- For governors, Medicaid looks ripe for slashing, By Kevin Sack, January 28, 2011, New York Times: “Hamstrung by federal prohibitions against lowering Medicaid eligibility, governors from both parties are exercising their remaining options in proposing bone-deep cuts to the program during the fourth consecutive year of brutal economic conditions. Because states confront budget gaps estimated at $125 billion, few essential services – schools, roads, parks – are likely to escape the ax. But the election of tough-minded governors, the evaporation of federal aid, the relentless growth of Medicaid rolls and the exhaustion of alternatives have made the program, which primarily covers low-income children and disabled adults, an outsize target…”
- Medicaid cuts could lead to higher taxes, insurance premiums, By Tim Eaton, January 28, 2011, Austin American-Statesman: “Even if you don’t rely on Medicaid, Texas lawmakers’ proposed cuts in the health care program could cost you money. Cutting Medicaid could have outcomes beyond fewer services for the poor, several local officials in the health care industry said. Notably, taxpayers in Central Texas could end up with increased local taxes and higher insurance premiums, according to several Central Texas health care professionals. Tom Banning, the CEO for the Texas Academy of Family Physicians, said the proposed cuts don’t equate to savings. Rather, there is simply a shuffling of expenses. ‘This has the potential to be the biggest cost shift to local governments that Texas has ever seen,’ Banning said. The two largest hospital groups in Austin echoed those concerns…”
Monthly Archives: January 2011
Exhaustion of Jobless Benefits
An uncertain future after jobless benefits expire, By Cristina Silva (AP), January 29, 2011, Washington Post: “The portraits of his dead father are among the few mementoes Bud Meyers is certain he will take with him when he is forced from his home of five years next month because he cannot pay the rent. His prized collection of mystery novels, the bedroom set he was once proud to purchase new and anything else that can’t fit into the trunk of a car must be left behind. More than two years after Meyers lost his job as a Las Vegas Strip bartender and nearly eight months after he exhausted his unemployment benefits, it has come to this: a careful inventory of a life’s possessions and the hopeless embrace of a future as a middle-aged homeless man. ‘I can’t believe this is happening to my life,’ Meyers, 55, said on a recent afternoon, as he surveyed the one-bedroom apartment he must soon abandon. ‘It’s a social holocaust.’ Meyers, who is single and childless, is among a growing number of men and women who no longer qualify for unemployment benefits because they have been out of work for so long…”
Child Care Subsidies – Washington
Washington welfare cuts get reprieve, By Jordan Schrader, January 29, 2011, Tacoma News Tribune: “Turea Ducharme has been on welfare before. She has no interest in going back. The South Tacoma single mom said she worked hard to move herself and her two children off of a government check and onto a paycheck. She became first a teller, now an assistant manager, at a Moneytree payday-lending office. Finding work left Ducharme in need of another form of public assistance: Day care subsidies that helped pay for someone to watch Niya, 4, and Devon, 10, while she worked. But state budget cuts have yanked that help away, and she worries about ending up back on the welfare rolls. ‘I’ll lose my job if I get to the point where I don’t have anyone to watch my kids,’ Ducharme worries. Thousands more parents could be placed in that situation in the next two-year budget period as further cuts to welfare programs loom, including the $725 million Working Connections Child Care program…”
States and Medicaid Funding
- Health-care law: Arizona tries new approach to get by federal Medicaid rules, By N.C. Aizenman, January 23, 2011, Washington Post: “Republican efforts to repeal or limit the reach of the new health-care law took a new direction last week when Arizona lawmakers approved a novel and controversial attempt to cut Medicaid for 280,000 of the state’s poor. The bill, requested and signed by Gov. Jan Brewer (R), empowers her to make a formal request, most likely this week, for a federal waiver to avoid complying with provisions of the law that prohibit states from tightening their eligibility requirements for Medicaid. Twenty-nine Republican governors, including Brewer, have signed a letter calling on President Obama and congressional leaders to remove the provision from the law. But Arizona is the first state to, in effect, play chicken with the Obama administration by directly requesting a reprieve and daring Health and Human Services Secretary Kathleen Sebelius to refuse…”
- States may face showdown with feds over cutting Medicaid rolls, By Marilyn Werber Serafini and Julie Appleby, January 28, 2011, Kaiser Health News: “Financially strapped governors, Congress and the Obama administration could be headed for a showdown over the Medicaid health care program that covers 48 million poor, disabled and elderly people nationwide. Arizona’s governor has already asked for permission to drop people from the joint federal-state program, which states say is eating up huge portions of their budgets. But to do so, they need the green light either from Congress or the Obama administration. If they don’t get one? States warn they may need to slash payments to doctors and hospitals and make deep cuts in other programs such as education. They could even thumb their nose at the law and cut eligibility, which would force the Obama administration to decide whether to cut all federal Medicaid funding to those states…”
Welfare Reform and General Assistance Program – Maine
- Demand for general assistance at critical point in Bangor, By Eric Russell, January 26, 2011, Bangor Daily News: “In the six years that Shawn Yardley has overseen the city’s health and community services department, he has never seen things this dire. On most mornings when he arrives at his office before 8 a.m., Yardley unlocks the door for residents who are waiting to fill out an application for general assistance. Most applicants are encouraged to make appointments, but walk-ins are becoming more common. Yardley always lets them wait in the lobby. Some have to wait for hours but they are always seen. General assistance, an emergency safety net program administered by municipalities but funded in part by the state, is becoming an increasingly used entitlement for people struggling with finances or waiting to receive federal subsidies…”
- TANF study to contribute to welfare debate, By Eric Russell, January 26, 2011, Bangor Daily News: “Advocacy groups are calling on lawmakers to focus on facts, not anecdotes and stereotypes, as Gov. Paul LePage and the Republican-controlled Legislature gear up to tackle welfare reform. Maine Equal Justice Partners and the Maine Women’s Lobby released a study Wednesday of Temporary Assistance for Needy Families – or TANF – cases in Maine. TANF is a federal entitlement program, administered by states, that provides a cash benefit to families with dependent children and includes an education and retraining program called ASPIRE. Last year, Maine distributed roughly $32 million in TANF benefits. The yearlong study, conducted by Thomas Chalmers McLaughlin at the University of New England and Sandy Butler at the University of Maine, concluded that recent discussions of welfare reform make unfair generalizations about TANF families…”
Supplemental Nutrition Assistance Program Enrollment
- Food-stamp use reaches record level in Oregon, By Michael Rose, January 20, 2011, Statesman Journal: “For 14 months, Oregon’s unemployment rate has hovered between 10.5 percent and 10.7 percent. That’s bad enough, but another sign of economic hardship keeps rising to record levels: food-stamp recipients. People receiving benefits from Oregon’s Supplemental Nutrition Assistance Program increased by 7,467 in December. The total number of Oregonians in the SNAP program – formerly known as food stamps – now stands at 748,886…”
- Food stamps now help 1 in 5 in Jacksonville, By Deirdre Conner, Florida Times-Union: “Food stamp use has more than doubled in Duval County over the past five years. That grim statistic is twice the national average and is the second highest in a study of 22 cities nationwide, according to a report released Monday. The report, issued by the Food Research and Action Center, an anti-hunger advocacy group, showed Jacksonville as second only to Las Vegas in the growth in people who depend on the federal Supplemental Nutrition Assistance Program, which is commonly called food stamps. It looked at a geographically balanced cross section of urban areas…”
State Medicaid Programs
- Hospitals, poor patients face new costs, By Kay Lazar and Stephen Smith, January 27, 2011, Boston Globe: “Payments to hospitals and other health care providers would be slashed and low-income patients served by Medicaid would have to pay higher copayments under the spending plan Governor Deval Patrick proposed yesterday for the next budget year. But the biggest savings in the $10 billion program that serves 1.2 million residents would come from revising and rebidding Medicaid contracts to encourage health care providers to work together to drive down costs. With health care spending, including Medicaid, now making up 39 percent of the state budget, Patrick said it was time to take aggressive action to halt the relentless trend upward…”
- Minnesota health CEOs taking a whack at Medicaid, By Warren Wolfe, January 26, 2011, Minneapolis-St. Paul Star Tribune: “Concerned that the Legislature and governor might get it wrong, CEOs from seven major health plans and providers have drawn up their own plan to streamline Minnesota’s massive Medicaid program — and carve $1.8 billion from the projected $6.2 billion deficit. The plan is sure to draw political fire. It suggests up to $170 million in cuts to state-funded services that help keep the elderly and disabled out of institutions, for example, and captures $280 million in higher taxes on tobacco and alcohol. Nonetheless, its influential authors and specific targets will make it part of the debate as lawmakers grapple with a state budget in which health care consumes 30 percent of all spending…”
- Gov. Steve Beshear wants Medicaid funds shifted to avoid shortage, By Deborah Yetter, January 19, 2011, Louisville Courier-Journal: “Seeking to prevent deep cuts in services, Gov. Steve Beshear said Wednesday that he will ask lawmakers to shift $166.5 million from next year’s Medicaid budget into the current fiscal year. The maneuver would allow Kentucky to draw more federal matching money for Medicaid from federal stimulus funds, though it only postpones the need to achieve savings or make cuts in the program. The stimulus funds expire June 30, which is also the end of the current fiscal year. If nothing is done, Kentucky’s $6 billion-a-year Medicaid program could wind up as much as $600 million short this year, the governor said. And that, he said, could lead to ‘devastating’ cuts of up to 30 percent in the federal-state health plan for the poor and disabled that serves more than 800,000 people…”
Poverty Measurement in the US
Measure by measure, January 20, 2011, The Economist: “Most people have an inherent sense of what it means to be poor. But choosing a definition is much trickier. Is poverty an absolute or relative condition? What is a decent standard of living? Such questions have dogged America’s social scientists for decades. This month the Census Bureau published a preliminary estimate of poverty, using a new definition. It was 16 years in the making. But it is not quite finished yet. Poverty means different things in different countries. In Europe, the poor are those whose income falls below 60% of the median. Britain uses three measures: one relative, one absolute and a broader indicator of material deprivation, such as whether a child can celebrate his birthday. The concept of poverty becomes even more slippery when attempting international comparisons. The United Nations’ ‘human- development index’ assesses countries across a range of indicators, such as schooling and life expectancy…”
Infant Mortality Rate – Milwaukee, WI
- For Milwaukee’s children, an early grave, By Crocker Stephenson, January 22, 2011, Milwaukee Journal Sentinel: “On a bitter January afternoon, a 22-year-old mother sits on the edge of her bed and feeds her infant daughter. The child, Rashyia, born in December, is healthy. She coos, eyes closed. She touches her mother’s cheek with her perfect hand. Rashyia and her mother, Lakisha Stinson, live in a small attic apartment on Milwaukee’s near north side. Three modest rooms. The kitchen has just three chairs and a table that is missing its glass top. The living room has no furniture. The bedroom has a bed and a Pack ‘n Play crib, a gift from Wheaton Franciscan-St. Joseph’s Hospital, whose staff, nurses and doctors brought Rashyia through a high-risk pregnancy and into the world. Rashyia and her mother live in a neighborhood where the rate at which African-American babies, such as Rashyia, die during their first year of life is worse than Botswana. Public health experts have long considered the infant mortality rate to be an essential indicator of a community’s well-being…”
- It takes a community to keep babies alive, Editorial, January 22, 2011, Milwaukee Journal Sentinel: “Milwaukee’s littlest children are dying at appalling rates – rates that are among the worst in the country; rates that rival the world’s poorest nations. These are babies who never live to blow out their first birthday candle – three-quarters of them dead before they are a month old. They are babies such as the little boy born prematurely to Denelle McManus in January 2007. Denelle was in good health; she had good prenatal care; she didn’t smoke or drink. She was 32 years old when she lost her child. The boy, named Tavion, lived eight days before dying of a heart condition. Denelle’s mother, Patricia McManus, is chief executive of the Black Health Coalition of Wisconsin. An expert in urban issues, McManus has worked 30 years to reduce Milwaukee’s infant mortality rate and now believes that it will take a communitywide effort to save these children, an effort that is beginning to take shape with McManus as one of the leaders…”
Kids Count Report – Nebraska
- Behavioral, mental health problems play big role in other childhood issues, By Erin Andersen, January 25, 2011, Lincoln Journal Star: “One in 10 Nebraska kids is not all right. One in 10 suffers from some sort of behavioral health problem, according to the 2010 Kids Count in Nebraska report being issued Tuesday by Voices for Children. Those kids — with behavioral, emotional and psychological troubles — make up more than 26 percent of children in foster care, 65 to 70 percent of the children in the juvenile justice system and a disproportionate number of school drop-outs and children in poverty, said Melissa Breazile, research coordinator for Voices for Children in Nebraska. This year’s Kids Count report is a mixed bag. While graduation rates have increased and dropout, school expulsion and infant mortality rates have dipped, poverty and its many related issues have increased — some rather significantly…”
- Kids Count sounds alarm on cuts, By Sam Womack, January 25, 2011, Omaha World-Herald: “In 2008, 34 youths with a history of behavioral health problems were dropped off at ‘safe haven’ locations throughout the state. In response, the state enacted big changes. The Legislature limited the safe abandonment law to infants less than 30 days old. In mid-2009 it passed legislation that created programs to connect families with resources to manage child behavioral health issues. This year, several of those services are on the chopping block. As a response, the 2010 Kids Count report focuses on Nebraska’s estimated 90,000 youths with mental, emotional or behavioral disorders, the services available and the need for more preventive action. Kids Count is compiled by Voices for Children, a statewide research and policy group that times the release of its report to the start of new state legislative sessions…”
States and Prisoner Re-entry Programs
States help ex-inmates find jobs, By Steven Greenhouse, January 24, 2011, New York Times: “Faced with yawning budget gaps and high unemployment, California, Michigan, New York and several other states are attacking both problems with a surprising strategy: helping ex-convicts find jobs to keep them from ending up back in prison. The approach is backed by prisoner advocates as well as liberal and conservative government officials, who say it pays off in cold, hard numbers. Michigan, for example, spends $35,000 a year to keep someone in prison – more than the cost of educating a University of Michigan student. Through vigorous job placement programs and prudent use of parole, state officials say they have cut the prison population by 7,500, or about 15 percent, over the last four years, yielding more than $200 million in annual savings. Michigan spends $56 million a year on various re-entry programs, including substance abuse treatment and job training…”
Arizona Republic Series: Losing Ground, Arizona’s Middle Class
- Arizona’s middle class: Defining American ideal, By Betty Beard, January 23, 2011, Arizona Republic: “America’s middle class has never been easy to define, measure or study. It’s loosely seen as those falling between the impoverished and the rich, the vast group that makes enough money to aspire to the American dream. The dream varies depending on the individual. But generally, “middle class” means enough to live on, with a little bit more. It means in typical times, you can support a household, buy a home and pay a mortgage, afford medical care, help the kids with college costs and plot out a comfortable retirement. With the ‘little bit more,’ you can indulge – an upgraded smartphone, a relaxing vacation, a better car. ‘It’s a headache trying to define,’ said John Russo, of the Center for Working Class Studies at Ohio’s Youngstown State University. It would seem obvious that the middle class could be defined by money – perhaps broadly, such as those between the 20th and 80th percentiles in income, or more narrowly, such as those earning a certain percentage below or above the median income. In Arizona, the median income last year was almost $33,000. But Philadelphia-based economist Joel Naroff said that defining the middle class based solely on income can be misleading…”
- Arizona’s middle class: Poverty casts longer shadow, By Betty Beard, January 24, 2011, Arizona Republic: “Gas prices hover near $3. Medical costs are on the rise, and child care can be expensive. And there’s always an emergency home repair that just wasn’t in the budget. It’s hard to climb back to a middle-class lifestyle after a tumble into joblessness and poverty, as many Arizonans are finding. In September, the U.S. Census Bureau said Arizona had the nation’s second-worst poverty rate in 2009, behind Mississippi. The percentage of impoverished Arizonans was said to have increased to 21 percent in 2009 from 18 percent in 2008. The one-year change highlights the devastating impact of the Great Recession in Arizona, which typically falls in the upper third of the 50 states for high poverty rates. The lower-middle class, in particular, faces a shaky short-term outlook…”
- Arizona’s middle class in crisis: Many are barely hanging on, By Betty Beard, January 23, 2011, Arizona Republic: “Arizonans are coming to terms with a harsh reality: Life is different now. Fundamentally, profoundly different. More than 3 1/2 years after home prices peaked, and three years after the recession began, the economic aftershocks continue. In the job-networking groups and the partially built subdivisions, in the nervous break-room conversations, many middle-class dreams are under siege…”
State Medicaid Programs – Arizona, Minnesota
- Arizona lawmakers back governor on Medicaid waiver, By Paul Davenport (AP), January 20, 2011, Washington Post: “The Arizona Legislature on Thursday authorized Republican Gov. Jan Brewer to seek a federal waiver allowing the cash-short state to temporarily remove nearly 300,000 people from its Medicaid rolls in the first such request by a state. The House and Senate approved the authorization requested by Brewer amid questions about whether the waiver request would be approved by President Barack Obama’s administration, and if the legislation would survive an anticipated court challenge. Brewer wants to suspend the eligibility of 280,000 low-income adults, which would scale back the state’s coverage to near that of most other states and save $541.5 million. It’s the single biggest element in Brewer’s plan to eliminate a projected $1.1 billion shortfall in the next state budget…”
- Dayton: Medicaid shift will be soon, By Warren Wolfe, January 20, 2011, Minneapolis-St. Paul Star Tribune: “Briskly brushing aside the views of his predecessor, Gov. Mark Dayton said Thursday that Minnesota will begin a major expansion of its Medicaid program on March 1, not in October as the Pawlenty administration had projected. His decision to move about 95,000 patients into Medicaid was a ‘no-brainer,’ Dayton said at a news conference. The shift will offer more comprehensive care for most of the affected patients and is expected to bring Minnesota about $1.1 billion in federal funds over the next biennium. There will be no net cost to the state beyond what it would have spent for those patients who are currently on two state health plans, state analysts concluded. While the move was applauded by many health care providers and Dayton’s DFL allies, Republicans said the expansion will be shortsighted…”
State Unemployment Funds
States will soon have to start paying interest on their massive unemployment borrowing, By Olga Pierce, January 14, 2011, ProPublica: “Sometimes it’s time to pay the piper. And sometimes that piper is the federal government. And sometimes the piper wants more than $1 billion. Soon. Because of the high jobless rate and past fiscal irresponsibility, 30 states have collectively had to borrow more than $40 billion from the federal government just to keep unemployment insurance checks in the mail. A provision in the stimulus bill made those loans interest-free for an extended grace period. But no more. Efforts to include an extension of the grace period in Obama’s tax cut extension enacted at the end of last year failed, and the first batch of 14 states will have to start paying interest before the end of this year. Given that state budgets need to be hammered out in advance, that means state legislatures will soon face tough choices as they come back in session…”
States and Medicaid Funding – California
- Supreme Court to decide on health care payments for poor people, By David G. Savage, January 18, 2011, Los Angeles Times: “The Supreme Court announced Tuesday it will decide whether to give California and other cash-strapped states more freedom to reduce how much they pay to doctors, hospitals and other providers under the Medicaid program for poor people. The case, which involves about $1 billion in Medicaid cutbacks adopted by the California legislature in 2008 but blocked by federal courts, could greatly complicate the national debate over the funding of health care, as the states try to cut back on their Medicaid spending, while the Obama administration tries to hold the line. Gov. Jerry Brown, in his initial budget plan this year, proposed to slash by 10% what the state pays to these health care providers, which would save the state nearly $719 million…”
- U.S. Supreme Court to take Medi-Cal lawsuit case, By Bob Egelko, January 19, 2011, San Francisco Chronicle: “The U.S. Supreme Court granted California’s request Tuesday to decide whether the state can be sued for cutting fees to doctors and hospitals that treat poor people, a case that will affect Gov. Jerry Brown’s ability to reduce spending for social services. Federal courts in the last two years have blocked attempts by then-Gov. Arnold Schwarzenegger and the Legislature to lower Medi-Cal payments and in-home care workers’ wages by hundreds of millions of dollars, saying federal laws require states to maintain poor people’s access to basic health care. On Tuesday, the high court agreed to decide whether the lower courts should have even considered those cases. The state denies it is violating the law and argues that only the federal government can enforce the laws governing Medicaid, the federal-state program known as Medi-Cal in California. Medi-Cal providers and their patients have no right to sue a state for allegedly violating federal Medicaid rules, lawyers for California told the Supreme Court…”
Unemployment Benefit Debit Cards
States’ unemployment debit cards often carry hidden costs, fees, By Pamela M. Prah, January 20, 2011, Stateline.org: “Like many out-of-work Americans, Philip Tressler gets his unemployment benefits deposited directly into his checking account. He could have received the benefits via a debit card that the state also offers. But Tressler, who was laid off 14 months ago after 32 years working for a grocery distributor in western Pennsylvania, didn’t go for the card. ‘It’s just not convenient,’ he says, especially since he doesn’t use the same bank that issues the state’s debit card. But there’s more than inconvenience at issue when it comes to state debit cards for the unemployed. Had Tressler decided to take one, he might have been subjected to a whole array of extra charges, including $1.50 for each withdrawal of cash from an ATM that isn’t ‘in-network.’ Pennsylvania is among some 30 states that offer debit cards as vehicles for unemployment insurance payments. These cards have their advantages. Workers get their benefits quicker, and states save money. And people without bank accounts can avoid check-cashing fees and make purchases without carrying large amounts of cash…”
Tax Cut Legislation and the Working Poor
New tax law may hold a surprise for working poor, By Tim Lockette, January 20, 2011, Anniston Star: “When President Barack Obama and congressional Republicans cut a deal on the extension of Bush-era tax cuts last month, the move was billed as a tax reduction for all. But the working poor may find an unpleasant surprise in their paychecks this month, says one tax expert. ‘If you’re a low-wage earner, you’ll be worse off, as will about 50 million households,’ said Roberton Williams, a scholar at the nonprofit Tax Policy Center, which is run jointly by the Urban Institute and the Brookings Institution. ‘You’ll probably see the effects of the change in your next paycheck.’ The Star contacted Williams after a reader pointed out that her first January paycheck was actually smaller than her paycheck from last year – despite a recent compromise tax bill that was widely interpreted as a tax cut. Republicans and Democrats sparred throughout December over extension of Bush-era cuts to income taxes, which were set to expire Dec. 31 of last year…”
Foster Care Placements – Utah
Utah foster care placements up 38% in past decade, legislative audit finds, By Marjorie Cortez, January 19, 2011, Deseret News: “The fallout of the 1993 federal lawsuit that challenged Utah’s child welfare practices may be a 38 percent increase in children being placed in foster care, a new legislative audit suggests. ‘Others believe the David C. vs. Leavitt lawsuit has made DCFS (the Division of Child and Family Services) and court staff risk averse and led them to protect children in foster care more than in-home,’ according to a performance audit of the Division of Child and Family Services released Tuesday. DCFS has operated under a court-appointed monitor for more than a decade under the lawsuit. Federal oversight ended in 2007. During the past decade, foster care placements in Utah have increased by 38 percent while the number of families that receive in-home supports that allow children to stay in their family homes has decreased by 40 percent, the audit by Legislative Auditor General shows…”
Opinions: Poverty Measurement
- Poverty and recovery, Editorial, January 19, 2011, New York Times: “In 2008, the first year of the Great Recession, the number of Americans living in poverty rose by 1.7 million to nearly 47.5 million. While hugely painful, that rise wasn’t surprising given the unraveling economy. What is surprising is that recent census data show that those poverty numbers held steady in 2009, even though job loss worsened significantly that year. Clearly, the sheer scale of poverty – 15.7 percent of the country’s population – is unacceptable. But to keep millions more Americans from falling into poverty during a deep recession is a genuine accomplishment that holds a vital lesson: the safety net, fortified by stimulus, staved off an even more damaging crisis…”
- Where does the poverty line truly lie?, By Andrew Chambers, January 19, 2011, The Guardian: “Thailand is a development success story. The country is on target to meet or exceed all its millennium development goals (MDGs), and absolute poverty ($1 a day) is now less than 2%. However, do these statistics accurately measure what poverty is, and what is the next step in poverty reduction for middle-income countries like Thailand? How to define and measure poverty, therefore, is not just a dry academic debate, as these decisions greatly affect what policies are pursued…”
Suburban Poverty and Schools – Des Moines, IA
Suburban schools see growing levels of financial stress among families, By Sheena Dooley, January 18, 2011, Des Moines Register: “The number of low-income families living in Des Moines suburbs is on the rise, a trend that is pushing educators to find ways to ensure school-age youngsters keep pace academically. Iowa had more than 180,700 children and teens who qualified for free or reduced-price meals in 2009-10, up nearly 32,000 from 2004-05. Among those seeing the largest increases were suburban Des Moines districts. In 2009-10, for instance, 14 percent of Johnston’s students qualified for free or reduced-price meals. That percentage has more than doubled since the 2004-05 school year. Over the past five years, hundreds of suburbanites in Iowa and the nation have fallen out of the middle class. The result has been increased levels of poverty and demands for social services in communities where low-income residents have typically been in the shadows…”