1. “Marijuana is for use by qualified patients only. Keep out of reach of children.”;
2. “Marijuana use during pregnancy or breastfeeding poses potential harms.”;
3. “Marijuana is not approved by the FDA to treat, cure, or prevent any disease.”; and
4. “Do not operate a vehicle or machinery under the influence of marijuana.”
It is no secret that public policy and programs were traditionally focused on the delivery of services and benefits to target individuals. But over the past decade, age-friendly community initiatives (AFCIs) have taken up the charge for real quality of life improvements. As these community initiatives take hold, there are additional ways to reduce the effects of destructive policies. Without action, these policies will continue to bring down a community and institutionalize its elders and misguided. With active community involvement working in conjunction with these initiatives, we can, in a sense, double its effect. As a working community, we can reduce crime, unemployment, homelessness, food insecurity, water waste, and discrimination. We can increase economic recovery, affordability of housing, transportation, education, aging in place initiatives, water safety, security, and social tolerance. Perhaps one would think of this as an unattainable utopia. Now, what would one think if this model showed real results in just one year?
The 2015 White House Conference on Aging (WHCoA) identified “creating and supporting communities that are age friendly” as an important way to support health, vigor, and aging in place in the community. Communities for a Lifetime is one program that started the path toward this utopian lifestyle. Communities for a Lifetime, as a title, has already been implemented in Florida, Maryland, Michigan, Indiana, and New York. Each state has its own version that is designed for their particular residents' needs. However, the programs share basic goals: improving transportation, housing, social participation, respect and social inclusion, civic participation, employment, communication and information, community support and health services, and outdoor spaces and buildings. All of these goals support the original ‘Communities for Life’ concept developed by Dr. Gema Hernandez of “Elder Ready, Children Friendly, and Family Focused” developed by Dr. Gema Hernandez . Cesar Chavez alluded to these goals when he said, “We cannot seek achievement for ourselves and forget about progress and prosperity for our community... Our ambitions must be broad enough to include the aspirations and needs of others, for their sakes and for our own.”
It starts in just one community, one neighborhood. From there it can build on itself through funding and education. It can educate the misguided in emerging fields like health and nursing, city planning and green energy, water sustainability and food management. It will elevate the burden of society to be the shoulders of society. It will feed the hungry, house the poor, and facilitate aging in place. It will educate unskilled labor to a skilled labor force, transport the old and young, provide daycare for the poor, and slim the fat of the town by building a walking score to 90[1] , all while providing a more diverse and tolerant society.
This paper will detail The Hemp Store Cafe's community involvement action plan. This initiative will allow for building a sustainable age-friendly community, a community that propagates real quality of life improvements. This paper will provide in detail an estimated sustainable funding platform, staffing alternatives, pre-service and in-service training, and job placement, as well as identify targeted recipients. It will also provide a theoretical and research rationale for the program, recognize obstacles, and show how the program will meet the needs of the community.
The Need for Such a Proposal
The theoretical and research rationale for the program is based on the “Communities for Life” concept of providing needed services to the community and its residents that benefit everyone. This rationale is supported by common sense, a multitude of federal and state lawmakers, and countless governmental departments and research projects[2]. Over the past decade, age-friendly community initiatives (AFCIs) have led the charge for real quality of life improvements in all areas studied including public health, environment, civil, economic, quality of life, and most importantly social tolerance.
Delivering formal services and support in home and community-based programs can improve the quality of care individuals receive as well as reduce health care costs. Medicaid is shifting spending from institutional long-term services and support to home and community-based services. The Affordable Care Act helps support this effort through the Balancing Incentives Program[3]. While this short paper will focus on those policies and initiatives listed above, there are many other coexisting guidelines that could be streamlined together to improve efficiency and reduce costs.[4]
The beginning phase for the Hemp Store's action plan will start through an initial analysis of the community’s needs and obstacles. This phase will exploit the program’s full effectiveness by identifying gaps and setting priorities for our initiative during the first five years. A biennial assessment is needed for program changes through identified best-practice analysis. A full reevaluation of program effectiveness, introduced every eight years, will re-identify gaps and priorities. The second phase of the program involves implementing public health components into the infrastructure of the community. Working to improve sidewalks, roadways, parks and recreational areas, and improving public transportation will also be part of this second phase. Activities like health fairs, mobile medical units, immunization campaigns, and blood drives are some ways The Hemp Store will promote enthusiasm for community initiatives. These activities will entice involvement from local hospitals, religious organizations, and local private and governmental agencies.
As an example, Portland, Oregon has adopted a 20-minute Neighborhood Concept, and so far, it’s paying off. Portlanders drive 20% less than people living in cities of comparable size[5]. Every dollar not spent on vehicular expenses is another dollar that stays in Portland’s economy. This 20-minute Neighborhood Concept has been found to increases transportation routes that link low-income and working class communities. This link has also proven benefits in lowering transportation costs and decreasing social inequality. It does so at the neighborhood level by emphasizing access to critical services within walking distance . The final phase incorporates sustainability and safety measures that will provide maintenance and longevity services. These services include traffic profile analysis, age friendly roadway improvements, free Uber -like ride sharing, and lighted walking paths for families and older adults.
An example of how Communities for Life could look at this phase, exists just outside Austin, Texas. The Mueller Community is a 700 acre, nonprofit, compact, mixed-use development project. It has transformed an abandoned municipal airport into a real working community. Although they do not use the title 'Communities for a Life', they do emphasize community involvement as a “give-and-take” and state that they have a “clear community vision”. The community has 140 acres of parks featuring hike/bike trails, picnic areas, unique playgrounds, native landscaping, water features, and public art. It also has a children’s hospital and a museum for kids. The development focuses on minority and women-owned business enterprises (MWBE)[6] as partners in the development process. Mueller also established the Mueller Affordable Homes Program. This “visionary” accomplishment provides an astonishing 25% of the community’s homes to low-income and elderly households. This 25% is truly the backbone of their vision statement; “Many planned communities around the country pride themselves on being exclusive. But at Mueller, it’s all about being inclusive”. To this end, they actively work to attract a diverse and vibrant population of people representing many different backgrounds and incomes.
While all of these policies, incentives, and initiatives center on low-income, older adults and those in the greatest need, the key to success in each of them is, and will be, their diversity in helping all in need. With a concentrated focus on all demographics and cohorts, an interesting phenomenon happens-- an unprecedented social tolerance for diversity. One example of this amazing, unintentional benefit is Bristol, England, also known as the “City of Sanctuary.[7]” With over 50 different religions in the city, Bristol has achieved diversity with tolerance. The Bristol Hospitality Network[8] prides its success on its policy. It “extends solidarity to people seeking asylum and experiencing destitution through accommodation and creative community involvement”.
Proposal Obstacles
Communities for Life is well underway in many parts of the United States. Although there always seems to be a lack of volunteer staffing, funding, and physiological barriers in achieving these very attainable models, all of these obstacles are interrelated. Like most permanently funded programs, people who have money are not keen on just giving it away. There is only so much money in our government and those funds are spread thinly. A way must be found to prioritize these funds into needed programs and services. Without doing so, new community concepts and initiatives will be stalled or abandoned. This was the case with the 2015 HUD 202 program[9] that was not reallocated funds for the year 2016. The Section 202 Housing for the Elderly program provides funding to facilitate the creation of multifamily housing for very low income elderly persons. There are no plans to reinstate the funding anytime in the future for this valuable program. But, in order to “maximize the effectiveness of Section 202 funds”, the Department will layer the program's operating assistance onto other affordable housing sources[10].
Funding
Establishing sustainable funds is key in the success of a program, but it cannot unlock some physiological barriers that prevent permanent financing. Funding for the Older Americans Act (OAA) program has declined in relation to the number of individuals in need of services, as the recipients of HUD Section 202 will attest to. Continuous re-authorization of funds does not help build a reliable and trustworthy program. Not knowing the amount of, or even if funds will be available at all, stalls program initiatives and limits growth potential. The solution is clear; find funding that is, and will be, continuous and mandated solely for its purpose.
There are many “out-of-the-box” solutions that will work for all of these issues, if lawmakers commit to them. Some involve real monies while others are workforce related. It may sound out of place, but the American prison system is awash with extra funds. Although prisons are needed, this writer, along with previous presidents and the Global Commission on Drug Policy, believes in using facts, figures, and best-practices to find solutions. After pardoning 46 non-violent drug offenders, President Obama announced that they served disproportionate sentences for their crimes and he called for more sentencing reforms.
This writer struggles to agree with the Global Commission on Drug Policy recommendations to decriminalize the use of illicit drug use. But, the evidence is clear. Sentencing and drug policy reform is being considered. Colorado recently passed a state law to regulate and tax cannabis. After 11 months, the first statistics were in. Colorado collected $40 million in tax revenue with $8 million going towards youth education and drug prevention. Traffic fatalities declined, violent crime decreased, economic growth increased, and it had the lowest unemployment rate in years[11]. Washington state generated roughly $70 million dollars in legal cannabis sales taxes over the course of the first year, with similar results in crime and unemployment.
According to a study done by the Oregon Law Review for the RAND cooperation, legalization of cannabis could generate significant tax revenues to the order of 3 billion per year. The total supply of cannabis in the US could be achieved with the use of less than 10,000 acres of land. A cost range of only $5,000 to $20,000 per acre suggests the total cost to produce all required cannabis at about $100 million. “Most of the $30 billion or so consumers are willing to pay, is available to be captured as profits and/or taxes[12] . The zeros matter. One way to capitalize on these zeros is to make the production and sale a government monopoly, although this has its own complications. The real solution is to blend non-profit organizations into a government run mix. The government would run the production and non-profits would run the distribution. This will reduce gray-market activity and restrict for-profit marketing efforts. It will alleviate public-health concerns by limiting the number of licensed distributors and mandate zero funding for marketing practices.
By using the $3 billion in tax revenue, we can progressively contribute to the health and well-being of all Americans. The revenue goes to three general categories of AFCIs Age Friendly Community Initiatives, including community planning approaches, support-focused approaches, and cross-sector partnership approaches . One method would be to split the revenue into thirds. The first third would go to ‘community planning approaches’ such as transportation and safe mobility, housing and universal design, civic engagement and social participation, access to services, and support[13]. These designs could be run by local governments or other means such as university research groups, policy changes, and service or advocacy organizations. The second portion would go to ‘support-focused approaches’ such as “enhancing community-wide networks of informal and formal sources of support”. This category focuses on transforming social relationships at the community level[14]. The last third, ‘cross-sector partnership approaches’, would help bind the first two categories. This category enhances the collaboration among different organizations (local, state, and federal) to expand the range of sectors focused on aging.[15] With the right policies and oversight, this proposal will benefit all community members.
Relevant Issues
Laws in the U.S. are tough on crime, while weak on discrimination. A ruling by the Supreme Court, The Olmstead Decision[16] , has led the way for changing this. The ruling was made not only for those with disabilities, but was fundamentally charged with the identification of unjustified segregation as discrimination. The decision reflects two evident judgments: “Institutional placement of persons who can handle and benefit from community settings perpetuates unwarranted assumptions that persons so isolated are incapable or unworthy of participating in community life, cf., e.g., Allen v. Wright, 468 U.S. 737, 755; and institutional confinement severely diminishes individuals’ everyday life activities”…“including family relations, social contacts, work options, economic independence, educational advancement, and cultural enrichment”. The OAA (Older Americans Act), Title IV, section 417, and section 422, supports this ruling. The United States Justice Department made the Olmstead Decision a priority of its Civil Rights division and quickly made clear that this decision applied to all state and Medicaid funded institutions, including nursing facilities. The Olmstead ruling, along with the Affordable Care Act, Older Americans Act, Americans With Disability Act, and Home and Community-Based Services, strives to build on the importance of community innovations for those in need and those who would face institutionalization. To this end, Title III B and Title IV of the OAA work to incorporate a community environment that supports the Activities for Health Independence and Longevity, Multigenerational and Civic Engagement, and Community Innovations for Aging in Place. The OAA has set the example in policy for helping improve the lives of everyone it touches. Nonetheless, funding, coordination, and implantation of this policy is a broken system as persistent problems interfere with substantial and necessary change. Relevant issues like political bias, regulatory and professional rigidity, funding shortfalls, inattention to physical environments in all settings, poor communication, and information dissemination can be overcome. The baby boomers are quickly coming of age and will soon be looking for these services. From these issues, political bias and regulatory rigidity will continue to change with each coming election. But if the funding is secure and the location is sound, baby boomers will communicate and spread the word through interacting with the community and its services.
Physiological Barriers
The issue with this obstacle is clear. The media and governmental agencies have convinced the public that drug users are bad people and that they must be severely punished by long-term incarceration. Getting over this marketed physiological barrier is extremely important to decreasing the use of drugs. Looking only at cannabis legalization and reforming the sentencing of nonviolent drug users, can, and will, build healthy communities. Re-marketing cannabis with factual, up-to-date national and global research that supports the true facts of cannabis[17] will alleviate this barrier. By marketing true facts, promoting abstinence, and creating and providing rehabilitation services, we can support responsible and informed drug policies.
Staffing the Proposal
With 1 out of every 100 adults locked up in this country (approx. 2.2 million), that’s nearly as many as the next two leaders in incarceration combined, China and Russia. In his HBO segment, John Oliver slams Americas racist and corrupt prison system. This is due to the “racial inequity in incarcerations, the horrid conditions in which prisoners live”, and converting our prison system to a for profit industry through privatization. The racial inequity involved with incarcerations is staggering. Roughly 60% of people in prison are minorities while the total US minority percentage stands at 36.3% . The largest segment of prisoners are incarcerated for nonviolent drug charges.[18] Twenty-five billion dollars is spent annually on this racially driven injustice.
The Global Commission on Drugs calls for an end to the criminalization and incarceration of users, along with targeted prevention, and harm reduction and treatment strategies. Drug Cartels could see from 30-60% loss in revenue from just Cannabis sales alone, if policies change. The solution is clear. By redirecting the reduction of law enforcement expenses, an estimated $8 billion a year, we can fund Communities for Life staffing throughout the US. We can divert non-violent criminals and drug users through proven rehabilitation programs that will prevent recidivism. Recidivism currently stands at 56.7% during the first year after release, 67.8 % in 3 years, and 76.6% in 5 years. The Communities for Life proposal can reduce this rate to as little as 10% . The inner-city neighborhoods to which most released prisoners return have high crime rates, low education standards, and very few jobs. A pre- and post-prison employment and support system will help rebuild communities and reduce incarceration rates. This would go a long way in building communities that work together and age together. If we, as a population, can get this right, the community and all that it offers, will improve the overall quality of life for our aging Americans and for generations of affected low-income and minority families.
If funding is the main issue in implementing real quality of life changes in the community, then this is certainly one option. Sentencing reform is simple. Community involvement in exchange for jail or prison time for nonviolent crimes will provide the manpower, experience, and employment for community centers and local gardens, while instilling a sense of pride in their own work and community. While keeping current volunteer recruitment companions, one should focus on retired military and police who have the institutional knowledge in guiding and mentoring individuals who will perform their community service in these newly formed community areas. According to the results of a 5-year follow-up study of released prisoners, two factors stand out as the main component in recidivist offenders. “Employment status… and the offender’s level of formal education are the most important predictors of recidivism among released offenders, regardless of their type of offense”.
The average annual cost of incarceration in Federal prisons in 2016 was between $26,082 and $31,977 per inmate. This cost dramatically increases when factoring in the cost of security, health care, operations, administration, support, and rehabilitation programs. The amount with these additional costs is estimated at $47,102 per inmate, per year. Currently there are approximately 94,134 nonviolent drug offenders in federal prison. That is to say, the US spends more than $4.4 billion each year on housing and caring for these nonviolent Americans.
These costs do not include local jails. Currently there are approximately 1.4 million men and women in local jails. A surprising fact to note is that up to 12 million people cycle through the jail system every year. It is also important to note that the jail is one of a community’s largest investments and its funding is drawn from the same sources that support public hospitals, schools, social services, roads, and many other essential functions of local government. The U.S. Department of Justice estimated that local communities spent $22.2 billion on jails in 2011 to house these men and women. While $22 billion seems high, this number again does not include what other city agencies spend in additional support. With services such as health care, education programs for those incarcerated, administration, jail employee benefits and capital costs, this amount virtually doubles when calculating in these additional costs, to as much as $40 billion per year. Incarceration is not a business. We must revert back to a government-run, or non-profit, prison system.
Communities for Life could provide a solution for education and post-release employment needs. Bruce Western’s doctoral theses states that the total gross cost of reintegrating, educating, and employing 250,000 released prisoners would be $8.5 billion nationally. Remembering that the savings in law enforcement expenses is estimated at $8 billion a year, Western's proposal proves there is permanent and sustainable funding. The Communities for Life proposal mirrors Western’s, comprising four elements: (1) expanded in-prison correctional programs such as education and work training, (2) transitional employment after release, (3) parole reform to support the effectiveness of transitional jobs, and (4) the elimination of bans on some federal benefits, like voting, for people with criminal records.
Targeted Recipients: Meeting the Needs of the Community
“Elder Ready, Children Friendly and Family Focused” is the motto. It reveals who is to benefit and how they will benefit. In order to do this, we must first find a location for them to reap these benefits. Using Portland, Oregon, the Mueller Community, and the Bristol Hospitality Network as a base, we as a people can solve the issues of homelessness and hunger among our elderly, our children, and our needy families. We can do this using proper community planning, green energy, and waste water and food management.
Along with these suggestions, location for these centers must provide ease of access to community services through public and other transportation options. Reaching needed services should not be an issue. The OAA, ADA, ACA-HCBS, Long Term Service Support (LTSS), and the Olmstead ruling all state the importance of community innovations to this end and most of these policies authorize funds and/or grants to achieve this goal. By achieving this goal, access to needed services, information, and knowledgeable individuals who take pride in serving their community and its population will no longer be a challenging obstacle. Locally grown organic produce reduces the financial burden and transportation inefficiencies while improving water management, quality of life, population health, and again, most importantly, cultural diversity.
Homelessness
According to Amnesty International, 3.5 million Americans are homeless. Many of them are our veterans struggling with mental issues like PTSD and financial hardships. They also report that there are 18.5 million vacant homes in the US. The solution is clear. With the Communities for Life concept we can house all the homeless and support AFCIs. Several initiatives are taking the lead, like the Neighborhood Stabilization Program (NSP) and others in the Department of Housing and Urban Development (HUD), Department of Veterans Affairs (VA), Department of Health and Human Services, and Department of Education. These programs and departments are targeting homelessness with funding. For the 2015 fiscal year it is at $4.5 billion. These programs are working. With an estimated 578,424[19] people experiencing homelessness on any given night, that is an 11% decrease since 2007. Sadly, these numbers are a bit misleading. The decrease is due in part to the number of people in poor households living doubled up with family and friends. This cohort grew to 7.7 million people, with an increase of 3.7% from 2012 to 2013, with 39 states seeing increases. Since 2007, the number of people living doubled up has increased by 67%. Remembering the $4.4 billion spent by the federal government on nonviolent prisoners, together with this $4.5 billion, we can introduce a shift in how this money is spent. We can buy and modify these 18.5 million abandoned and vacant homes for the homeless, low-income, and older adults, thus providing homes and modifications that meet their needs. With this $8.9 billion, together with just 20% of the estimated cost saving to local jails ($2.3 billion), we can shift funds to other housing and community programs. Along with this, there are a number of programs that overlap beneficiaries. That amount was at $61.48 billion in 2015. For a total estimated permanent budget of around $25 billion per year, this proposal offers a solution to purchase houses for families and older adults. It will also pay for and build communities.
Alleviating Food Insecurity
In this country, 40% of all food produced goes to landfills[20] uneaten, while perfectly fine for consumption.[21] In 2013, 14.3% (17.5 million) households were food insecure, while 5.6% (6.8 million) households had very low food security. Americans wasted 35 million tons of food in 2012. That is to say, we tossed way $165 billion into the trash. According to the Natural Resources Defense Council, getting food from the farm to our homes “eats up 10 percent of the total U.S. energy budget, uses 50 percent of U.S. land, and swallows 80 percent of all freshwater consumed in the United States”.
There are four ways to remove inefficiencies in the food system through the help of businesses, government, consumers, and at each step in the supply chain. For example, Stop and Shop was able to save an estimated $100 million annually after an analysis of freshness, shrink, and customer satisfaction in their perishables department. In 2015, H.R. 644 Fighting Hunger Incentive Act of 2015, passed the House. This bill could have solved this issue, but after the Senate changed the title and all of its contents, the bill had nothing to do with fighting hunger. The new title, Trade Facilitation and Trade Enforcement Act of 2015, reauthorized trade facilitation and trade enforcement functions and activities, and other purposes . The bill in its original form resembled a comprehensive policy proposal set forth in France which made it a “legal obligation to donate extra food to non-profit organizations that ask for it”. Corporations would be required to include data on food waste in “Corporate Social Responsibility” announcements and businesses would be required to find “alternatives to landfilling”. A national agency would be dedicated to the study of food waste, mandated clarification of expiration dates, and implementation of “education and public awareness” campaigns, [22]. With the estimated savings annually, this could be one alternative to long-term food insecurity for older adults and low-income families.
We must remember the unallocated 80% of estimated savings to local jails ($11.5 billion), along with the $100 billion spent in food assistance, and the $165 billion that went into the trash. This is a very large amount and will support the hungry. This proposal does not advocate using the entire $100 billion spent on food assistance, nor does it expect to save the entire $165 billion thrown into the trash. What it does advocate is a review of effectiveness of current programs like the “Special Milk Program”. With this one program, the federal government subsidizes $10 billion per year to dairy farmers. This program is used to assist the Dairy Product Price Support Program (DPPSP). The US Secretary of Agriculture is authorized to carry out this program under the Commodity Credit Corporation (CCC) borrowing authority. This price fixing by the US was originally enacted in 1949.[23] It is used to raise the price of milk to a level that supports all dairy farmers. Reducing the number of dairy farmers would save this $10 billion and lower the price of milk to its fair market price. With this one redirection of funds, we could supply milk to the school programs that currently use it. We could also redirect a large percentage of that 40% food waste to eliminate hunger altogether. As much as $20 billion a year could go to fund projects like OzHarvest[24] and transport edible food waste to empty plates.
Conclusion
By 2030, one in five Americans will be 65 years of age or older (U.S. Census Bureau, 2008). Their care will cost an estimated $760 billion if impairment levels remain consistent. (Congressional Budget Office, 2004). We, as a people, know how to maintain health and support the aging process through building healthy Communities for Life. We must urgently enact policies and programs that will help pay for and alleviate the burden of ill health and its costs to our budget and our lives. Neighborhoods like Portland Oregon, The Mueller Community, and the Bristol Hospitality Network are setting the standard. They provide benefits to all affected, while increasing cultural diversity, health, happiness, and improving the quality of life for older adults and low-income and minority populations, all while serving public needs. All we have to do is act.
Currently over 88% of the population is in support of legalization of cannabis. Eight states and the District of Columbia have made cannabis legal for recreational use. Twenty-nine states and the District of Columbia have made cannabis legal for medicinal use. The legalization of cannabis will happen throughout the US. Like it or not, it is here. We must urgently pass informed and prudent laws that will support the community using these additional tax revenues. If we do not, it is certain that the same for-profit businesses pushing for this legalization, will quickly step in. If we do nothing, we do nothing to benefit those in need.
By providing jobs that not only pay, but also educate Americans caught up in the for profit prison system, we will elevate the burden of society to be the shoulders of society.[25] We will educate these Americans in contemporary health and nursing, city planning and green energy, water sustainability and food management, all the while building green communities that truly support its citizens. We will solve the issues of homelessness and hunger among our elderly, our children and our families. We must not sit idle. We must act urgently by deliberately influencing social and physical environments to benefit all.
"When we have inner peace, we can be at peace with those around us. When our community is in a state of peace, it can share that peace with neighboring communities."
– The Dalai Lama.
[1] “Walk Score's mission is to promote walkable neighborhoods. Walkable neighborhoods are one of the simplest and best solutions for the environment, our health, and our economy” https://www.walkscore.com/about.shtml.
[2] 1The U.S. Department of Health and Human Services- Office of Community Services, Health Impact Assessment; The Role of Health Impact Assessment (HIA) found that the HIA useful tool for identifying the impact of a new policy, program, or major transportation project on community and individual health; Healthy People 2020- Educational and Community-Based Programs. The Office of the Surgeon General’s National Prevention Strategy: Building Healthy and Safe Community Environments and Empowering People to Make Healthy Choices. The CDC- Recommendations for Improving Health through Transportation, National Prevention Strategy: America's Plan for Better Health and Wellness. The 2011 CDC co-sponsored National Research Council report Improving Health in the United States, to name just a few important departments and studies setting the example.
[3] “Balancing Incentives Program which will have invested nearly $3 billion in 21 states by September 2015. Participating states may use the Balancing Incentive Program funds to increase access to home and community based services. Research indicates that states that have invested in rebalancing have saved money in their long-term services and supports spending compared to the amount that they would have spent had they not invested in rebalancing.”.
[4] Evidence-Based Care Transitions Program -ACA, Community-based Care Transitions Program -CMS, Aging and Disability Resource Center (ADRC) care transition programs-AoA, Transportation Research and Demonstration Program -ACL, and many others run through states and hospitals - The Transitional Care Model (TCM); The Care Transitions Intervention (CTI); Re-engineered Discharge (RED) can all be united to streamline this one process. Other ACA policies are: Home and Community-Based Services State Plan Option, Section 2402 under Title II Role Of Public Programs; Community First Choice, Section 2401 under Title II Role Of Public Programs, Proposed Regulation 42 CFR Part 441 - 2/25/11, CMCS Informational Bulletin - 2/26/11; State Balancing Incentive Payments Program, Section 10202 under Title II Amendments, State Medicaid Director Letter SMDL#11-010, Funding Opportunity Description and Grant Application (OMB Control No: 0938-1145); Money Follows the Person (MFP), Section 2403 under Title II Role Of Public Programs; and Demonstration Grant for Testing Experience and Functional Assessment Tools (TEFT).
[5] The average direct price of maintaining and operating a car in the U.S. is $8,487 per year; owning and operating a bicycle costs a mere $400 a year in expenses and maintenance. By increasing public transportation families could save this cost for other needs. In Portland, fast-paced roads are being reworked to slow traffic. Two-lane thoroughfares are being changed to one-lane roads to allow for wider sidewalks and bicycle lanes. “Mayors are putting a stake in the ground and declaring that cars are no longer king” .
[6] “Our mission is to better prepare Minority and Women Business Enterprises (MWBE) to aggressively seek and win Public and Private sector business opportunities. We provide a nationwide Minority and Women Business Development Program which educates, mentors, and leverages the capabilities of these Minority and Women business Enterprises to maximize profitability and sustainability” http://www.mwbe.com/comp/about.htm.
[7] http://www.npr.org/2015/09/09/438797634/mayor-in-england-encourages-bristol-residents-to-take-in-refugees.
[8] The Hospitality of Bristol Project started in February 2015. It is a collaborative project between the University of Bristol and community organizations, including BHN, Dignity for Asylum Seekers and the Barton Hill Walled Garden. The nature of the project is quite explorative, it is a way to find out what makes good hospitality and how we can improve the network in terms of it welcome, while for the university researchers is a way to find out more about community driven research projects and what hospitality means in multi-cultural settings.
[9] The Section 202 Housing for the Elderly program provides funding to facilitate the creation of multifamily housing for very low-income elderly persons. Nearly 400,000 homes for low-income elderly households have been produced to date. Section 202 is currently the only federal program that expressly addresses this need for affordable elderly housing. Its impact is amplified through the leverage of other housing resources such as Section 8, Community Development Block Grants (CDBG), HOME Investment Partnerships Program (HOME), and Low-Income Housing Tax Credits (LIHTC), .
[10] The HUD 202 program has been layered with the “HOME Investment Partnerships Program (HOME)” that provides formula grants to states and localities that communities use - often in partnership with local nonprofit groups - to fund a wide range of activities including building, buying, and/or rehabilitating affordable housing for rent or homeownership or providing direct rental assistance to low-income people. It is the largest Federal block grant to state and local governments designed exclusively to create affordable housing for low-income households. HOME is a matched funds program, so local jurisdictions must have matching funds available.
[11] According to the Washington Post, voter support in legalized states stands at; D.C.: 64.9 percent, Oregon: 56.1 percent, Washington: 55.7 percent, Colorado: 55.3 percent, Alaska: 53.2 percent. Taxes in each state are collected at; D.C.: 25% at 3 levels, producer, retailer, and consumer; percent, Oregon: 35% per ounce; Washington: 25% at 3 levels, producer, retailer, and consumer, Colorado: 15% at wholesale and 1% sales, Alaska: $50 per ounce. The revenue goes to new school construction, state general fund for enforcement, studies and public health monitoring, 40 percent to a school fund; 20 percent to a mental health, alcoholism and drug services account; 15 percent to state police; 20 percent to cities and counties for local law enforcement; and 5 percent to alcohol and drug abuse prevention, early intervention and treatment services; with the remainder split, 50 percent to a state health plan trust account; 15 percent for reducing substance abuse among young people; 10 percent for a public health program; less than 10 percent to study the short- and long-term effects of marijuana use, to provide health and dental care and to fund bridge building.
[12] “The value of taxes on marijuana that could be carried in a duffel bag would approximate the median family income; a passenger car could carry marijuana with $1 million worth of taxes”.
[13] Examples of community planning approaches and tools to support them include the AdvantAge Initiative (Feldman & Oberlink, 2003), the Lifelong Communities Initiative in Atlanta, Georgia (Atlanta Regional Commission, 2009), AARP Public Policy Institute’s Livable Communities Initiative (AARP, 2014), the Milken Institute’s Best Cities for Successful Aging Initiative (Chatterjee & DeVol, 2014) and the WHO’s Global Age-Friendly Cities Project (WHO, 2007), .
[14] Two nationally prominent models of this type are Villages and Naturally Occurring Retirement Community Supportive Service Programs (NORC programs), (Greenfield, Scharlach, Lehning, Davitt, & Graham, 2013). Villages are usually membership-based, neighborhood organizations (Scharlach, Lehning, & Graham, 2012), whereas NORC programs are typically part of larger multiservice, community-based organizations (Vladeck, 2004), .
[15] Examples of cross-sector partnership approaches include the Robert Wood Johnson Foundation’s Community Partnerships for Older Adults (CPFOA) program (Bolda, Saucier, Maddox, Wetle, & Lowe, 2006), and several grantees as part of Community Innovations for Aging in Place (CIAIP), an OAA demonstration program, which made cross-sector partnership the cornerstone of its initiatives (Oberlink, 2014)., .
[16] Justice Ginsburg delivered the opinion of the Court with respect to Parts I, II, and III—A, concluding that, under Title II of the ADA, (a) The integration and reasonable-modifications regulations issued by the Attorney General rest on two key determinations: (1) Unjustified placement or retention of persons in institutions severely limits their exposure to the outside community, and therefore constitutes a form of discrimination based on disability prohibited by Title II, and (2) qualifying their obligation to avoid unjustified isolation of individuals with disabilities.
[17] To date there have been zero known overdose deaths from cannabis while legal prescription drugs are involved in 82% of all overdoses. Prescription drugs kill over 100,000 people every year . Washington D.C. and 25 states have legalized medical marijuana. Even the NIH's National Institute on Drug Abuse lists medical uses for cannabis; Glaucoma, reverse the carcinogenic effects of tobacco and improve lung health, control epileptic seizures, decreases Dravet's Syndrome symptoms, stops cancer cells from spreading, decrease anxiety, slow the progression of Alzheimer's disease, eases pain in multiple sclerosis-arthritis-muscle spasms, lessens side effects from treating hepatitis C and increases treatment effectiveness, treats inflammatory bowel diseases, including Crohn's disease, keeps you skinny and helps your metabolism, spurs creativity in the brain, soothes tremors with Parkinson's disease, helps veterans suffering from PTSD, protects the brain after a stroke, protect the brain from concussions and trauma, help eliminate nightmares, reduces pain and nausea from chemo, and stimulates appetite, help people trying to cut back on drinking and other drug use . And the biggest and most important discovery of cannabis is not just its non-lethality but it is also non-chemically addictive. The prescription painkiller overdose epidemic is killing 44 people in the U.S. every day, with many more becoming chemically and physiologically addicted.
[18] Only 7% of Americans think we are winning the war on drugs, . "We are driven by a sense of urgency. There is a widespread acknowledgment that the current system is not working, but also recognition that change is both necessary and achievable. We are convinced that the 2016 United Nations General Assembly Special Session (UNGASS) is an historic opportunity to discuss the shortcomings of the drug control regime, identify workable alternatives and align the debate with ongoing debates on the post-2015 development agenda and human rights." Fernando Henrique Cardoso, leading member of the Global Commission on Politics and Drugs and former President of Brazil. The Global Commission proposes five pathways to improve the global drug policy regime. After putting people ́s health and safety at the center of the picture, governments are urged to ensure access to essential medicines and pain control. The Commissioners call for an end to the criminalization and incarceration of users together with targeted prevention, harm reduction and treatment strategies for dependent users.
[19] Meaning they were sleeping outside or in an emergency shelter or transitional housing program. From 2013 to 2014, a period of ongoing recovery from the Great Recession, overall homelessness decreased by 2.3 % and homelessness decreased among every major subpopulation: unsheltered persons (10%), families (2.7%), chronically homeless individuals (2.5%), and veterans (10.5%) .
[20] Food waste is also harmful for the environment. When food sits in landfills, it emits methane, which is 21 times more potent than carbon dioxide as a greenhouse gas. As the impacts of climate change continue to get more severe, we should be taking every effort to reduce our own carbon footprint. Reducing the amount of food we waste is just one way to do so .
[21] The U.S. government should conduct a comprehensive study for food losses in our food system and establish national goals for food waste reduction. One key action will be to standardize and clarify the meaning of date labels on food so that consumers stop throwing out items due to misinterpretation. State and local governments should lead by setting targets and implementing food waste prevention campaigns in their jurisdictions as well as their own operations. Businesses should start by understanding the extent and opportunity of their own waste streams and adopting best practices. Americans can help reduce waste by learning when food goes bad, buying imperfect produce, and storing and cooking food with an eye to reducing waste.
[22] “Here in the US, we don't have a comprehensive set of federal policies on food waste reduction. Fortunately, things are beginning to change. Late this summer, the US government, with leadership from the EPA, will announce first-ever national food waste reduction targets. In sync with the United Nations Sustainable Development Goals process, the targets will lay out national food waste reduction goals through the year 2030.” This statement was made before the changes to H.R. 644.
[23] Provisions of the Agricultural Act of 1949, as amended, required that the price of milk paid to producers be supported at a level between 75 and 90 percent parity to assure an adequate supply of milk, reflect changes in the cost of production and assure a level of farm income to maintain productive capacity sufficient to meet future needs; however, since Oct. 21, 1981, the support price has been established by Congress either at specific price levels or by formula related to expected surplus, rather than parity levels.
[24] Australia’s leading food rescue organization, OzHarvest, will transform food destined-for-landfill into gourmet, high quality restaurant meals for its latest innovative pop-up café project. The organization collects approximately 340,000 kilograms of surplus food each month from all types of food businesses including supermarkets, cafés, restaurants, catering companies, events and even farms. It has delivered more than 33 million meals, saved more than 11,000 tons of food from landfill across its 10 years of operations, providing much needed food relief to Australians in need. OzHarvest services more than 680 welfare organizations in Sydney, Adelaide, Brisbane, Canberra, Gold Coast, Melbourne, Newcastle, Perth and in regional areas via its REAP food rescue program, including homeless shelters, women’s and men’s refuges, youth shelters and organizations that service families in vulnerable communities.
[25] This would provide ex-prisoners with valuable work experience, while simultaneously allowing them to contribute to the community. The combination of transitional employment, transitional housing, and drug treatment for prisoners with substance abuse problems would significantly improve the economic and social reintegration of former prisoners into their communities, and improve the quality of life in those communities.