Tag Community Perspectives

Guest Blog By: Dr. Matt Cox

Two facts to start with:

1. At the end of July, the CDC forecasted that the rate of COVID deaths is going to accelerate over the next month (at least).
2. 2020 marks the 50^th anniversary of the Clean Air Act.

We’re in the middle of a global pandemic, with a respiratory virus wreaking havoc on the American population and its economy. The human toll continues to grow in many communities, cities, and states; deaths and hospitalizations are up, to say nothing of the impacts of social isolation, quarantines, and the recession.

How is that connected to the passage of one of America’s most important environmental laws? Simply put, if the Clean Air Act had never been passed, these COVID outcomes would almost certainly be much worse.

In 2011, the EPA projected that the Clean Air Act would help the country dodge 200,000 heart attacks and 230,000 premature deaths this year, although I’m pretty sure they didn’t factor “global pandemic” into their model.

Economists, engineers, and policy analysts have estimated the human damage wrought by air pollution, coming in with a price tag over $750 billion a year, or about 5% of US GDP.

These costs are almost entirely the result of the impact on public health – lost workdays, heart attacks, strokes, and premature deaths. How many COVID deaths would not have occurred if we had better air quality? Unfortunately, our air quality has recently been getting worse, impacting about half of the US population.

One focus of my organization is trying to improve outcomes across the country, community by community, city by city, state by state, by working on energy and environmental policy. Energy consumption is a major cause of air pollution across this country, and the impacts are not randomly distributed. Where you live and what you live in are major drivers of energy costs, and systemic racism in the American context has led to frontline communities bearing the brunt of these costs.

This is not new in American life – the environmental justice movement started in a rural county of North Carolina in the early 80s. These concerns are increasingly studied through energy burdens – the percent of household income spent on energy bills.

Structural and systemic causes drive low-income and communities of color to face higher barriers to accessing opportunities to alleviate high utility burdens [1] [2] [3], including low wages, the wealth gap, and other financial barriers [4], historical governmental policies such as redlining [5], housing quality [6], and even higher costs for energy-efficient equipment from neighborhood retailers [7]. Utility bills are also the most commonly-cited reason that people turn to short-term loan products, contributing to chronic poverty in the United States [8]. And ultimately, this circles back to health again – in addition to the toll on mental health such levels of stress can have, a fifth of American households report skipping a meal or not filling a prescription in order to keep the lights on.

So that’s a lot of doom and gloom. What do we do about it? Clean energy has a lot to offer this conversation and demonstrates how so much of this is tied together. From 2016 through 2019, we were asked to assess the public health impact of one of the most impactful energy efficiency programs of the past decade – the Atlanta Better Buildings Challenge. We utilized our AI-enabled modeling of the US energy system to assess the impacts, and the results were eye-opening.

This voluntary program in Atlanta, Georgia, had public health benefits as far away as Maine and Minnesota, and in 2017, the biggest beneficiary of the whole effort wasn’t even Atlanta – it was Birmingham, Alabama! The effort had also added jobs to the city and grown the economy.

We’ve also done recent studies of full-on clean energy transitions in states with significant Appalachian footprints – North Carolina (cool video summary) and Virginia. In North Carolina, a big push would save folks $100 a year, create over 100,000 jobs, reduce every major pollutant, and in the process reduce missed work days by 255 YEARS while saving 1200 lives. In Virginia, we showed that a transition to a fully-decarbonized power sector would save Virginians over $3.5 billion in health costs, while also saving households thousands of dollars on energy bills and being an overall cost-effective strategy. This message was ultimately compelling enough that it became state law in early 2020, when Governor Northam signed the Virginia Clean Economy Act.

There’s plenty to be optimistic about because we have the tools and the knowledge to make things better. There’s also plenty to be aware of, because there’s so much work to do to capture those opportunities to make a better world. Making the world more just in terms of health outcomes, clean energy, and many other areas can be a massive win-win…if we muster the political and economic will to bring it into being.

To learn more about Greenlink Analytics, please click on their logo to visit their website, or on any of their social media links

References

[1] Ross, L., A. Drehobl, and B. Stickles. 2018. The High Cost of Energy in Rural America: Household Energy Burdens and Opportunities for Energy Efficiency. Washington, DC: ACEEE. www.aceee.org/research-report/u1806.

[2] Jessel, S., S. Sawyer, and D. Hernández. 2019. “Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature.” Frontiers Public Health 7: 356. www.ncbi.nlm.nih.gov/pmc/articles/PMC6920209/.

[3] Berry, C., C. Hronis, and M. Woodward. 2018. “Who’s Energy Insecure? You Might be Surprised.” In Proceedings of the ACEEE 2018 Summary Study on Energy Efficiency in Buildings, 13: 1–14.

[4] Jargowsky, P. 2015. Architecture of Segregation: Civil Unrest, the Concentration of Poverty, and Public Policy. New York and Rutgers-Camden: Century Foundation, and Center for Urban Research and Education. apps.tcf.org/architecture-of-segregation.

[5] Rothstein, R. 2017. The Color of Law: A Forgotten History of How Our Government Segregated America. Liveright Publishing.

[6] Bednar, D., T. Reames, and G. Keoleian. 2017. “The Intersection of Energy Justice: Modeling the Spatial, Racial/Ethnic and Socioeconomic Patterns of Urban Residential Heating Consumption and Efficiency in Detroit, Michigan.” Energy and Buildings 143: 25–34. doi.org/10.1016/j.enbuild.2017.03.028.

[7] Reames, T., M. Reiner, M. Stacey. 2018. “An incandescent truth: Disparities in energy-efficient lighting availability and prices in an urban U.S. county.” Applied Energy Vol 218. doi.org/10.1016/j.apenergy.2018.02.143.

[8] Levy, R. and J. Sledge. 2012. A Complex Portrait: An Examination of Small-Dollar Credit Consumers. Chicago. Center for Financial Services Innovation.

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

By: Marcus J. Hopkins

In March of this year (2020, in case this is being read in some post-apocalyptic hellscape where Internet access has finally been restored), I attended a conference in Raleigh, NC, along with CEG’s Founder & Executive Director, A. Toni Young. The day before we got on the plane, we both conferred over the phone:

 “So…have you heard anything about this conference being cancelled,” asked Toni.

“Nope, which actually surprises me, given that this is a conference about preventing the spread of infectious disease among People Who Inject Drugs (PWIDs),” I relied.

“Well, you’re still going, right?”

“Unless you tell me that we shouldn’t go, I plan on being there,” I hedged.

“I’ll see you, tomorrow.”

By the day the conference was scheduled to end, the organizers had fundamentally changed the final day’s activity to discuss COVID-19, and the fact that many of us were headed back to states where the public health infrastructures were not prepared to deal with a pandemic outbreak – Kentucky, North Carolina, Tennessee, Virginia, and West Virginia. Outside of the handful of urban areas, once you get outside the suburbs, access to healthcare in Appalachia becomes not only scarce, but virtually non-existent.

But our discussions on that final day weren’t about the spread of COVID-19, itself, but how potential shutdowns were going to impact the lives of those whom our organizations were committed to serving.

When looking at rural and suburban areas where opioid (and occasionally meth) addiction is high, there are certain factors that tend to coalesce to create an environment ripe for the growth of addiction: lower incomes, higher rates of unemployment, areas where industries have left, lower levels of educational attainment, less access to economic resources, and areas where industries that require hard labor are the drivers of the economy (Office of Disease Prevention & Health Promotion, 2020).

Those factors essentially are Appalachia.

An economy built upon hard labor? Coal mining, logging, and agriculture.

Areas where industries have left? Coal mining’s not quite dead, yet, but it’s been dying for decades, and the fossil fuel industry’s hold on this part of the country is lessening, every day.

Lower levels of educational attainment? For the percentage of residents reporting less than high school completion, Kentucky (15.5%), Tennessee (14.2%), and West Virginia (14.4%) all have percentages of their population higher than the national average (13.1%) (Appalachia Regional Advisory Committee, 2016).

Less access to economic resources? Most of Appalachia is typified by bucolic scenery, the majority of which is geographically isolating.

Lower incomes? While the national poverty rate is 15.6%, the combined Appalachian regions of Alabama, Kentucky, Tennessee, Virinia, and West Virginia is 19.7% (Federation of Appalachian Housing Enterprises, n.d.).

When I brought my last partner, a born and bred Los Angeleno, to West Virginia to visit family over the holidays, in 2010, we drove up from Tennessee, through Virginia and West Virginia, to get to Morgantown. Along the way, he got an education in what “poverty” means, in Appalachia, versus Southern California.

For him, his perception of poverty existed in an urban desert: rundown apartment complexes, neighborhoods whose shopfronts were mostly boarded up or empty, and food being bought from “liquor stores,” because grocers had long since departed the area.

While driving through Preston County, WV, he turned to me and asked in horror, “Is that a shack?!”

“No…that’s someone’s home, and they likely have neither electricity, nor running water.”

Many of the clients served by 501(c)(3) organizations, Community-Based Organizations, and other non-profits in Appalachia live in these kinds of conditions. Whenever I go to conferences on HIV, Viral Hepatitis, and other infectious diseases, I keep trying to explain to people that the numbers coming out of West Virginia (e.g. – the highest rates of new Hepatitis B and Hepatitis C infectious in the U.S. per 100,000) are only a fraction of the story.

Because of the geographically isolated nature of Appalachia, there are tens of thousands of residents who are not reached for testing, alone, much less treatment. This is where small, community-based organizations – Rural Health Service Providers (RHSPs) – come into play. They serve as the links that get isolated populations to services, or, in most cases, take those services to the isolated.

So, when shutdown protocols were being announced, we immediately predicted two outcomes:

1. Feelings of social isolation would increase, driving many people to overindulge in drugs, thus increasing the number and rate of overdose deaths;
2. Delivering services to these people would become both more vital, and more difficult to achieve, as the delivery model largely depends upon isolated people coming to more central areas to access services (meaning that house calls would become necessary.

Though both predictions came to fruition – overdose deaths did increase, particularly in Appalachia – the second issue has proven to be the most difficult to overcome.

The issue that exists, for many of these small groups, is that their entire operations often rely upon both volunteers, and individual donations, meaning that there are no consistent sources of revenue. A lot of these organizations are put together by local people doing their best to bring resources to local residents, and they all have day jobs. In the past month, I received an E-mail from one of these organizers asking for a personal donation; another organizer told us that her group received a grant of $350 to purchase supplies.

$350 is awesome, but it falls extremely short of what is needed to combat the problem.

Moreover, while the people who organize these groups have hearts full to bursting and are dedicated to their missions, what they often lack are the kinds of resources they need to apply for and receive private and federal grant monies that could support their organizations.

Whenever federal funds are allocated for use in “rural health,” they are almost instantly gobbled up by Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Look-a-Like (LALs) who have staff members whose jobs are dedicated to finding, applying for, and receiving grants.

So, how do these organizations compete?

Right now, they largely don’t, and that is a serious problem that CEG, along with TruEvolution, Inc. (Riverside, CA), is trying to address.

In the coming month, we will be unveiling a new national project that is aiming to create a way for these organizations to access federal, state, and local funds that would allow them to build, repair, expand, modernize, and mobilize their operations to meet clients and patients where they live, rather than expecting them to travel to urban areas to access services.

That’s all I can say, right now, but look forward to this unveiling in the coming weeks, because I think this one has a lot of great potential.

References

Appalachia Region Advisory Committee. (2016, October). Identifying and Addressing Regional Education Needs, Figure 1. Educational attainment by state, 2014. A-1. Washington, DC: United States Department of Education: Appalachia Regional Advisory Committee. Retrieved from: https://www2.ed.gov/about/bdscomm/list/rac/appalachian-region.pdf

Federation of Appalachian Housing Enterprises. (n.d.) Appalachian Poverty. Berea, KY: Federation of Appalachian Housing Enterprises: Appalachian Poverty. Retrieved from: https://fahe.org/appalachian-poverty/

Office of Disease Prevention and Health Promotion. (2020). Substance Abuse Across the Life Stages. Washington, DC: United States Department of Health and Human Services: Office of Disease Prevention and Health Promotion: Leading Health Indicators: 2020 LHI Topics: Substance Abuse: Life Stages & Determinants. Retrieved from: https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Substance-Abuse/determinants

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

Guest Blog By: Alphonso David
(Reprinted with permission from The Root)

When black people and our allies take to the streets tonight in protest—as we have on previous nights past and as we will on nights to come—we will be calling for justice. Justice for our community means justice for George Floyd. Justice for our community means justice for Breonna Taylor. And justice for our community means justice for Brianna “BB” Hill, because when we declare Black Lives Matter, we also mean Black Trans Lives Matter.

You are not alone if you do not know the name Brianna “BB” Hill, but you should. She was a black transgender woman killed months before George Floyd’s horrific murder sent thousands into the street in righteous protest.

A community leader in Kansas City, where BB lived, said of BB, “When BB was in the room, there was no mistake.” She was a beloved member of the Dior Family in the local ballroom scene, “a firecracker,” and a passionate fan of Kansas City football. And like so many black transgender women trying to survive in a system structured against them at every turn, BB grappled with homelessness and poverty.

On May 24, 2019, two Kansas City police officers assaulted BB. In a video recorded by a concerned bystander, Officer Matthew Brummett slams her face to the sidewalk before dropping his knee onto her neck and right shoulder as she cries out in pain. In spite of the video, it took a year for charges to be brought against the officers.

But for BB, it was too late. On October 26, 2019, BB was shot and killed. She was one of at least 26 transgender and gender nonconforming people killed in the United States in 2019, the majority of whom were Black transgender women.

Since 2013, when the Human Rights Campaign began tracking this data, we have seen at least 172 transgender and gender nonconforming people violently killed in the United States. Seventy-three percent of these individuals were black. Since March 28 of this year alone, we have seen seven violent deaths of transgender and gender nonconforming people in the United States, constituting the second-highest spike the Human Rights Campaign has ever tracked. This horrific spike in violence is disturbing and particularly so, given that they all occurred during a period of quarantine and curfew. Just last week, Tony McDade, a black transgender man in Florida, was shot by the police.

These numbers are more than just statistics. Behind these numbers are real people who left behind loved ones and dreams for the future. Tragically, there are more deaths we don’t know because these deaths are all too often unreported due to a variety of factors, including inaccuracy and indifference by law enforcement, the media and the victim’s family.

In this moment of reckoning, as so many across the nation are demanding an end to white supremacy and the toxic complicity and indifference it feeds off of, we must remember that when we declare Black Lives Matter, we also mean Black Trans Lives. No person going forward can be indifferent to the cost of our racist systems on the black minds and bodies that are brutalized or the black lives that are shattered every day. And this challenge to confront indifference includes, by necessity, our black transgender, non-binary and gender non-conforming siblings.

It is a shameful fact that for too long the LGBTQ movement has not done enough to protect, empower and listen to the transgender community—particularly those who are black and brown. Last year, a few weeks after I joined the Human Rights Campaign and before COVID-19 shut down much of the country, I embarked on a listening tour to hear directly from community leaders. Trans leaders of color told me of the violence, harassment, discrimination and utter indifference they faced. They told me how they had been treated as disposable by those who were supposed to be protecting their interests. These advocates made it clear that both our movement and our nation had failed them.

This heartbreaking reality is compounded by the fact that our movement simply would not exist as we know it without transgender and gender non-conforming women of color. It was Marsha P. Johnson, Sylvia Rivera, Stormé DeLarverie, Miss Major Griffin-Gracy and countless others who refused to bow before police brutality and oppression at Stonewall and changed our nation forever in the process.

The fight for liberation has always required all of us. Bayard Rustin, a close collaborator of Martin Luther King, Jr., organized the March on Washington and was a key figure in the civil rights movement. Pauli Murray, a black gender-nonconforming legal and spiritual leader, laid the intellectual groundwork that brought us that much closer to gender justice. The Black Lives Matter movement was established by leaders like Alicia Garza and Charlene Carruthers whose transformative leadership was founded in a black, queer, feminist praxis. And in this moment of crisis, there has been so much healing and hope brought by the leadership of two transgender black leaders in Minneapolis—City Council Vice President Andrea Jenkins and City Council member Phillipe Cunningham. Jenkins and Cunningham were the first and remain the only openly transgender black leaders serving elected public offices in the U.S.

The fight for liberation must go on with all of us together. As we mourn George and BB and Breonna and and Tony and Ahmaud and Nina and all the black victims of violence known and unknown, we carry them with us. We may come to the struggle from different backgrounds and carry different experiences with us—but our fight for liberation is one and the same. We are the beloved community we need. Their lives mattered. Black Trans Lives Matter. And we must never give up or be divided on these truths.

Alphonso David is president of the Human Rights Campaign. Alphonso is an accomplished and nationally recognized LGBTQ civil rights lawyer and advocate. He’s the first civil rights lawyer, the first black man and first person of color to serve as president of HRC in the organization’s 40-year history.

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Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

By: Ty Williams

“Tony McDade could have been me,” is all I keep thinking.

I still have not processed exactly what is happening in America, in 2020. For the last two weeks, I’ve watched a country that is supposed to be so free – so liberal – continually make excuses for hate, condone bigoted behavior, and allow police to act as judge, jury, and executioner.

Just like the rest of the world, I watched the fucked up video of a coward kneeling on an unarmed BLACK MAN.  No bystanders could legally help George Floyd, and the officers that should have intervened just watched. It reminded me, again, that I could have been George.

So, George was murdered on May 25^th, 2020, and the world starts to riot.

Tony McDade was murdered two days after, on May 27^th, 2020, was misgendered as “black woman,” and yet, nothing.

Even after gaining national recognition from our former President, who acknowledged Tony’s death, I still hear only two names: Breonna Taylor and George Floyd.

Let’s be clear: Breonna Taylor and George Floyd’s murders are not less important than Tony’s.

Just like Eric Garner…

Just like Oscar Grant…

Just like so many other Black individuals killed by the police.

I feel as though, when it comes to murders of LGBTQ individuals, we are often left out of the conversation.

Does the movement that is upon us, now – Black Lives Matter – require us to sacrifice our LGBTQ identities in order to support the greater call?

Why is it that the only two names you hear are George and Breonna?

I can tell you why: they are Cisgender individuals.

Even though we hate to admit it, even as black people, we pick and choose which black folx we want to support and care about.

We don’t want to talk about cultural bias, because, if we do, then we’re airing our dirty laundry.

Newsflash:

Our dirty laundry has been aired.

We have to do better.

You can’t scream, “Black lives matter,” and not mention that it was founded by members of the LGBTQ community.

But, that’s for another day.  Generational curses are real, and we, as black folx, have to do better at holding ourselves accountable.

We all should be saying, “George Floyd,” after being called to “Say His Name!”

We should all be saying. “Tony McDade,” after being called to “Say His Name!”

It is this lack of recognition that has made me very conflicted to go out and protest.

Here’s why:

What we do know from the Facebook video is that Tony was involved in an altercation, the day before his death. He stated that, when he saw the guys, again, he was going to, “…get them.”

See, there’s an old saying in the hood: “You live by the streets; you die by the streets.”

What many don’t know is that I spoke with Tony, a week before the Facebook incident – a week before Tony’s death.  He told me his story about how he’d just gotten out of prison, back in January. He was reaching out on how to transition. Little did I know, that would be the first and last conversation I would have with Tony.

May 29^th, 2020 is a day that will largely remain a mystery, and it’s something of a blur:

Media outlets reported that there was a police shooting involving a woman. The woman was a suspect in a stabbing. It took two days to realize that the woman was not a woman, but my brother, Tony McDade.

The first thing that came to my mind was, “If the media had him gendered properly, as male, would we have known it was Tony, sooner?”

Then it’s the next question: “Was he shot, because he was a suspect and a Black man, or because he gave police a reason?”

See, I know that, even if you do everything right, you still can be shot for being a Black man in America.

After I found out it was Tony, it just sparked something in me. Like…I’ve been advocating for transmen, for a few years now. I always a Black man, first; Trans, second!  Toni just confirmed what I always felt – just like Black Cis-men, Black Transmen fall victim to the same systematic oppression bullshit.

The first thing the media did was bring up Tony’s police record, just as they do with so-called “thugs” (AKA – “Black men”).  They will bring up anything negative to negate the fact that an office decided to discharge their weapon with no warning.  Florida law, of course, protects officers involved in shootings from having their names released.

I know that, when I walk I out my door, every day, the world sees a Black man, first. So, I know I could be cashing a so-called bad check, and yelling out, “I’m trans!  I can’t breathe!” damn sure isn’t going save me.

I also feel that it’s my responsibility to make sure my brother’s name is remembered and when people yell, “Black Lives Matter,” they remember Tony McDade.

Remember, Trans people are Black too.

Tony’s murder sparked so many feelings and emotions.

Feelings of knowing that I lost someone I feel as though I let down; a person who was crying out for help, but just couldn’t reach in time. The thought that I could’ve been Tony keeps popping in my head.  I know how and what it feels like to be judged.

It wasn’t until the last couple of years of my transition that I learned how to navigate as a black man. I hate how systems have placed restrictions on us.  If I say how I feel, I have to be careful because I have male privilege, but don’t be smarter than the white man.  If I don’t speak up, I’m selling out and all these other things.

I mean, where did all these rules come from?  I’m just trying to make it back home.

I don’t want to negate the fact that another life was lost, and another black man is gone too soon.

 I can’t help but to think about again the similarities Black Transmen have with Black cis men. Yet, we are all yelling, “Black Lives Matter.”

The only compromise I could come to was to have moment of silence and protest in Tony’s name on June 6^th, 2020 – the date of Tony’s funeral.

It wasn’t until I was out on the B in Washington, DC, on Black Lives Matter Plaza, where I had time to pause, look around, and see all the beautiful people coming together – all races, ages, and etc.

Not one vendor or Cis person mentioned Tony McDade. It just amazes me.

I don’t know if I’m more taken aback because Tony is a Transman, or because Tony wasn’t even considered a factor because of his background and for being Trans.

Why am stuck?  It shouldn’t be so hard to write and say how I feel, and yet…this is .

As I continue to process how I have to navigate being safe in America, I find out that my brother, Tony McDade, is gunned down by the damn police.

My fear has become reality:

A Black Transman has been killed by the police and no one gives a damn.

I said what I said.

Ty Williams is the Project Coordinator for the Community Education Group. You can follow him on his Facebook Page and Instagram by clicking on their respective icons.

CEG is a national organization that offers local programs and policy solutions.

We serving diverse populations, prioritizing indigenous populations and populations in need

CEG’s work includes Direct Service programs, Policy work, and Capacity Building

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

Guest Blog By: Katrina Harmon, Executive Director, West Virginia Child Care Association

As the African proverb so wisely states, ‘It takes a village.’  In my role as Executive Director of the WV Child Care Association (WVCCA), I’ve repeatedly witnessed the truth in this statement as I represent a village of providers serving West Virginia’s foster care youth.

In addition to providing a wide continuum of care that includes therapeutic foster care placement, adoption services, behavioral health, family-based treatment, independent and transitional living support, positive behavior support, substance abuse prevention, treatment, recovery and many, many more services, this village of providers is a voice for children who have experienced abuse, neglect, emotional and behavioral challenges, substance abuse and/or delinquency.

WVCCA’s mission is to advocate for children and families by influencing public policy, sharing member knowledge and resources, and embracing partnerships.  To grow and nurture the proverbial village, the services and partnerships within our individual communities must continually be evaluated, modified and expanded based on the needs.

Known for our perseverance and resourcefulness, West Virginians are always willing to lend a hand to their neighbors and take care of ‘their own.’   So, in West Virginia, our “villages” seem to encompass so many more contributors, and for good reason.

While the roots of addiction issues have historically run deep in Appalachia, no one was prepared for the millions of prescription pills that flooded the state between 2008 to 2017 (Eyre, 2016). From there came a transition from opioids to heroin to fentanyl, and in some regions of the state, methamphetamine. Those drugs are stronger; more lethal. Unsurprisingly, deaths from overdoses rose higher in West Virginia than in any other state (West Virginia Department of Health and Human Resources, 2017).

No one was prepared for the myriad issues that came with the flood of drug use. The crisis has taken a toll on industry, education, and the overall family structure; it contributes to violence, crime, housing, and homelessness in every city and small community across the state. While each community has experienced the crisis slightly differently, none has been left unaffected.

In May 2018, the West Virginia Department of Health & Human Resources (DHHR) reportedthat West Virginia ranked as the state with the most child removals in the U.S. 83% of open child abuse/neglect cases involved drugs (Samples, 2018).  According to the State Inpatient Databases, rates for Neonatal Abstinence Syndrome (NAS) in WV increased 284% from 2009 to 2014.  Overall, 14.3% of all WV infants were born substance exposed and 5% were diagnosed with NAS (Samples).

When comparing 2014 with 2017, there was a 46% increase in the number of youths in the custody of the state (Samples).  During that same time period, the State reported a 22% increase in accepted abuse/neglect referrals and a 34% increase in open CPS cases (Samples).  63% of the children entering care were aged 10 and younger, and 43% of the children were placed in kinship/relative placements.

Simultaneously, the State averaged a 23% vacancy rate for Child Protection Service (CPS) positions and adoptions had increased 113% since 2006 – the highest in the nation (Samples).  Growth nationally for adoptions was trending at only 6% with PA, OH, and MD seeing declines ranging from 5-28% (Children’s Bureau, n.d.).

With record numbers of children and families requiring CPS interventions due to the drug crises, and the resulting skyrocket of expenditures, the State Department began to form strategic initiatives that included efforts to:

1. improve the coordination of wrap around and other services for children and parents to mitigate number of children that need taken into state custody;
2. improve clinical oversight in order to move children into most appropriate care in least restrictive setting;
3. ensure that medical records follow a child wherever they receive services.

Additionally, in 2019, the WV State Legislature further enacted the procurement of a dedicated Managed Care Organization (MCO) in an effort to better coordinate the health care needs of the State’s foster care population (Relating to Foster Care, 2019). 

In November 2019, Aetna Better Health of West Virginia was selected to achieve the goals of streamlining the administration of health services, tailoring services to meet the needs of enrolled populations, coordinating care for members, and working to transition members from out-of-state care to community-based treatment in West Virginia. 

Simultaneously, on the federal level, West Virginia plans to become one of the first states in the country to adopt the Family First Prevention Services Act (FFPSA), as part of the Bipartisan Budget Act of 2018.

FFPSA redirects federal funds to provide services to keep children safely with their families and out of foster care, and when foster care is needed allows federal reimbursement for care in family-based settings and certain residential treatment programs for children with emotional and behavioral disturbance requiring special treatment.  Covered services will include mental health and substance abuse prevention and treatment, in-home parent skill-based programs, parent education, individual and family counseling in the home.

FFPSA further allows federal Title IV-E funds to be utilized for residential programs that serve parents with Substance Use Disorders (SUDs), their children, and allows additional investments to keep children safely with families (and kin) that lead to permanency and/or reunification, such as Kinship Navigator programs.

The Family First Prevention Act will change the way child welfare agencies work with families.  No longer will the federal government incentivize out-of-home placements by paying Title IV-E only after children are removed. The prevention services act will allow states to claim funds for providing in-home services parenting education, mental health and substance abuse services to at risk families in an effort to keep families together.

If states continue to remove children at the current rates, there will never be enough residential or foster care beds to meet the need.  Through serving more families at home, before crisis states are reached, the hope is to reduce the trauma to families and children that removal causes (Family First Act, n.d.).

During the 2020 WV Legislative Session, well-intentioned legislators once again worked to fix systems that have been broken by the drug crises, and the state’s child welfare system was once again in their focus.  The passage of the “Foster Parent Bill of Rights,” promised an additional $16.9 million to increase reimbursement rates for foster families and, for the first time, raise those rates for kinship families to be an equivalent amount.  The broad-ranging bill enumerated certain rights for foster families and foster children while also providing greater detail for the duties of guardians ad litem, who officially speak on behalf of children (HB 4092, 2020).

There’s been a lot of work done in a very short period.  Service providers, bureaucrats, legislators and many, many other stakeholders have stepped up to make change and care for one of West Virginia’s most vulnerable population – our kids.  But just fixing state systems won’t get us out of these scary times; we need to work on fixing communities and fixing the individual families within our communities. 

While the crisis continues to reveal itself in very real, tangible ways, our neighborhoods continue to develop real, tangible solutions, and they are impactful.  Local churches are initiating foster care open houses, backpack programs are springing up for food insecure students; local businesses are sponsoring after-school tutoring; local United Way programs are allocating funds towards after-school programs so kids have a safe place to hang out; teachers are opening their homes to students who need emergency placement; police officers are volunteering at summer camps for at-risk kids, because they see the needs of these kids when answering emergency calls at their homes; grandparents on limited, fixed incomes are trying to determine how to keep their grandchildren fed while learning the new technologies required for the children in their care to academically succeed; and countless parents are offering up spare bedrooms or couches to their children’s friends who have been displaced.

It really ‘takes a village.’ 

As government funding is released and disseminated, it is imperative that we ensure our front-line community stakeholders and providers get the resources they need to meaningfully respond to the specific challenges and opportunities within their area.  While successful programs can be replicated, it’s important to remember no two communities are molded exactly the same. Research shows that the people most directly affected by systemic barriers and inequities are the best positioned to drive change in their own neighborhoods.

To all those involved in making change, your acts of kindness don’t just give kids hope, they keep the spirit of your ‘village’ alive. Maybe one day, rather than telling the state’s story of the drug crisis through death rates and dying communities, we will finally be able to tell it through the acts of good people who, despite all the odds and negative statistics and stories, saved their neighborhoods with each and every small act working together to raise ‘the village.’

You can learn more about the West Virginia Child Care Association by visiting their website by clicking on their logo, below, or by Liking their Facebook page by clicking the icon below the logo.

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References

Children’s Bureau. (n.d.). Adoption Data. Washington, DC: United States Department of Health and Human Services: Administration for Children & Families: Children’s Bureau: Child Welfare Outcomes Report Data. Retrieved from: https://cwoutcomes.acf.hhs.gov/cwodatasite/adopted/index

Eyre, E. (2016a, December 17). Drug firms poured 780M painkillers into WV amid rise of overdoses. Charleston, WV: Charleston Gazette-Mail. Retrieved from: http://www.wvgazettemail.com/news-health/20161217/drug-firms-poured-780m-painkillers-into-wv-amid-rise-of-overdoses

Family First Act. (n.d.). Family First Prevention Services Act. Family First Act: About the Law. Retrieved from: https://familyfirstact.org/about-law

House Bill 4092. (2019). https://legiscan.com/WV/text/HB4092/id/2171356/West_Virginia-2020-HB4092-Enrolled.html

Relating to Foster Care, WV Code, Chapter 44. (2019). https://legiscan.com/WV/text/HB2010/id/1958217/West_Virginia-2019-HB2010-Enrolled.html

Samples, J. (2018, May). West Virginia’s Child Welfare Crisis A Path Forward. Charleston, WV: West Virginia Department of Health and Human Resources: Bureau for Public Health. Retrieved from: http://wvahc.org/wp-content/uploads/Prez-on-Child-Welfare-1.pdf

West Virginia Department of Health and Human Resources. (2017, August 17). WEST VIRGINIA DRUG OVERDOSE DEATHS HISTORICAL OVERVIEW 2001-2015. Charleston, WV: West Virginia Department of Health and Human Resources: Bureau for Public Health: Office of Epidemiology and Prevention: Outbreaks. Retrieved from: https://dhhr.wv.gov/oeps/disease/ob/documents/opioid/wv-drug-overdoses-2001_2015.pdf

CEG is a national organization that offers local programs and policy solutions.

We serving diverse populations, prioritizing indigenous populations and populations in need

CEG’s work includes Direct Service programs, Policy work, and Capacity Building

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

By: Marcus J. Hopkins

When I first tested HIV-positive, I was living in Atlanta, GA.  It was April 12^th, 2005, and I was 23 and unready to face my diagnosis.  I ignored it, for two years, in part of that unpreparedness, and in part because, at the time, the treatment recommendation was to not initiate treatment until patients were diagnosed as having AIDS, the qualification for which is having one’s CD4 cell count drop below 200 cells per mm³. 

On October 17^th, 2007, after being admitted to Broward General in Ft. Lauderdale, FL, I had them run my numbers, after ignoring them for over two years, and that CD4 count came back at 67.

It was official – I had AIDS.

Once I got a doctor and got prescribed my medications, I went to a Rite Aid with my supposedly full-coverage employer-provided insurance, only to be told that, after filling the scrip for one of my three medications, my insurance was maxed out, and I wouldn’t be able to get the drugs I desperately needed.  I’m not really a big “crier,” but at that time, I wept in a pharmacy.

Luckily, my then-partner lived with a man who would later form the ADAP Advocacy Association (aaa+) who told me about the Ryan White Act and how to get coverage for my medications.  After jumping through several hurdles, including gathering tax documents, paycheck stubs, a birth certificate, two forms of photo identification, and selling a kidney (that last one isn’t a thing), I was able to get an appointment and get approved for the AIDS Drug Assistance Program (ADAP).

I began taking meds on November 19^th, 2007, and by Valentine’s Day, 2008, my viral load (the number of actively replicating HIV virus in my blood) was undetectable, where I have remained, with the exception of two months, for over 13 years.

During that time, I have moved from Florida to Tennessee, from Tennessee to California, and from California to West Virginia, and during those moves, I encountered a unique phenomenon: HIV testing has largely failed to reach rural America.

I know, right?  It’s 2020 – nearly forty years after the Centers for Disease Control and Prevention (CDC) published the first article directly related to what was then called GRID (Gay-Related Immune Deficiency) in the June 5^th, 1981 Morbidity and Mortality Weekly Report (MMWR) – Pneumocystis Pneumonia – Los Angeles (CDC, 1981).  One would think that, after four decades, rural America would have its collective “stuff” together and be testing its population, right?

Unfortunately, no.

Both in Tennessee (specifically, Northeast Tennessee in the Appalachian Mountains), and in West Virginia, outside of the few metro areas, HIV testing has not been a priority.  For the very same reason that doctors in this part of the country told patients not to worry about getting vaccinated for Hepatitis B (HBV), people living in rural America – particularly in the geographically isolated Appalachian Mountain region – have been living under the shared illusion that their isolation has served as a good enough preventative measure against infectious diseases.  Worse, still, is that these Americans have been told that this is the case, not only by physicians who should know better, but by the people whom they elect into office.

This has been a common refrain about every epidemic in human history:

“This is a big city problem!  We don’t have to worry about heroin/meth/HBV/HCV/HIV/STDs/STIs/COVID-19, here!  Our folks are better than that!”

This prevailing theme has been proven false not just in the recent past, but over the course of millennia.  The people who believed that the rich, the politically empowered, and the men of the cloth (e.g. – priests) would never contract the plague in 14^th Century Europe are the very same people who have claimed that those of us who live in rural America don’t have to worry about the ills of urban society, because our “goodness” protects us.

Perhaps, they should go and reread accounts from the 14^th Century that depict entire monasteries filled with the bodies of the dead.  If that’s too far back for them to look, they might simply look at the recently discovered rural Plague Pit found in Lincolnshire, England on the site of a 14^th Century monastery filled with 48 bodies, including more than two-dozen children (Sharman, 2020).

Dr. Hugh Willmott, one of the workers at the Thornton Abbey archaeology dig site in rural England said this:

“The finding of a previously unknown and completely unexpected mass burial dating to this period in a quiet corner of rural Lincolnshire is thus far unique, and sheds light into the real difficulties faced by a small community ill-prepared to face such a devastating threat.” (Sharman)

This assessment of past preparedness should serve as a dark portent of things to come, not only as they related to the burgeoning rates of new HIV diagnoses directly linked to Injection Drug Use (IDU), such as West Virginia has seen in the past three years), but as it relates to another, more pressing concern: COVID-19.

Having lived in West Virginia, again, for seven years, and carrying the banner that reads: “We must begin offering opt-out testing for Viral Hepatitis and HIV to every single person at every single medical appointment, regardless of specialty” (a long, unwieldy banner to carry, to be certain), I, along with others who work in the Infectious Disease space, have been sounding the alarm about COVID-19, as well.  Sadly – and yet, unsurprisingly – I have encountered much the same mindset about COVID-19 as I did when waving the HIV testing flag: “It can’t happen, here.”

Once COVID-19 really hits rural America – particularly the geographically isolated Appalachian Mountain region (I know…I keep hammering this description home) – rural America is not ready to respond.  We do not have in place the kind of rural public health infrastructure that is necessary to effectively respond to an outbreak in rural regions.

People who travel from rural areas to the suburbs or urban areas of their state for work will contract COVID-19.  They will carry that virus back to their loved ones, at home, as well as to every person they encounter, along the way.

Once they begin to shed virus, every single point of contact becomes a potential point of infection.

Once they begin to show symptoms, they will have to travel back into the suburban and urban medical facilities for diagnosis, treatment, and, potentially, intensive care, and each person they encounter along the way has the potential to contract the virus.

This has been the course of every viral pandemic outbreak in human history.  It isn’t just a random prediction; it’s a pattern that repeats itself, every single time.  Sadly, Americans don’t seem to learn these lessons for ourselves, until someone we personally know and love dies.

WBOY 12 in Clarksburg, WV has a running tally on new cases and deaths in the state of West Virginia (here) that reported an increase of 42 cases in the state since May 23^rd, 2020 at 5:00 PM.  To most people, “42 new cases” doesn’t sound like a lot, compared to the overall population of the state.

When you think about the fact that those 42 patients will likely come into contact with at least three people (potentially creating 126 new diagnoses), and those three people will likely come into contact with at least another three people (378 more diagnoses, on top of the original 168)…like a 1980s Fabergé Organics shampoo commercial, only without the benefit of “…super fresh-smelling hair”.

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

It was these thoughts I was thinking, this morning, as I ventured to a Walmart in Grafton, West Virginia, to pick up something my mother had ordered, and saw only store employees and a handful of shoppers wearing facemasks (myself, included).

There was no social distancing; no facemasks to be found.  As I waiting to pick up my mother’s item, I listened to the haunting strains of Naked Eyes’ “Always Something There to Remind Me” and thought to myself, “I wonder if these people will remember this day as the day they contracted COVID-19.

References

Centers for Disease Control and Prevention. (1981, June 05). Pneumocystis Pneumonia — Los Angeles. Morbidity and Mortality Weekly Report, 30(21), 1-3. Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm

Sharman, J. (2020, February 19). Medieval Black Death burial site in Lincolnshire uproots previous theories about plague. London, United Kingdom: Independent Digital News & Media Limited: The Independent: News: Science: Archaeology. Retrieved from: https://www.independent.co.uk/news/science/archaeology/black-death-mass-grave-uk-lincolnshire-thornton-abbey-plague-a9344091.html

CEG is a national organization that offers local programs and policy solutions.

We serving diverse populations, prioritizing indigenous populations and populations in need

CEG’s work includes Direct Service programs, Policy work, and Capacity Building

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may be graphic due to the nature of the issues being addressed by the author.

By: A. Toni Young

I’d like to welcome readers to the first entry in CEG’s new blog, Community Perspectives.  This post will serve as a brief introduction to the purpose of this blog, and a brief explanation of why I think it’s so important to hear from people we might not otherwise encounter.

The work that CEG has done in Washington, DC, West Virginia, Australia, Mexico, and beyond has consistently focused on the underserved and unheard.  When I first started, we were the National Women and HIV/Project.  In would become the Community Education Group, back in 1994, part of what called me to service was my dear friend Stephen M. Clement – the first, but not the last, of my dear friends to parish from “The Plague”.

On one of my last visits with Stephen, a gay, white, red-headed Texan, he looked me and said, “One day, HIV is going to look more like you than me.  More women, black and brown people.”

I was a bit shocked, but he went on to say, “I would be one of your only friends in a position to pay your medical bills if you got sick.”

Most women and people of color impacted by AIDS at this time – 1992 – had few resources, organizations, or a voice in policy.

CEG’s Background

Founded in 1993 as the National Women and HIV/AIDS Project (NWAP), Community Education Group’s (CEG) focus has always been on the Black community, particularly the risks and challenges faced by Black women.  NWAP’s immediate goal was eliminating the myth that HIV only affected homosexual white males.  Broadcasting the message that everyone was at risk, the new non-profit conducted face-to-face outreach and distributed culturally conscious pamphlets and posters to other organizations and the public, nationwide.

In 1999, NWAP became the Community Education Group (CEG), as I sought to expand the organization’s efforts to better address the challenges facing my Southeast DC community.  At this time, in addition to reaching out to heterosexual men and the recently incarcerated, CEG began to focus on creating strong, innovative community-based programming and providing training and technical assistance to fellow nonprofits.  With the knowledge that the HIV/AIDS epidemic could not be stopped by only talking to women, nor by only talking about HIV, CEG became the organization most capable of offering HIV testing to the DC neighborhoods hardest hit by the HIV epidemic, best able to develop and spread health messaging in our Black community, and a leader of collaborative and capacity building efforts.

            CEG’s Organizational Mission – CEG seeks to stop the spread of HIV and eliminate health disparities in high-risk communities by training community health workers, educating and testing hard to reach populations, and sharing our expertise with other organizations through national networks and local capacity-building efforts.

Over the years, I, along with various team members, put together a number of programs aimed directly at aiding underserved communities in the DC area.  We put out media campaigns; we engaged in direct service provision in DC neighborhoods where nobody else would go; we distributed condoms, conducted HIV tests, and linked people into care using our CHAMPs (Community HIV/AIDS Mobilization Prevention Services) model, using peer-based outreach and services.  For over twenty years, CEG’s work set standards for service provision in underserved communities, and of that work I was and am immensely proud.

When I moved to West Virginia, eight years ago, my plan was to retire.  I bought a cabin, moved in with my dogs and cat, and planned to stay involved in a remote capacity, at most.  But, like most of my life stories (of which there are many), things never quite turn out the way I initially expect.

What I found in West Virginia was yet another community of underserved, unheard voices facing an HIV epidemic and, again, nobody was talking about it.  While I knew, intellectually, that rural America had cases of HIV, what I didn’t know was how deep – how hidden – the problem was.

When we talk about HIV infection rates in the South, we think of jurisdictions like Georgia, Florida, Alabama, and Texas – areas where rates of new infections are still high, and black and brown people are paying the price.  What I found in West Virginia (and Kentucky…and Ohio…and Indiana) was that a culture of “not talking about it” had led to outbreaks of Viral Hepatitis, which we were catching, and also pockets of HIV.

When the news of the outbreak in Scott County, Indiana made waves, back in 2015, I looked around West Virginia and saw the exact same circumstances, here, that made Scott County ripe for an epidemic: an area devastated by local industry job losses; high rates of physical and social isolation; high rates of Injection Drug Use and overdose deaths.  On top of all of those factors, West Virginia has almost no rural public health infrastructure in place to provide healthcare services to these people who were at high risk of an HIV outbreak.

And that’s what happened.  West Virginia saw a 13% increase in new HIV infections from 2017 to 2018, and a staggering 67.8% increase from 2018 to 2019.  In 2019, 61.6% of those newly identified cases listed Injection Drug Use as a primary risk factor for transmission (OEPS, 2020).

Unlike the outbreak in Scott County, Indiana, what didn’t happen was the kind of national and international press coverage that put Scott County on the map for HIV advocates.  Instead, little attention has been paid to West Virginians who are battling the same exigent circumstances as Scott County, but with added geographic and topographic barriers to care.

Once again, voices are not being heard.  Once again, meaningful change is not occurring, because those who have been failed by our healthcare system are being scapegoated and their voices ignored.

What’s more is that this problem isn’t specific to West Virginia – rural Americans across the United States are facing gaps in service, and despite all of the rhetoric about politicians listening to “Real Americans” when making decisions, those same politicians are happy to look the other way when it comes to adequately funding healthcare programs and infrastructure building that will serve these “Real Americans.”

This is why we have started Community Perspectives.  To give voice to people who might not otherwise be heard.  To introduce America to the people who are in the trenches our nation’s syndemic healthcare crises, whether that be Substance Use Disorder, Viral Hepatitis, Trans Health, HIV, or even access to basic utilities like running water.

Community Perspectives will feature pieces written by myself, our Policy Coordinator, Marcus J. Hopkins, and our Project Coordinator, Ty Williams.  In addition, we will be featuring voices from West Virginia and beyond, telling us their stories, and adding their Perspectives to our Community. Thank you, for continuing to be a part of Community Education Group’s community, and I hope you will follow this blog and share it with your friends, neighbors, family, and networks so that we can make these voices heard.

References

Office of Epidemiology and Prevention. (2020, May 01). HIV Diagnoses by County, West Virginia, 2018-2019 (As of May 1, 2020). Charleston, WV. West Virginia Department of Health & Human Resources: Bureau for Public Health: Office of Epidemiology & Prevention: HIV and AIDS. Retrieved from: https://oeps.wv.gov/hiv-aids/documents/data/WV_HIV_2018-2020.pdf

CEG is a national organization that offers local programs and policy solutions.

We serving diverse populations, prioritizing indigenous populations and populations in need

CEG’s work includes Direct Service programs, Policy work, and Capacity Building

Disclaimer: Blog posts on CEG’s Community Perspectives blog do not necessarily reflect the views of the Community Education Group, its grantors, its corporate sponsors, or its organizational partners, but rather they provide a neutral platform whereby each author serves to promote open, honest discussion about issues specific to their personal expertise, lived experience, and perspective. Please note that some of the content on Community Perspectives may begraphic due to the nature of the issues being addressed by the author.

Community Education Group will be launching its new blog, Community Perspectives, on May 18th, 2020.

Community Perspectives will focus on the issues that impact the work CEG does in West Virginia, nationally, and globally, and will feature weekly articles by CEG’s staff, including Founder & Executive Director, A. Toni Young, West Virginia Policy Coordinator, Marcus J. Hopkins, and Project Coordinator, Ty Williams. We will also feature one guest column each month, from people whose work creates a huge impact on the lives of the people we serve.

Check back on Monday, May 18th, 2020, for our inaugural post from our fearless leader, A. Toni Young, with new posts coming out each Monday.