Check out the opinion piece written for the Brooklyn Daily Eagle by HJ team members Shena and Jenn about hopsital closures in low-income communities of color in Brooklyn and what they mean for access to care. You can read the piece here.
See below—and congratulations to Shena, Jenn, and Alyssa for their hard work!
Brooklyn, NY (April 10, 2013)—In conjunction with the proposed redesign of Brooklyn’s Health Care System the Community Health Planning Workgroup (CPHW), a consortium of community stakeholders, healthcare providers and community health planners, today released The Need for Caring in North and Central Brooklyn, A Community Health Needs Assessment, sponsored by The Brooklyn Hospital Center, the I M Foundation, and the New York State Department of Health. The Community Health Needs Assessment, conducted by the Brooklyn Perinatal Network, the Commission on the Public’s Health System, and New York Lawyers for the Public Interest, sheds additional light on North and Central Brooklyn residents’ perception of the needs, gaps and barriers to care in their communities.
The report covers 15 zip codes, including Bedford Stuyvesant, Bushwick, Brownsville, Crown Heights, Cypresss Hills, East Flatbush, East New York, Flatbush, Fort Greene, Prospect Heights, Williamsburg, Downtown Brooklyn, Gowanus and Greenpoint, and addresses key findings, focus group results, and recommendations.
Field surveys and focus groups were used to capture the voices of the community. Community residents completed over 600 surveys, and 79 residents participated in nine focus groups targeting groups underrepresented in the survey sample, including teens; individuals with disabilities; Spanish speakers receiving mental health services; immigrants; men aged 18-35 and 45-55; senior citizens; pregnant women; and LGBTQ individuals.
Following the completion of the Community Health Needs Assessment, listening sessions were held to solicit community input and feedback concerning the findings.
Among the key findings:
“We are really pleased to have had the opportunity to ensure that the community’s voice is a driving factor in how healthcare is delivered and look forward to the healthcare planning developments that come from the CHNA process. We are hopeful that our process will serve as a model way to meet the needs of communities being served,” said Shena Elrington of New York Lawyers for the Public Interest who served as co-lead partner in the development of the report.
The report concluded with approximately 15 critical recommendations to improve healthcare in Brooklyn. These included addressing accessibility; improving screening, outreach, cultural and linguistic competency, patient-centered care, and customer service training; providing extended hours for primary care; increasing awareness and access to low-cost health services/insurance; providing financial support of efforts by grassroots community-based organizations (CBOs) to promote community resources; coordinating a network of health care and social service providers; engaging community residents; targeting services to focus on particular illnesses and communities; increasing access to specific health care services; working with Access-A-Ride to address transportation issues; increasing the number of providers who accept public health insurance; and increasing availability and access to mental health services.
If you’re passionate about access to health care, racial justice, and advocating on behalf of underserved communities, check out this exciting new job opportunity:
New York Lawyers for the Public Interest (NYLPI) is seeking applications for a Community Organizer in its Health Justice Program. NYLPI is a nonprofit civil rights law firm committed to advancing equality and civil rights through community lawyering and partnerships with the private bar. NYLPI’s Health Justice Program works to ensure that people from medically underserved neighborhoods who face barriers due to limited English proficiency or racial or ethnic discrimination have access to quality health care.
The Community Organizer will be an integral part of the Health Justice team, working alongside attorneys and advocates to develop and implement the program’s campaigns and cases. In addition to community outreach, the organizer will be responsible for helping to develop community campaigns; lobbying; building coalitions of community members and community-based organizations; convening trainings and meetings; creating outreach materials; assisting with plaintiff searches; providing technical assistance to community leaders and activists; and educating the public, elected officials and the media about health justice.
NYLPI pioneered the practice of community lawyering in the five boroughs of New York City. With every case and every campaign, we continue to develop an ambitious, participatory, and dynamic approach to working with marginalized communities. Our work draws on a range of strengths: firm community partnerships; effective organizing; media savvy; effective legislative advocacy; and bold, creative approaches to litigation.
NYLPI offers a competitive salary commensurate with experience plus excellent benefits. NYLPI is an Equal Employment Opportunity employer and actively recruits people of color and individuals with disabilities.
Please send applications by March 22, 2013 to email@example.com with the words: “Attention: Health Justice Community Organizer Position.” Applications must include a cover letter, resume, writing sample, and three references (including daytime telephone numbers). Please mention where you saw this posting in your cover letter. To learn more about NYLPI, visit www.nylpi.org.
Feel free to share this posting far and wide!
Christine Chiu is a staff attorney and the newest addition to the Health Justice team. Christine has already hit the ground running and we’re excited to fight the fight for social justice with her. She joined NYLPI after spending a year at African Services Committee as a Kirkland & Ellis New York City Public Service Fellow representing primarily African undocumented clients seeking immigration relief. Christine was an International Institute for Law and Justice Scholar at NYU School of Law and focused her studies on human rights and social justice law. While earning her J.D., Christine worked at the U.N. International Criminal Tribunal for Rwanda, Platform for Labour Action – advocating for the rights of marginalized workers in Uganda, and the Door Legal Services – providing legal assistance to New York City youth. She also co-authored a report on discrimination against Muslim communities in post-9/11 counterterrorism policy. Christine enjoys baking, eating baked goods, and snuggling with her geriatric dog.
by Jennifer Swayne, Staff Attorney – Health Justice Program
On Friday, December 14, 2012, we once again faced unspeakable tragedy as a gunman broke into Sandy Hook Elementary School in Newtown, CT and opened fire, killing a total of 28 people—20 of whom were children. While many of the initial conversations surrounding this horrible tragedy focused on the ongoing debate about gun control, very few of those conversations focused on mental illness, the stigma surrounding it, and access to mental health care services. Some news sources have reported that the gunman faced mental illness, though it is not clear what, if any, mental health services he and his family may have sought in the past. However, what is certain is that we need to engage in dialogue on mental illness, as there are many individuals who face significant stigma and who are not able to access critical mental health services consistently.
Mental illness knows no race, culture, ethnicity, language, socioeconomic status, age, gender, or religion, yet there is stigma and overwhelming silence surrounding its impact. Many have probably encountered someone with mental illness without even realizing it, especially since about 1 in 4 adults age 18 and over, and about 1 in 5 children age birth to 18 suffer from a diagnosable mental illness at some point in their lives. Because of the stigma surrounding mental illness, however, we continue to miss opportunities to help others get the support and assistance they need, especially when those who exhibit signs of mental illness are simply labeled and dismissed as “crazy.” Instead, we are relegated to hindsight assessment when it is much too late to take action.
The mass shooting that happened in Newtown is an extreme, and there is nothing that excuses the actions of the gunman. However, mental illness is much more complex than this extreme case of violence we have witnessed suggests. For instance, people with mental illness face greater risk of becoming the victim of crime rather than being the perpetrator. Therefore, we must be careful not to let a single person’s actions symbolize our collective understanding of how mental illness manifests and operates.
Further, we have a health care system where mental health parity has been lacking, and sadly, quality mental health services remain a luxury reserved for those who have the ability to pay in cash for those services. The result is that those who have no insurance, those who rely on private insurance with limited mental health benefits, and those who rely on public insurance often go without needed mental health services that can help them live full and productive lives. Untreated mental illness can result in homelessness, incarceration, victimization, high burden placed on families and caretakers, and productivity loss, not to mention the financial costs of healthcare expenditures resulting directly from failure to treat mental illness sooner rather than later.
New York State is in the process of redesigning its system of behavioral health services for some of the most vulnerable people in our society—low-income children from birth to age 21 who use public insurance. This is a group that has suffered immensely from lack of adequate mental health services. Under Medicaid, the system of mental health care for children has been overwhelmingly underfunded and the New York State systems that serve children—Department of Health (DOH), Office of Mental Health (OMH), Office of Children and Family Services (OCFS), Office of Alcoholism and Substance Abuse Services (OASAS), Department of Education (DOE)—and other agencies at the local level, have not coordinated their efforts to serve children, leading to a disjointed system.
It is promising that New York State is engaging in a process to revamp the system of care for our children, but we have to make sure that it is a system that will actually work and result in real change or else children will continue to face dire consequences and suffer from the stigma of mental illness well into adulthood. Children with mental health problems have lower educational achievement, greater involvement with the criminal justice system and fewer stable and long-term placements in the child welfare system than their peers. In attempts to access mental health services, publicly insured children are also more likely to rely on restrictive or costly services such as juvenile detention, residential treatment, emergency rooms, and are more likely to be placed out of their homes in order to obtain critical services, as opposed to being able to readily access outpatient services, especially if they are children of color.
On December 14, NYLPI and the Children’s Defense Fund submitted joint comments (which you can access here) regarding the critical mental health services that children need to New York’s OMH, OASAS, and OCFS. In our comments we:
(1) address the health disparities that impact receipt of mental health care;
(2) list the services that children should receive and who should provide those services;
(3) highlight the importance of cultural and linguistic competency;
(4) discuss the need for early identification and prevention measures such as behavioral health screening; and
(5) stress the need for training and funding so that providers are able to actually provide the appropriate services.
As we can see, mental illness is complex and it is not going away. We must proactively engage in creating a better system of care rather than responding in the aftermath of tragedy. It is vital that we have honest and ongoing conversations about the state of our society, mental illness, stigma, and access to appropriate mental health care services.
Medical repatriations of undocumented immigrants likely to rise as result of federal funding reductions to safety net hospitals under Affordable Care Act
New York, NY, and Newark, New Jersey, December 17, 2012 − Today, the Center for Social Justice (CSJ) at Seton Hall University School of Law and New York Lawyers for the Public Interest (NYLPI) released a report documenting an alarming number of cases in which U.S. hospitals have forcibly repatriated vulnerable undocumented patients, who are ineligible for public insurance as a result of their immigration status, in an effort to cut costs. This practice is inherently risky and often results in significant deterioration of a patient’s health, or even death. The report asserts that such actions are in violation of basic human rights, in particular the right to due process and the right to life.
According to the report, the U.S. is responsible for this situation by failing to appropriately reform immigration and health care laws and protect those within its borders from human rights abuses. The report argues that medical deportations will likely increase as safety net hospitals, which provide the majority of care to undocumented and un- or underinsured patients, encounter tremendous financial pressure resulting from dramatic funding cutbacks under the Affordable Care Act.
The report cites more than 800 cases of attempted or actual medical deportations across the country in recent years, including: a nineteen-year-old girl who died shortly after being wheeled out of a hospital back entrance typically used for garbage disposal and transferred to Mexico; a car accident victim who died shortly after being left on the tarmac at an airport in Guatemala; and a young man with catastrophic brain injury who remains bed-ridden and suffering from constant seizures after being forcibly deported to his elderly mother’s hilltop home in Guatemala.
According to Lori A. Nessel, a Professor at Seton Hall University School of Law and Director of the School’s Center for Social Justice, “When immigrants are in need of ongoing medical care, they find themselves at the crossroads of two systems that are in dire need of reform—health care and immigration law. Aside from emergency care, hospitals are not reimbursed by the government for providing ongoing treatment for uninsured immigrant patients. Therefore, many hospitals are engaging in de facto deportations of immigrant patients without any governmental oversight or accountability. This type of situation is ripe for abuse.”
“Any efforts at comprehensive immigration reform must take into account the reality that there are millions of immigrants with long-standing ties to this country who are not eligible for health insurance. Because health reform has excluded these immigrants from its reach, they remain uninsured and at a heightened risk of medical deportation,” added Shena Elrington, Director of the Health Justice Program at NYLPI. “Absent legislative or regulatory change, the number of forced or coerced medical repatriations is likely to grow as hospitals face mounting financial pressures and reduced Charity Care and federal contributions.”
Rachel Lopez, an Assistant Clinical Professor with CSJ stated, “The U.S. is bound to protect immigrants’ rights to due process under both international law and the U.S. Constitution. Hospitals are becoming immigration agents and taking matters into their own hands. It is incumbent on the government to stop the disturbing practice of medical deportation and to ensure that all persons within the country are treated with basic dignity.”
More information about this issue can be found at medicalrepatriation.wordpress.com, a NYLPI- and CSJ-run website that monitors news and advocacy developments on the topic of medical deportation.
About New York Lawyers for the Public Interest
New York Lawyers for the Public Interest (NYLPI) advances equality and civil rights, with a focus on health justice, disability rights and environmental justice, through the power of community lawyering and partnerships with the private bar. Through community lawyering, NYLPI puts its legal, policy and community organizing expertise at the service of New York City communities and individuals.
About the Center for Social Justice at Seton Hall University School of Law
The Center for Social Justice (CSJ) is one of the nation’s strongest pro bono and clinical programs, empowering students to gain critical, hands-on experience by providing pro bono legal services for economically disadvantaged residents in the region. The cases on which students work span the range from the local to global. Providing educational equity for urban students, litigating on behalf of the victims of real estate fraud, protecting the human rights of immigrants, and obtaining asylum for those fleeing persecution are just some of the issues that CSJ faculty and students team up to address.
Lori A. Nessel, Professor of Law and Director, Center for Social Justice, Seton Hall University School of Law, Lori.Nessel@shu.edu, 973-642-8708
Stephanie Ramirez, New York Lawyers for the Public Interest, firstname.lastname@example.org, 212-784-5704