Larry James' Urban Daily

What you give away. . .Vince Gill

2009-12-06T06:00:00.000-06:00

Thanksgiving reflection. . .

Mayor Wiseman takes the cake!

2009-12-05T17:45:00.000-06:00

Just read this!

Amazing!

Talk about taking the cake?

Evidenced-based care

2009-12-04T06:00:00.005-06:00

On Thanksgiving day, while walking down a very uneven sidewalk toward the park with the grandchildren, Brenda tripped and fell. She broke her fall by stiff-arming the sidewalk. She bumped and scratched her face and badly bruised her hand. She shook off her injury and went on to the park!

The next day, after a short visit with her doctor, she went to a local hospital emergency room to have her hand checked out. After a lengthy wait and a couple of rounds of X-rays, she learned that no bones were broken. During the exam, the examining nurse practitioner (she never saw a physician) questioned her about the scratch on her face, finally suggesting an MRI to make sure there were no broken bones in her face. Brenda assured her that such a procedure was not necessary and that another X-ray would suffice, if even was really necessary.

She left glad to know that there were no broken bones and with her hand and arm wrapped up to the elbow. She also wondered if the attending staff was guilty of over prescribing treatment.

In a "fee for service" health care system like we now experience, her suspicions make a lot of sense.

Then, on Sunday morning, The Dallas Morning News carried a front page story on evidence-based medicine and cost sharing and the move of the Baylor Health Care System to such a strategy for providing care to its patients (by the way, the ER Brenda visited was not a Baylor hospital!).

No one wants to talk rationally about health care realities these days. But, in view of rising costs and our return in health and wellness benefits for what we pay, the time has come for serious discussions. From the report it sounds as if Baylor will lead the way in that much-needed conversation. Good for them!

Be sure and read the story, "Baylor will try new Rx," by clicking here.

Dramatic rise in elderly seeking food assistance

2009-12-03T06:00:00.001-06:00

Found the following report in The Huffington Post. The trend reported here is one we've noticed in Dallas at our Resource Center.

ALBANY, N.Y. — Older Americans who were raised on stories of the Great Depression and acquired lifelong habits of thrift now find themselves crowding soup kitchens and food pantries in greater numbers for the first time after seeing retirement funds, second jobs and nest eggs wiped out by recession.

"What we see in line is lots of gray hair, lots of walkers," said Marti Forman, CEO of The Cooperative Feeding Program in Fort Lauderdale, Fla.

The help is crucial for many fixed-income seniors, who can't always keep up with rising food prices.

"It's a lifeline. It just means that you can function," said Ronald Shewchuk of Ithaca, N.Y. "Otherwise we would have to sell our house. I don't know what we would do. Go to an old age home."

The number of seniors living alone who seek help from food pantries in the U.S. increased 81 percent to 408,000 in 2008, compared to 225,000 in 2006, according to the U.S. Department of Agriculture. Overall, 4.7 million households used American food pantries in 2008, compared to about 3.7 million in 2006.

"Seniors thought they were OK, but they're not OK," said Virginia Skinner, director of Development at The Association of Arizona Food Banks in Phoenix, citing the downturn in the area's housing market.

Catholic Charities USA, which has 170 agencies across the country helping the needy, issued a 2009 third-quarter report that found a 54 percent increase in requests for food and services from seniors nationwide compared to the same period last year.

Despite the increased need, it can be difficult for some older people to come forward and seek help.

To read more click here.

Thoughtful comment on Medicaid and its improvement

2009-12-02T06:00:00.022-06:00

Dr. James Baker is the CEO of Metrocare Services here in Dallas, Texas.

Metrocare Services, formerly known as the Dallas County Mental Health Mental Retardation (MHMR) Center, has served Dallas County for over 40 years by providing first rate clinical and social services to persons with mental illness, developmental disability, or severe emotional problems.

Jim is an expert on mental health care delivery among the poor and, thus, an expert on Medicaid.

Click here to refresh your memory on my previous post that addressed what I considered an outrageous comment about Medicaid made by Senator Lamar Alexander (TN-R). Be sure and read the comments on that post.

Here's what Dr. Baker left in the comment box on that earlier post:

I want to go back to the original question by c hand: Why do "so few physicians...accept patients covered by the ... very good plan?" and why do patients with these plans have to wait for care?

Medicaid IS a very good plans from the perspective of its benefits, that is, what it will pay for. It is very generous in that respect.

The reason docs dont "accept patients" (actually it is the insurance that many dont accept...) is that Medicaid's reimbursement does not even cover most docs' costs for the services.

And if Congress doesnt repeal a Medicare reimbursement cut of 21% that is set for Jan 1st, the same access problems will worsen for the elderly that already happen for the poor.

The fix is counter-intuitive: increase both the number of people covered and the doc rates for both programs, so that access is easier and happens sooner in the course of a disease, so that the cost of each episode goes way down -- and therefore so does the total cost to taxpayers...

Unfortunately since it is counter-intuitive, many policymakers have a hard time grasping this reality...

Wednesday, November 25, 2009 3:30:00 PM CST

Jim, thanks for the clear and rational explanation.

Ever consider a run for Congress?

Hunger: We Must Do More and Better

2009-12-01T06:00:00.001-06:00

Editorial: Texas must fight hunger all year

04:00 PM CST on Monday, November 23, 2009

While millions of Texas households prepare to celebrate Thanksgiving with a hearty family meal, millions of their fellow Texans aren't sure when or how they'll get their next meal.

"Texans should be shocked that a state as prosperous as Texas is doing so poorly," says the state's agriculture commissioner, Republican Todd Staples.

According to federal statistics released last week, 16.3 percent of Texas households lack regular access to adequate nutrition or face hunger nightly. The percentage of so-called "food insecure" households in Texas is more than 4 points higher than the national average of 12.2 percent, ranking Texas ahead of only Mississippi. In these households, people regularly skip meals, eat cheaper and less nutritious foods, depend on government aid like food stamps or seek help from food pantries.

The recession can be blamed for only part of Texas' misery; it rated an abysmal 15.2 percent of "food insecure" households a decade ago, when its economy was booming. Now, says Jan Pruitt, executive director of the North Texas Food Bank, member agencies are seeing about 36 percent more new food recipients and distributing 50 percent more food each week.

The food bank readily accepts contributions in food and money all year, but Pruitt says eradicating hunger also requires such comprehensive strategies as making sure the needy, especially those with children, receive food stamps and other assistance.

Texans can confront hunger in small and large ways. A few hopeful signs emerged at a hunger summit in Waco last week. Led by the Texas Hunger Initiative, a coalition of federal, state and local agencies agreed to campaign to make sure Texas schoolchildren don't go hungry during the summer when subsidized breakfasts and lunches are less accessible. Churches, youth organizations and school districts will be asked next month to help get food to the 2.5 million school-age children eligible for summer feeding programs. Likewise, Staples will issue a similar anti-hunger challenge to mayors across Texas.

Hunger has been with us forever and will stay with us until enough people insist that it will not continue. It's good to hear more voices shouting this message.

People don't choose to be hungry, which is why prosperous Texans shouldn't ignore others' suffering when the holiday season ends. It's honorable to volunteer at food banks or to write a check to provide food for the needy, but eventually Texans must come to grips with the reality that this state's dismal record on combating hunger is getting worse.

Fighting Texas hunger

•Donate food and cash to the North Texas Food Bank or its member agencies. For contribution details, go to www.ntfb.org or call (214) 330-1396. Or visit http://www.centraldallasministries.org/ and donate online.

•Urge Texas legislators to support efforts to provide food stamps and other programs to needy families, especially those with children. Only a small portion of eligible recipients in Texas currently participate in food stamp and summer feeding programs. For contact info go to http://www.legis.state.tx.us/

•Contact the Texas Hunger Initiative and ask how you can help. For more information, go to www.baylor.edu/texashunger/ or call 254-710-3704.

What's The Big Story? Find out at dallasnews.com/opinion

Jobs and a future

2009-11-30T06:00:00.002-06:00

We're making progress on our plan to install solar panels on 100 homes occupied by very low-income folks in South Dallas. It appears that all of the players needed to make it happen are lining up! More on that to follow.

Regarding new jobs and the new frontiers of energy technology, I found this piece by Bob Herbert encouraging. Let me know what you think.

Signs of Hope
By BOB HERBERT
Published: November 23, 2009

I came to Detroit and its environs, the seat of America’s glorious industrial past, to see if I could get a glimpse of the future. Is the economic, social and physical deterioration that has caused so much misery in the Motor City a sign of what’s in store for larger and larger segments of the United States?

Or are there new industries waiting in the wings — some of them right here in the Detroit metropolitan area — with new jobs and bright new prospects for whole new generations of American dreamers?

I found real reason to hope when a gentleman named Stan Ovshinsky took me on a tour of a remarkably quiet and pristine manufacturing plant in Auburn Hills, which is about 30 miles north of Detroit and is home to Chrysler’s headquarters. What is being produced in the plant is potentially revolutionary. A machine about the length of a football field runs 24 hours a day, seven days a week, turning out mile after mile after mile of thin, flexible solar energy material, from which solar panels can be sliced and shaped.

You want new industry in the United States, with astonishing technological advances, new mass production techniques and jobs, jobs, jobs? Try energy.

Read on here.

"I Will Thank You"

2009-11-29T06:00:00.000-06:00

Forgive me and indulge me.

My 7-year-old granddaughter, Gracie, shared this song with us on Thanksgiving Day.

Urban death, urban despair

2009-11-28T06:00:00.002-06:00

Each year for the past 15, Central Dallas Ministries has assisted low-income families bury their dead. While every situation is unique, all share in common a desperation and an anxiety impossible to describe. I find nothing more unsettling or difficult as the challenge facing very poor families when they've lost a loved one. On top of the natural grief, the burden of claiming the remains and finding a way to pay for burial often proves extremely difficult.

My own experience with these awful times drew me to the report below about the city of Detroit and the difficulties facing its morgue. The story reports on what may best be regarded as a symbol of urban despair in our nation's central cities.
_______________________________

Unburied bodies tell the tale of Detroit — a city in despairTim Reid in Detroit

The abandoned corpses, in white body bags with number tags tied to each toe, lie one above the other on steel racks inside a giant freezer in Detroit’s central mortuary, like discarded shoes in the back of a wardrobe.

Some have lain here for years, but in recent months the number of unclaimed bodies has reached a record high. For in this city that once symbolised the American Dream many cannot even afford to bury their dead.

“I have not seen this many unclaimed bodies in 13 years on the job,” said Albert Samuels, chief investigator at the mortuary. “It started happening when the economy went south last year. I have never seen this many people struggling to give people their last resting place.”

Unburied bodies piling up in the city mortuary — it reached 70 earlier this year — is the latest and perhaps most appalling indignity to be heaped on the people of Detroit. The motor city that once boasted the highest median income and home ownership rate in the US is today in the midst of a long and agonising death spiral.

To read the entire article click here.

Break in. . .

2009-11-27T06:00:00.000-06:00

The back door to our Resource Center warehouse includes a faulty locking mechanism. As a result, a stiff slam or a hard kick can be necessary to engage the latch.

On Wednesday evening I received a call that the alarm was sounding at the building. I went to the building, disarmed and rearmed the security system and performed the obligatory slam to secure the door.

As I drove away from the building, I noticed a person--at the time I thought it a woman--walking slowly up the street away from the corner bus stop. I've experienced these kinds of after dark encounters countless times. Normally I would have lowered my window and engaged in a bit of conversation. But, it was Thanksgiving Eve, we had grandchildren at home. I was in a hurry.

Mistake.

About an hour after my first call, I received a second reporting that the front door of the building had been smashed and numerous items stolen from the upstairs office suite and kitchen. The person who broke in had been apprehended, cuffed and given a seat in the back of a squad car. When I caught a glimpse of his face, I realized the prisoner was none other than the person I had seen less than an hour before crossing the street as I left for home.

As we fixed the door to secure the building, one of our guys commented, "Well, he probably didn't know where he was going to spend Thanksgiving, but now he does."

Sad deal.

I wish I had talked to him. Asked him what he needed, if anything. Responded to him like I would like to be treated had I been all alone on the dark night. I know. I know. He broke in. He was the person responsible for the mess.

But, still. I wonder how much happens in the city simply because people like me just pass on by?

Pegasus Thanksgiving Report: Hungry North Texans

2009-11-26T12:00:00.002-06:00

This report appeared in Pegasus News, a Dallas on-line news service:

Traditional Thanksgiving dinner too costly for some North Texans

by Lena Dirbashi

A few Thanksgivings ago, Andre Alston worked as a permanent substitute teacher at Dallas ISD. For years, he taught English, math, science, and reading. But four years ago, the school district decided that his college degree, a two-year associates degree, wasn't enough and laid him off.

It didn't take him long to find another job -- but not without compromise. Alston's new job at Macy's department store was paying him a fraction of how much he got paid as a teacher. Soon, he found himself caught between paying the bills and buying food. "When you get to that point," he said. "You just feel really bad." With no immediate family close by and nobody to turn to, Alston felt weak, overwhelmed, and sad. One day, he was standing at the unemployment office and noticed a flier for the Central Dallas Ministries (CDM). He paid them a visit that changed everything. Alston was finally able to enjoy a happy Thanksgiving.

Central Dallas Ministries, one of more than 300 food pantries in the Dallas-Forth Worth area, is overwhelmed in the weeks leading up to the holidays. The average number of food recipients for 2009 was 4,575 individuals per month at the Ministries, and that number is expected to double during the holidays. The North Texas Food Bank (NTFB), which distributes food to the Ministries and 291 member agencies, doubled its staff and trucks to confront the drastic increase in need.

To read the entire story click here.

To learn more about Central Dallas Ministries go to http://www.centraldallasministries.org/.

More on spread of hunger in USA

2009-11-26T06:00:00.001-06:00

Thanksgiving 2010: Now this disturbing report from The Washington Post:

America's economic pain brings hunger pangs

By Amy Goldstein
Washington Post Staff Writer
Tuesday, November 17, 2009

The nation's economic crisis has catapulted the number of Americans who lack enough food to the highest level since the government has been keeping track, according to a new federal report, which shows that nearly 50 million people -- including almost one child in four -- struggled last year to get enough to eat.

At a time when rising poverty, widespread unemployment and other effects of the recession have been well documented, the report released Monday by the U.S. Department of Agriculture provides the government's first detailed portrait of the toll that the faltering economy has taken on Americans' access to food.

The magnitude of the increase in food shortages -- and, in some cases, outright hunger -- identified in the report startled even the nation's leading anti-poverty advocates, who have grown accustomed to longer lines lately at food banks and soup kitchens. The findings also intensify pressure on the White House to fulfill a pledge to stamp out childhood hunger made by President Obama, who called the report "unsettling."

The data show that dependable access to adequate food has especially deteriorated among families with children. In 2008, nearly 17 million children, or 22.5 percent, lived in households in which food at times was scarce -- 4 million children more than the year before. And the number of youngsters who sometimes were outright hungry rose from nearly 700,000 to almost 1.1 million.

Among Americans of all ages, more than 16 percent -- or 49 million people -- sometimes ran short of nutritious food, compared with about 12 percent the year before. The deterioration in access to food during 2008 among both children and adults far eclipses that of any other single year in the report's history.

Read the full report here.

From the First Lady of the United States and President Obama

2009-11-25T14:39:00.000-06:00

Tomorrow, many of us will gather around the table with family and friends to give thanks over a feast of turkey, mashed potatoes and gravy -- and let’s not forget pumpkin pie!

But for some in this country, the feast will not be as bountiful. In fact, it won’t be much of a feast at all. Hunger is on the rise in America -- hitting its highest levels in nearly 15 years. A recent report released by the USDA reveals that in 2008 an estimated 1.1 million children were living in households that experienced hunger multiple times over the past year.

To combat hunger this winter, we’re launching, in coordination with the Corporation for National and Community Service and the U.S. Department of Agriculture, the United We Serve: Feed a Neighbor initiative -- a program that empowers you with all the resources you need to mobilize against the hunger crisis in your community. Learn how you can get started today here.

Barack and I are committed to doing all we can to end hunger by making food programs more accessible to eligible families. But government can only do so much -- it will take all of us working together to put an end to hunger in America.

That’s why we’ve made it easy for you to get involved at Serve.gov. Find local volunteer opportunities like delivering meals to homebound seniors, offering your professional skills at a food pantry, or planting a community garden and sharing produce with your neighbors. You can also create your own volunteer opportunity using our anti-hunger toolkit.

holiday season let’s recommit to serving our communities and working together to feed American families.

Get started giving back today.

Thank you,
Michelle

First Lady Michelle Obama
The White House

Uninsured children

2009-11-25T06:00:00.002-06:00

This from a recent Johns Hopkins' study:

Using more than 23 million hospital records from 37 states between 1988 and 2005, the Johns Hopkins investigators compared the risk of death in children with insurance and in those without. Other factors being equal, researchers found that uninsured children in the study were 60 percent more likely to die in the hospital than those with insurance. When comparing death rates by underlying disease, the uninsured appeared to have increased risk of dying independent regardless of their medical condition, the study found. The findings only capture deaths during hospitalization and do not reflect deaths after discharge from the hospital, nor do they count children who died without ever being hospitalized, the researchers say, which means the real death toll of non-insurance could be even higher.

"If you are a child without insurance, if you're seriously ill and end up in the hospital, you are 60 percent more likely to die than the sick child in the next room who has insurance," says lead investigator Fizan Abdullah, M.D., Ph.D., a pediatric surgeon at the Johns Hopkins Children's Center.

Read the full report here.

From my perspective in inner city Dallas, I vote that every single child be covered by adequate health insurance like CHIP.

CityWalk@Akard. . .images

2009-11-24T15:12:00.000-06:00

CityWalk@Akard. . .images

2009-11-24T15:07:00.000-06:00

CityWalk@Akard. . .images

2009-11-24T15:04:00.000-06:00

CityWalk@Akard. . .images

2009-11-24T15:00:00.000-06:00

Friday at Central Dallas Ministries Resource Center

2009-11-24T06:00:00.004-06:00

This is the scene that greeted us on Friday morning.

A line of neighbors over 100 strong strung out in the heavy rain.

Why?

Waiting to receive groceries, including fresh vegetables and fruit.

The need, the food insecurity, the hunger--it's all on the increase, and dramatically.

"Medical ghetto"?

2009-11-23T06:06:00.000-06:00

Even though I expect this post will set off a firestorm of comments, many or most of which will be very negative, I cannot find the words to properly express just how offensive I find the words of Senator Lamar Alexander (R-TN) during a speech he delivered in the current Senate health care debate.

Give him your attention.

In the first place, Medicaid represents the only health care option available to a portion, and only a portion, of the very poor in America. The major negative associated with Medicaid relates directly to the fact that so few physicians will accept patients covered by the otherwise very good plan.

As a result, my poorest neighbors must wait for care, and not only in long lines or in crowded clinic and ER waiting rooms, but for weeks at a time for scheduled treatment. This would be remedied if we had the benefit of a comprehensive, national health care plan.

But second, and even more offensive, if the good Senator feels that Medicaid is a "health care ghetto." doesn't he have a moral responsibility to improve it? Doesn't he have a fiscal responsibility to the nation to reform it, extend it and promote it? Hasn't he signed on as a national leader with the responsibilities that accompany such a decision?

Never mind the obvious race baiting here. Let's talk quality, equity and health care justice, not to mention improving the nation's wellness and health outcomes across a broad array of health measures.

Senator, please!

Shane Claiborne

2009-11-22T06:00:00.000-06:00

November 18, 2009, 9:05 AM

What If Jesus Meant All That Stuff?

This radical Christian's ministry for the poor, The Simple Way, has gotten him in some trouble with his fellow Evangelicals. We asked him to address those who don't believe.

By Shane Claiborne

To all my nonbelieving, sort-of-believing, and used-to-be-believing friends: I feel like I should begin with a confession. I am sorry that so often the biggest obstacle to God has been Christians. Christians who have had so much to say with our mouths and so little to show with our lives. I am sorry that so often we have forgotten the Christ of our Christianity.

Forgive us. Forgive us for the embarrassing things we have done in the name of God.

The other night I headed into downtown Philly for a stroll with some friends from out of town. We walked down to Penn's Landing along the river, where there are street performers, artists, musicians. We passed a great magician who did some pretty sweet tricks like pour change out of his iPhone, and then there was a preacher. He wasn't quite as captivating as the magician. He stood on a box, yelling into a microphone, and beside him was a coffin with a fake dead body inside. He talked about how we are all going to die and go to hell if we don't know Jesus.

Some folks snickered. Some told him to shut the hell up. A couple of teenagers tried to steal the dead body in the coffin. All I could do was think to myself, I want to jump up on a box beside him and yell at the top of my lungs, "God is not a monster." Maybe next time I will.

The more I have read the Bible and studied the life of Jesus, the more I have become convinced that Christianity spreads best not through force but through fascination.

Read the entire essay here.

Perfection: Don Larsen 1956

2009-11-21T06:00:00.000-06:00

Remembering the wind

2009-11-20T06:00:00.003-06:00

Recently, during an important strategy session at United Way of Metropolitan Dallas, Dr. Paul Jargowsky, a professor of public policy in the School of Economic, Political and Policy Sciences at the University of Texas at Dallas, told a story from his own, recent experience. It seems that last weekend the good professor took a long and vigorous bike ride. At the half way point he felt really strong. He was enjoying a great ride and workout. He felt extremely alive, like he could have peddled on for a long, long time.

Then, he turned around.

At that point the strong, autumn Texas wind hit him squarely in the face.

No wonder the first half of the ride felt so good. He enjoyed the benefit of a 25 mile per hour wind at this back! Peddling home proved much more difficult than and not nearly as exhilarating as the first half of the ride.

He concluded that most of us don't realize that we've been riding through life with a strong wind at our backs, while lots of others ride directly into a tough gale. Our peddling has been so much easier. Our advantage so very clear. Our understanding so unaffected by our privilege.

As he told his parable, everyone in the room grew silent. We knew he was spot on right.

[Jargowsky, an expert in urban poverty and inner city communities, authored the important book, Poverty and Place: Ghettos, Barrios and the American City (New York: Russell Sage Foundation, 1997)--Winner of the 1999 Prize for the Best Book in Urban Affairs, Urban Affairs Association; Named "One of the Outstanding Academic Books of 1997" by Choice Magazine.]

So, how much is enough?

2009-11-19T06:00:00.001-06:00

Leo Tolstoy's little story, "How Much Land Does a Man Need?" offers a very helpful reading experience for the Thanksgiving season.

The story forces me to ask myself, "How much _________ do I really need?" My blank can be filled in with any number of items, concerns, aspirations.

Surrounded and, far too often, defined by material concerns, consumer anxieties and the never ending quest for accumulating more and more, Tolstoy calls me out.

After all, how much land does a man need?

Read the story here.

I'd love your reactions.

Be That Woman

2009-11-18T06:00:00.001-06:00

The Washington Area Women's Foundation, in partnership with RP3 Agency, produced this video depicting the tough circumstances women confront far too often, especially in urban centers like Dallas.

But the story doesn't need to end there.

Investing in the lives of girls and women pays off big time!

Those of us who work in urban settings among low-income folks understand this truth. This creative little 2-minute video intends to encourage such investments in this specially placed and powerful human capital resource.