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President-elect Donald Trump picked a retired surgeon to be the secretary of Housing and Urban Development

Advocates for low-income housing voiced concern Monday about President-elect Donald Trump's decision to tap Dr. Ben Carson, a retired Johns Hopkins neurosurgeon who has little experience with housing policy, to lead the Department of Housing and Urban Development,.

Carson, who railed against safety-net programs during his campaign for president this year, would inherit a Great Society-era department with a $48 billion budget that helps millions of Americans avoid homelessness. In Baltimore, about 27,000 families live in HUD-subsidized public housing or receive federal help to pay the rent.

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Advocates in Maryland and elsewhere said they are hopeful for areas of agreement but will be watching closely to see how Carson will handle the deep budget cuts Trump has promised, as well as the fate of Obama administration regulations to reduce housing segregation and lead paint.

"Ben Carson has a brilliant mind and is passionate about strengthening communities and families within those communities," Trump said in a statement Monday. "We have talked at length about my urban renewal agenda and our message of economic revival, very much including our inner cities."

Trump called attention to unemployment and violence in Baltimore during the presidential campaign, and vowed to "create economic zones" and "incentives for companies to move in" to cities. But the New York real estate developer did not detail what those incentives might look like, how they would be implemented or who would pay for them.

Unlike other Cabinet nominees Trump has announced, Carson has virtually no record on the issues he would oversee, making it difficult to predict his approach. The longtime former Baltimore County man grew up in poverty in Detroit but has never explicitly said whether his family lived in public housing or received rent assistance of the sort HUD provides.

With the help of scholarships, Carson earned degrees at Yale and the University of Michigan's medical school. At 33, he was named director of pediatric neurosurgery at Hopkins, the youngest person to lead a major division at the institution. He retired from Hopkins in 2013 and moved to Florida.

The blank slate that Carson presents on housing has given a measure of optimism — but also fear — to advocates who want the housing department to play a central role in addressing urban decay.

"He may not share the views that everybody who has been involved with housing has held, but I'm hopeful we will all be working together," said Robert Strupp, executive director of the advocacy group Baltimore Neighborhoods Inc.

One of the first issues Carson will confront is a regulation approved by the Obama administration last year intended to nudge cities toward reducing racial segregation.

Congress sanctioned that effort in the 1968 Fair Housing Act, but it has largely been ignored ever since.

The regulation, known as Affirmatively Furthering Fair Housing, requires local housing agencies to develop plans to confront segregation and ensure that poor black families receiving assistance are not forced to live in blighted neighborhoods.

Baltimore remains one of the most segregated cities in the nation, and it was the focus of a landmark court settlement in 2012 that required HUD to help families move from areas of poverty to stronger neighborhoods in the city and surrounding counties.

"The vigorous nature with which the [Obama] administration has taken on that issue has been refreshing," Strupp said.

But many Republicans, including Carson, have described the regulation as a federal overreach, and the Trump administration could move quickly to unwind it.

Critics say the measure opens the possibility of the government imposing zoning requirements on local officials.

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"For the federal government to come in and try to override local [zoning] concerns is wrong," said Rick Manning, president of Americans for Limited Government. "The federal government doesn't get to impose its will on what is essentially tens of thousands of individual choices."

In an op-ed essay last year, Carson described the rule as a "mandated social-engineering scheme."

Advocates are also eyeing a rule proposed this year that would impose tougher restrictions on lead paint in HUD-assisted housing.

Carson based his presidential campaign largely on the idea that safety-net programs create a culture of dependency that inflicts long-term damage on low-income families.

Carson's expected nomination drew criticism from Democrats on Capitol Hill. Some pointed out that a Carson spokesman said recently that his boss was unlikely to join the next Cabinet because "he has no government experience" and wouldn't want to "cripple the presidency."

Carson walked those comments back, and said before Thanksgiving he was seriously considering the housing job.

Baltimore Rep. Elijah E. Cummings, a Democrat, praised Carson as "a phenomenal neurosurgeon" but described him as "woefully unqualified" to oversee the federal housing department.

Republican Sen. Richard Shelby of Alabama, chairman of the Senate Committee on Banking, Housing, and Urban Affairs, did not respond to a request for comment.

Senate Majority Leader Mitch McConnell said Carson's "lifelong career of selfless service will be a positive addition to the incoming administration."

Advoactes for low-income housing said one of their main concerns is basic and familiar: a fear that budget cuts could significantly reduce federal development grants to cities, reducing the number of families that receive help.

Trump has vowed to trim federal spending by 1 percent annually, which he has predicted would save $1 trillion over a decade.

In the Baltimore region, more than 100,000 people are on waiting lists for subsidized housing, which advocates say means current funding is not meeting the need. Nearly 59,000 people are on waiting lists in Baltimore City alone.

Diane Yentel, president of the National Low Income Housing Coalition, said the inflationary costs involved in housing mean proposed cuts would have a far greater impact than 1 percent.

Still, Yentel said she is hopeful the rhetoric of the campaign trail will give way once Trump and Carson are in office.

"There's a very tight connection between affordable housing and improving health benefits, and with that comes lower costs to the health care system," she said. "There's some real potential with Dr. Ben Carson coming in with his health care background to get that."

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