• Election 2014: Women's Rights in the Balance

    Oct 30, 2014Andrea Flynn

    As the election approaches, a number of close-call races could have disparate impact on women. This piece is the overview in our Election 2014: Women's Rights in the Balance series. The state-by-state analyses, to be published over the course of Thursday, October 30 and Friday, October 31, can be found here.

    As the election approaches, a number of close-call races could have disparate impact on women. This piece is the overview in our Election 2014: Women's Rights in the Balance series. The state-by-state analyses, to be published over the course of Thursday, October 30 and Friday, October 31, can be found here.

    Pundits have long anticipated that women voters would be the deciding factor in many of the midterm races across the United States. This seems only fitting, given that the outcome of many of this year’s races will shape policies and programs that have a disproportionate impact on women's health, economic security, and overall wellbeing. From birth control to fair pay to food stamps, there is a lot at stake, both at the national and state level.

    With the elections less than a week away, control of the Senate is a tossup (and, according to a number of polls, that’s being generous to the Democrats). What if the Republicans gain a majority? For starters, it would certainly make it more difficult to advance proactive legislation on health access, reproductive and sexual health and rights, gun violence, safety net funding, and financial regulations, among other issues.

    Even with the current Democratic majority, getting legislation passed has been a herculean effort. Remember a year ago when the federal government shut down for two weeks because of the GOP’s disdain for the Affordable Care Act (ACA), and specifically its requirement that insurance companies pay for birth control? If lawmakers can’t do the job of keeping open the very government that employs them, it’s hardly surprising they can’t find a legislative fix to the Hobby Lobby ruling. The “Not My Bosses Business Act” – introduced by Senators Patty Murray (D-WA) and Mark Udall (D-CO) in the wake of this summer’s Supreme Court decision – would have restored the ACA requirement that employer-based health plans cover all FDA-approved methods of contraception. But Republicans filibustered the vote, Democrats fell four votes shy of breaking the filibuster, and the bill met a swift end. Nothing about the fate of this bill – or many others like it – was surprising given the complete intransigence that has come to characterize Washington.

    A more conservative Senate will mean even more attempts to reduce non-defense discretionary spending while concerns about ISIS, Russia, and other national security issues drive up the Pentagon budget. It will mean greater efforts to shrink the social safety net, to keep financial regulations at bay, to restrict reproductive health access, and to dismantle the ACA, President Obama’s crowning political achievement. As Politico pointed out recently, it’s nearly impossible for Republicans to completely repeal the ACA. But they would certainly try to overturn the law’s most vulnerable components or use appropriations and reconciliation battles to eviscerate it. And Republicans would use their strengthened political muscle to push for other measures that have been sidelined under Democratic control. Senate Minority leader Mitch McConnell has promised to push for a 20-week abortion ban if Republicans gain control of the Senate, and there would surely be more where that came from.

    Of course, President Obama would veto any legislation that undermines his own policy priorities, but it remains to be seen how much political capital he would need to spend – and what he would be asked to give up – in order to stay the course. Funding for Planned Parenthood in exchange for the employer mandate? Federal protections for contraceptive access in order to pay for essential safety programs like food stamps? Reducing funding for Medicaid expansion in order to authorize a funding extension for the Children’s Health Insurance Program?

    Meanwhile, because of the gridlock in federal politics, states have become an increasingly important battleground for both parties to test and advance their priorities, particularly those that relate to critical – and often controversial – social issues. Each party has seen wins thanks to the shifting focus to the states. Look no further than the historic gains in LGBT rights on the one hand, and the significant restrictions in abortion access on the other, that have swept the country in recent years. This election will determine the path states will take in a number of other important areas: Medicaid expansion, abortion and family planning access, safety net programs, fair and equal pay, and paid sick and family leave.

    To more deeply explore what the midterm elections will mean for women and families, the Roosevelt Institute is releasing a series of articles that examine where the candidates in a number of “close-call” states stand on the issues. Many of these articles were researched by and co-written with students from these states involved with Roosevelt’s Campus Network, the nation’s largest student policy think tank. Our hope is that these pieces will help voters and advocates assess the pressing health and socioeconomic challenges women face in states across the country, and to illustrate where each candidate stands on policies that will have a disproportionate impact on women and their families. 

    Read the state-by-state analyses in this series, to be published over the course of Thursday, October 30 and Friday, October 31, here.

    Andrea Flynn is a Fellow at the Roosevelt Institute. Follow her on Twitter @dreaflynn.

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  • We Need Pretrial Detention Reform in Massachusetts

    Oct 29, 2014Jessica Morris

    Alternatives to bail won't just reduce overcrowding in jails: they will create a more just justice system.

    Alternatives to bail won't just reduce overcrowding in jails: they will create a more just justice system.

    There is a bill pending in the Massachusetts House Committee on Ways and Means to build a bail jail in Middlesex County. Led by Representative Kay Khan (D-Newton), H.1434 proposes for a new facility for women charged of a crime and awaiting trial. This jail is not for convicted prisoners, but for women who are charged with violent and nonviolent crimes and cannot afford bail.

    Three states away in New Jersey, residents are preparing to vote on Ballot Question Number 1, a bail reform legislation, in this November’s election. Signed by Governor Chris Christie (R-NJ), this policy states that dangerous suspects can be held in jail without bail, while non-dangerous suspects can be released through alternatives to bail. Both of these states attempt to tackle the overcrowding issue in jails, but New Jersey’s legislation will alleviate this issue through a long-term and humanizing solution. New Jersey has shown that bail reform is a bipartisan issue that can only be solved through intentional policy.

    Massachusetts can learn from New Jersey’s responsible approach. There has been a growth of pre-trial detention in the state. From 2005 to 2014, pre-trial detainees in Massachusetts Department of Correction custody increased by 23 percent. This growth of pre-trial detention significantly impacts women. 34 percent of total female inmates in Massachusetts's jurisdiction this year are awaiting trial, but only 3 percent of total male inmates. Most women awaiting trial in Massachusetts are not able to make bail (80 percent cannot make bail of $2,000 or less and a third cannot make $500 or less). Many need services – not to be in jails. Two-thirds of the women in Massachusetts state prison have a diagnosed mental illness and half of them use psychotropic drugs. Prisons, such as the bail jail proposed in Middlesex County, can exacerbate mental illness when the women truly only need proper substance abuse and mental health treatments.

    A study by the Pretrial Justice Institute shows that judges are inclined to assign harsher punishments to pretrial detainees than to those who are able to make bail. Thus, a person’s credibility is determined by money, no matter the verdict. Those who can afford to pay their bail do not undergo the ramifications of being in jail. They are able to continue supporting their families or continue their education. If they cannot afford bail, however, they have to go through the obstacles of pausing their lives and are more likely to commit recidivism; pretrial detainees are six times more likely to return to jail because of the challenges they face once released.

    States such as Colorado, Delaware, Kentucky, Maine, Ohio, Virginia, and possibly soon New Jersey have reformed their pretrial systems. Massachusetts needs to join them. Facilities across the state of Massachusetts are overcrowded by up to 155 percent, and this could be alleviated by using electronic monitoring as an alternative to incarceration. New Jersey’s proposed legislation does this by having bail depend on risk and not whether someone can afford to pay to get out of jail. A judge will only present bail as a last resort if electronic monitoring might not assure the defendant's appearance at their trial or if he or she is believed to pose a threat to public safety.

    Massachusetts has the political will to take the same path as New Jersey and reform its system. Through legislation similar to New Jersey’s bail reform, pretrial detainees charged with nonviolent crimes should be enrolled in an electronic monitoring program instead of entering a facility. There is a high financial cost for the state and social cost for defendants of having people await trials in jails. An electronic monitoring program is cheaper on both fronts. Defendants would have the ability to return to their lives fully and freely until they are tried. The idea of innocent until proven guilty is currently obsolete in Massachusetts because of the bail system, but it can be restored through reform that ensures liberty prior to trials.

    Jessica Morris is the Roosevelt Institute | Campus Network Senior Fellow for Equal Justice. She studies politics and gender studies at Mount Holyoke College.

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  • California Community Colleges Building the Workforce of Tomorrow

    Oct 29, 2014Rachel Kanakaole

    A new program offering career-focused bachelor's degrees at California Community Colleges could begin to shift the combined higher education and employment crises in the state.

    "Education is the key to unlock the golden door of freedom." George Washington Carver

    A new program offering career-focused bachelor's degrees at California Community Colleges could begin to shift the combined higher education and employment crises in the state.

    "Education is the key to unlock the golden door of freedom." George Washington Carver

    Living in a society where possessing a college degree is key to securing a well-paying job, the opportunity and access to obtain those degrees is crucial. As students strive to build a better standard of living for themselves and their communities, policy makers and higher education advocates have been stuck with the strenuous task of finding more creative and impactful solutions to educating people. In an era of high demand yet seemingly limited supply, class offerings at the university level in California have become increasingly scarce, leaving it to community colleges to increase their role in educating the workforce of tomorrow.

    Historically, community colleges are known for offering two-year degrees and certificate programs to students who are looking to quickly enter the workforce. While there is a transfer student population planning to transition to a four-year university, that is not their widely known purpose, at least not in California. According to the Vision Statement posted on the website of the California Community Colleges Chancellor's Office, community colleges are designed to "provide access to lifelong learning for all citizens and create a skilled, progressive workforce to advance the state’s interests." In the advancement of this mission statement, Governor Jerry Brown has just signed into law a pilot program allowing certain community colleges to offer a bachelor's degree program for courses not currently offered at the California State University (CSU) or University of California (UC) level.

    Senate Bill 850, drafted by Senator Marty Block from San Diego calls for selected districts to develop a pilot program to offer a bachelor's degree program beginning in the 2017-2018 school year, and ending in 2022-2023. It is the intention of the pilot program to offer degrees in courses not otherwise available at traditional four-year institutions, focusing on more direct, career-driven programs such as dental hygiene or radiology. According to the text of the bill itself, the intention is "to produce more professionals in health, biotechnology, public safety, and other in-demand fields." Advocates of the bill stress that the pilot program is not trying to compete with the UC or CSU systems, which is why it was tailored to specific fields. In an attempt to keep costs affordable for students, pricing for classes in the program are capped at the rates offered by CSUs. Also, in order to prevent money from the Board of Governors (BOG) waiver from being shifted away from students still obtaining the traditional two-year degrees and certificates, the bill calls for students enrolling in the pilot program to apply for a Free Federal Financial Aid Application or California Dream Act application in lieu of a BOG waiver.

    The most promising aspect of this bill is its mission to fill the gap between employers who need workers, and workers who need employers to provide jobs. It is specifically outlined in the bill that districts must "identify and document unmet workforce needs in the subject area of the baccalaureate degree to be offered and offer a baccalaureate degree at a campus in a subject area with unmet workforce needs in the local community or region of the district." The districts have an added responsibility to strategically plan which BA programs to offer in order to most beneficially serve the surrounding community. While we won't know the impact this law will have on California Community Colleges just yet, considering the fact it passed with a unanimous vote, the least we can say is our representatives believe there is some positive change to be made.

    While this program is nothing brand-new, with colleges in twenty-one other states already offering BA degrees in similar areas described in the bill, it is new to California, and has the potential to begin to shift the dynamic regarding education and workforce needs across the state. Florida is a great example of a state that allows community colleges to offer BA degrees. Educators in Florida saw enrollment in community college BA programs quadruple in a period of five years. Currently, twenty-five of their twenty-eight community colleges offer BA degree programs. This just goes to show, while SB 850 is by no means the end-all solution to the crisis affecting the higher education or employment systems in California, it is a step forward in the direction of progress for students and workers everywhere.

    Rachel Kanakaole is the Chapter Head of the San Bernardino Valley Community College chapter of the Roosevelt Institute | Campus Network and one of the New Chapters Coordinator for the Western Region.

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  • Threat of Ebola Highlights Problems in the U.S. Public Health System

    Oct 15, 2014Emily Cerciello

    It is likely that Ebola will be contained in the United States, but errors in Texas show we have room for improvement in responding to public health emergencies.

    It is likely that Ebola will be contained in the United States, but errors in Texas show we have room for improvement in responding to public health emergencies.

    On October 15, the second case of Ebola transmitted in the United States was confirmed in Texas between patient Thomas Eric Duncan and a health worker. Even more frightening, perhaps, is the sequence of events leading up to the transmission, and the many questions it generates about the preparedness of the U.S. in responding to public health emergencies.

    Six days after Duncan arrived in the United States  – having passed a screening for fever at a Liberian airport – his symptoms progressed and he sought care at a Texas hospital, where he was promptly sent home with antibiotics.

    The hospital claimed his early discharge was the fault of the electronic health record (EHR) for not communicating the patient’s travel history, but soon issued a correction saying his history was “available to the full care team…there was no flaw in the EHR.”

    No matter who or what is at fault for letting Duncan fall through the cracks, we cannot let this huge breach in protocol happen again.

    More than a week later, and several days after the patient was confirmed to have Ebola, the apartment at which he was staying with four individuals remained unsterilized. The quarantined family had the responsibility of arranging clean bedding until a waste management company agreed to clean the apartment. When they arrived, contractors wore no protective equipment and used power washers to sanitize – a practice which is likely not the most effective method of treating infectious surfaces.

    And then, on October 12, the CDC confirmed that a nurse who had worn full protective gear while treating Duncan had contracted Ebola due to a yet unknown breach in protocol. On, October 15, another nurse who treated Duncan was confirmed to have the virus, showing symptoms just one day after boarding a commercial flight returning from Cleveland to Dallas.

    These events point to several issues in the U.S. public health infrastructure: who is in charge when high-stakes infectious diseases spread? How should the U.S. prevent diseases originating in other countries? What can we learn from this case to prevent other errors in the system?

    First, we need to decide who, or which agency, is in charge when a public health emergency occurs. Larry Copeland, a reporter at USA Todayagrees. Currently, the CDC provides assistance and guidelines to states and educates providers about how to prepare for Ebola. The choice to enact these protocols and successful operation of these procedures remains with the states. The CDC also issues guidelines to prohibit practitioners who have treated Ebola patients from boarding commercial flights. Separately, the Department of Homeland Security controls issues of air travel, including providing guidance to airlines and calling for symptom screenings at high-profile airports.

    So there is no single entity leading the public health response to Ebola. While the CDC may fall into this role, it is up to individual hospitals and practitioners to respond promptly and effectively. Unfortunately, in Texas, several errors – including sending the patient home while infected, delaying sanitation of the patient's apartment, and developing two more confirmed cases – showcase how disorganization in public health can lead to unfavorable outcomes.

    And how should the U.S. prevent diseases originating in other countries? Experts agree that closing borders of West African countries would worsen the crisis. Unfortunately, the issue of Ebola as it relates to air travel has become politicized by conservatives, prompting CDC Director Tom Frieden to speak out strongly against a travel banConservative Republicans have even attempted to relate Ebola to anti-immigration reform by claiming that migrants from Central America could bring Ebola through the southern U.S. border (despite the fact that no outbreak of Ebola has ever occurred in Latin America).

    In a press conference, Dr. Frieden assured that strong core public health functions could stop the spread of Ebola. Although the CDC and public health workers successfully tracked close contacts of Duncan and isolated those at high risk, those steps could not stop the first incorrect diagnosis or the spread to front-line health workers – arguably the most important role in stopping the epidemic.

    The implications of public health slipups cannot be understated. We need to start a conversation about the relationship between federal, state and local public health authorities. We need to simplify and communicate protocols to hospitals and ensure that providers and communities are enacting preparations for infectious diseases. Valuing the field of public health as much as we do individual appointment-based care is essential to stopping an epidemic. We need to organize authority and mobilize an informed and efficient workforce to improve the preparedness of the U.S. health system in responding to public health emergencies.

    Emily Cerciello is the Roosevelt Institute | Campus Network Senior Fellow for Health Care, and a senior at the University of North Carolina at Chapel Hill.

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