directing patients down that path.

“We see many sick people who need medicine to survive but cannot afford to pay for it themselves. So this is really a matter of life and death.” Although it is possible to be restored to Medicaid retroactively, clients whose insurance has lapsed often have to reschedule doctors’ appointments and delay filling prescriptions.

Why is this happening? IMA has been subjected to an extended series of budget cuts — and we’ve blogged before about the many problems that result when the agency isn’t capable of performing its functions. At a recent meeting with public benefits advocates, the head of IMA said that Medicaid recertifications would be processed by a dedicated team starting this month. We hope this will improve the situation.

Here at Bread for the City, we’ve engaged our clients in learning about nutrition.  We’ve provided fresh produce, distributed healthy recipes and we have even taught cooking classes.  But preparing balanced meals starts at the grocery store.  While we may shop at our local grocery on a weekly basis, do we really know how to shop?

Grocery stores and food manufacturers employ tricky advertising schemes to convince us to buy a lot of items that aren’t actually good for our health. But we have it in our power to make healthy choices; we just need to be armed with knowledge.

On Tuesday, September 20th, Bread for the City’s nutrition consultant, Sharon Gruber, led a workshop through the Safeway on 5th and L, NW; it is just a 10-minute walk from our NW location. (The Giant across the street has recently closed for two years for renovation, so this Safeway is now the closest full-service grocery store for many of our clients. This new store appears to be more upscale in some ways, but the prices seem to be consistent with other area groceries.)

Despite the rain, we had the perfect sized group to facilitate a truly meaningful trip down the aisles.

The focus of the workshop was to draw client attention to advertising and merchandising strategies employed by grocers and food manufactures to lead us to buy unhealthy items. For example, grocers often place large, cheap, and unhealthy items like pyramid displays of soda cans and 2-for-1 potato chips bags at the entrance of the store.  Why is that?  Those food stuffs are inexpensive to make, and therefore, supermarkets’ profits on the sale of those items is much higher. But as a consumer, we have to be mindful that though it may be a bargain buy that day, the costs to our health may be significant.

Also, we discussed food packaging.  Although brightly colored boxes make claims like “0 grams transfat” or “whole grain,” Sharon led us through a critical consideration of the nutrition labels.  The moral of the lesson was: don’t trust the packaging!  The FDA allows companies to “round down” their contents of transfat so that the products can claim “0 grams of transfat” when, in fact, they still contain a small amount of transfat per serving. Or, a product can be marketed as “with whole grains” when only a fraction of the grains are actually whole grains.

We did find healthy foods — even ones that were on sale! We just had to look a little more closely. For example, we found healthy alternatives for crackers, soups, and meats, at the same price as the unhealthy options. If we have the willingness to spend a few extra minutes in the store on our next grocery run, we’ll surely find the items that fit our budget and support our diets.

Participants helped guide the discussion, asking Sharon to talk about certain concerns such as produce that can help lower blood pressure, as well as how to pick out a healthy prepared soup.  We all shared recipes and preparation techniques on the spot.

I hope you’ll join us on our next nutrition workshop on-site at the grocery store.  The perks begin with a $10 gift certificate for participants to buy healthy food — and continue on as we become informed consumers that can’t be tricked by marketing campaigns.  Health is the priority!

Did you know that Bread for the City’s lawyers assist people who are struggling with family law issues?

Much of Bread for the City’s legal practice focuses on housing law (defending tenants’ rights) or public benefits (helping people secure food stamps, Social Security disability benefits, etc). Our family law practice is now growing, too!

Our Family Law team provides help to low-income D.C. residents struggling with family issues like domestic violence, divorce, and child custody. This summer, Bread for the City’s legal clinic brought on our eleventh full-time staff attorney: Vanessa Batters-Thompson, who has joined us to work on our new Child Support Project.

People in DC’s child support court are in particular need of legal services. When child support is properly implemented, it can drastically improve the quality of life for the children it impacts. In addition to helping lift families out of poverty, studies show that children who receive financial support often show improvement developmentally and academically. Additionally, parents who owe child support are more likely to be involved in the child’s life when they are able to comply with the court order.  Courts, therefore, have an interest in setting child support orders at a reasonable and manageable level.

Unfortunately, our legal system often results in flawed child support orders that can make difficult situations worse. Obligations are often set too low or too high because parents’ difficulty in navigating the legal system prevents them from sharing important facts and legal arguments with the court.

In response, Bread for the City has partnered with the Legal Aid Society of DC to start the Child Support Court-Based Legal Services Project — which is where Vanessa comes in.

This new project builds off of the success of our similar Landlord Tenant Court-Based Legal Services Project. Both projects place our attorneys on site in court, where they can provide same-day representation to those facing serious legal matters.

That enables us to help more people like Mr. B.

Mr. B was in court as a result of his inability to pay child support.  While he had been reliably paying $400 a month, he was laid off from his job.  Mr. B told the child support agency that he lost his position, but he was not aware that he also needed to file a motion with the court asking for a reduction until he found another job.  In addition to unnecessarily accruing substantial arrearages, Mr. B was now facing jail time for not complying with an unmodified court order.

Vanessa was able to represent Mr. B in his hearing and get his support payment reduced to an amount he could pay until he finds a job. As a result, Mr. B made his payment on the spot.

Bread for the City is excited about expanding our family law services to help clients like Mr. B and countless others.  Through this Project, we will have more resources to increase access to justice for parents, improve the operation of the child support court and, ultimately, ensure DC’s families receive the necessary support they deserve.