New York Lawyers for the Public Interest and the Center for Social Justice at Seton Hall University School of Law Release Report Documenting Hundreds of Cases of Coerced Medical Repatriation of Undocumented Immigrants by U.S. Hospitals

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.

______________________________________________________________________________

Media Contacts:

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, sramirez@groupgordon.com, 212-784-5704

Suffolk County Language Access Executive Order Signed!

by Lindsey Hennawi, Program Assistant

Great news! On November 14^th, 2012, Suffolk County Executive Steve Ballone signed an executive order requiring county government agencies to translate vital public documents into the top six languages spoken by limited English proficient (LEP) residents of Suffolk County and to provide interpretation services for all LEP residents as well.

Twenty percent of Suffolk County’s 1.5 million residents are LEP. Now, residents whose primary languages are Italian, Mandarin, Spanish, Polish, French Creole, and Portuguese will be able to access local government offices and communicate with officials. This means victims of domestic violence and hate crimes can access police protection. Residents affected by Superstorm Sandy can receive much needed information about recovery efforts. Support services such as unemployment insurance and public benefits are now also accessible to LEP residents. Thanks to this executive order, an individual’s language will no longer be a barrier to participation in government services or access to important resources.

The order is descended from similar legislation, including President Clinton’s 2000 executive order that mandated all agencies receiving federal funding develop language access plans in order to comply with the 1964 Civil Rights Act’s prohibition of discrimination based on national origin; Mayor Bloomberg’s Executive Order 120, signed in 2008, that bans city agencies from discriminating against residents based on their primary language or national origin; and Governor Cuomo’s 2011 Executive Order 26 that does the same for executive state agencies.

One of the first of its kind in a suburban county in the United States, Mr. Ballone’s executive order comes on the heels of the previous Suffolk County executive, Steve Levy, who in his tenure utilized county police as immigration agents, criminalized Latino day laborers, and marginalized Latino-majority neighborhoods, earning the county a reputation for anti-immigrant resentment and violence.

Suffolk County’s executive order is a result of the advocacy of the organizations with which NYLPI partnered on this campaign, including the Long Island Civic Engagement Table, the Long Island Language Advocates Coalition, Make the Road New York, the Center for Popular Democracy, and other groups that have tirelessly promoted immigrants’ rights in Suffolk County for years. Since 2009, NYLPI has advocated for language access orders on the city, state, and county level, and is currently working to develop materials to help other advocates replicate these efforts.

We are thrilled Suffolk County has taken this critical step toward advancing the civil rights of LEP individuals and making New York a more inclusive home for all its diverse residents. Congratulations to all of the advocates involved and thank you, Steve Ballone, for your work toward equality and justice on behalf of LEP residents! May yours be one of many county orders to come.

The Affordable Care Act and Deferred Action for Childhood Arrivals: Immigrant Exclusion in Health Reform

by Lindsey Hennawi, Program Assistant

It’s tough to be hard on President Obama just one month away from the presidential election.

After all, the Patient Protection and Affordable Care Act, an unprecedented piece of health care legislation, has been lauded by health justice advocates across the country for its promise to provide uninsured and underinsured Americans with options for health coverage which were previously unavailable to them. And the recently implemented federal policy known as Deferred Action for Childhood Arrivals (DACA) allows would-be DREAMers—undocumented youth who were brought to the US as children and who would be granted a path to citizenship under the as of yet un-passed Development, Relief, and Education for Alien Minors Act—to apply for work authorization and live without fear of being deported.

While these measures are historic, they also both fall short. The strength of the DACA program as a means to advance the rights and status of undocumented immigrants was undermined by a barely publicized announcement from the White House. According to the new rule, DACA individuals will be excluded from health coverage under the Affordable Care Act. In the past, people granted deferred action status were considered “lawfully present” undocumented immigrants and were thus eligible to participate in federal benefits programs. This new policy, however, explicitly exempts those who qualify for DACA relief from participating in these programs.

While some states have systems in place whereby lawfully present undocumented immigrants are still eligible for public health insurance from state pools of funding, this option is not universally available. Without the federal guarantee that lawfully present undocumented immigrants can benefit from the new Exchanges and Medicaid, these individuals will have to rely on whatever standards their state imposes, which can vary widely and may disproportionately impact certain immigrant communities. Some states have already started to deny benefits to DACA beneficiaries. Notorious anti-immigrant Arizona Governor Jan Brewer, for example, has illegally ordered state agencies to deny drivers’ licenses and other state benefits to DACA grantees. Apparently inspired, governors in Mississippi, Nebraska, and Texas have made similar declarations.

As a result of this federal exclusion, hundreds of thousands of undocumented youth who no longer have to worry about being deported still have to worry about how to access health care—an issue President Obama himself has described as central to the very success and character of our democracy.

There are a lot of good, practical reasons why DACA individuals should not be denied benefits under health care reform. The Affordable Care Act, with its pledge to insure the 30 million undocumented American citizens, completely excluded undocumented immigrants. The ACA will gradually reduce federal funding  allocated to compensate hospitals for the care they provide to uninsured and underinsured  patients, and the loss of this funding may threaten these hospitals’ ability to treat undocumented immigrants. The Exchanges, which will serve as a conduit through which people can purchase health insurance under the Affordable Care Act, could benefit from the addition of young, healthy people (such as many DACA individuals) paying into the pool in order to spread risk. And without regular access to affordable primary and preventive care, we will see an increase in negative health outcomes and costs that may ultimately burden the system.

Without inclusive, federal protections for health care access, undocumented immigrants will always be subject to denials of access to care, and the president’s landmark health care reform will fall short of achieving its lofty and sorely needed goal. If President Obama really wants to work toward improving immigrant rights and health—or even just to preserve the American democracy in which he believes—he needs to reconsider and reverse his latest decision. It’s just the right thing to do.

The Battle Isn’t Over: What’s Next for the SafeRx Campaign

Knowing how to take prescription medications safely is incredibly important—especially for people who are limited English proficient (LEP) or have other difficulties understanding prescription medication labels.  New York recently passed landmark SafeRx legislation that will greatly increase many New Yorkers’ access to prescription medication. Under SafeRx, prescription pads will have to reflect a patient’s language preference and medication labels will become more patient-friendly. Pharmacies will be required to provide translation and interpretation services to LEP consumers. But while the passage of SafeRx represents a huge victory, we still have more work to do.

The law will go into full effect in late March of 2013. The New York State Board of Pharmacy (SBOP) is currently in the process of drafting recommendations for the implementation of the legislation. Unfortunately, the SBOP has failed to include stakeholders—advocates and LEP consumers—in the process. The SBOP has yet to schedule even one formal public hearing at which advocates and consumers can provide input on how to best implement the new law. Only one informal meeting has been mentioned, but not scheduled—and it’s in Buffalo. Not exactly an easy trip to make for many people around the state.

In response to the limited opportunities for stakeholder engagement, members of the SafeRx Coalition have published a report which discusses several key recommendations for the implementation of SafeRx legislation. (You can also read the accompanying cover letter to the SBOP here.) Through our recommendations, we hope to balance the interests of consumers and the pharmacy industry alike, while still meeting the health needs of New Yorkers.

Here’s a quick rundown of our recommendations:

Determine Pharmacy Primary Languages Fairly
Rather than selecting languages based on whether or not 1% of the general population speaks a given language, SBOP should require translation services in the top seven languages spoken throughout the state. This approach ensures that a uniform standard is applied statewide.

Standardize Prescription Labels
Prescription labels should be patient-centered. Labels should have clear directions, written in simple and large fonts.

Notify Patients of Their Rights
A Patient Bill of Rights should be translated into the selected languages and shared with consumers on pharmacy websites, in stores, and through other outreach.

Include Mail Order Pharmacies
Those count, too! Resources should be dedicated to assessing the language access needs of consumers who use mail order pharmacies and the services that these pharmacies currently provide. In fact, many mail order pharmacies actually have already begun providing language services.

Eliminate the Waiver Option
As the legislation stands now, pharmacies have the ability to opt-out of the requirement to provide language assistance services. But the whole point of the SafeRx campaign is that pharmacies have a federal obligation to do so. Pharmacies shouldn’t be given the ability to dodge their legal responsibilities.

Promote Liability & Accountability
SBOP should implement a plan to monitor and assess pharmacies’ compliance with the law.

Modify Prescription Pads
The NYS prescription pad should be revised to reflect if a patient is LEP and, if so, what the primary language spoken is.

If implemented correctly, SafeRx could improve business for pharmacies by improving customer service and consumer loyalty. For the healthcare system as a whole, SafeRx could dramatically reduce the 700,000 emergency room visits and 100,000 hospitalizations that occur every year when patients misunderstand how to take prescription meds [i]—saving the healthcare system over 3 billion dollars per year overall. [ii]  

With millions of New Yorkers who stand to benefit and millions of dollars to be saved, there’s no reason for the SBOP not to get on board with our recommendations.  And with the clock ticking toward when the legislation will take effect, the time to do so is now.

---

[i] Daniel Budnitz, et al., National Surveillance of Emergency Department Visits for Outpatient Adverse Drug Events, Journal of the American Medical Association (JAMA), 2006; 296 (15):1858-1866.

[ii] William Shrank, et al., Educating Patients About Their Medications: The Potential and Limitations of Written Drug Information, Health Affairs, 2007; 26 (3):731-40.

Segregated Health Care & the Latino Communitiy

Last week, we met with the New York State Assembly/Senate Puerto Rican and Hispanic Task Force to discuss the issue of segregated care in New York private teaching hospitals and our Health Equity Bill (A07699/S5785).

We brought a small but mighty group of advocates, doctors, and community residents to present before the Task Force on this important issue. According to 2009 United Hospital Fund data, 61.2% of Latinos in New York are on Medicaid or uninsured – meaning that the steering of patients based on insurance type has a particularly strong impact on the Latino community. Access to quality-health care is already difficult for Latinos – language/cultural barriers, above-average poverty rates, restrictions on health care for immigrants, etc. – so the addition of unfair hospital policies, like segregated health care, which have no medical, financial, or moral grounds should not be allowed to continue in New York.

Our bill will make it illegal to separate patients based on insurance type so that all patients are treated with the same care, in the same setting, and with the same respect once they enter a hospital.

Special thanks to our partners, Bronx Health REACH, and bill sponsors, Assemblymember Nelson Castro and Senator Gustavo Rivera for joining us at the Task Force meeting.

Below, you can watch our presentation:

NYS Assembly/Senate Puerto Rican & Hispanic Task Force Meeting 02.29.12 from Somos New York

To view our powerpoint presentation from the Task Force meeting, click here.

Advocacy Tools – An Example from the SafeRx Campaign

by Jennifer Swayne, Staff Attorney

We are excited to share with you a significant victory for New York, where Governor Andrew Cuomo included a plan known as SafeRx in his Executive Budget released January 17, 2012!   As many of our readers know, SafeRx is a plan that NYLPI, Make the Road New York and other organizations have been working to implement statewide over the past several years to make sure that patients understand their prescriptions.

SafeRx has been an important campaign for us because it recognizes the rights of immigrants, people of color, seniors, those who are disabled, and others to understand how to take their medications.  SafeRx requires that chain and mail-order pharmacies throughout New York state provide language access services for those who are limited English proficient (LEP), and requires that prescription labels be standardized so that they are easier to understand for patients such as the elderly who have trouble reading and understanding labels.  SafeRx also requires modification of prescription pads to allow prescribers to indicate if a patient is LEP.

Our work on SafeRx included the pursuit of passing New York state legislation, where SafeRx had been introduced as a bill.  However, given the politicized and slow nature of passing legislation, we jumped on the opportunity to be involved in another process known as the Medicaid Redesign Team (MRT) process.  The MRT members were appointed by Governor Cuomo and convened to tackle various cuts to Medicaid in New York and to help determine what might go into the Governor’s Executive Budget.  While we continued to pursue legislation, we saw the MRT process as an additional opportunity to continue our advocacy, and as an alternative to the legislative bill enactment process.

NYLPI’s Health Justice Director, Nisha Agarwal, and Make the Road’s Director of Health Advocacy, Theo Oshiro both sat on the MRT Health Disparities Work Group, one of the many groups whose members were selected by the MRT to help assess various factors impacting Medicaid.  Through the Health Disparities Work Group, the full MRT had access to experts, documents, and presentations providing very important information about the ways that New York was actually losing money by not incorporating prescription safety for patients in pharmacies. After a series of meetings, the Health Disparities Work Group selected some of the most pressing issues—including SafeRx—as part of its recommendations to the MRT.  Even with the prospect of cuts, the MRT recognized the importance of patient safety in pharmacies and passed these recommendations to the Governor to be included in the budget.

Fortunately, this strategy was successful!  We were able to get SafeRx included in the Executive Budget.  Now, unless the legislature decides to take out the provisions regarding accessible prescription labels, the original legislation will essentially pass as part of an omnibus budget bill.

This serves as an example of one of the many advocacy tools that can be used to bring about positive changes for those lacking access to healthcare and other rights.  Legislation is but one means, and looking for other opportunities within the policy process is critical for us to be able to continue our work on behalf of those underserved in healthcare.  In addition to coalition building and continually voicing our concern over how patients are treated in pharmacies, participating in discussion and action items surrounding budget cuts, and inserting our work into the executive process proved to be a great strategy that prevented us from being bogged down by the legislative process.

There is certainly more work to do—for example, making sure the final enacted budget accurately reflects all provisions of SafeRx—but right now we can breathe just a little easier knowing that the Governor’s budget reflects the understanding that patient safety has to be a part of any discussion about the budget.  We know that such an understanding will help reduce health disparities and improve access to care for people of color, immigrants, seniors, people with disabilities and many others as well—the ideals that we work so hard to make others recognize.  For more information on SafeRx, please click here!

Bridging Theory and Practice for Language Rights

Check out a newly published article in the Journal of Health Care for the Poor and Underserved, co-authored by Health Justice Director, Nisha Agarwal, on the importance of language access in the pharmacy setting. This is an area where the evidence about the importance of providing language concordant services for patients who are limited English proficient (LEP) keeps growing and, despite all the discussion in medical circles about “evidence-based” policymaking, we continue to face resistance at state agencies charged with protecting and advancing public health. Instead of collaborative discussions about how to improve access to prescription medications for immigrant communities and reducing health disparities, we hear complaints about how language assistance services might put huge chain pharmacies out of business – immigrant scape-goating at its worst.

We’re taking our fight to the pages of research journals, as well as to the corridors of power in Albany and to the streets until we win. Join us in this effort! Send us an email and let us know that you’d like to join the coalition to ensure Safe Access for Everyone to prescription medications (SafeRx): healthjustice[at]nylpi.org.

Ready to Leave with No Place to Go

by Shena Elrington, Staff Attorney

Undocumented immigrants lack access to viable long-term care options. This is hardly surprising, given the surge in anti-immigrant sentiment, the serious budget crises facing federal, state and local governments and the piecemeal way in which we approach health care delivery. Although not surprising, the lack of long-term care options has very real consequences for both the lives of these immigrants and the overall well-being of the healthcare system.

A flurry of recent newspaper articles has brought the plight facing undocumented immigrants in need of long-term care into sharp focus. In the typical scenario, an undocumented immigrant suffers a catastrophic injury or illness, such as stroke, and is rushed to the emergency room, where she receives care, as required by federal law. The initial injury or illness may have been so severe that the patient becomes incapacitated, unable to feed or care for herself. The hospital then looks for appropriate long-term care facilities, such as nursing homes, to care for the patient. Finding such a facility, however, is nearly impossible because the patient cannot pay out of pocket and is ineligible for Medicaid because of her immigration status. The hospital, unable to find an appropriate facility to discharge the patient, chooses whether to continue to treat the patient, at a cost of several thousand dollars per day, for an indefinite period of time.

Some undocumented immigrants who find themselves in this precarious situation fare better than others. They all, however, live in a constant state of uncertainty, unsure of when the hospital will stop caring for them. And when the hospital terminates treatment, as it inevitably will, undocumented immigrants are faced with a truly terrifying range of “choices”, leading them closer and closer to death.

In September, a hospital in Atlanta refused to provide dialysis to nearly two dozen undocumented immigrants who had been receiving treatment for years. As deadly toxins built up in their systems, some immigrants sought care at various emergency departments, but were refused treatment because their conditions had not deteriorated significantly enough to trigger the hospital’s duty to provide emergency care under federal law. These immigrants were forced to wait until they were literally at death’s door to receive treatment. After much wrangling and public outrage, the hospital agreed to continue to provide dialysis for three more years.

But, what happens when that three-year period comes to an end?

Some hospitals, acting outside the federal immigration process, actually contract with private transport agencies to have these patients, with or without their consent, flown back to their home countries, without ensuring that there are any healthcare facilities in those countries able to support their needs. In essence, these immigrants are sent home to die. Based on our work with community partners and advocates, we know these “medical deportations” are not isolated events.

The perils undocumented immigrants in need of long-term care face are the direct result of failures in our immigration and health policies. Our current system mandates that hospitals provide care to undocumented immigrants when they are so ill that they require emergency treatment, at the most expensive point of access in the health care system – the emergency room – yet provides no real avenue for them to receive cheaper preventative care or be moved from more expensive acute care facilities to more appropriate, and less expensive, long term care facilities like nursing homes when necessary.

While health reform expanded the number of Americans eligible for Medicaid, it fell short of including undocumented immigrants – prohibiting them from even purchasing insurance within the exchanges. While the majority of undocumented immigrants are young and healthy, it is inevitable that tragedy will strike at one point or another and some immigrants will need long-term care. Our current policies make no provisions for this eventuality. Worst yet, there is virtually no oversight over hospitals that repatriate patients to their home countries, discharging them to family members or facilities abroad that often lack the means to properly care for them. And, there is little to no discussion of the legal and ethical breaches healthcare providers and hospitals may be committing by failing to discharge undocumented immigrants to appropriate healthcare facilities.

We need to discuss these issues, even if talking about them is difficult in a political climate where anti-immigrant sentiment runs rampant and budget cuts seem to always land on the backs of the poor, because some of our most fundamental values are at stake. Just a few weeks ago, we glimpsed the erosion of these values during a Republican presidential nominee debate, when the audience proudly affirmed their willingness to let a hypothetical 30 year old man who needed intensive care die because he opted out of health insurance. There is little doubt that this crowd would feel the same way about an undocumented immigrant in need of care, who had no access to insurance to begin with. Is this really the kind of world we want to live in?

Save Our Safety Net – Video from Medicaid Redesign Hearings

On February 4, 2011 – Governor Cuomo’s Mediciad Redesign Team (MRT) held a public hearing in NYC. The MRT has been charged with finding $2.85 billion of cuts to New York’s Medicaid budget by March 1st. The MRT – which has a disappointing lack of consumer voices  – gave New Yorkers 2 minutes during the hearings to give their suggestions for Medicaid redesign.

This video captures the repeatedly expressed sentiment that cuts to already struggling safety net providers will have catastrophic impacts on low-income, immigrant and disabled communities.

Do You Understand Your Prescription Labels?

We here in NYLPI’s Health Justice Program, along with our partners Make the Road New York, are getting ready to hold a press conference at 12:30pm on Tuesday, December 14 near City Hall at Broadway and Park Place (East side of Broadway).  We will use that opportunity to release our new report detailing our findings from a monitoring study of language access in pharmacies, and to join with consumers, advocates, and State Assemblyman Richard Gottfried, State Senator Jose Peralta, and Councilmember Julissa Ferraras in calling for the state legislature to pass a bill that would ensure standardized prescription drug labels and language assistance services in chain pharmacies all across New York State.

It may seem like  common sense, but prescription drug labels are only effective if patients are able to understand them.  That feeling of confusion upon returning home from the pharmacy and not understanding how to take the medication is universal.  With dozens of ways for a pharmacist to write “take once a day,” it is often challenging for patients to understand and act correctly on just one prescription instruction.  For those who take multiple medications, such as the elderly, and for the over 2.4 million people in the New York who speak English less than “very well” and are therefore considered limited English proficient (LEP), though, the lack of translation and prescription label standardization makes labels literally incomprehensible.

The consequences of patients’ misunderstanding prescription labels can be dire and costly.  Every year, unintended misuse of prescription medications causes over one million “adverse drug events,” resulting in expensive visits to the emergency room, hospitalization, and even death.

Everyone should be given the opportunity to understand their prescription medication labels.  Fortunately, solutions exist to this serious health problem that are simple, inexpensive, and efficient for pharmacies to implement.  Creating easy-to-understand, standardized prescription labels, and providing that information in a patient’s language in person or over the phone, can significantly improve health outcomes.

Since 2007, NYLPI and Make the Road have been championing the issue of safe access to prescription medications in New York State, particularly with regard to language access.  We worked with the New York State Office of the Attorney General to enforce existing laws relating to language access in pharmacies, which resulted in settlement agreements with seven chain pharmacies operating across the state.  We also worked with the New York City Council to pass the Language Access in Pharmacies Act, which requires chain pharmacies in the city to provide translation and interpretation services for LEP consumers filling prescriptions.

This past summer, Make the Road and NYLPI surveyed over 250 chain pharmacies across New York—including Rite Aid, Duane Reade, K Mart, CVS, Pathmark, Target and Walgreens—to determine the extent to which pharmacies were complying with the city law and Attorney General settlement agreements.  Chain pharmacies not bound by local law or the settlement agreements were also surveyed to determine whether additional regulation actually improves access to services for patients.

What we found encourages us that our efforts thus far are significantly improving the health and safety of all New Yorkers.  It also pushes us forward in our work toward making that goal a reality.  Among other findings, our results show that:

• The settlement agreements and local law have led to significant improvements in the provision of language assistance services compared to when we began this work in 2007.
• However, nearly 50% of pharmacies surveyed were still unable to state that they met the prescription label translation requirements of the laws.
• Further, almost 30% of surveyed pharmacies could not state that they provided mandated interpretation services for medication counseling.
• Pharmacies not subject to the settlement agreements or local law provide the poorest access to limited English proficient consumers.

While the oversight and additional regulation by state and local authorities have had a positive impact on patient access to pharmacies, more needs to be done.  The city law only covers New York City chain pharmacies and the settlement agreement expires in 2013.  In addition to the ongoing language barriers, the fact remains that many consumers, regardless of the language that they speak, continue to have a difficult time understanding the instructions and labels that accompany their medication, and there is little in existing law to help them.

The state bill, championed by Assembly Member Gottfried and State Senator Tom Duane, contains provisions that would ensure that all patients can better understand their prescription medications.  The bill, which would apply to all chain pharmacies across New York, would authorize the State Board of Pharmacy to create a framework for standardized prescription labels that are easier for consumers to understand.  It would also expand upon the legal requirements already contained in the local law and would codify many of the translation and interpretation requirements of the settlement agreements.

We hope you will join us at the press conference, and will sign on to show your support for New York Assembly bill A11627 (Gottfried) and Senate bill 8365 (Duane) and to call on members of the Assembly and Senate to sponsor and support the legislation.