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First Edition: January 7, 2020 – Kaiser Health News

Today's early morning highlights from the major news organizations.

Kaiser Health News:In Massachusetts, Minors Need Permission For Abortion, But That Could ChangeShe was 15 and recovering from rape, when she realized she was pregnant. She knew right away that she wanted to terminate the pregnancy. But as in many states, Massachusetts required and still requires minors to get a parents consent before an abortion. I knew I couldnt tell my mom or my immediate family members because my pregnancy was the result of a sexual assault from a family friend, the now 23-year-old woman said. (KHN and NPR agreed to withhold her name.) Her home, she added, wasnt necessarily a safe or healthy one at the time. (Bebinger, 1/7)

California Healthline:Fecal Bacteria In Californias Waterways Increases With Homeless CrisisPresident Donald Trump, a self-described germophobe, has made no secret of his disgust with Californias growing homeless problem, which he has called a disgrace and inappropriate and equated to living in hell. We should all work together to clean up these hazardous waste and homeless sites before the whole city rots away, Trump tweeted about San Francisco on Oct. 26. Very bad and dangerous conditions, also severely impacting the Pacific Ocean and water supply. (Alemndrala, 1/6)

Politico:Congress' Health Agenda Barrels Toward 2020 Buzz SawRepublicans and Democrats have a narrow opening to cut big deals on drug pricing and surprise medical bills and address two key concerns of voters just in time for 2020 electoral politics to drive them apart. Congressional leaders are feeling renewed urgency to do something about the high-profile issues, but they fear impeachment and escalating tensions with Iran could swamp the legislative agenda. And on drug pricing, both sides are reluctant to let the other claim victory on a pocketbook issue that recent polling shows ranks high among voter concerns. (Cancryn and Ollstein, 1/7)

Bloomberg:Congress Seeks Drug-Pricing Deal In Spite Of 2020 RancorIn an election year when nobody expects Congress to pass meaningful legislation, lawmakers are feeling strong political pressure to reach a deal on at least one main voter priority: lowering drug prices. The most likely result could be a small deal that caps out-of-pocket costs for Medicare beneficiaries but leaves more contentious questions of market intervention until after the election. (Wasson, 1/7)

The Hill:Analysis: ObamaCare Market Stable And Profitable Despite Loss Of Individual MandateThe ObamaCare market is stable and profitable for insurers despite the repeal of the laws mandate to have coverage, a new analysis finds. When Republicans repealed the health laws mandate to have coverage in the 2017 tax law, many Democrats and some policy experts warned the move would cause chaos in the markets as healthy people dropped coverage, leaving only sick, expensive patients remaining. (Sullivan, 1/6)

Vox:Obamacare Looks Surprisingly Sturdy After The Individual Mandates RepealThe individual market continues to go through a soft attrition: Premiums continue to increase, but only slightly, and enrollment is shrinking, again slightly. Its not a death spiral, but the market is slowly being winnowed to a core customer base: People who get federal assistance to cover their premiums, and unsubsidized customers who dont receive that help but need good health insurance. (Scott, 1/6)

The Hill:Supreme Court Sets Friday Deadline For Responses In ObamaCare CaseThe Supreme Court on Monday told the Trump administration and a group of states to respond by the end of the week to an effort by Democrats to expedite a challenge to a lower court ruling that struck down a key tenet of ObamaCare. The court asked the health care law's opponents to file a response to the motion by Friday afternoon. Democrats challengingthedecision from the 5th Circuit Court of Appeals that ruled the Affordable Care Act's individual mandate unconstitutionalasked the Supreme Court last week to expeditea briefing schedule and to hear the case before the current term ends in June. (Neidig, 1/6)

Modern Healthcare:Brad Smith Appointed New CMS Innovation Center LeaderBrad Smith, who co-founded palliative care provider Aspire Health is the new director of the CMS' Center for Medicare and Medicaid Innovation. The HHS announced Monday that Smith would be the new leader of the CMS' delivery model testing center, replacing Adam Boehler who left the role in the fall after roughly a year when he was nominated for another role in the Trump administration. (Castellucci, 1/6)

The Washington Post:EPA Says It Will Cut Pollution From Heavy Duty Diesel TrucksThe Environmental Protection Agency on Monday said it would soon propose tougher restrictions on pollution from heavy-duty trucks, an uncharacteristic move to tighten existing standards from an administration that has prided itself on a series of regulatory rollbacks. Heavy-duty vehicles are the largest mobile source of nitrogen oxide, a pollutant linked to heart and lung disease. They also tend to remain in service far longer than other vehicles. (Dennis, 1/6)

The New York Times:E.P.A. Aims To Reduce Truck Pollution, And Avert Tougher State ControlsWhile the move could give President Trump a nominal environmental achievement for the 2020 campaign, public health experts say the truck regulations are not as out of line with administration policy as they would appear. The emerging rule will quite likely limit nitrogen dioxide pollution more than current standards, they say, but still fall far short of what is necessary to significantly prevent respiratory illness and even premature deaths. (Davenport, 1/6)

The Associated Press:US To Start Collecting DNA From People Detained At BorderThe U.S. government on Monday launched a pilot program to collect DNA from people in immigration custody and submit it to the FBI, with plans to expand nationwide. The information would go into a massive criminal database run by the FBI, where it would be held indefinitely. A memo outlining the program published Monday by the Department of Homeland Security said U.S. citizens and permanent residents holding a green card who are detained could be subject to DNA testing, as well as asylum seekers and people entering the country without authorization. (Merchant, 1/6)

Los Angeles Times:California Vaping Bill Targets Flavors Not Covered By Trump's BanDays after concerns over youth vaping led the Trump administration to announce a partial ban on many e-cigarette pods, California lawmakers on Monday introduced a much stronger measure to outlaw store sales of all flavored tobacco products in the state. The proposal would go far beyond the federal governments plan, announced Thursday, for a temporary ban on many candy- and fruit-flavored e-cigarette products that could be lifted if companies can convince the U.S. Food and Drug Administration that the pods are safe. (McGreevy, 1/6)

The Wall Street Journal:Schools Seek Ways To Curb Vaping Among StudentsStudents caught vaping more than once at Northgate High School in Walnut Creek, Calif., are required to attend Saturday vape schoolalong with a parent. The four-hour Saturday requirement includes lessons on the dangers of vaping, a method of inhaling nicotine and other substances that has been associated with a nationwide outbreak of lung injuries and deaths. An official at the high school, where 15% of students admit to having vaped, said the lessons are helping. But its a continuing problem, he said, as freshmen are arriving already exposed to vaping. (Hobbs, 1/6)

The New York Times:A.I. Comes To The Operating RoomBrain surgeons are bringing artificial intelligence and new imaging techniques into the operating room, to diagnose tumors as accurately as pathologists, and much faster, according to a report in the journal Nature Medicine. The new approach streamlines the standard practice of analyzing tissue samples while the patient is still on the operating table, to help guide brain surgery and later treatment. (Grady, 1/6)

Reuters:Drug Developers Take Fresh Aim At 'Guided-Missile' Cancer DrugsDozens of drugmakers are conducting human trials for a record 89 therapies that pair antibodies with toxic agents to fight cancer, evidence of renewed confidence in an approach that has long fallen short of its promise, an analysis compiled for Reuters shows. These antibody-drug conjugates, or ADCs, from companies including AztraZeneca and GlaxoSmithKline, are described by researchers as "guided missiles" packing a powerful anti-cancer punch. (1/6)

USA Today:As Marijuana Induced Psychosis Rises, Mental Health Treatment ElusiveWhenGarrett Riggmoved from a"transitional living program" facility near Chicago last month into a group home, it was a major milestonefor the 27-year-old, who traveled 1,000miles from his home in Denverto get treatment after a cannabis-induced psychotic break five years ago. Rigg had to leave his hometown because it lacked suitable long-term treatment, according to his mother,Connie Kabrick.The three marijuana dispensaries at the intersection ahalf block from herhome are the reason why she says he can't move back.(O'Donnell, 1/6)

The New York Times:Go Ahead And Complain. It Might Be Good For You.Weve all done it: Whether its about traffic, our boss or our partners annoying habits, complaining is just something we do, like breathing though hopefully not as often, said Robin Kowalski, a professor of psychology at Clemson University. Even though it may come naturally, griping isnt necessarily always a good thing. Ruminating on negative feelings, and reinforcing them through constant discussion with other people, can lead to catastrophizing, which is something that can contribute to depression, said Margot Bastin, who studies communication between friends at the department of School Psychology and Development in Context at the Dutch university Katholieke Universiteit Leuven. (Higgs, 1/6)

Reuters:Former Women Players To Join New Research Into DementiaFormer female professional soccer players will be included for the first time in research into possible links between heading balls and dementia thanks to a new project launched on Tuesday. Researchers at the University of East Anglia (UEA) will carry out long-term cognitive tests on former men and women players to shed more light on the findings of a report by the University of Glasgow and Hampden Sports Clinic last year. (1/6)

Reuters:Cutting Out Alcohol May Reduce Atrial Fibrillation EpisodesFor people with atrial fibrillation, abstinence from alcohol may make the heart beat better. Eliminating most alcohol consumption dramatically cuts the number of episodes of the potentially deadly heart rhythm disturbance among moderate and heavy drinkers, according to a study published in the New England Journal of Medicine. (1/7)

The New York Times:Whole Milk May Be Better When It Comes To Childrens WeightWhole milk may be healthier for childrens weight than low-fat milk, a review of studies suggests. The American Academy of Pediatrics currently recommends switching to skim or low-fat (1 percent) milk at age 2. Canadian researchers analyzed 14 prospective studies including 20,897 children up to 18 years old. The studies compared children who drank whole milk (3.25 percent fat) with those given milk containing less than 2 percent fat. (Bakalar, 1/7)

Los Angeles Times:Eight Science Stories To Watch For In 2020Scientists have been searching for ways to detect cancer in its earliest stages, when treatments are most likely to be effective. In 2020, theyll be harnessing the power of biomarkers to aid them in this mission. Biomarkers are distinctive bits of protein or DNA that can be detected in bodily fluids like blood and urine. The trick is to identify ones that are reliable signals of malignancy. Candidates are being tested in ever-larger groups of people to determine whether theyre accurate and can be trusted not to generate too many false-positive results. (Netburn, Healy, Rosen, Khan and Kaplan, 12/27)

The Associated Press:Report: 123 Children Died In 2019 Despite Contact With DCFSA report highlighting persistent problems within Illinois' child welfare agency showed 123 children died in the past fiscal year despite having contact with the Department of Children and Family Services. It was the highest number since the fiscal year ending in 2005, when the number was 139 deaths, according to annual reports released each January by the department's inspector general. The lowest it was during that that time was 84 in the fiscal year ending in 2010. (Tareen, 1/6)

ProPublica:Californias Jails Are In A Deadly Crisis. Heres How Experts Suggest Fixing Them.Nearly a decade after California overhauled its prison and jail system, policymakers are considering reforms to the states landmark criminal justice transformation, calling for more oversight of county sheriffs and higher standards for inmate care. Gov. Gavin Newsom has said he is crafting plans focused on local lockups, where homicides have surged, and exploring how to give the state more power to oversee the sheriffs who run them. More details are expected this week when the governor unveils his state budget proposal. (Pohl and Gabrielson, 1/6)

The Associated Press:Regulator Cites Failures At Hospital Where 3 Preemies DiedA major Pennsylvania hospital where three premature infants died in a bacterial outbreak last year routinely failed to sanitize the equipment it used to prepare donor breast milk, according to a state health department report released Monday. Health department staff ordered Geisinger Medical Center in Danville to correct several deficiencies, determining the hospitals systemic failure to prevent infection in its most vulnerable patients constituted immediate jeopardy a legal finding that means Geisinger placed its patients at risk of serious injury or death. (1/6)

The Associated Press:Maryland Wins $3.6M To Address Opioid Abuse During PregnancyMarylands Health Department has received $3.6 million in federal funding to address opioid use among pregnant and new mothers. The department launched the initiative, called the Maternal Opioid Model, this month, according to a statement released by the agency on Monday. The initiative focuses on improving substance abuse treatment for pregnant and postpartum mothers on Medicaid by providing them with additional resources during and after their pregnancies, the department said. (1/7)

The Washington Post:Bed Bugs Are Released Inside A Pennsylvania WalmartPennsylvania State Police are searching for the pest who left bedbugs in a Walmart. A store manager of a Washington Township, Pa., Walmart found a closed pill bottle containing live bugs in a boys jacket that was for sale Thursday, according to police. He threw out the jacket and the container without contacting authorities but found more insects later. (Beachum, 1/6)

ProPublica:Inside A Training Course Where School Workers Learn How To Physically Restrain StudentsIn the year that weve reported on restraint and seclusion, we have worked hard to become experts on the topic. Were not educators, but we are dedicated learners. We read books and studies about how to work with children who have behavior disorders, and we talked to academic experts and researchers across the country about seclusion, or confining students in a place they cant leave, and physical restraint. We learned by observing, too. ProPublica Illinois reporting fellow Lakeidra Chavis and I spent two days watching a Crisis Prevention Institute, or CPI, training for educators in the Chicago suburbs. (Richards, 1/3)

The Wall Street Journal:States Weigh Measures To Stop Transgender Athletes From Competing In Womens SportsMore statehouses are wading into the contentious debate over the participation of transgender athletes in mens and womens sports. In recent weeks, Republican legislators in at least five states have drafted measures aimed at preventing athletes from competing in categories different than their biological sex. Lawmakers say they are specifically concerned about female athletes facing unfair competition. (Gersham, 1/7)

First Edition: January 7, 2020 - Kaiser Health News

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Bed Bugs In Maryland Schools | What Parents Need To Know

Every time we turn around, there seems to be another news story about bed bugs. These blood-eating pests are being found in libraries, movie theaters, retirement homes, daycares, retail stores, apartment complexes, and the list goes on and on. In this article, we're going to focus on schools--specifically kindergarten through twelfth grade. If you're a parent of a student, here's what you need to know.

These are hitchhiking pests. Understanding how they spread is key in preventing them from spreading to your home.

There is a belief that bed bugs only infest dirty homes. This is not true. They have been found infesting the cleanest of environments. This is because bed bugs are not drawn to filth. They are attracted to areas where humans sleep or lounge. Therefore, they can be brought into a school on any child, which makes controlling the spread of these bugs difficult. It isn't a simple matter of checking students for proper hygiene.

It is also important to point out that bed bugs can come in on teachers and staff. This pest is not limited to traveling only on children. An immature bed bug nymph is as small as the tip on a pen and mostly transparent. This is not a bug you're going to easily notice.

Why do teachers, staff, or students bring bed bugs in from their home? Don't they know that bed bugs spread this way? Yes. And, while some may go to school knowing that they have a bed bug infestation, most don't realize they have one. Bed bug infestations often go unnoticed for months. During this time, everyone living in the home has the potential to spread bugs to another location.

How can an infestation go on for months? Don't bed bugs leave painful welts when they bite? They can. But they don't always leave welts. As much as 30% of people who are bitten have no reaction to these bites, even when bitten repeatedly. A slightly higher percentage have no reaction at first but develop a more pronounced reaction over time.

There are two primary ways bed bugs spread to schools, and subsequently, to other homes. Immature bed bugs get into objects that are carried to and from school or they lay eggs on these items. The spread of a bed bug infestation by immature nymphs requires these bugs to crawl from an infested item to another item. The spread of an infestation by eggs usually occurs when an object is transferred from one student to another. This may be an item of clothing, a book, a bag, a piece of furniture, or even an electronic device.

DIY methods for preventing an infestation of bed bugs are a lot of work and are not 100% effective. Since these are hitchhiking bugs, a focus must be placed on inspecting items that come and go from your home.

Wash clothing on the hottest temperature to kill bed bugs in all stages of development.

Check all objects coming and going for tiny white eggs, black streaks, blood stains, insect casings, or these tiny bugs.

Keep active communication with you children about what bed bugs look like and what signs to be aware of.

Keep clutter in your home to a minimum so it is easier to see signs of these bugs.

Check mattresses, box springs, and upholstered furniture periodically for black streaks, black patches, tiny black droppings, shed insect casings, brown blood staining, tiny white eggs, or the bugs themselves.

The best and easiest way to get rid of bed bugs is to have a pest controller do routine K9 Bed Bug Inspections. Dogs have a powerful sense of smell that allows them to locate these pests. This is a method used by resorts and hotels to maintain a bed-bug free environment for their guests. Without routine inspections, it is impossible to safeguard against a bed bug infestation. These insects don't come in from your yard. They come in on you, your spouse, your kids, your extended family, your friends, and the friends your kids invite over.

Make K9 Detection Services a part of your ongoing pest plan. Reach out to us today to schedule service and get your defenses in place before these bugs take root.

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Bed Bugs In Maryland Schools | What Parents Need To Know

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Maryland, United States Bed Bug Registry Map Bed Bug …

First, its important to note that bed bugs are non-discriminatory pests, they dont care how grand or how little your home is, if its sparkling clean or a mess. All theyre after is a blood meal and they can find that anywhere people congregate. Homeowners often discover bed bugs after: Theyve arrived home from a vacation or business trip Continue reading

When Angie Smiths daughter was born, she made sure to keep her infant in her arms or a swing. If Arabella stopped moving, the roaches would start crawling all over her. It was the worst roach problem Ive ever seen, Smith said Continue reading

Maryland Daily Record (subscription) Baltimore Co. family gets $70K for bed bug infestation at Kushner-owned property Maryland Daily Record (subscription) But she did not know the home's property management company had treated the unit with chemicals until the day before she moved in to address a problem with bed bugs . In June, Han settled for $70,000 her lawsuit against JK2 Westminster LLC, Continue reading

This combination of photos provided by Elyria Police Department shows from left, Jamie Adkins and Brian Dekam. Authorities say Adkins and Dekam, two baby sitters, have been charged with putting five children infested with fleas, bedbugs and lice into the back of a U-Haul truck in Ohio. Continue reading

Bengaluru FC and Mohun Bagan picked up their second win in two games as they beat Chennai City FC an The 2017 edition of the Hero I-League gets underway today and we have two exciting matches lined up .. Continue reading

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Maryland, United States Bed Bug Registry Map Bed Bug ...

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Top Rated Bed Bug Treatments For Homes In MD, VA & D.C.

First, its important to note that bed bugs are non-discriminatory pests, they dont care how grand or how little your home is, if its sparkling clean or a mess. All theyre after is a blood meal and they can find that anywhere people congregate. Homeowners often discover bed bugs after:

Theyve arrived home from a vacation or business trip. Bed bugs are notorious for being found in beds and may hitch a ride on your suitcase from the airport or train station. They can also be found on planes, trains, taxis, and other public transportation. In fact, entomologists speculate that the rising cases of bed bug infestations may be due, in part, to increased international travel.

Bringing home used furniture, mattresses or other secondhand items. If you see items on the side of the road marked free, keep driving by as it could be infested and discarded by the previous owner. You should also be careful when browsing at moving or garage sales and even at second hand stores. If you decide that the item is a must have, inspect very carefully (paying special attention to seams) for live bed bugs or signs of them.

Having houseguests in residence. Welcoming out of town family and friends for the holidays or just because is exciting. It can also lead to bed bug infestations. Your guests may have traveled on public transportation or stayed at a hotel a night or two when in route to your house. They may unknowingly bring bed bugs into your dwelling.

Picking your college student up. School dormitories have become a hot spot for bed bug activity and if your child hasnt been careful, he or she could accidentally bring bed bugs back on their belongings.

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Top Rated Bed Bug Treatments For Homes In MD, VA & D.C.

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Affordable housing shortage leaves hundreds calling hotels along Jeff Davis home –

When Angie Smiths daughter was born, she made sure to keep her infant in her arms or a swing. If Arabella stopped moving, the roaches would start crawling all over her.

It was the worst roach problem Ive ever seen, Smith said.

Smith paid $270 per week to live in Americas Best Value Inn near Jefferson Davis Highway in Chesterfield County for eight months with Arabella and her two other children. The motel room allowed her to get away from her on-again, off-again relationship with her babys father, and also provided relief from a home mortgage and other bills.

In an increasingly impoverished Chesterfield, an affordable housing scarcity, coupled with credit and background requirements for apartments, has led hundreds of people like Smith to settle for months or years at motels, many along the Jeff Davis corridor. This past school year, 160 Chesterfield students lived in hotels or motels. Across the state, nearly 3,000 students found shelter the same way.

It is up to county and state inspectors to enforce regulations designed to protect people from unhealthy conditions at the motels. The fear of eviction leaves many motel residents feeling powerless to complain about the conditions, so the inspectors ability to investigate complaints and proactively inspect properties is critical.

On the local level, however, hundreds of Chesterfield inspection reports indicated that inspectors examined two mobile home parks more than three nearby motels. And year after year, state health inspection reports of three Chesterfield motels described similar problems.

My suspicion is that many localities turn a blind eye to the really horrible living conditions in a lot of these extended-stay motels, said Phil Storey, an attorney with Richmonds Legal Aid Justice Center, which provides services to low-income individuals.

Chesterfield officials and poverty and housing advocates say affordable housing is a nationwide problem and serious issues exist at some motels, but they differ in how they talk about addressing the problem.

County planners say that the county is playing its part in tackling affordable housing in the region and that Chesterfield has a large stock of affordable housing units. Poverty and housing advocates call on localities like Chesterfield to take a more active role.

In the meantime, many families are at the mercy of the motel owners, living in the kinds of conditions that Smith said she wouldnt wish on anyone.

In May, Trimaine Minnie Reed opened her dresser drawer to find cockroaches crawling over her socks and underwear. She has lived with the roaches for three years at Americas Best, now in Room 120 after moving from another room where she said the bathroom ceiling had caved in.

Reed is one of the few residents who have taken the battle to court. She asserted her rights under the Landlord-Tenant Act when B.R. Patel, Americas Best owner, tried to remove her for failing to pay her rent. Because Reed had stayed at the motel longer than 90 days, Patel was legally required to issue her an eviction-related notice. On the court date for the eviction proceeding, Reed planned to tell a judge about the motels conditions.

Patel referred questions to his lawyer, R. Glen Morgan, who said, Theres plenty of other hotels. Obviously, its not that bad or she would leave.

The owners of two other motels that also have significant tenant populations, the Virginian Motel and Par 3 Motel, declined to comment or didnt respond to multiple requests for comment.

Most of the motel tenants arent like Reed. Instead, they silently count down the months or years until they can move out, or drift to another motel. After her tax-return money came in, Smith moved her family into a cheaper rental cabin in Chesterfield where she pays $200 a week.

Some people just slip through the cracks, Smith said.

Less than a mile from Americas Best Value Inn, Twonneil Butlers son once scraped a leg when the bathroom floor at the Virginian gave out beneath him. When Butler asked to have the floor fixed, it took a week for the owner to provide a piece of plywood that could patch up the hole, Butler said.

He later found all of his belongings scattered in the Virginians parking lot after he didnt pay his rent. His things were eventually stolen or thrown in dumpsters. The Virginians owner declined to comment.

Its Pay me or get out, Butler said. Things need to change. The upkeep needs to be taken care of.

On the state level, health inspection reports of three motels told a story of persistent problems.

The Virginia Department of Health is the only agency with the power to inspect the inside of hotel rooms at any time for their overall condition, as long as those rooms are vacant and ready to rent. VDH does not inspect mobile home parks because those are private residences, but it does go above state requirements by inspecting about 10 percent of rooms in all Chesterfield hotels.

Four of five state health inspection reports from 2014 to 2016 at Americas Best Value Inn noted unspecified insects, roaches or bedbugs. Six customer complaints were filed in the same period because of roaches or bedbugs. On two separate inspections from January 2014, mice droppings were observed.

Citations of health code violations werent unique to Americas Best Value Inn. The Par 3 Motel and Virginian Motel both received complaints about bed bugs, with social services at one point assisting an elderly man and his mother moving out of an infested room at the Virginian.

That should send a red flag to an inspector. Even if it is a small problem, if its the same problem year after year it should send a red flag, said Dennis OConnor, environmental health supervisor for the Chesterfield Health District.

Following up on cited violations depends on the severity of the situation, OConnor said, and for minor problems, were going to hope they correct it.

In Chesterfield, the Bermuda Estates and Shady Hill mobile home parks are less than 20 miles from the Par 3 Motel, Virginian Motel and Americas Best Value Inn along the Jeff Davis corridor. With the exception of the Par 3, the properties lie in an area the county identified as needing proactive inspections.

But in the past decade, Chesterfield inspectors opened cases in the two mobile home parks six times more often than at the three motels, according to a review of more than 350 Chesterfield building and zoning inspection records. This was even though the fewer inspections at the motels revealed more serious issues.

That is concerning to me, no doubt about it. I would have to do some research on that. (The disparity) should be an oversight, if at all. We are concerned about every facility in the county, said Supervisor James Holland, whose district includes part of the corridor.

Deputy County Administrator William Dupler said there is a whole lot more opportunity for violations to occur at the mobile home parks. Local inspectors can examine inside motel rooms only on the rare occasion that they obtain a warrant or they are invited into a room by the resident or the motel owner. But, like at the nearby mobile home parks, local inspectors are able to issue violations for external red flags like damaged siding, mold, trash, crumbling structures, or cracked paint and windows.

Care and maintenance of a property is not the countys responsibility. Its the owners responsibility, Dupler said. By and large these mobile home park owners dont maintain their properties to the same standard as the motel owners do.

Inoperable vehicles or discarded materials like old furniture or baby seats sitting outside were among the most common violations at the mobile home parks. At the motels, however, the fewer inspections revealed vermin, collapsed stairs and, in one case, a septic tank at Par 3 leaking into nearby woods.

An anonymous complaint prompted the inspection that revealed the leaking septic tank. Over the past decade, it often took complaints for an issue at the motels to come to the attention of county building or zoning inspectors.

A woman temporarily staying at Americas Best Value called the county in February 2016 with complaints about holes in the walls, inoperable door locks and bugs crawling on the beds. An inspector closed the case a month later, saying the owner said all problems have been corrected.

The story was different at the two mobile home parks, where greater numbers of proactive inspections contributed to the much higher tide of violations.

Chesterfield Board of Supervisors Chairwoman Dorothy Jaeckle, who represents part of the Jeff Davis corridor, said the centralization provided by the countys new Community Enhancement Department will help with the motels issues.

One of the goals of the Department of Community Enhancement is to centralize many of the aspects of revitalization and redevelopment. I believe with the police, fire and EMS, social services, building and zoning working as a group, many of the issues you mentioned will be at the forefront and more pressure will be put on landlords to make the necessary improvements, Jaeckle wrote in an email.

Its unclear how many more cases may have been opened if the fear of eviction didnt hang over many of the motel residents or if there had been more proactive inspections.

When someone stays at the motel for longer than 90 days, they have rights under the Landlord-Tenant Act, including that landlords cant retaliate against tenants for lodging complaints. But the law often doesnt offer its intended protection, said Marcellinus L.M.B Slag, an attorney with the Legal Aid Justice Center. Landlords often simply claim in court that the eviction wasnt connected to the tenants prior complaint.

Its an exploited population, Slag said.

Outside a Chesterfield courtroom in early July, Reed held a folder of papers and some photos of her room that she wanted to show the judge. Reed said she felt like a hostage because she feared leaving her room might mean she would be locked out.

Its an exploited population, Slag said.

Last Tuesday, in a room not far from Reeds at Americas Best, Liliana Ratliff played with a moldy vent broken off from the air-conditioning unit in early August. Water sprinkled from the rumbling machine and soaked the carpet. The 2-year-old then sauntered over to the bathroom, where roach traps sat near her bare feet and patches of mold stained the walls. In the main room, her mother, Kelsey, packed stuffed animals and clothes while Lilianas 5-week-old sister sat in a swing.

Three Chesterfield police officers who knocked on the familys door that morning told Kelsey Ratliff that she and her children had to leave for failing to pay rent. The family had stayed at Americas Best for longer than 90 days, but because they had switched rooms about two months ago because of the conditions in their previous room, Ratliff said she wasnt protected under the Landlord-Tenant Act. Ratliff wasnt sure where they would stay that night. All of the nearby extended-stay motels were booked, and she needed something that was $200 a week or less.

Nearly two dozen people living in motels along Jefferson Davis like Ratliff gave a common reason for why they werent living somewhere else: The motels are the best they can afford.

A Chesterfield committee recently called housing affordability an economic trend of concern, noting that someone earning the $7.25 hourly minimum wage would have to work at least 89 hours a week to afford a one-bedroom apartment rental in the county, where the median rent is $1,123. That trend, the committee continued, could affect the entire county in terms of stunted business growth, increased public safety calls and less tax revenue, among other things.

At the same time, the total number of people living in poverty in Chesterfield increased by 107 percent between 2000 and 2015, to 24,002. A family of four earning below $24,257 was considered living below the federal poverty line in 2015.

The problem isnt confined to Chesterfields borders. According to the 2017 Out of Reach report by the National Low Income Housing Coalition, Virginia is ranked 11th on a list of the most unaffordable states in the U.S. for renters.

Dupler, the deputy county administrator, said that if Chesterfield had the solution, so would the rest of the nation.

We dont like the fact that these motels have transitioned to housing for people. We dont think that is right. But we didnt transition them to housing for people. I think you ought to go ask the (motel) owners about it. What are they doing to provide affordable housing for people? Dupler said, adding that Chesterfield has a large stock of affordable housing. What is within our authority to address it? There are not a lot of tools out there to address it.

Housing advocates called for mandatory minimums for affordable housing units in new developments to address the huge scarcity of affordable housing along the corridor and throughout the county. They also called for greater transparency in the apartment application process and a broad rental subsidy program that could start off as a pilot partially funded by the county.

The Chesterfield Towne Center area and a wide span of the county should be priority areas for affordable housing development, according to a recently released report by the L. Douglas Wilder School of Government and Public Affairs at Virginia Commonwealth University. There are 67,000 more modest-wage jobs than low-cost housing units in a suburban doughnut around the city of Richmond.

We dont have a regulation today that requires affordable dwelling units as a percentage of a development. Some metropolitan areas do have those, said Kirk Turner, Chesterfields former planning director and new head of the Community Enhancement Department. We just havent gotten there yet. Thats not to say that might not be in our future, but it isnt today.

A coalition created by officials in Portland, Ore., helped preserve 11 buildings that provide affordable housing. Rockville, Md., adopted a plan to replace a failing strip mall with a town center that required 15 percent of 644 units to be affordable.

Those two examples were cited in a study commissioned by the Partnership for Housing Affordability, on which Dupler serves as a board member.

Were participating in some regional efforts to affect the housing affordability issue. Its a tough nut to crack, Dupler said. He added that the county recently expanded a tax credit program for homeowners who rehabilitate their homes.

Discussions over revisions to two of Chesterfields high-level plans are ongoing, including revisions to one plan aimed at revitalizing the northern section of the corridor that calls for more affordable housing options.

Just laying out a plan without zoning or financial incentives is going to be a challenge, said Greta Harris, the president of the nonprofit Better Housing Coalition whose aim is to increase quality affordable housing in the region. Quality affordable housing is not inexpensive. So that is where the political will comes in. We need policy, mandates, to get private and nonprofit working in concert with one another.

Supervisor Holland said he believes the county could encourage developers more to be socially conscious to improve affordable housing along the corridor, and was pleased with the countys willingness to waive fees for developers who want to build along Jeff Davis. Carrie Coyner, who is Jaeckles counterpart on the School Board and who represents the Jeff Davis corridor, said the countys plans should call for more affordable housing options in such a way that the countys average salary is reflected in each elementary school zone.

Housing advocates also suggested a broad rental subsidy program funded in part by the county.

Across the nation, 3 of every 4 eligible low-income renter households do not receive federal rental assistance due to funding shortages. The number of unassisted renter households with worst-case housing needs rose by more than 30 percent between 2007 and 2013, according to the Center on Budget and Policy Priorities. That means long waiting lists are common. Its unclear how long a waiting list is for a federal program that enables low-income families to choose and lease affordable housing in the Chesterfield and Colonial Heights areas because that waiting list is now closed. The program served 501 households in 2016.

County officials responded by saying a program like that would probably be administered by the state or federal government.

For those who do have enough money to pay rent, there are then hurdles in the apartment application process like credit and background checks.

Youre one medical problem, one loss of a job, from ruining your credit. A middle-income family with one judgment against them is one step away from that person in a hotel. And that should scare everyone, Coyner said. If we want to truly change the lives of people who are living in overpriced housing, we would be out there meeting one person at a time to rebuild their credit.

Jaeckle, the Board of Supervisors chairwoman, wrote in an email that the countys social services department is working to help people become financially independent.

Christine Marra, an attorney with the Virginia Poverty Law Center, said housing providers should be required to publicize their tenant selection criteria.

Many landlords are using third-party screening companies, and it is not uncommon for these companies to get it wrong. They are doing searches that are using a portion of peoples names, she said, adding that those searches often look for past arrests that didnt necessarily lead to a conviction.

Advocates said that for the immediate future, localities should value mobile home parks. Their median monthly cost, according to one study looking at 20 area jurisdictions, is $400 less than the $993 median monthly home cost in the region.

We sort of overlooked our mobile homes as affordable housing, but some of our mobile homes are valuable assets. And we want to make sure we are protecting them, Coyner said.

Nineteen mobile home parks consisting of 1,657 units still exist in Chesterfield, though the countys 2017 housing report noted that it is the only housing type in the county to shrink since 2001, reducing by a total of 25 percent because they either shut down or were redeveloped.

Its not a place to raise children, Pam Steele said of the motels. But where are they going to go if (Americas Best Value Inns owner) says screw it? Does somebody have a plan for that? Weve got to come up with a solution.

Steeles sign-in sheet on a Friday in early June is nearly filled. She is the intake coordinator at the Place of Miracles Caf, which sits adjacent to Americas Best and serves free meals donated by nearby businesses.

Next to more than half of the names on the sign-in sheet are abbreviations for the motels in which the clients are staying. The rest live in tents or mobile home parks.

The cafe is part of a patchwork of nonprofits and unofficial community organizations that attempt to fill gaps in services for the long-term motel residents. These groups of mainly volunteers feed families, help with rent or pressure motel owners about room conditions. They also acknowledged their efforts are Band-Aids on a larger problem.

Chris Lane said if he and his community organization called the Guardians had more support from the county, more progress could be made on addressing poverty. For Steele, the motel owners are a necessary evil since she has only seen plans and committees come from the county.

Do you want them in a moldy motel room or do you want them in a tent in the woods? she said.

Its awful, but where are you going to put them? Steele said.

Trimaine Reed woke up for her second court date on July 20 unsure of where she would be sleeping that night.

She would never get to show the judge the photos of her room. It took about 10 minutes for the judge to decide that Reed had to move out of her home of three years. She forgot to file paperwork laying out her defense to the claim that she owed $4,015.81 to Americas Best Value Inn, so the judge ruled in the motels favor.

Reed didnt understand what happened as she stood before the judge. Outside the courtroom, when she was told the eviction was official, she started to cry.

The motels attorney offered to forgo the money it argued was owed if Reed would agree to cover the attorneys fees and move out within a day or so. Reed eventually agreed, but that meant she needed to figure out where to go at that moment.

An attempt to join a rehab center didnt work out. Moving to another motel, as Americas Best Value Inns lawyer suggested she could, wasnt an option.

The majority of hotels on Willis Road is the same as Americas Best Value, Reed said. Its not that easy.

Within days, she packed up her Bible and the Twilight board game her sister gave her several years ago for her birthday.

Above: Kelsey Ratliff stands with her daughter Liliana, 2, in the doorway of their room at Americas Best Value Inn while Chesterfield County police officers explain that she must vacate the property. Ratliff had lived at the motel since Christmas 2016, but because she has switched rooms, the Landlord-Tenant Act does not apply to her and she is not eligible for the official eviction process.

A Place of Miracles Caf operates out of the building adjoining Americas Best Value Inn on Willis Road. We serve hot homemade meals Tuesday through Friday to the needy who live in the run-down motels and trailer parks around the Jefferson Davis corridor, its website reads. Clients sign in for dinner with their name and the abbreviation for the motel they live in.

The Snow White Motel is just one of many properties along Jeff Davis filling the housing gap for people unable to afford apartments and homes.

Angie Smith, 38, and her daughter Angelina cut through the woods on their way to buy school clothes at a thrift store in March. They live in a rental cabin along Jeff Davis Highway. That stretch of the road doesnt have sidewalks, so they go through the woods to avoid traffic. They used to live at Americas Best Value Inn on Willis Road.

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Affordable housing shortage leaves hundreds calling hotels along Jeff Davis home -

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