Applying the Broken Windows Theory to Code Enforcement in Urban Communities

The 2008 to 2012 global recession resulted in a landscape of abandoned homes in many neighborhoods across the United States due to the crisis that severely impacted the real estate and financial markets. Although very few communities were spared the negative effect of scattered vacant and unmaintained homes, this large spread dilemma impacted many urban areas more significantly as residential property values and socio-economic conditions were already compressed by limited personal household and public resources. But this rise in properties that once were homes to families known and seen to neighbors that now had become edifices of visual neglect, unsafe locations, and prime targets for eventual squatting, created an environment for widespread concern and reaction from all levels of government. At the local government level, one by one, each jurisdiction began adopting new policies and implementing programs in an effort to curtail the problems associated with extended periods of property maintenance neglect caused by the abandonment by owners, and seemingly lackadaisical response by the financial institutions that became responsible for those assets.

Control in a Changing Neighborhood Environment

Code Enforcement agencies immediately responded to the distress calls and complaints from neighbors and community leaders that had become desperate to try to eradicate the problems associated with the conditions of these abandoned homes, but quickly became overwhelmed both by demand for services and funding necessary to provide adequate property maintenance and nuisance abatement. Vacant property registration programs quickly found their way into local legislation that shared common requirements for mortgagees or ‘banks’ to step in after a property was abandoned by their owners and take responsibilities to provide proper responsible party information, local property management, routine maintenance and security. These registration programs, due to the requirements imposed on the banks, actually provided a sense of structure and control that was needed in order for the banks to properly respond and for communities to feel a sense of control. While these programs were highly effective, the slow turnover rate of these properties to new owners, still left neighborhoods with homes that are visibly unoccupied, not well-maintained, and subject to continuous vandalism and trespass.

The economic decline also hit property owners of homes and rentals who walked away from properties where there were no mortgages leaving no interested parties to immediately step in and take responsibility for maintenance adding another level of concern for areas that were already economically depressed and dealing with higher incidents of criminal activity. In a response to citizens to create safer communities and increase livability, one of the theoretical tools used in the practice of law enforcement, the broken windows theory, is making its way into the thinking of how to attain environments free from visual signs of neglect and public nuisances through its application to code enforcement efforts.

The Broken Windows Theory

The broken windows theory is based on the premise that unimpeded disorder in urban communities leads to additional crime and anti-social behavior. This criminological theory was introduced in 1982 by two social scientists, James Q. Wilson and George L. Kelling. Prior to this viewpoint on crime, many police agencies focused their attention unmistakably on crime fighting and addressing more serious crimes while petty criminal behavior seemed more inconsequential, time consuming, and unrelated to major criminal activity. The centerpiece of this ideology is the picture of an abandoned structure with broken windows. The term ‘broken windows’ does not necessarily mean that properties in disrepair lead to more serious crimes being committed by individuals but rather as a metaphor for an urban environment of disorder. Therefore this theory may be easily misinterpreted to mean that if an environment is eradicated of visual blight then more serious crimes will not occur, such as robbery or murder, which has been the center of much debate since the introduction of this theory. In fact, the theory in a literal sense would be demonstrated by the existence of a few broken windows on a structure that remain in disrepair, leading to additional disorderly conduct and more windows being broken, litter being thrown on the property grounds, graffiti, and vandalism, eventually leading to more major crimes such as squatting, drug use, fires, and even rape or murder at that structure. When this theory was applied to law enforcement in New York City in the mid-1980s, the focus on addressing disorderly criminal behavior targeted graffiti, toll-machine jumping, public drinking, panhandlers, and prostitution. While these all seemed to be minor crimes in comparison to the robbery, burglaries, murders, and drug dealing for example, the application of the theory was that cracking down on these small offenses, worked to create a more orderly environment that people would more readily see and that would create an atmosphere where people would be less tolerable of disorderly conduct. Persons that routinely perform minor criminal acts would be held responsible by coming into contact with law enforcement officials more frequently and would not commit more serious crimes. In addition, citizens would feel more comfortable reporting crime to law enforcement more frequently if they felt that there concerns were not viewed as petty or a waste of time. This would lead to citizens feeling more sense of control and order in their communities.

Misapplication of Theory to Code Enforcement

Like the examples given previously regarding abandoned homes, the environment that exists due to persistent poor conditions create unfavorable settings that challenges the norms that we all live by through our codes, creates a feeling of disorder, and promotes an atmosphere that leads to further deterioration and neglect. When public administration practitioners try to apply the broken windows theory to code enforcement, it is easy to mistakenly implement programs where the belief is that increased attention to addressing code violations for minor code violations such as property maintenance, landscaping, and improper parking will lead to more safer and attractive neighborhoods. While there is no doubt that a direct relationship does exist between increased attention on obtaining adherence to property maintenance codes results in more attractive communities, this is not the premise of the theory of broken windows but rather just a causal relationship between the attention of code enforcement regarding a particular area and the result from obtaining compliance. Any area where code enforcement is focusing its attention will most likely attain positive results. However, cleaning up a neighborhood that has not improved its socio-economics may not necessarily lead to an environment where code enforcement staffing levels or attention may be reduced without the risks of recurrence of code violations over time. In fact, if priorities have to shift or resources are reduced and a neighborhood is left unattended, without other controls or incentives in place, code violations will most likely start to increase until more attention is given again. The cause for this is simple as the core of any group, neighborhood, or community is made up of people. The environment or landscape is believed to communicate messages to people as human behavior and various other factors have to be taken into consideration in addition to the built environment to achieve the desired results and maintain them.

Applying the Theory to Code Enforcement

At the core of the theory of broken windows is the effort required to address social disorder. The main premise of the theory is that minor crimes can lead to more serious crimes if left unaddressed. However, the minor crimes that are addressed are those that are considered to be inclusive of disorderly conduct. The regulations, codes, and laws that are put into place by governments, help create the environment of norms that we live by. The typical homeowner association deed-restrictions or rules are examples of a close level of control and order that is put into place in a community by the community members that are designed to establish and provide a safe, well-maintained environment for its residents. While these rules often may be viewed at as extremely strict or limiting on personal freedoms at the home, they do serve as the norms for persons in the community in which they live that creates and informal bond shared by everyone. A simple requirement that every property owner pays monthly dues that includes standard alarm monitoring for each home or requiring a gate card access in order to enter the neighborhood provides an added level of safety that everyone can participate in which deters criminals from targeting homes in that community. When it comes to code enforcement, a simple regulation that limits what residents may store on the exteriors of their homes, may create a safer and more orderly environment that can provide peace of mind to residents in an area susceptible to environmental conditions involving high winds, tornadoes, or storms by reducing airborne projectiles that can cause damage to property or even loss of life. When it comes to urban communities that are dealing with higher incidents of criminal activity or public nuisances and behaviors, applying the broken windows theory to help reduce these activities has to be done in a strategic and targeted manner.

Specific Strategies

Enforcement efforts geared towards addressing instances of disorder should be the principal focus. Likewise, regulations that are put into place to eliminate disorderly behavior, activities, and appearances have to be enforced in a consistent and expeditious manner. While focusing on property aesthetics has a high value, residents and business owners who are exposed to abandoned properties, illegal uses, unlicensed activities, and crime, are much less likely to feel safe or willing to make further investment into their homes and businesses and may rather look towards getting out of that environment when possible. Priorities should always be established in conjunction with stakeholder input in order to focus the attention of code enforcement on solving specific problems that promote disorder. A mutual understanding has to be in place, especially if your jurisdiction has to balance limited resources as not all violations will be able to be given the same high level of attention by code enforcement staff. Together, most community members can develop programs and foster environments of compliance with the code through alternative methods and programs. Here are some programs and ideas that may provide assistance to code enforcement officers by augmenting their efforts to allow them to focus on other priorities:

• Registration and maintenance requirements for abandoned and vacant properties.

• Landlord registration and inspection programs for rental properties.

• Low cost lot clearing programs for owners of vacant lots performed by local public works or vendors on a routine basis.

• Good neighbor post cards for distribution by neighborhood civic associations.

• Volunteers.

• Use of other government field staff trained to identify code violations and provide public information or courtesy notices.

• Cross-training of other staff to increase enforcement authority of agencies with similar code enforcement needs such as public works, engineering, public service aides, fire departments, building inspections, zoning, environmental, health agencies, social services. Examples: A social worker that visits a home that is poorly maintained may be trained to identify minimum housing standards and provide a courtesy notice that will later be referred to code enforcement or a housing assistance program if not corrected. A public works employee that notices a trash pile that was illegally dumped on a privately owned vacant lot who is authorized to request an immediate pickup of the trash or post a notice of abatement for the property owner.

• Homeowner and Business Owner manuals and guides that provide code compliance information, assistance programs, and contact information for other regulatory agencies.

• Signs throughout neighborhood indicating certain restrictions such as prohibited commercial vehicle parking, storage of inoperable vehicles, bulk trash rules and timeframes.

In code enforcement, if code officers were to become very nitpicky in what codes are enforced and community members were to feel that inadequate attention is being given to more serious ones, it probably wouldn’t take long before complaints to the local government come pouring in from voters and a refocus sought by local officials and political leaders. As with the application of the theory to crimes, it is not just focusing attention on minor crimes, likewise minor code violations, but the type of minor issues chosen to be addressed that is key. The goal is to link code enforcement efforts with a theory that is based on crime prevention through the appearance of a well-maintained and orderly environment. While residents who are aware that minor code violations are treated seriously should become hesitant to commit more serious violations, chances are that this may not be the case. The elimination of minor violations may not prevent more serious crimes or code violations from occurring when you take into consideration the factors related to the more serious offenses such as economics and opportunity. In criminology, one of the most significant deterrents to criminal behavior is the lack of opportunity and reduced chance of getting away with a crime. This is why it may be more unlikely that a person will illegally park a car in their gated community if they feel the chance of it being towed is extremely high. If your jurisdiction does not have enough staff to address all minor violations in a quick and expeditious manner all of the time, chances are that those efforts will only be effective during focused operations such as sweeps, but will not be sustainable to create long term change. So the best approach to applying the broken windows theory to code enforcement would be to focus attention on those violations that would be considered to promote disorder and look for other opportunities to augment your program to address minor violations.

Here are just some examples of code violations that when left unchecked, may allow similar behavior to proliferate and contribute to more serious violations:

• Unmaintained abandoned homes

• Storage of Junk Vehicles

• Graffiti

• Illegal Dumping

• Open storage of junk items

• Bulk trash improperly placed throughout neighborhood

• Unauthorized use of vacant lots for social gatherings of other unpermitted activities

• Public nuisances and noise disturbances

• Unlicensed rooming houses and substandard housing

• Illegal uses such as unlicensed social clubs operating from residences

Similar to law enforcement crackdown on activities such as drug dealing and prostitution, code enforcement also has to concentrate its effort towards solving and eliminating certain problems affecting a community to promote stability and a safe environment. Significant reduction of the above problems may promote and foster a sense of community pride and change behaviors and attitudes towards residents own compliance efforts and encourage investments in property enhancements.

Conclusion

The broken windows theory has had numerous critics, since the years it was introduced, by other theorists and social scientists either totally contradicting the theory or discrediting its actual application in being responsible for reducing crime. A study done by Robert J. Sampson and Stephen W. Raudenbush provided the argument that crime was not caused by social disorder but that the lack of cohesion of residents and their tolerance of lack of control of social spaces within a community actually contributes to the crime rate. However, as in law enforcement’s efforts to reduce crime, there usually is no silver bullet approach and crime prevention requires numerous strategies from Crime Prevention through Environmental Design (CPTED) to Community Policing. In code enforcement, economic rejuvenation and surges in the real estate market and lending has helped to eliminate blighted properties not directly related to addressing indirect code violations. Also, changes in personal financial situations often may have a direct effect on a person’s ability to correct or prevent code violations. Since it is typical that the majority of persons correct code violations once they are made aware that a problem exists, attention is the most important factor with keeping properties in compliance with maintenance codes. If an effort to reduce crime through applying the broken windows theory is sought, the use of code enforcement should be focused on addressing those violations that contribute to a disorderly environment versus the common code violation for aesthetic violations. Use of police records to identify locations of high volumes of police calls may show properties, that from the outside, do not appear to have any major violations, but the illegal use of the property may be a contributing factor to crime occurring in the community or at least a location that may be taxing law enforcement resources. While any effort to improve the appearance of a community will reap rewards, the reduction of crime and feeling of safety for members of a community is directly related to the removal of those specific areas or ‘hotspots’ that are the contributing to the disorder and criminal element. The elimination of those properties that are the most blighted and in major disrepair or abandoned, will reap benefits beyond just the improvement of the quality of life of the adjacent neighbors, but an increase in real estate value as just the mere existence of abandoned homes and deteriorated structures has a direct and negative impact on the community and how it is perceived by others.

Big Changes to Federal DHS Supervision Rules

Proposed changes to the “incident to services” rule in the 2016 Medicare Physician Fee Schedule are set to seriously impact how medical practices provide certain services, bill for them as well as how they share income from those services.

Incident to services are services or items that are furnished as an integral part of the professional services of a physicians or other practitioner in the course of diagnosis or treatment. 80 Fed. Reg. at 41785. They are billed to CMS as though the physician actually provided the service. One of the rule’s key requirements is that a physician directly supervise the performance of the services, which in the past has meant that a physician who is part of the practice has to be physically present in the office when the services are provided. If, for instance, a physician in the practice was present when physical therapy or diagnostic imaging was provided to a patient, the services could be billed to CMS as though the physician actually provided the services, even though the services was provided by, for instance, a licensed physical therapist or imaging technician.

The proposed change would, however, require that the ordering physician be the physician who directly supervises performance of the service. Moreover, in order to bill anything under a physician’s provider number “incident to” that physician’s services, the proposed rule forbids the “auxiliary personnel” that perform the incident to services from (1) having been excluded from Medicare, Medicaid or any other federal healthcare program and (2) having had their enrollment revoked.

Why is CMS proposing this change? A simple bottom line reason: Money. CMS apparently believes that the change will enable them to deny requested payment for improperly submitted claims or recoup payments made. This could translate into huge dollars for them and major issues for medical practices going forward.

How does this potentially affect practices? At a minimum, the changes will require practices to:

(a) Strictly background check any employee who would potentially provide incident to services;
(b) Update all compliance policies and procedures to include this provision;
(c) Include this new requirement in their self-audits as well as ensure training of employees covers the material;
(d) Prepare the practice for a payment reduction, since billing for services under the auxiliary personnel typically entitles a practice to reduced reimbursement;
(e) Reconsider how they allocate profits from incident to services. Might require a reworking of employment contracts or arrangements.

Addiction Treatment Is a Story in Search of a Villain

There’s a difference between something that’s interesting and worthy of comment vs. a journalistic attempt to concoct controversy and intrigue that people might buy. There’s not much of the former, but a lot of the latter. People in recovery being victimized by horrible, greedy people is an interesting story. Unfortunately, it’s off the mark and really not helpful to anyone.

There are three pretty safe assumptions we can almost all agree on: first, there are a lot of people who want to live life without active addiction. Second, many of them think they need help to create a better life. Third, some providers of help to people in recovery make a bunch of money providing that service.

There’s probably nothing new about any of this. What is new? Maybe this: we live in a time when the concept of privacy is rapidly changing. Lines between what’s said and what’s not said, between what’s OK on the TV at 6 at night have changed. And public discussion about all sorts of things that once were considered to be private, including addiction, is front and center. That sort of “boundary” change invites thing public discussion of addiction, gender identification and all sorts of stuff. Our culture has changed.

It also seems like the more “transparent” we become as a culture, the greater the tolerance and need for being entertained. Reality TV gets more and more shocking, interesting. And our need for a good story is the product of a voracious human appetite for stimulation. And that leads us to confuse what’s probative with what’s entertaining.

There’s a lot of entertaining stuff written about the addiction treatment industry, but not all of it is honest or even useful. Look, the fact that addiction is now part of the public conversation is probably a good thing. Maybe talking about it is a good step in the direction of addressing it like any other health related issue. Non one’s shocked, shamed or judged for dealing with arthritis, allergies or cancer, but addiction invites all of that nastiness.

So what’s fact versus entertainment? What’s the wheat vs. the chaff? The “story,” the one being pumped into the public consciousness about people in recovery, is that they’re powerless as powerless victims of wealthy people who want to steal from insurance companies. And I can’t ignore that the story arises in our culture at a time when a popularized belief is that only bad people have more money than they need to live, that there are “good” people and “bad” people and that the differentiating factor is money. Good people = don’t have a lot of money. Bad people = have a lot of money. And bad people can become good by giving money to good people.

Let’s dial back to the recent newspaper article: the guy they say was a “bad” man has never been charged with anything. It had a picture of the guy’s face. Is that so people can say he looks like he’s done something bad? I don’t get the value there. Maybe that’s entertaining, but of no value.

The lawsuit described in the article (that hadn’t been answered by the other party) says all sorts of things that anyone can say in a lawsuit. It may shock some to know that what lawyers say in lawsuits doesn’t have to be true. I didn’t see in the article the fact that the business sued is owed millions by the insurance company or that the parties have been trying to come to terms to settle an unrelated business issue for months. Seems relevant, but only if you want to discuss the facts. Otherwise, it’s just… entertainment.

And the bit about insurance companies paying a lot for tox lab services… No one tells an insurance company what to pay. They decide what to pay. Where’s the story? Where’s the villain, the victim? The story needs one, right? In order to be entertaining, there has to be a victim and a villain. That’s what makes it fun, right? It makes it entertainment. And that’s different from reporting facts about an issue.

In the drug and alcohol treatment space, there are serious elements of the truth that are missing, because they don’t sell, such as:

1. The treatment industry is undergoing a huge change because they’ve expanded from providing psychotherapeutic services to providing medical services;

2. Insurer challenges and law enforcement activity is a huge wake up call to an industry that needs to be woken up to compliance and viewing medical services in the same way traditional medical service providers view them-driven by scientifically validated and documented medical necessity. Physicians have played within these boundaries for many years, but treatment providers are new to what’s required to provide medical services;

3. Providers that make a lot of money from treating people in recovery do so almost entirely because they do a good job and know how to manage their expenses. Our community does not yet believe the healthcare providers ought to work solely for non-profit organizations and be part of a “healthcare clergy” (“If you really cared, you’d do it for free”);

4. Insurance companies have been masterful in managing the PR related to the treatment industry. In an era of record-breaking insurance company profits, they often don’t have any policies and procedures about how many or how much of anything people in recovery should receive, but then refuse to pay and point the finger at providers. And ironically, many treatment providers beg payers for such guidelines and have approached them to contract (at lower rates than the insurers are paying!);

5. Insurance companies decide how much to pay for services, not the providers; and

6. Neither treatment center owners nor those in recovery speak with one voice and have no effective political/legislative power. Insurance companies, however, have enormous political and legislative power.

Despite lots of talk that can sound very open minded when it comes to addiction, I’m not convinced that we actually are open minded. Articles fly around that oversimplify things and sell stories designed to entertain. There is a huge gap in available insurance benefits for people in recovery from addiction. The current squeeze (payment denials, delays and reductions) placed by insurers on treatment providers, for instance, is missing from any other aspect of healthcare.

In fact, the payer challenges to providers in this space reflect a view by insurers of addiction treatment as episodic, not chronic. Payers don’t challenge diabetes treatment like they challenge addiction treatment. Laws are passed (the recent sober home regulation law) that reflect the fact that the state of Florida won’t protect people in recovery who reside in sober homes (they kicked the issue to some unregulated, and unnamed “not for profit” entity). At the end of the day, there is really no consequence for this sort of showboating, since both the treatment industry and people in recovery are easy to kick around. They’re still outcasts and lack any serious political presence.

If there is ever going to be meaningful treatment for addiction, then the entire story needs to be told, and all the players need to work together to agree on meaningful solutions. The problem with the treatment industry isn’t that there are a bunch of fat cats taking advantage of addicts. The problem is that our culture is more interested in pointing fingers and sticking our heads in the sand on this issue (imagine how real treatment might affect the prison conglomerate!) than we are in creating solutions. Right now, there is no urgency to the issue of treatment (because it’s not being pressed). Instead, we’re just entertaining ourselves.