View of Boston in the fall from the 73 Tremont Street building.

“I am no longer accepting the things I cannot change. I am changing the things I cannot accept.” -Angela Davis

From the cushioned luxury of my university perch, I’ve spent a great deal of time and spilled a great deal of ink critiquing the institutional circuit of jails, rehab programs, detention facilities, drug courts, temporary housing and battered women’s and homeless shelters through which millions of poor, sick and suffering Americans cycle, often beginning in childhood and continuing for decades. I’ve argued for a paradigm shift away from policies that aim to “manage” individuals who are sick / addicted / criminal / poor / powerless to policies that address the structural violences of racism, environmental degradation, poverty, unregulated capitalism, sexism and other gross inequalities — the violences that give rise to a growing caste of Americans marked by prison and all-too-often doomed to life (and death) on the margins.

My job is comfortable. I unpack the problem, point to the need for systemic change, and then leave it up to others — for example, those work on the front lines in struggling communities — to come up with the immediate answers that their friends, neighbors, families, patients and clients need right now. However, I’ve been increasingly challenged by colleagues, friends and readers asking me: “Short of a revolution, what do you suggest we do?”

The reality is that revolutions take time. They’re the result of tireless grassroots efforts, community-building, and policy-lobbying. The people working on the front lines in struggling communities aren’t working independently of each other — nor are they necessarily working toward the kind of long-term paradigm shift we’re hoping for. In my experience, I’ve come across programs and policies that seek to alleviate the most immediate suffering while avoiding the structural oppressions that perpetuate that suffering. I’ve also come across programs and policies that mean well, but ultimately reinforce the system that makes them necessary in the first place. Real change is tedious, needs resources, and often has to fend off not only direct opposition but also counterproductive short-term alleviation. In this post, I’ve pulled together the best models that I’ve found.

I. Harm Reduction and Housing First

Living on the streets and in shelters makes people vulnerable to illness, abuse, violence and arrest. Secure housing is not a panacea, but it’s a necessary prerequisite for stable relationships, employment and health. In this era of the housing market, millions of Americans are priced out of the home ownership as well as the rental markets. While public and subsidized housing can be helpful, all-too-often these housing programs enforce rules that are unrealistic for the people most in need of them. I know women in the Boston area who have lost their public or subsidized housing because a boyfriend slept over, a relative staying at the apartment committed a crime, an ex-boyfriend created a scene by pounding on the door or — even worse — assaulting the woman, a teenage child was arrested and placed into juvenile detention, or the woman herself was seen drunk or high.

Secure housing, housing where breaking trivial rules or having overnight guests isn’t grounds for eviction, allows people to cook, eat, bathe, use the toilet, get dressed, sleep, rest, think, get organized and nurture relationships in some semblance of privacy and dignity.

While I’m not thrilled with the phrase, “low threshold housing,” initiatives such as the Massachusetts Housing and Shelter Alliance’s Home and Healthy for Good initiative offers a realistic and empathetic alternative (emphasis mine):

“The Housing First model represents a paradigm shift in the way chronic homelessness is addressed. Often in traditional housing programs, homeless individuals are expected to move forward through a linear service delivery system, with housing saved as a “reward” for individuals who are compliant with other requirements – such as maintaining sobriety or finding employment. However, homeless individuals struggle to meet these demands when they are also dealing with the challenges and instability of homelessness. Housing First represents a shift toward “low-threshold” housing, in which the barriers to housing have been removed. Housing First programs recognize that homeless individuals can more easily maintain their sobriety, find employment, and achieve other health and life goals when they have a permanent place to live. Housing First tenants live in leased, independent apartments or shared living arrangements that are integrated into the community. Tenants have access to a broad range of comprehensive community-based services, including medical and mental health care, substance abuse treatment, case management, vocational training and life skills training. However, participants are not required to participate in services – there are no compliance requirements in order to enter or stay in the program. By removing these barriers to housing, individuals are given an opportunity to deal with the complex health and life issues they face as tenants, rather than as clients of a prescribed system of care.

a low-income housing development in Chicago. Photo by Robert R. Gigliotti via Flickr

I’m also optimistic about initiatives like the Vera Institute’s Family Justice Program, which has partnered with the “New York City Housing Authority, the Corporation for Supportive Housing, the New York City Department of Homeless Services (DHS), and multiple nonprofit reentry service providers to develop, implement, and study a two-year pilot program that reunites 150 eligible formerly incarcerated individuals with their families in public housing while also providing them with case management services.”

II. Meaningful Work

Research demonstrates that engagement in productive activities reduces recidivism. While many Americans struggle to find jobs in this sluggish economy, unemployment among those with criminal records is as high as 50%. The criminalized and marginalized women I have worked with for the past decade rarely land jobs. As Tonya explains, “As soon as you [a potential employer] see me you don’t think ‘maybe she has skills.’ They just have stereotypes – ‘ghetto black.’” The jobs they are offered tend to be poorly paid and only temporary, without paths for advancement, and the work is often meaningless and demeaning. For example, at fast food restaurants, employees are yelled at on a regular basis, they can be fired for calling in sick, and they’re often punished with the most undesirable shifts or dangerous work stations. Many of the women I know report that their bosses “expect” sexual favors from “women like us,” and the men in their lives report that bosses often expect them to “hook them up” with drugs or prostitutes.

Full-time employment in the traditional, mainstream sense is simply unrealistic for many under-educated, chronically ill, marginalized or criminalized Americans. With that in mind, significant and long-term volunteer work can provide opportunities to develop new skills, form supportive social ties, contribute to a sense of worth and meaning in life (probably the best antidotes to substance abuse), and create safer communities. I tend to agree both with the Biblical aphorism that “idle hands are the devil’s workshop,” and with Holocaust survivor and philosopher Viktor Frankl that people are driven by a “striving to find meaning in one’s life,” and that it is this sense of meaning that enables people to overcome painful experiences.

Because criminalized men and women are unlikely to be hired in “regular” jobs, a program of volunteer positions should not consider itself a stepping stone to “regular” (that is, low wage, demeaning, and unstable) work. Rather, volunteer opportunities should include the potential for participants to move into positions of greater responsibility within the agency or facility over time. It is crucial that a program of volunteer work provide stipends for workers. A stipend indicates that work is valued, encourages long-term commitment to the volunteer position, and helps volunteers cover expenses such as transportation to work, rent, a telephone, and commodities including soap and diapers that are not covered by food stamps.

The majority of the Boston-area women with whom I work have, at various times, participated in programs that require them to engage in “fake” work such as repeatedly mopping the same stairwells. Yet there are true pressing needs for volunteer workers in many agencies that help the elderly, the disabled, the community and the environment. Nearly all of the women I know cite generosity, sociability and “helping other people” as their best character traits. Volunteer work can build on these character traits and help women develop a sense of purpose and self-esteem through helping others. The visible presence of people with felony convictions doing voluntary, effective community work can raise the overall status and reduce the stigma of ex-prisoners in the community. A study of a volunteer program for ex-prisoners in the UK found that, “Recognition by others, and the opportunity to relate as people of equal worth, had enabled these women to establish themselves in their own eyes, and in the eyes of others, as contributing and valued members of society” (Eaton, 1993, p. 101). To that end, the Sue Ryder Foundation in the UK encourages and trains prisoners and former prisoners as volunteers in the Foundation’s work with hospice and neurological care. A 2012 evaluation of the program pointed to the positive experiences of working in an environment in which everyone was treated equally, with dignity, and as valued members of a team engaged in important work.

Initiatives of this sort do not cost more than the currently popular dead-end job training programs, fill real needs of non-profit and social service agencies, and may even lead to paid work for some participants.

III. Activism, Advocacy and Community Building

Our entire culture, from television shows and movies to industries such as pharmaceuticals, cosmetics, and fashion, already tells us that we’re not good enough; that it’s our fault that we aren’t what we see on screen. Pop-therapeutic culture sends the message that people who stay in abusive relationships “choose” to be victims. Health, wealth, and autonomy are valued above everything else. So it’s easy to see how people who suffer from illness, poverty, abuse and incarceration end up feeling isolated by society at large, especially after being told (directly and indirectly) that they’re “losers.” And nothing is more isolating than prison where, in order to survive, one learns not to trust anyone – not the guards, not the parole board, not the courts, and often — but certainly not always — not even other prisoners.

Many of the programs aimed at rehabilitating marginalized and criminalized Americans focus on encouraging them to “take responsibility” for their problems and condemn any hint of social or political analysis as “denial.” They place blame on the individual, compounding feelings of mental isolation. I am particularly concerned with the ubiquitous presence of twelve-step programs (“admit my powerlessness; turn myself over to a Higher Power; do an on-going moral inventory of my flaws”) and “rehabilitative” reading materials at prisons, rehab centers, homeless shelters and half-way houses.

Happily, there are a growing number of organizations that reject this model.

In San Francisco, the Center for Young Women’s Development has created Sisters Rising, a nine-month-long paid internship in which young women of color train to become community organizers and learn resume-building skills. “As community organizers, they learn about the systemic issues that have directly affected their lives, such as the fact that young women of color are disproportionately suspended from school, are far more likely to be murdered and experience intimate partner violence at greater rates than white girls and women. … Although the job is part-time, with most of the women in the program working 10 to 15 hours per week, many who go through the program end up becoming full-time employees at the center.”

Here in Boston, Families for Justice as Healing makes clear in its name that “healing” isn’t just about therapy or treatment. True healing can only come about in a just society. In my own interactions with the organization, I saw a group of formerly incarcerated women share their stories about mothering while in prison. In the course of the sharing, perspectives shifted from, “I’m a failure as a mother,” to, “We’ve all been put in situations that make it impossible for us to be effective mothers.” At the end of the session, each woman prepared testimony for a hearing in the state legislature on a bill providing community alternatives to incarceration for parents who are primary caregivers of their children. I came away from that session thinking about organizations like Mothers Against Drunk Driving (MADD) – women who have experienced the unimaginable horror of losing a child, a horror from which they will never “recover.” These women found meaningful work in lobbying for policy changes to prevent more mothers from going through the same horror. When organizations such as the Center for Young Women’s Development or Families for Justice as Healing successfully promote policies that strengthen families and communities, they weaken the power of the institutional circuit and offer real alternatives to lives spent as institutional captives.

IV. Legislative and Policy Initiatives

There has been some talk lately of bi-partisan calls to overhaul the judicial and correctional systems. I admit that I am suspicious of politicians looking to reduce incarceration solely for economic motives and with no interest in reinvesting in communities that have been torn apart by the policies of the last three decades. This is a legitimate concern given the history of initiatives such as Clinton’s so-called “welfare reform,” the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. Still, I do think that there are a number of initiatives that have reasonable chances of being adopted and that are unlikely to backfire.

The REDEEM Act (Record Expungement Designed to Enhance Employment) introduced by Senators Cory Booker and Rand Paul calls for creating a federal pathway for sealing the records of convictions for nonviolent adults, as well as automatically sealing and in some cases expunging juvenile records. In addition, the REDEEM ACT proposes lifting the lifetime ban on SNAP (food stamps) and TANF (welfare) benefits for many non-violent drug offenders. These bans have been extraordinarily detrimental, as Cory Booker explains, “some of the most disadvantaged U.S. citizens, after release from jail, face impossible odds of supporting themselves and their families as they search for a job.” That, in turn, increases the chances of re-incarceration.

Bail reform is a second area in which there is currently a great deal of positive momentum. According to the Pre-Trial Justice Institute: (1) 6 in 10 people in jail in the U.S. are awaiting trial and have not been convicted of their charges. (2) Many of these unconvicted people are incarcerated because they are too poor to pay their bails of a few hundred dollars. (3) A person who spends as little as two or three days in jail is 40% more likely to commit a crime in the future even if they were innocent of the charge for which they were initially held. (4) Pretrial detention increases the chance of conviction, a sentence of incarceration and a longer sentence than for those who are released pretrial.

Bail reform legislation currently is under consideration in a number of states. In Massachusetts, the Massachusetts Bail Fund and the Pretrial Working Group are advocating for SD1491/HD3156 Pretrial & Bail Reform, a bill that mandates the consultation of a validated risk assessment tool to help judges make informed release/detention decisions rather than allowing release/detention to be determined by the individual’s ability to pay cash bail.

It will take years and work and money and a whole lot of good luck to dismantle the prison industrial complex. But the groundwork has already been laid in communities around the country. And so, stepping outside of the ivory tower’s claims to impartiality and objectivity, I’m asking readers to donate time and money to support and strengthen that work. Most of it is difficult, underfunded, and at times dangerous. I’ve linked to a few organizations that I believe in and have come across in my work. If you want to help, I urge you to seek out local and national organizations, programs, and initiatives that are striving to bring positive, effective change to our systemic problems.


According to a June 30, 2015 article in the Gloucester Times, “Responding to a scourge of heroin and opioid addiction, the head of one of [Massachusetts] largest jails wants to build a detox unit to treat addicts awaiting court dates for minor, drug-related offenses. Essex County Sheriff Frank Cousins is asking the state for permission — and money — to construct a 42-bed detox unit at the Middleton House of Corrections. ‘These are the people who are arrested for possession of drugs while committing quality-of-life crimes,’ Cousins said in an interview. ‘We need to get these people out of the jail cells and into treatment.’”

Jails and prisons are not optimal settings for providing drug treatment. The coercive nature of incarceration negates the possibility for individuals to be active participants in addressing their health issues. People may distrust the treatment provided in prison (often with good cause), or experience treatment as just one more hoop to jump through in order to get out.  Even in best case scenarios with willing participants and skillful providers, jail settings magnify the social and personal powerlessness that draw people into substance abuse in the first place.

Sheriff Cousin’s proposal is far from the best of scenarios. The jail-based detox unit he has called for is meant to house people who have not yet been tried; that is, people who have not faced a judge or jury – people who have not had their day in court. Not only does this sort of pre-trial detention potentially constitute a gross abrogation of basic human and constitutional rights to a fair trial, it also removes individuals from their families and local support networks – including their ongoing sources of medical and mental health care.

There are a number of bills currently working their way through the Massachusetts legislature that call for limiting the use of pre-trial incarceration and replacing it – when appropriate – with rational tools for assessing whether or not an individual is violent and / or a flight risk. For example, H.1584 & S.802 call for basing pre-trial detention on risk of not returning to court, rather than on an individual’s ability to pay monetary bail.

Ironically, a month before Sheriff Cousins’ call for jail expansion, Gloucester Police Chief Leonard Campanello launched a pilot drug amnesty plan, explaining that for addicts “Arresting them or coercing them into treatment just doesn’t work.”

Let’s hope that Gloucester Police Chief Campanello’s own colleagues in Essex County heed his advice.

Click here to read Lois Ahren’s “A Less Expensive Option” letter to the Gloucester Times.

For more on the issue of carceral treatment see Incarceration by Any Other Name: A Return to the Cuckoo’s Nest?

For more on building carceral facilities see Civil Commitment: If You Build It They Will Come


This is part one of a two-part series about bills regarding incarceration that are currently under consideration in Massachusetts

“Notwithstanding any general or special law to the contrary, there shall be established a women’s regional correctional facility in Eastern Massachusetts to address the unique and specific needs of female pre-trial detainees and county offenders in Suffolk, Middlesex, Essex, Norfolk, Plymouth and Barnstable counties. This facility will provide specialized programming, access to vital medical services and shall address specific needs of incarcerated women not currently provided by the Commonwealth.” – S. 1297

Unique and Specific Needs

I’m never quite sure what’s “unique” about women’s needs, given that women are more than half of the U.S. population. Be that as it may, having spent the past decade speaking with women pre-, during and post-incarceration, I know that jails and prisons are not optimal – or even appropriate – settings for providing health care or social services. The coercive nature of incarceration does not allow women to be active participants in addressing their health issues. Prisoners cannot seek medical care in an autonomous way (requests for medical attention are channeled through correctional officers resulting in delays and even denial of care) and women often distrust the medical care provided in prison. Mental health services in particular are of questionable value when provided in coercive settings. Though the details are fictional, this truth is well dramatized in Orange is the New Black‘s Brook Soso‘s experiences with her counselor Sam Healy (spoiler alert: she tries to commit suicide as a consequence of his therapeutic skills.) Rather than serving a therapeutic purpose, incarceration cuts women off from support networks as well as their on-going sources of medical and mental health care, exacerbating whatever challenges they faced before they were locked up. Even in best case scenarios of willing participants and skillful providers, jail settings magnify the social and personal powerlessness that created this female “neediness” in the first place.

More broadly, it is inappropriate for jails and prisons to compensate for the failure of the State to provide for women’s “specific needs.” Jails and prisons are not social service or therapeutic agencies, and that distinction needs to be made clear as a matter of human rights.

Pre-trial Detention

The new jail called for in S. 1297 would serve as a setting for pre-trial detention; that is, incarceration of individuals who have not yet been tried or proven guilty (individuals who, in line with American jurisprudence, are presumed innocent.)

Although women comprise only 7% of state prisoners they comprise 33% of pretrial detainees held by the Massachusetts Department of Corrections. This disparity reflects substantially lower rates of major and violent crimes committed by women coupled with substantially higher rates of poverty among women. Women incarcerated in pre-trial status typically have been arrested for non-violent crimes and are too poor to pay even minimal bail fees. It is not unusual for women to be unable to come up with bails of $100 or $200 dollars. As one woman whom I interviewed explained, “There are lots of women in the Awaiting Trial Unit who are $10 short on bail. They can pay most of it but not all so they are kept in jail which costs the State a lot more.”

Yet very few women incarcerated in Massachusetts need to be removed from the community in order to preserve public safety. In fact, they are far more likely to have been victims than perpetrators of violent crimes; nearly all live with chronic physical and mental illnesses; the majority has experienced sexual and physical abuse; many are homeless; most are poor; and about half struggle with basic literacy and learning skills.

There are a number of bills and conversations currently working their way through the Massachusetts legislature that call for limiting the use of pre-trial incarceration and replacing it – when appropriate — with rational tools for assessing whether or not an individual is violent and / or a flight risk. For example, H.1584 & S.802 calls for basing pre-trial detention on an individual’s risk of not returning to court, rather than his or her ability to pay a monetary bail. In states where these tools have been adopted, the rate of pre-trial incarceration has dramatically declined for women. More important, there has been no increase in criminal activity or recidivism carried out by women awaiting trial at home rather than in a correctional facility.

Facility – Shmacility!

The road to hell, as they say, can be paved with good intentions. And the impetus behind S.1297 is indeed benevolent (I know the track record of the bill’s sponsor to be a true advocate for women); the goal is indeed to help “needy” women. But, as feminists have made clear for the past half century – paternalism, while often kindly intended, erases agency and obscures the underlying structures of oppression. Indeed, the use of the word “facility” rather than “jail” in and of itself obfuscates the situation. But as long as that facility has locked doors and is run by the Department of Corrections it is a jail. And we do not need more jails. Period.


A decade ago I traveled to the Mississippi Delta, Texas’s Rio Grande Valley, the rust belt of Illinois, the mountains of northern Idaho and the cities of eastern Massachusetts in order to learn how uninsured Americans manage (or don’t manage) their health and healthcare in diverse circumstances. This spring and summer I returned to these communities to seek out the same individuals and families I’d met ten years ago. I wanted to hear how they’ve fared in the wake of the Affordable Care Act.

It is clear to me that June 23, 2015’s Supreme Court ruling in King v. Burwell is good news for millions of middle-class Americans living in states whose leaders chose not to set up insurance marketplaces (“exchanges”). People in those states will not lose their insurance subsidies because the federal rather than the state government facilitates the exchange.

The states impacted by King v. Burwell are, however, mostly the same ones impacted by the 2012 Supreme Court ruling (NFIB v. Sebelius) which allowed states to opt out of the ACAs Medicaid expansion. Lower income people in those states will continue to fall into the coverage gap — the no man’s land for people who earn too little to qualify for subsidized insurance through the exchange but who do not qualify for Medicaid in their home states. In some of those states only extremely poor parents and children are eligible for Medicaid, leaving large numbers of people who are childless or near elderly or poor but not destitute unable to access healthcare.

Texas, one of the states that did not expand Medicaid, has a federally facilitated marketplace. During my return trip to the Rio Grande Valley, I was able to locate 18 of the 26 individuals and families (all adults) I’d met a decade ago. At the time, all were uninsured. Fourteen of the 18 are now insured – a figure that, on the face of it, looks encouraging.

However, of the 14 who are insured, 5 now are covered by Medicare via Disability (as a consequence of becoming sufficiently disabled to qualify for SSI or SSDI). In other words, a third of the newly insured people are covered because their health deteriorated to a the point in which they no longer are able to work. One person is covered by Medicare because she is over 65. Two people have Medicaid but only as a supplement to Medicare; no one qualified for Medicaid as their primary insurance.

All 4 of the uninsured people fall into the coverage gap – when they applied for insurance on the exchange they found that their incomes are too low to qualify for subsidies. The experiences of the Martinez family (a pseudonym) are typical. Maria works full-time in a food service job that provides health insurance for her but requires a bi-weekly payment of $250 to cover her children. Her bi-weekly income is $500, so she had to turn down the coverage. Her husband, Enrique, is a truck driver whose employer does not offer insurance but he earns too little to qualify for a subsidized premium on the exchange. For a short time their youngest child was eligible for Medicaid (CHIP), but then Enrique’s income went up (marginally) and she no longer qualified. In 2013 Enrique spoke with an ACA enrollment specialist who helped him apply for an exemption from the penalty for not having insurance. In 2014 he forgot to re-apply and had to pay $190 in fines ($95 for himself and $95 for their 21 year old child.) In the meantime, he takes medication for high blood pressure when the border with Mexico is safe enough for him to cross over and buy pills there. I make no claim to extraordinary prophetic powers, but my guess is that in another five years he will join the ranks of disabled Texans.

That leaves 5 who are insured via the exchange and 5 now insured through employers – certainly a step up from when I first met them. However, all 10 of these Texans are unhappy with their insurance, for the most part because of high deductibles and co-pays. Rosa, an energetic and articulate middle-aged woman, is reimbursed by her employer for part of the cost of the premium she purchased through the exchange. Because of her low salary she chose a “bronze” plan with a low monthly premium (all that she could afford) but a $4500 annual deductible and $1000 co-pay for hospitalization. With a history of tumors in her breast and kidney, she needs scans that she cannot afford even with insurance. I fear that she too, will join the growing ranks of Americans who are disabled.

Shortly after the Supreme Court’s ruling on the ACA, President Obama spoke from the Rose Garden celebrating our national declaration that health care is a right, not a privilege. Now the challenge is to turn that declaration into reality on the ground – even in states whose leaders would rather thumb their noses at the feds than allow residents of their state to access the care that they need in order to remain healthy.

For more on health insurance read  Health Insurance Roulette: The House Always Wins

For more on the original research in the five states read  Uninsured in America: Life and Death in the Land of Opportunity



mother prison baby

A bill to create community-­based sentencing alternatives for non-­violent primary caretakers of dependent children (House Bill #1382) was filed a few months ago in Massachusetts. The mover behind this bill was Andrea James, a formerly incarcerated woman and founder of Families for Justice as Healing. According to James, the goal of the bill is “alleviating the harm to children and primary caretaker parents caused by separation due to incarceration of the parents, while reducing recidivism and strengthening family unity and communities.” Citing a report issued by Erika Kates, Ph.D, of the Wellesley Centers for Women, James emphasizes that an estimated two-thirds to three-quarters of incarcerated women in Massachusetts are mothers, over half of whom likely lived with their children prior to arrest.

My own strong support for this proposed legislation grows out of the research I have conducted for the past decade among Massachusetts women who have been incarcerated. The majority of these women were primary caretakers of dependent children at the time that they were incarcerated, and the consequences of incarceration were and remain overwhelmingly negative for the children, their mothers, and often for the entire extended family.

When mothers are sent to prison, their children become collateral captives, following their mothers into the institutional circuit and often ending up in foster care or living with an extended family member who may be less able to parent than the incarcerated mother.

Continue reading


My friend Isabella has been beside herself with worry over her son and her housing situation. Ever since the first time we met (seven years ago!) in a half-way house for women, she has told me that she wants Americans who are fortunate enough to live in secure and stable housing to know what people who are dependent upon the institutional circuit of shelters, clinics, welfare, jails and DYS must go through just to (barely) hang on. I urged her to writer down her experiences. What follows is a Facebook conversation between us about what she’s been going through these past few months.

Isabella: Like many others, my husband and teen-age son and I have been living in what they call “scatter shelters.” What that means is that there aren’t enough good solutions for homeless families so they put us in apartments scattered around the city. Because we are a family, we were given one bedroom in a four bedroom apartment shared by four families. Some of the families have several kids, so it was very crowded. We all shared the living, kitchen and bathroom. One of our housemates at that apartment was an alcoholic and hit our son in the head with a bottle of Grey Goose. After that the manager moved us into another shared apartment in even worse conditions than the first one.

We are not criminals or children, but at the scatter shelter we all have a 9:00 curfew, 11:00 on weekends (though we can get a weekend pass.)

One weekend our son was staying with his grandmother and he called us up to say she had kicked him out. But it was after curfew (he had permission to be out but we had not arranged to be out) so we had to call the shelter supervisor to get permission to go and get him. By the time we reached her and got permission the last T [public transportation] had run so we had to take a taxi, which cost us $120 – a very big part of our monthly income.


Susan: Are you able to set up the apartment to feel like home?


Isabella: Because of all the moves and living in one room most of our stuff is in storage, including a television and really nice living room set that my father bought us before we lost our housing. But storage is expensive and we owe $3000 to the storage company. The company will not accept a partial payment and told us that they would auction off our stuff if we can’t come up with all of the money right away. But both of us are disabled and we live on Social Security so we couldn’t come up with the money.


I’ve been anxious and depressed through all of this, but what’s happened in the past two weeks has pushed me over the edge and I’m crying as I write this.


Susan: What’s been going on?


Isabella: Our son had gotten into some trouble for which he was put on probation. Unfortunately, he violated the terms of his probation and so he was taken into DYS (Department of Youth Services) custody for an indefinite time of anywhere between two weeks until up until his eighteenth birthday. So I’m SUPER STRESSED OUT, losing my mind actually, because we have NO IDEA where we’re gonna go. They’re saying that since our son is in the custody of DYS that he cannot be considered a part of our “case file” so we can’t stay in the family shelter. But he can’t be released by DYS to us if we don’t have a stable environment to live in. But we’re going to lose our place in the shelter because he is not living with us RIGHT AT THIS MOMENT and without him as part of our case file we are $26 over the monthly limit to qualify for a homeless shelter.

I called the housing office and was told that our son DOESN’T qualify as homeless, because and I quote the almighty DIRECTOR of DHCD, “He already has a place to stay [in DYS custody]; so he’s not homeless…” They said, “When he gets out and is homeless have him call us to verify he’s on the streets and we’ll reevaluate your eligibility.”

So basically we’re stuck in a Catch 22: Damned if we do, damned if we don’t!!! He CANNOT be released if we do not have a place for him to stay…BUT, we cannot keep a place to stay if he remains in lockup!!! I can’t win! I’m losing my fucking mind!!!!!! I’m so sorry for the vulgarity but I am flabbergasted.

I’m SO SUPER STRESSED I have no idea where we’re going and the thought of being homeless with our son frightens me like nothing has ever frightened me before.


While many of the poor, chronically ill and criminalized women I know turn their anger and blame on particular “bitches” who work in social and correctional services, Isabella has made clear to me from the first time we talked that, “It’s a system that is designed for us to fail.” Emergency assistance programs make frequent changes in eligibility criteria for receiving services, causing feelings of uncertainty and vulnerability in those who are dependent upon welfare as well as obligating recipients to spend great amounts of time and energy re-certifying their eligibility for the support and services that, in most other industrialized countries, are considered a basic right.

Even when you qualify for assistance, it turns out that Social Security Insurance (SSI) and Temporary Assistance to Needy Family (welfare) remittances are not sufficient to live on. As a result, recipients also are drawn into homeless shelters or other housing programs. Homeless shelters, while better than the street in most instances, are structured around rules that seem designed for people to break them. For a mother, residence in a homeless shelter is a surefire way to draw in child welfare services. Child welfare services are more likely than not to send women to drug testing programs which in turn easily leads them into the correctional system. Conditions of probation and parole — such as requiring constant urine tests — make it impossible to hold down a job. And children like Isabella’s son who were drawn into child welfare services are more likely than other children to end up in juvenile detention facilities, jails and prisons – all but guaranteeing that they will remain stuck in the same institutional circuit that failed them from the start.

You can read more about Isabella and the institutional circuit in Can’t Catch a Break.


I recently read this powerful piece by Jean Trounstine. Jean has graciously agreed to let me repost it here, so that I can share it with my readers. It originally appeared at


Every semester my students from Voices Behind Bars, a class I teach at Middlesex Community College in Massachusetts, go to prison. They used to visit state institutions but now that the Massachusetts state prisons do not offer tours (perhaps because it is a hassle to have outsiders trooping through them and criticizing what they see) the students take a tour of Billerica House of Correction, where they experience confinement to some degree and listen for an hour to an incarcerated man talk about his life and what it is like to be behind bars.

Originally, the Middlesex House of Correction was built in 1929 and housed 300 men. Now it has more than 1100, after a $37 million dollar expansion which prison officials say was to accommodate the closing of the Cambridge Jail —not without objections from activists and community members who opposed more prison building (actually costing $43 million per The Lowell Sun.)

I’ve always thought it’s not ideal to have my students learn about prison by going to a place where people are only kept for 2 1/2 years, the county sentence at a house of correction. Certainly a far cry from a life sentence. I told myself students couldn’t really learn as much about the strains of prison without seeing the harsher conditions that exist in state institutions. That is, until this last visit.

Most of the tour went as usual. We went through the older part of the facility where cells can get up to 110 degrees in the summer. We saw the visiting room where men talk to their loved ones through glass. The officer who showed the students around Billerica explained that prisoners must walk on the green stripes in the hallways; there were the usual men cleaning with mops and pushing large barrels down walkways; the smell was of too much cleaning fluid. We passed through the health unit where men were waiting to see practitioners and others were isolated in cells. It was prison as usual.

We no longer are allowed to see the Hole or what prison officials call the Segregation Unit, since men are there disciplined to solitary confinement which my students know Supreme Court Justice Anthony Kennedy recently said can drive men mad. Therefore, the highlight of the tour is always taking them into what is called a “pod.” A pod is the relatively new term in prison construction where prisoners can live in a contained unit. These pods are somewhat stale and robot-like but they allow the COs the ability to see what is going on.

We entered the pod where men do drug treatment and have earned some privileges. It has the reputation of being a better place to reside than the old part of the institution which is pretty grim and can house two men in a cell. To the left is one old institutional unit at Blillerica, looking a little prettier than it really is with whitewashed grey walls, all somehow devoid of color in reality:

On the pod we entered, those incarcerated run some of the addiction groups themselves, we were told. On the tier above the day room where prisoners sit, eat, and play cards at the tables, are rows of cells where men live. The same cells are on the first floor all around the room.  Each cell has a tiny vertical slit—a window—and when we come into their space, the men inevitably stare out the window at us. At times, they’ve pounded on their doors; at other times, they’ve all been at tables eating lunch, trying to ignore the fact that there are outsiders nearby.

This time, when the twenty of us entered, there were only a few men in their brownish beige uniforms sitting at tables. Another two were talking to the guards who policed the room, two perched at a computerized station at one end. The students all took turns entering a cell to see what it is like, a rather disturbing experience on many levels for most of them. One student, we’ll call her Sofia, suddenly turned toward me as Spanish was heard above us. She pointed up at a window where a man smiled widely and pressed his face against the slit.

“That’s my brother,” Sofia said, her eyes filling with tears.

I looked up and he waved at me, his sister’s teacher. Sofia looked away.

I asked the young woman if she had known he would be here, and yes, Sofia said, she knew he was in this  facility but no, she had no idea she might see him. She seemed torn, wanting to look, wanting to hide. She said under her breath as others continued their entrance into cells, as far as she knew, he had no hope of ever not doing drugs. She’d lost touch, she said. She couldn’t imagine he might be doing OK.

But the young man’s face lit with joy when he saw her, and before we left that unit, it was almost as if a light went off for her too. Prison became about loneliness, about being apart, about the kind of pain that happens when families break up. It was no longer just about this space or this room or that hallway. Sofia’s brother, as close as he was, was nowhere near his sister. And would not be for a long time, perhaps never. She understood that and so did I.

When we exited Billerica that day, Sofia told the other students about her brother behind bars. Now, after walking through Billerica, and after being with Sofia, they understood why prison was not just a physical place, but a deep wound.


My friend Tonya, a woman in her late thirties who has lived in poverty for decades, called me today. “I feel like a sponge,” she said. “Everyone’s problems trickle down onto me and I absorb them all.”

Tonya was referring to the term “trickle-down economics.” While she didn’t have the exact definition of trickle-down economic theory in mind (trickle-down economics is the idea that tax breaks and other economic benefits provided to businesses and upper income levels “trickle down” to benefit all members of society), she clearly understood that trickle-down economic policies have not worked for her over the decades in which the gap between rich and poor has widened dramatically.

Trickle-down prosperity is at best “voodoo economics” and at worst a cruel trick played on the majority of the American people. But trickle-down poverty is all-too-true at the level of families and households. Eighty percent of Americans do not have sufficient savings to weather a two month loss of income. For these millions of people, an illness or job loss affecting one member of a household trickles down and out to networks of friends and family shouldering the responsibility to help pay for basic housing and subsistence food.

Poverty also trickles down from generation to generation. Children who experience poverty are more likely than other children to grow up to be poor. Tonya is already keenly aware of this fact. As a young mother, she could not afford housing. She and her daughter lived in shelters, parks, friends’ living rooms, and – for a time – in the stairwells of local universities. Tonya eventually lost custody of her daughter on the grounds of not providing a safe environment for her. Her daughter did not thrive in the years she lived with relatives, a foster family and in institutional settings. Now in her early twenties, she does not have a high school diploma, struggles with reading and writing, and has never held a job. She does, however, have a baby. And just like when she herself was a young child, she is dependent upon other people offering her a place to stay.

Everyone –extended family and social workers alike – expects that Tonya will take the grandbaby. But Tonya, who finally has a stable place to live, is raising a young son of her own and barely scraping by on a few hundred dollars a month of welfare payments. (Full disclosure: I have known her son since the day he was born and can vouch for Tonya’s dedicated parenting and for her son’s unbelievable cuteness!) For a variety of reasons – lack of education, health challenges, bias against out-spoken Black women – she has not been able to keep a steady job. Most recently she was hired to work at a local supermarket for wages that she describes as “high school kid wages” but was fired after a few weeks when she had to call in sick with a throat infection, despite showing her boss a note from her doctor attesting to her infectious health status.

For the past six months Tonya has been stretching her welfare check to help support her daughter, grandchild and a brother who has mental health problems as well as a criminal record that essentially makes him unemployable. She is terrified that the expenses of taking on another person will take away resources that her son needs. There are days when she does not have the money for bus fare so she cannot take her son to school – a sort of trickle-down educational deficit issue that gravely worries her. She also is behind in her rent and in danger of losing her housing, which would likely mean that her son would be taken from her.

I asked her, “Can’t anyone help you out? Can your mother help? Your son’s father?” “No one has any money,” she replied. “We’re all in the same boat. And I’m the one who’s been keeping it going for everyone but there are days when my head is bobbing up and down to get air. I’m near the snapping point; my hair is falling out and I am having nightmares every night. I don’t know why I can’t get ahead. I can’t even catch up. I see people who have the life I want – a job and a house. There’s something wrong with me that I can’t have those things.”

“Tonya,” I told her. “There’s nothing wrong with you that a good dose of fair and rational economic policies wouldn’t cure.”


You can read more about Tonya here: Sex, race and prison’s violent double standard: Incarcerating men hurts women, too


I’m excited to share that I will be making three appearances in the Boston area soon! I will speak about the day-to-day lives of Boston-area women who struggle with violence, poverty, illness and the challenges of an unforgiving world at these venues:

On Wednesday, March 25 at 7:00PM, I will be at Porter Square Books at 25 White Street in Cambridge, a “fiercely independent” bookstore that encourages and promotes face-to-face conversations between local authors and readers.

On Wednesday, April 8 at 12:00 noon I will speak about the problems of fragmented health care and social services for criminalized women at the University of Massachusetts, Amherst, Arnold House, Room 120.


On Sunday, April 26 from 11:30AM to 12:30PM, I will be at Church of Our Saviour at 21 Marathon Street in Arlington, an Episcopal church seeking insight into the complexities of being helpful to marginalized people.

All events are free and open to the public. Please come and let your friends know!

Candidate Charlie Baker; photo by Matt West

After running on a campaign of new and smart ways to reduce government spending, Massachusetts Governor Charlie Baker (R) has proposed budget cuts for fiscal year 2016 that are neither new nor smart — going after the low-hanging fruit of government funded Medicaid (MassHealth) for the Commonwealth’s poorest, sickest and most vulnerable residents. Most of the proposed savings to MassHealth in Gov. Baker’s plan are merely a matter of bookkeeping – shifting costs from fiscal year 2016 to fiscal 2017. But the Administration also aims to reduce spending by requiring over one million residents enrolled in MassHealth to prove that they are still eligible. Though the Administration has not provided an estimate of how many ineligible people are enrolled, Baker’s budget team estimates that this move will save the Commonwealth $210 million.

The immediate plan is for the Commonwealth to contact 1.2 million people who were automatically re-enrolled in MassHealth when the Health Connector (‘Exchange’) website experienced technical failures in 2013. Each of these people will receive two letters asking them to reconfirm their eligibility. After 60 days those who do not respond will lose coverage. That may not sound unreasonable, but as a sociologist who works with low income women, I suspect this plan presents disproportionate hardships for residents who do not have permanent addresses or who struggle with understanding government forms and with gathering the required documentation; that is, the people who most need consistent healthcare coverage. Individuals who lose eligibility will be allowed to re-certify in the future, but the immediate effect will be disrupted care and an uptick in expensive emergency department usage.

The scanty information released by Governor Baker’s office indicates three categories of potentially ineligible people who would be eliminated from the MassHealth rolls. The most straightforward are people who still are on MassHealth plans but have moved out of state and receive coverage elsewhere. These people, however, would not seem to account for much spending given that they have other insurance where they actually live so are unlikely to use MassHealth benefits. The second category is people who have had a change in income sufficient to place them over the eligibility threshold. Given the absence of a meaningful economic recovery for low wage workers in Massachusetts, this category likely consists of individuals and families whose current earnings push them marginally over the eligibility line. Switching these people from MassHealth to the heavily subsidized insurance policies that they are eligible for through the Health Connector is unlikely to make much of a difference in the budget.

A third category – people who are purposely cheating or “working the system” — has not been explicitly singled out in statements from the Governor’s office. But given 2010 gubernatorial candidate Charlie Baker’s fake electronic benefit cards that said: “Deval Patrick’s Massachusetts EBT Welfare Card. Swipe me for booze, cash, cigarettes, and/or lottery tickets at taxpayers’ expense,” weeding out Medicaid cheaters certainly lurks behind the call for re-certification. Again, we have no information regarding numbers, but we do know that hunts for fraudulent welfare claims consistently turn up very little cheating and thus very little cost-saving. Last year, for example, Maine Gov. Paul LePage (R) released data intending to prove widespread welfare abuse but in fact showed that 99% of all welfare benefit transactions were legitimate and legal.

The re-certification process in and of itself will be costly. If we calculate (modestly) 15 minutes for a government worker to process a straightforward re-certification, the 1.2 million re-certifications will take approximately 300,000 hours. And if we assume (modestly) a salary of $15 / hour for the workers who process re-certifications, the bureaucratic cost will come to 4.5 million dollars – a substantial chunk of what the Administration is looking to cut from the MassHealth budget and money that surely could be spent in a manner more conducive to protecting the health of Massachusetts’ residents.

These numbers are just an estimate, and I assume the Governor’s staff has more accurate numbers. But even if I’m off by 50%, we’re still looking at a cost cutting plan that is likely to cost the Commonwealth a great deal both in terms of salaries and in terms of health.

For more on the larger picture of  health care coverage click:  Health Insurance Roulette: The House Always Wins