CPT | Cuyahoga Politics Today:

The Cleveland Way

Yet another study has identified Cleveland as being at the bottom of the pit when it comes to quality of life. Or as the mayor might say, the b***hole of the nation. WalletHub, a financial services website, announced this week that Cleveland residents are the most stressed in the nation. We rank first — i.e., worst — when it comes to "financial stress". We have the highest divorce rate, the second highest poverty rate, and are third worst when it comes to "health and safety stress".

Had the surveyors factored in police misconduct, we'd have been a runaway winner.

Let’s cut to the chase. Making our condition worse is that the three public issues roiling the nation right now — the economy, the pandemic, and systemic inequality/police misconduct — all weigh most heavily on black people, and Cleveland is a majority black town. So black people are out of work and without financial resources, going untested and getting sick, hospitalized, and dying from coronavirus, and soon to be evicted, on the street and subject to the whims of hostile “safety” forces organized to contain the unruly and the unwanted from invading or disrupting the peace and comfort of the mostly white enclaves that circle the urban core and its first ring suburbs.

Rank these issues — we listed them alphabetically — however you want in terms of salience. They all cry out for being addressed systemically, which means elected officials need to be part of the solution.

Cuyahoga’s most prominent public officials are county executive Armond Budish and Cleveland mayor Frank Jackson. While these gentlemen have enjoyed near-unanimous establishment support, it's hard to envision two more pedestrian and disconnected chief executives. 

Budish has never embraced the idea of holding Ohio’s second-most powerful elected office — as the position was touted during debate over county reorganization in 2009. And his stature has shriveled since he so badly mismanaged the county jail in ways that contributed to a string of inmate deaths under conditions decried as “inhumane” by federal monitors. He has been effectively a lame duck for the past two year, a status unlikely to change over the next two years.

Some politicians might draw strength from being effectively immune to the voters and find courage in seizing moral high ground. Alas, Budish was characteristically timid and indecisive last Friday as he practically begged county residents to wear masks. It’s understandable that his mask edict was devoid of teeth: the county has few resources to even throw a scare into the selfish unmasked. But odds are he could have assembled several dozen area mayors to line up behind a bolder plea.

Which brings us to Frank Jackson. Frank calls me every couple of weeks, usually just before six o’clock dinnertime. His recorded voice informs me that he is about to speak to Cleveland citizens and that I should stay on the line. His tone is both intrusive and flat, so devoid of warmth and energy it’s like a declaration that he hates the imminent engagement with the people who have repeatedly voted him into office.

Frank has been either mayor or council president since the 20^th century. Whatever ambition or drive or fire he might have had in 1999 has long since dissipated. He is the Decider-in-Chief at City Hall who acts on the premise that if voters don’t like what he’s doing, they can vote him out. Short of that, don’t call or petition him with concerns about a living minimum wage, or lead abatement or budgetary concerns that money should be allocated to basic human needs instead of plush digs for corporate elites [Rocket Mortgage FieldHouse, Sherwin-Williams tax breaks].

Catering to the wishes of the political donor class might be acceptable if Clevelanders didn’t have to live with these realities: a water department that mis-bills city residents, shuts off their water, puts liens on their property, and then forecloses and kicks them out; a health department that supports a resolution declaring racism a public health crisis but is itself thoroughly indifferent to its own longstanding hospitality to that very virus; a top Jackson administration official, James McGrath, who first as police chief and then as safety director [he retired last month], tolerated and condoned, and perhaps encouraged, all manner of felonious behavior from police officers sworn to protect and serve the people.

Or, failing that, in pandemic times, say maybe every hundred years or so, calling upon those fat cat friends to say, hey, we have a problem here, can you help us out by testing a few hundred thousand people so we can try and keep as many of them alive as possible?

Cleveland is justly celebrated for being home to three of the nation’s top medical systems. The quasi-public one, MetroHealth, got millions from in COVID money from the state but has yet to figure out how to test the masses.

The other two — Cleveland Clinic and University Hospitals — are huge behemoths, owners of acres and acres of tax-exempt properties, and possess such great wealth that one might think their status as nonprofit entities meant they would step forward in times of great crisis to at least test the black and brown people who live all around them.

We don’t know if the mayor has called upon these friends in times like these. We do know they have yet to step up in any meaningful way to help those most in need. And we know that no one in City Hall — not the mayor, or any of his wannabe successors on city council — have called them out for their indifference.

As we reported this past week, a few entities — some black churches, Greater Cleveland Congregations, Neighborhood Family Practice — are trying heroically to stand in the gap. Their efforts are heroic but are dwarfed by the need.

Is there one elected official willing to call out the mighty Clinic? To be sure, they would be swiftly reminded, “that’s not the Cleveland way”.

Perhaps “the Cleveland way” is why we sit atop virtually every index of misery.

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"The pandemic recession has really only just started."

More Medicaid funding needed to survive the recession, advocates say

By Susan Tebben

File photo by Justin Sullivan/Getty Images.

After cuts to the state’s health care assistance program, Medicaid advocates are hoping a temporary federal funding increase will continue.

In May, Ohio Gov. Mike DeWine announced cuts to many state agencies, but the biggest cuts hit Medicaid and education. The budget for Medicaid was chopped by $210 million.

Much of that original cut represented savings from a lack of service due to stay-at-home orders this spring. Whether those savings can continue remains to be seen as health care services reopen.

The think tank Policy Matters, and other Medicaid advocates partnered with medical professionals on Tuesday to discuss reasons Ohio’s U.S. Senators should support funding for the program in a proposed federal stimulus bill, also known as the HEROES Act.

Participants in a virtual call said the state will need increased Medicaid funds to account for a recession that will last longer than the pandemic. 

In March, President Donald Trump signed a law that provided a temporary 6.2% increase to the Federal Medical Assistance Percentage (FMAP), the federal share of Medicaid expenditures in each state. The increase was effective Jan. 1 of this year, and is set to extend “through the last day of the calendar quarter in which the public health emergency declared by the Secretary of Health and Human Services for COVID-19…terminates,” according to a document from the federal Centers for Medicare & Medicaid Services. 

The state saw a similar temporary funding increase during the 2008 recession, but Wendy Patton, senior project director for Policy Matters, said the help ended too soon. Following the recession, significant budget cuts were made because of the abrupt end to the funding.

Because high unemployment is forecasted to last through most of 2021, Patton said the FMAP funding needs to be assured through the entire pandemic-induced recession.

The problem is that the pandemic recession has really only just started,” Patton said. “This is the kind of devastation we don’t want to see following the pandemic.”

Medical professionals say the Medicaid funding is needed not just to account for the effect of COVID-19 on health, but the impacts on mental health and even the opioid epidemic, which exists amid the pandemic and is exacerbated by it.

Pickaway County cardiologist and member of the progressive Physicians Action Network Dr. Greg Lam said there has been a rise in drug overdoses throughout the pandemic, and the stress of the public health crisis has caused a host of other issues for patients, including depression.

“We are in the medical and economic fight for our lives, and without increasing (FMAP funding) people will die, communities will suffer,” Lam said.

Children in particular are in need of the Medicaid safety net as school districts plan to bring them back to classrooms. Of the 2.6 million children living in Ohio, one in five were living in poverty before the pandemic, and with adults losing jobs and the health insurance that came with those jobs, health assistance will be a major part of keeping students safe, according to Kelly Vyzral, senior health policy associate for Children’s Defense Fund Ohio. 

“Whatever (school reopening) ends up looking like, we want them all to have the appropriate immunizations and well-checks to protect everyone’s health,” Vyzral said.

Without the immunizations, Vyzral said the state could be setting themselves up for even more public health problems, such as measles outbreaks and other diseases currently controlled by vaccines.

The group plans to reach out to U.S. Sen. Sherrod Brown and Sen. Rob Portman and urge their support of an increase in the next proposed federal stimulus bill.

Brown’s office told the Ohio Capital Journal said the senator has advocated for another increase in FMAP of 14% in HEROES Act funding and continues to push for the funding.

“The last thing Ohioans should have to worry about during an economic downturn caused by a public health crisis is losing access to health care,” Brown said in a statement.

Portman’s position is unknown, as his office had not returned a call by press time.

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This story is provided by Ohio Capital Journal, a part of States Newsroom, a national 501 (c)(3) nonprofit. See the original story here.

Racism in U.S. health care

How racism in US health system hinders care and costs lives of African Americans

By Tamika C.B. Zapolski and Ukamaka M. Oruche

Photo by Joe Raedle/Getty Images.

As the COVID-19 pandemic swept across the U.S., the virus hit African Americans disproportionately hard. African Americans are still contracting the illness – and dying from it – at rates twice as high as would be expected based on their share of the population.

In Michigan, African Americans are only 14% of the population, but account for one-third of the state’s COVID-19 cases and 40% of its deaths.

In some states the disparities are even more stark. Wisconsin and Missouri have infection and mortality rates three or more times greater than expected based on their share of the population.

Speculation has suggested these disproportions are due to several factors: African Americans are more likely to live in poor neighborhoods, work at riskier occupations, and have more underlying health conditions and limited access to health care. But similar inequities exist in African American communities with above-average wealth and health care access. Staggering rates of COVID-19 occurred in Prince George’s County, Maryland – the nation’s wealthiest African American enclave. Comparable white communities were relatively unaffected.

As experts in clinical psychology and psychiatric nursing, we know this elevated risk for African Americans is not uncommon. It is true regardless of income, education level, or health care access. And it is true for other things besides COVID-19. African American women are more than twice as likely to die from childbirth than white women. Even if the African American women were educated and wealthy, they were more likely to die from childbirth than uneducated and poor white women.

Racism: the root cause

An analysis by the National Academy of Sciences found African Americans receive poorer quality care than white patients across all medical interventions and routine health services – even when insurance status, income, age, co-morbid conditions, and symptom expression were equal. Experts point to racism as a root cause for these disparities. Indeed, the American Academy of Pediatrics has outlined how racism impacts health outcomes for African American children. We suggest the same is true for COVID-19 outcomes among African American adults.

Other barriers negatively impact the health of African Americans. That includes implicit bias – attitudes, thoughts, and feelings existing outside of conscious awareness – as patients and providers communicate with each other.

Implicit bias from a doctor or nurse affects the quality and quantity of information shared with the patient about health conditions and treatment plans. The worst case scenarios: when providers withhold critical information about a health condition; when they don’t include the patient’s voice during decision making about care; and when they don’t refer the patient for further tests or specialty care. Implicit biases from health care workers can result in patients being less likely to understand their health conditions, which is necessary for patients to manage an illness effectively.

Averse interactions with physicians lead to long-lasting consequences for the patient, including unequal treatment and disparate health outcomes. And when it comes to ineffective patient-provider interactions, African Americans suffer the most.

Location, location, location

The location of hospitals, clinics, and other health care facilities are often a barrier to care. Transportation – or the lack of it – impacts the patient’s ability to receive services. African American patients have noted the frustration when health care facilities are not close to their homes. To get there, many of them rely on public transportation. The result: missed or cancelled appointments, sometimes due to policies regarding late arrival times by patients.

Differences also exist between African American and white patients in the length of wait time for appointments and the ability to schedule follow-up appointments. This can result in delayed health care – which leads to poorer health outcomes for illnesses, including COVID-19.

Recommendations for addressing racism

Consumers who are well informed about their health and confident in managing their care have better outcomes virtually across the board: in HIV-AIDS, cancer, diabetes, cardiovascular disease, and mental health conditions such as schizophrenia.

That said, here are three recommendations to address racism and reduce racial disparities in health care services:

1.      Health care professionals need to become more aware of their implicit bias. Identify the problem, as the saying goes, and you’re halfway to solving the problem. One way to become more aware: take the implicit bias test here.

2. Doctors and nurses need to be attentive and collaborative when communicating with patients. Empower the patient by encouraging questions and letting them express opinions. When patients believe the providers are there to support them, they manage their illness better. They also have a better perception of quality care. Ultimately this leads to improved health outcomes.

3.     Hospitals, clinics, and doctor’s offices should provide more flexibility in delivering services. Telehealth – when doctors and patients communicate online, instead of an in-person visit – should be one of those services. They should also restructure scheduling policies, emphasizing shorter wait times and more slack if patients are late.

Health inequity for African Americans is not a new phenomenon. COVID-19, however, shined a light on the problem. Racism is not isolated to health care services, and it remains pervasive throughout our society. But by taking the tangible steps outlined here, providers can begin to solve the problem.

• • •• • •

Tamika C.B. Zapolski is an Associate Professor of Psychology at Indiana University Purdue University ( IUPUI)
Ukamaka M. Oruche is an Associate Professor & Director of Global Programs at Indiana University Purdue University ( IUPUI)

This article is republished from The Conversation under a Creative Commons license. Read the original article.

CPT • Tensions mount in Garfield Hts. over police conduct, council behavior

Cuyahoga Politics Today

Citizens disturbed by Ward 2 councilman’s behavior, want him to step down

A growing number of citizens are beginning to ask
how much the city cares about them or, alternatively,
which residents their public officials care about.

A group of residents calling themselves "Aggrieved Citizens of Garfield Heights" plans to present a letter at tonight’s city council meeting expressing “great concern” over recent behaviors attributed to Ward 2 Councilman Charles Donahue Jr.

Their petition, signed by nearly 80 residents, says that they “do not feel safe, and … are not confident in his ability to fairly represent and make ethical decisions for the community.”

The group references recent police brutality in the city and community protests for racial equity. Their petition also refers to reports that Donahue allegedly pulled a revolver on another driver in an incident two months ago in a Giant Eagle parking lot, in addition to several other incidents of “poor behavior choices” where he has been antagonistic to black people, including on social media, resulting in “egregious pain”.

We reported last week on a Facebook post by Donahue in which he characterized NFL players who protest police brutality by kneeling  during the playing of the national anthem as “bitches”.

The letter cites the city charter provisions that permit council to expel any member for gross misconduct, and “demands a response from city leadership as well as that this letter be read on the council floor” at tonight’s meeting.

One resident, Lanene Jones of Ward 6, wrote an email to Mayor Vic Collova and every member of council about the incident involving Officer Malek. She spoke at the June 22 council meeting and participated in a June 25 community program on racism and policing issues.

Jones does not believe that city officials are responding adequately to citizen concern. Last night she wrote an extensive and detailed letter to the mayor and council “expressing her concerns about the growing racial tensions in our city and the lack of interest or urgency to address it from some of our leadership.”

The letter echoes the concerns of the citizen’s group in calling on Donahue to step down or be removed. It expresses dismay that Collova and Ward 3 Councilman Nenadovich said they were behind the police department 100% and that the mayor would refer to the police as “his boys”.

Jones’s letter goes on as follows:

“Your message to the black community is that you will back a rogue police officer 100% regardless of how they treat us. You will keep them on the payroll terrorizing us in our city while they spend their paychecks in the cities where they live. You will pay out thousands of dollars of taxpayer money to keep someone in power that is a threat to our civil liberties.  I am asking you again to remove him from his duties to protect your integrity and to protect the safety of the black community that lives here, raises children, shops, and pays taxes in this city. We should be your greater concern.”

During the current pandemic, council meets by conference call. The public may attend by calling 978.990.5000 and using access code 530352#. The regular council meeting starts at 7 PM, preceded by a caucus, which starts at 6:30PM.

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#BLM highlights need to re-imagine America

End Racism. NOW!

By Gregory L. Brown

America is in crisis and racism is the culprit.

As America commemorates the birthday of its independence, African American are bitterly reminded that the freedoms and liberties associated with America’s independence have not ever been fully and completed bestowed upon them. African Americans continue to suffer disproportionately from police brutality and violence, expanding disparities in health care and status, and deepening levels of wealth and income inequality. These conditions are the result of a society organized around a hierarchical racial construct that has White people at the top and Black people at the bottom. This racial hierarchy historically and currently informs the acquisition of wealth and property, employment and housing opportunities, health and wellness, and political power. Thus, the effects of racism support the notion that the Black lives do not matter.

the effects of racism support the notion that the Black lives do not matter

America is not working for Americans, particularly African Americans!  A recent survey determined that seventy percent (70%) of Americans believe the country is moving in the wrong direction. Currently, African Americans are acquiring and dying disproportionately from the COVID-19 virus, a once in a one-hundred-year public health pandemic that does not have a cure and is spreading out-of-control.  The closing of America’s enterprises to reduce the spread of the virus has led to the greatest level of unemployment and economic distress since the Great Depression.

While the nation confronts the effects of a deadly global public health pandemic and unprecedented economic distress and dislocation, racism has again raised its ugly head to let all Americans know that it is alive, well and continuing to plague society. The incidents related to the unnecessary use of lethal force against unarmed and in many instances subdued African Americans by police officers and White vigilantes during these challenging times have become the catalyst for right-minded people to protest racism, unjust police violence and unfair treatment.

Millions of people are protesting and marching in the streets of America to bring attention to propositions that “Racism in America must End, NOW!” and “Black Lives Matter”.  This protest movement has emerged when people are fearful of catching and/or dying from the COVID-19 virus and amid a national economic crisis that has created financial uncertainty for millions. Nevertheless, a multi-racial, multi-ethnic, multi-cultural protest movement has emerged, demanding that this country immediately eliminate racism in all forms.

Ending racism immediately has both moral and practical implications. As a moral imperative, racism in all forms is wrong! Racism disregards and dismisses our humanity. Racism not only diminishes its targets; it also diminishes the racist.

From a practical perspective racism is expensive. Maintaining institutions, systems, policies and practices based on racist views means society heavily invests in allowing some people to prosper socially, economically and politically while others are held back and held down for no other reason than they have different skin color. The cost of racism is so deeply embedded in the legal and cultural fabric of America that very little consideration is ever given to the ratio between costs and benefits to society or how much return is received for America’s investments in racism. 

Americans must dismantle and disassemble the America we know for a new re-imagined America we do not know and can only envision.

The time to end racism in America has finally arrived. It is time to make real America’s stated creed that “All Men Are Created Equal” and “Everyone is Endowed with the Inalienable Rights to Life, Liberty and the Pursuit of Happiness.” America for centuries has overpromised and underdelivered on the tenets of its founding documents. It must now do what is required to make right its implied and stated promises to all Americans.

The solution to racism in America is to eliminate it in all its forms in society. This really means Americans must dismantle and disassemble the America we know for a new re-imagined America we do not know and can only envision.

The first step is to convene tribunals across the country to confront truthfully the wrongs of racism historically and currently and develop opportunities for people and the country to reconcile racism’s wrongs by identifying a new re-imagined American society that is diverse, inclusive and equitable. America must finally reconcile the experiences of those who have been the targets of racism the evils and ills associated with it.

Next, America must envision a new and improved 21st century public safety plan. The current racial justice movement has determined that “defunding the police” is a public policy initiative to specifically address police violence towards African Americans and better identify how public safety meshes with health and wellness and social concerns. Defining new and improved ways to integrate public safety, social services and health will result in the most effective use of public and other funds to build the capacities of all people to be prosperous and healthy.

Additionally, we must create a national system that makes it very easy and accessible for anyone eligible to vote. We must develop and enforce policies that make it illegal for anyone to use strategies and tactics that suppress eligible African American voters’ rights and opportunities to vote.

To eliminate racism, we need all of society’s stakeholders to actively and jointly envision and design the framework and plans for the physical, social, economic and political renaissance of this country especially in urban communities. PolicyBridge and other local stakeholders from all segments of Northeast Ohio are currently developing an urban agenda to reinvigorate and empower neighborhoods and communities and the people residing in them that have been left behind.  

America is in crisis and racism is the culprit. Eliminating racism throughout America is the answer. The time to act is NOW! 

Gregory L. Brown is  Executive Director of PolicyBridge, a nonpartisan, African American led public policy think tank, based in Cleveland, Ohio.