WELCOME
Housing Conditions Pro Bono
Attorney Training
Co-sponsored by the Hispanic Bar Association of the District of Columbia
October 7, 2015
Introduction
Housing Conditions Pro Bono Attorney Training
October 7, 2015
Welcome
• Overview of Children’s Law Center
• Housing Conditions Work
• Children’s Law Center’s Pro Bono Program
• Caregiver (Adoption, Guardianship, and Custody)
• Custody Guardian ad Litem (CGAL)
• Special Education
• Housing Conditions
• Who are CLC Pro Bono Attorneys?
• Case Placement Procedures
• Resources and Mentoring
Controlling Pediatric Asthma
Past, Present, Future
The Experience in Metro Washington, DC
Molly Savitz, MSN, FNP, AE-C
IMPACT DC
Children’s National Health System
Disclosures: Grant Support
• Novartis for NIH/NIAID funded PROSE study
(NCT01430403)
• DC Department of Health Community Health
Administration (Grant Number HA.PSMB.CRI.052013)
• Fight For Children
Conceptual Model of Asthma
Child With Asthma
Individual & Social Factors
• Genetics
• Physical conditioning
• Socioeconomic status
• Stress
• Hormone levels
Environmental Factors
• Allergen sensitization and exposure
(dust, mold, roach, mice, pollen…)
• Viral infections
• Weather changes
• Air quality (irritants)
Medical Care Factors
• Access to care
• Quality of care
• Medication plan
• Adherence
• Technique
• Immunizations
Level of Asthma Control
Low Morbidity
• Few Symptoms
• Few school absences
• Few ED Visits
Poor
High Morbidity
• Many symptoms
• Many school absences
• Many ED Visits
Outline
• Past: Disparities in Asthma Outcomes
– Nationally
– Metro DC
• Present: Achieving Better Control in the Inner-city
– NIH Guidelines
– Healthy Homes
• Future: “Phenotypic Driven Care”
– Immunomodulators
National Experience with
Pediatric Asthma
• 7.1 million children <18y living with asthma in the US in 2009*
– 640,000 ED visits**
– 157,000 hospital admissions**
– 10.5 million annual lost school days*
• Morbidity is highly concentrated in urban environments
– Children’s National sees 1% of all ED visits for asthma
every year in our country!
*National Health Interview Survey
**National Hospital Medical Care Survey
Pediatric ED Visit Rates for Asthma
0-17y, inclusive
4.3x
441
450
400
350
300
274.1
250
200
150
100
102.3
75.6
50
0
Total 2004-5
Caucasian
2004-5
Akinbami L. Pediatrics 2009.
IMPACT DC, 2012.
African
American
2004-5
District of
Columbia 2010
Prevalence of Asthma among DC Residents Aged 1-17y
BRFSS
18%
0.2
0.18
0.16
0.14
0.12
0.1
0.08
0.06
0.04
0.02
0
2005
2006
2007
2008
2009
2010
Asthma Among Latinos-Hispanics
DC Hispanics
18%
Poverty in DC, 2000
Primary Care Access, 2005
Primary Care Access, 2005
Outline
• Past: Disparities in Asthma Outcomes
– Nationally
– Metro DC
• Present: Achieving Better Control in the Inner-city
– NIH Guidelines
– Healthy Homes
• Future: “Phenotypic Driven Care”
– Immunomodulators
National Institutes of Health
Guidelines for Asthma Care
1991
1997
2002
2007
Priorities of the NIH Guidelines
•
•
•
•
Proper diagnosis
Patient and family education
Identification and control of triggers
Clear medical plan
– Inhaled Corticosteroids (ICS)
• Effective longitudinal care
}
Child in Community with Asthma Experiences an
Acute Exacerbation
ED Visit and Discharge
21% within 30 days
Primary Care
Follow-up
Opportunities for
Improved Care
Liberman D.
Ped Emerg Care
2012.
Child in Community with Asthma Experiences an
Acute Exacerbation
ED Visit and Discharge
>70% within 15
days
Teach SJ.
Arch Ped Adol Med
2006.
Primary Care
Follow-up
Opportunities for
Improved Care
Asthma Education
Personalized Asthma Tools
Patient Device Education
Healthy Homes in DC
• Environmental tobacco smoke (63%) – more prevalent along
with roach and mold
• Dust mite (79%)
• Cockroach (31%)
• Mold/musty (23%)
• Furry pet (19%)
• Indoor air quality is highly correlated with asthma
morbidity and quality of life
Teach SJ et al. Pediatrics 2006;117;S152-S158
Healthy Homes in DC
100
89
90
82
80
70
60
50
58
58
46
45
41
40
30
20
14
13
7
10
0
Hazards Identified
Source: District Department of Energy and the Environment, 2015
MOLD
PEST
ACCESS
ROACHES
Summary of “Present”
• Disparities in asthma care and outcomes in Washington, DC
are striking and persistent
• Heavy reliance on EDs for episodic care by disadvantaged and
minority kids
• Things are improving due to a relentless focus on the most
“out of control” kids!!
Outline
• Past: Disparities in Asthma Outcomes
– Nationally
– Metro DC
• Present: Achieving Better Control in the Inner-city
– NIH Guidelines
• Future: “Phenotypic Driven Care”
– Immunomodulators
Conceptual Model of Asthma
Child With Asthma
Individual & Social Factors
• Genetics
• Physical conditioning
• Socioeconomic status
• Stress
• Hormone levels
Environmental Factors
• Allergen sensitization and exposure
(dust, mold, roach, mice, pollen…)
• Viral infections
• Weather changes
• Air quality (irritants)
Medical Care Factors
• Access to care
• Quality of care
• Medication plan
• Adherence
• Technique
• Immunizations
Level of Asthma Control
Low Morbidity
• Few Symptoms
• Few school absences
• Few ED Visits
Poor
High Morbidity
• Many symptoms
• Many school absences
• Many ED Visits
Hypothesis – Design
ICATA Trial – NEJM, March 2011
• Addition of omalizumab to treatment based on existing NIH
guidelines would improve disease control among atopic innercity children with moderate-to-severe disease
• Prospective multi-center randomized clinical trial of injected
omalizumab vs. injected placebo in inner-city kids with allergic
asthma
% of Participants with Exacerbations
Exacerbations
(n=211)
(n=208)
Housing Conditions Cases
An Overview
Kathy Zeisel, Senior Supervising Attorney
Adrian Alvarez, Staff Attorney
October 7, 2015
Outline of the Training
1. Background of CLC’s Medical Legal
Partnership Healthy Together and Housing
Conditions Pro Bono Partnership
2. Introduction to Housing in DC
3. Typical Housing Conditions Problems
4. Handling a Housing Conditions Case
What is Medical-Legal Partnership?
• A healthcare delivery model that integrates legal assistance as a
vital part of the healthcare delivery system
• Expanding the concept of medical care for low income families to
include legal representation
•
Program model based on prevention
• Removing non-medical barriers to children and families’ health and
wellbeing
• Address adverse social conditions negatively impacting health
through a variety of modalities
• MLPs work to address and prevent adverse social pressures with
legal remedies through:
• Direct Patient Contact
• Provider Training
• Systemic Advocacy
CLC’s Healthy Together: DC’s Medical
Legal Partnership for Children
Together:
DC’s Medical
L“[D]ramatic
differences in
…child and adult
health outcomes
based on social
factors such as
income and
wealth…begin early
in life-even before
birth-and
accumulate over
lifetimes and across
generations.”
CLC’s Healthy
Robert Wood Johnson Fdn,
Issue Brief Series: Exploring
the Social Determinants of
Health, March 2011
egal Partnership for Children
• Children’s National
• One of the oldest MLPs in the country
• In 2002 began with one lawyer
• In 2014 we now have ten lawyers and two
investigators
• A variety of CNMC clinics and programs:
• Four Children’s Health Center Locations
• Large focus on teen parents and SE
residents
• IMPACT DC
• Mary’s Center for Maternal & Child Health
• Originally, federally funded through Healthy
Start, Healthy Families
• Focus on immigrant community & children
with asthma
• Unity Health Center, Minnesota Avenue
Why Housing Conditions Cases?
•
•
•
•
•
•
Filling a community need
Hands-on lawyering
Direct advocacy
Litigation experience
Concrete results for children
Working with families
Housing In DC:
An Overview of the Basics
Basic Housing Vocabulary
• Subsidized Housing
• Catch-all term that covers all publicly financed housing options
• HUD: the Department of Housing and Urban Development
• Federal department that oversees all federally funded public housing.
• DCHA: DC Housing Authority
• Quasi-government organization that oversees most public housing options
in DC
• Is both a federal and local agency (and is neither fully)
• HQS: Housing Quality Standards
• These are the HUD standards used by HUD and DCHA to inspect properties
• DCRA: Department of Consumer and Regulatory Affairs
• DC Government agency that inspects residential, retail, commercial, etc.
properties.
• Responsible for enforcing the DC Housing Code
Who is the tenant?
• With a formal lease
• Without a formal lease
• Any arrangement where money is exchanged for a
place to stay.
• Foreclosure
• If the owner is foreclosed on, the tenant still has the right
to stay and the bank becomes the landlord.
• Ending the tenancy
• Must have good cause
• In DC, the end of a lease is NOT good cause for
eviction.
Common Types of Housing
• Private Housing
• Public Housing
• Owned and operated by DC Housing Authority (DCHA)
• Housing Choice Voucher Program (HCVP formerly “Section 8”)
• Tenant has voucher and the voucher moves with the
tenant
• Project Based Section 8
• Owned and operated by a private landlord; funding
stays with unit, not the tenant
• Moderate Rehabilitation Housing (MOD)
• Somewhat like Project Based Section 8, but run by
DCHA (HCVP Program)
Housing: Private Rental Housing
• Rental units where the tenant pays the full
cost of the rent
Housing: Project Based Section 8
• Private landlord receives direct funds from
HUD to operate subsidized housing.
• The subsidy stays with the unit.
• For most properties, oversight is by HUD
Office of Multifamily Programs and the local
HUD office.
Housing: Project Based Section 8
• Project Based Section 8 Properties
• Must apply to each property, which maintains their
own waitlist.
• Waitlists are generally shorter
• Housing may be for a specific population (ie: families,
disabled, elderly)
• No transfer between properties without a HUD
waiver
• You can find the lists of project-based section 8
on the HUD Office of Multifamily Programs:
• http://www.hud.gov/apps/section8/
DCHA Housing: Getting into It
• DC Housing Authority Waitlists
• There are currently 60,000 people on the waitlists for
Public Housing and HCVP combined
• For some housing, it will be a 20-43 year wait
• Other housing come available more frequently (seniors,
VASH, some local homeless and mental health vouchers)
• Preferences for: Homeless, veterans, seniors, DV survivors
• DCHA Waitlist Closed on April 12, 2013
Housing: Public Housing
Public Housing
Relationship
Tenant
DCHA
Owned and operated by DCHA
• Regular DCHA inspections of the
property
• Units are located throughout the
city
• People placed in public housing
from the central waiting list
maintained by DCHA (1133 N.
Capitol St NE)
• Transfers from one unit in one
neighborhood to another unit in a
different neighborhood are
possible
• Tenant recertifies at DCHA
Housing: HCVP
Relationships of HCVP operates several programs
within DCHA
HCVP
Housing choice vouchers (also still
called Section 8 vouchers) are far
Tenant
DCHA
Landlord
different from other public housing
options:
A voucher allowing recipients to
seek a place to rent on the open
market.
Recipients pay 30% of their income
toward rent. The government
covers the rest.
Voucher is portable
Housing: Moderate Rehabilitation Properties
(MOD Rehab)
• Administered by DCHA
• Operates like project-based Section 8
• Typically, there are no transfers out of the
program into other types of housing.
• These are many of the worst properties in
the city.
Who Oversees Whom…
Department of
Housing and Urban
Development (HUD)
Federal agency
DC Housing
Authority
Housing Choice
Voucher Program
Housing Choice
Voucher Program
(aka Section 8
Voucher/TenantBased Voucher)
Moderate
Rehabilitation
Properties (MOD
Rehab)
Project Based
Section 8
Public Housing
Housing Conditions:
The Law
Common Housing issues
• Infestations of mice, rats and/or cockroaches
•
•
•
•
In food/kitchen areas
Damaging furniture/mattresses
Crawling on children/biting children
Allergies from urine/feces/dander
• Mold/Moisture
• Allergies
• Unsafe structurally- Ceiling/Walls collapsing
Common Housing Issues
• Needs repairs or repairs are inadequate
• Screens missing or improperly installed
• Fridge leaks coolant into food
• Toilet does not work properly
• Sewage overflow
• Accessibility
• No wheelchair access
• Broken elevator
Housing Conditions: The Law
• DCMR Title 14, Chapters 1-15 outline the
Housing Code in DC
• DC has now adopted the International Property
Maintenance Code with some local
adaptations
• Unified document:
http://www.ecodes.biz/ecodes_support/Free_Resou
rces/2013DistrictofColumbia/13PropertyMaint/13D
CPropMaint_main.html
IPMC > Title 14
• 102.4.1 Code precedence. If a conflict arises
between the Housing Code,
Title 14 DCMR, Subtitle A and the Property
Maintenance Code, the
provisions of the Property Maintenance Code
shall take precedence.
Housing Conditions: The Law
• Warranty of Habitability: A landlord has a duty to provide
habitable apartments or houses and to repair housing code
violations. A landlord cannot waive this duty in a lease.
• No one has to live in unsafe, hazardous, or unsanitary
conditions
• Landlords must repair all conditions that are violations of
the Housing Code or IPMC
• Landlords may not ignore any problem that constitutes:
• a fire hazard, or
• a serious threat to life, health, or safety of tenant
The Mold Law
• The Air Quality Amendment Act of 2014 creates
requirements for landlords to remediate mold
• Role of DDOE Regulations
• Will define indoor mold contamination
• Hiring a consultant expert to develop regulations
• Might include visible mold, air test results
• Will define methods for mold assessments
• Will define best practices and work standards for
remediation
• For remediation above and below threshold
• Models available in the field
• Will develop licensing and certification requirements
• May recognize license/certification from neighboring states
The Mold Law
• Portions of the Law in Effect Now
• LL must inspect within 7 days of written notice
from Tenant
• LL must remediate visible mold within 30 days of
inspection
• DCRA may issue a NOV based on professional
mold assessment
Portions of law dependent on DDOE Regs
• DDOE regulations will:
• Set a threshold of indoor mold contamination
• Define best practices for mold assessments
• Define best practices and work standards for
remediation
• Develop licensing and certification requirements
Portions of law dependent on DDOE Regs
• Court finding violation based on professional mold
assessment may reimburse assessment costs and
award fees and costs
• Tenant must provide written copy of the report in order to
request reimbursement
• LL disclosures to prospective tenants must include
information about indoor mold contamination within
the past 3 years
• But not if mold was professionally remediated
• For mold below the DDOE threshold, owner may
remediate on his own but must follow DDOE
standards
• For mold above the DDOE threshold, only a
professional may remediate and must follow DDOE
standards
Portions of law dependent on DDOE Regs
• Portions of the Law Dependent on DDOE
Regulations
• Professional mold assessment finding indoor mold
contamination creates a rebuttable presumption of
violation of Housing Code / Property Maintenance
Code
• Note: but only if owner received written/electronic notice of
report
• Court may award treble damages when:
• Tenant discovered the mold;
• Professional mold assessment found mold above DDOE
threshold;
• Owner received written/electronic notice of the assessment;
• Owner did not remediate the mold within 60 days; and
• Owner acted in bad faith
Handling a Housing
Conditions Case
Challenges that Face our Clients
2015 Poverty Guidelines for
the 48 Contiguous States and
the District of Columbia
Persons in
family/
household
1
2
3
4
5
6
7
8
Poverty
guideline
$11,770
15,930
20,090
24,250
28,410
32,570
36,730
40,890
For families/households with
more that 8 persons, add
$3,960 for each additional
person
• Income
• Education/Literacy
• Reliance on public
transportation
• Barriers to communication:
• Inflexible job
• Transportation Costs
• Time commitment for using public
transportation
• Caring for an infant or other relative
• Cost of cell phone minutes
Representing Low Income Clients
• Get lots of ways to contact client
• Cell phone, family member’s cell phone
• Email address
• If your client falls out of contact, write a contact
letter.
• Offer assistance with transportation or meet in
your client’s neighborhood/home
• Do NOT use legalese (written communication
should be at an 8th grade level)
• Explain what a lawyer is and your roles
Working up your case
1. Document the problems: You can go and/or
you can send a paralegal or someone who
could testify in court.
2. Request any prior inspection reports (from
DCRA or DCHA).
3. Determine if you need any supplemental
reports (ie: from a mold inspector).
Who is the landlord?
• To find the landlord, look at the lease AND
check DCRA’s PIVS website:
http://pivs.dcra.dc.gov/PIVS/Search.aspx
• Property management companies often sign
the leases.
• BUT the owner has the ultimate legal
responsibility and provides the funds for
repairs, so you want to sue the owner.
Send a Demand Letter
• You may want to send a demand letter to the
landlord listing all of the problems.
• For mold cases, you should send a demand letter.
• This ensures that there is notice prior to filing.
• You do not have to do this if the tenant has notified
the LL of all the problems and you decide it is not a
good legal strategy.
• You may not want to do this if a TRO is needed or
there is another emergency.
Legal Options: DCRA Inspection
• Contact the Department of Consumer and Regulatory
Affairs (DCRA): (202) 442-9557
• How it should work:
• First inspection occurs within 1-2 weeks (except if no heat or water)
• If housing code violations exist, inspector will serve a notice of
violation on landlord
• NOV will have time limits for repairs
• Re-inspection by same inspector after repairs should have been
completed
• Fines issued if not in compliance
• Pros:
• You have an inspection report
• Cons:
• Delays case
• Inspector is not always as thorough as Court’s DCRA inspector
• Weak enforcement power, so LL may not make repairs
Legal Options: DCHA Inspection
• Contact the DC Housing Authority
• (202) 535-1000
• DCHA makes annual inspections of all its properties
• DCHA Inspections are based on Housing Quality Standards
(HQS) sent by HUD, not the DC Housing Code
• Can inspect more frequently upon request
• Pro:
• This may help you if you want to request a transfer or
accommodation
• Con:
• This may not be considered fully by the Court since it is not
a housing code inspection
Legal Options: ADA/Fair Housing Request
• A Reasonable Accommodation Request pursuant
to the Americans with Disabilities Act may be
appropriate when there is a reasonable change
that would allow a person with a disability to
have equal use or enjoyment of the property.
• Common requests include:
•
•
•
•
Removal of carpet
Transfer to a unit without carpet
Permission to make modifications to address needs of a child
Transfer to a larger unit because child’s medical equipment
will not fit or a child needs his own room due to disability
• HUD DOJ Joint Statement on RA under the Fair
Housing Act is a useful reference
Legal Options: Court
•
•
•
•
Landlord Tenant Court
Civil Cases
Small Claims Court
Housing Conditions Calendar
Legal Options: Housing Conditions Calendar
• A Calendar within Civil Court
• Provides Tenant a way to affirmatively bring
their Landlord into court regarding conditions.
• In landlord/tenant court, a tenant can withhold
rent, but must wait to be sued for eviction to get
before a judge.
• Court is ONLY for housing conditions repairs
• No rent, lease violations, or other issues
• Court will generally not deal with any money issues
Legal Options: Housing Conditions Calendar
• Filings:
• There are Court forms that you can use to file the
Complaint and Summons .
• Temporary Restraining Order and/or Preliminary
Injunction: You can use forms or draft your own.
• In forma pauperis: Most of your clients will qualify
for an IFP.
• If they do not qualify, it is $15 to file the case and
$10/motion.
• E-filing: After the initial filing, you should plan to file
online. If your client has an IFP, you will need to set
up a separate IFP account with DC Superior Court.
Legal Options: Housing Conditions Calendar
• Examples of when to file a TRO/PI:
• No heat
• Severe flooding
• Constructive eviction
• You may also consider a PI where there is
evidence you want in front of the judge prior
to the first court date, such as pictures or
reports.
Legal Options: Housing Conditions Calendar
• Once you file:
• Court is always on a Monday morning
• You will get a court date 3-4 weeks from the date
of filing
• Serving the landlord:
• Even though the Court will serve if you have an
IFP, you should personally serve the landlord
• File affidavit of service prior to return date if
possible
Legal Options: Housing Conditions Calendar
• First Court Date:
• If there is a dispute, the Court will likely order the
Court’s DCRA inspector to the unit.
• You may be able to get the landlord to agree to
some repairs
• You usually have to ask for a written order —the
Court does not regularly do them.
Legal Options: Housing Conditions Calendar
• DCRA Inspection
• Court inspector will go to the unit on a date set in court
• You or a representative can attend the inspection
• You may be able to email the inspectors and get a copy
prior to the court date
• Subsequent Court Dates:
• Court will set a return date 3-6 weeks later to review DCRA
inspection report and/or to check on repairs
• How long in Court?
• Cases can last a few months or over a year depending on
the speed and quality of the landlord’s repairs.
Legal Options: Housing Conditions Calendar
• Moving a case forward in the HCC
• The Judge generally treats HCC like a settlement
court—meaning that very few trials are conducted
and few orders are given.
• BUT the Rules of the Civil Court apply and you can
file motions, request orders or evidentiary
hearings and sanctions.
• You can hire experts (ie: mold, plumbers,
electricians) if you want to present evidence on
either the underlying problem or the proper
repair for it.
Contact Information
• Nancy Drane, Director, Pro Bono
T: 202.467.4900 x502
ndrane@childrenslawcenter.org
• Kathy Zeisel, Senior Supervising Attorney
T: 202-467-4900 ext. 547
kzeisel@childrenslawcenter.org
• Anne Cunningham, Senior Staff Attorney
T: 202-467-4900 ext. 533
acunningham@childrenslawcenter.org
• Adrian Alvarez, Staff Attorney
T: 202-467-4900 ext. 528
aalvarez@childrenslawcenter.org
Children’s Law Center fights so every child in DC can grow up
with a loving family, good health and a quality education. Judges,
pediatricians and families turn to us to be the voice for children
who are abused or neglected, who aren’t learning in school, or
who have health problems that can’t be solved by medicine alone.
With 100 staff and hundreds of pro bono lawyers, we reach
1 out of every 8 children in DC’s poorest neighborhoods – more than
5,000 children and families each year. And, we multiply this impact
by advocating for city-wide solutions that benefit all children.
Visit childrenslawcenter.org to learn more.