Mental Illness – Fighting Stigma and Improving Access to Care

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.

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

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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.

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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

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.

Acknowledging Difference, not Defeat: A Racial Justice Perspective on the Medicaid Debate

This post, by Health Justice Director Nisha Agarwal and Staff Attorney Shena Elrington, also appears on the Race-Talk blog, Huffington Post, and Alternet.

The federal Medicaid program has become something of a policy piñata in the national discourse. Over the course of the past year conservatives have been asking, “is Medicaid real health insurance?” The public insurance program for low-income individuals has been criticized for not providing sufficient access to physicians, long wait times to see a physician when one can be accessed, and poorer quality of care once patients get in the door – all of which conservatives argue are reasons to dismantle the program altogether. If being on Medicaid isn’t much better than being uninsured, why bother spending tax dollars on it?

Meanwhile, a recent editorial in the New York Times offered unequivocal praise for the Medicaid program, pointing to a study conducted in Oregon that allowed researchers to compare the experiences of people who received Medicaid coverage to those who did not. According to the study, Medicaid recipients reported better health than the uninsured recipients  and were less likely to have medical bills sent to  collection agencies or forgo other obligations in order to pay for their medical care. Supporters of the public health insurance plan were therefore able to hit back against conservative naysayers and argue that Medicaid truly is a program worth preserving and expanding.

While the national debate lurches back and forth, we find a more complicated reality on the ground, in the low-income communities of color where we work to eliminate race- and class-based biases in the health care system. The uncomfortable truth is that Medicaid beneficiaries do often receive poorer quality of health care, particularly when it comes to accessing specialists. But to see this you have to look at how Medicaid beneficiaries fare vis-à-vis privately insured individuals, not the uninsured, which has been the focus of current debates.

For example, in  our work with Bronx Health REACH, a faith-based community coalition in the Bronx, we have seen how Medicaid patients seeking specialty services at major New York City hospitals are seen in separate—effectively segregated—facilities from their privately-insured peers, with longer wait times, less experienced doctors, and much less continuity and coordination of care. (You can read more about these problems in this monograph published by the Bronx Health REACH coalition and in this complaint we filed with the New York State Attorney General.)

Working with low-income parents, we have also seen how children with Medicaid have to wait for grotesquely long periods of time before they can get mental health treatment and special education evaluations, if they are able to access these services at all, and how elite institutions providing such services refuse to serve publicly insured populations despite the significant shortage of pediatric mental health providers in New York City.

Our experience thus seems to support conservative arguments to some extent: Medicaid beneficiaries do not have sufficient access to physicians, experience long wait times to see a physician when one can be accessed, and suffer from poor quality of care once they get in the doctor’s door, at least when compared with those patients who are privately insured.

Undoubtedly the current climate surrounding Medicaid makes it difficult for advocates to point out the lower quality of care Medicaid beneficiaries receive, for fear that any criticism of the program will serve as powerful ammunition for the other side to use. But acknowledging certain aspects of the conservative argument need not mean that advocates have to accept the entirety of their conclusions. Something else we’ve learned through our work is that Medicaid isn’t “bad” insurance per se. Rather, healthcare providers and institutions choose to treat Medicaid beneficiaries badly by discriminating against them with respect to the quality of care provided. Consider the Bronx example. Hospitals in New York City (and elsewhere) are not only reimbursed by Medicaid for providing patient care, they also receive over $1 billion through the Medicaid program for non-patient purposes such as resident doctor training – a funding stream so substantial that the New York hospital industry is fighting tooth and nail to keep it safe from federal budget cuts. Medicaid seems to pay hospitals very well, and yet these same hospitals choose to provide segregated and unequal care to Medicaid beneficiaries. Why?

As with many things, these bizarre dynamics cannot be understood without accounting for race, and for the fact that the vast majority of publicly insured individuals in New York City are black and brown. We have heard how top-flight specialists want to be able to choose the patients that they treat, which is invariably code for avoiding people of color who are perceived to be more “complicated” and “non-compliant.” Elite NYC hospitals eager to attract these specialists happily comply to doctors’ demands by giving them fancy facilities to see their preferred patients, while the Medicaid patients are separated out into “clinics”, where they are treated by a rotating band of doctors-in-training.

In addition to wanting to attract renowned specialists, the hospitals want to attract the “right” kind of patients – that is, wealthy, white, suburban patients. Behind closed doors administrators will openly argue that their “‘paying’ patients will not want to sit in the same waiting room as people on Medicaid,” so it is simply better for the hospital to segregate the two groups.

Worse still, these biases become a part of the culture of how medicine is taught, with students and residents working with Medicaid patients in the clinics learning very early on that some patients—the kinds of patients they get to practice on, the poor patients of color—are less worthy than others. Indeed, research has suggested that by the end of their medical education, student doctors actually become more biased than they were when they began medical school. These biases, whether conscious or not, permeate the medical system at both an individual and systemic level, affecting the quality of care that Medicaid beneficiaries receive.

From our perspective, the debate about Medicaid is less about left-and-right and more about black and white. The conservatives’ sleight of hand is to point to quality of care problems for Medicaid beneficiaries and to jump from there to the conclusion that the Medicaid program is to blame, which obscures the mediating role that institutional racism plays in ensuring poor outcomes for Medicaid patients. Meanwhile, supporters of Medicaid effectively erase race from the debate as well by closing their eyes to the many challenges Medicaid beneficiaries face in accessing high-quality health care, despite the fact that they are walking in the door with an insurance that research shows is pretty good. A more nuanced position would acknowledge differences in care without accepting defeat. It is not the Medicaid program that must be dismantled, but the biased attitudes and policies that lead Medicaid patients to get inferior quality of care.

Action Alert: Email the MRT

In response to the hurried and flawed process used to develop proposals for New York Medicaid redesign, the Save Our Safety Net-Campaign asks allies to send emails to members of the Medicaid Redesign Team (MRT) expressing our distaste with their decision making process.

Sample text and email addresses of MRT members are below.

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Subject: Disappointed with Medicaid Redesign Process

Sample text:

“Medicaid Redesign Team -

We are saddened and angered by the “rush to judgment” on February 24th in the vote of the Medicaid Redesign Team to approve a package of recommendations that you had in your hands for less than 24 hours.  There had been major changes in what recommendations you were being asked to vote on, yet you voted.  The information was just made available on the web site the same day as the vote.  The aborting of the time frame by five days meant the public had no opportunity to review, digest, and comment on this package – much of which will have a dramatic impact on people’s lives.

The process had so many flaws that it would be difficult to name all of them.  But while trying to appear as this was a public transparent process, in the end it was anything but open and public.  To cite just one “mistake”, Mr. Introne acknowledged publicly at the meeting on February 24^th that people who had been listed in support of proposal #67, had actually spoke in opposition to this proposal.  #67, or Berger 2, would make money available to close, consolidate or merge hospitals, nursing homes, and clinics and was actively supported by Ken Raske (GNYHA) and Stephen Berger.”

Email addresses of MRT members:

Ann Monroe<amonroe@chfwcny.org>;Arlene Gonzalez-Sanchez<arlenesanchez@oasas.state.ny.us>;Joe Giglio (Assembly)<giglioj@assembly.state.ny.us>; Assemblyman Richard N. Gottfried<gottfried@assembly.state.ny.us>; Carol Raphael<craphael@vnsny.org>; DanSisto<dsisto@hanys.org>; Dennis Rivera<drseiu@aol.com>; Dr. JeffreySachs<jsachs@sachsmessage.com>; Nirav Shah<nrs02@health.state.ny.us>; Dr. William Streck<william.streck@bassett.org>; Ed Matthews<ematthews@ucpnyc.org>; Eli Feldman<efeldman@mjhs.org>; Elizabeth Swain<eswain@chcanys.org>; Frank Branchini<fbranchini@emblemhealth.com>; GeorgeGresham<georgeg@1199.org>; James Introne<James.Introne@exec.ny.gov>; Jason Helgerson<jah23@health.state.ny.us>; Karen Ballard<kballard@nyc.rr.com>; Ken Raske<raske@gnyha.org>; Lara Kassel<lkassel@cdrnys.org>; Linda Gibbs<lgibbs@cityhall.nyc.gov>; Lisa Ullman<Lisa.Ullman@exec.ny.gov>; Max Chmura<max.e.chmura@omr.state.ny.us>; MikeDowling<mdowling@nshs.edu>; Mike Hogan<cocomfh@omh.state.ny.us>; RobertMegna<Robert.Megna@budget.state.ny.us>; Kemp Hannon (Senate)<hannon@nysenate.gov>; Thomas Duane (Senate)<duane@nysenate.gov>; SteveAcquario<sacquario@nysac.org>; Steve Berger<sberger@odysseyinvestment.com>

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.

Medicaid Reform and Retrenchment: Your Voice is Needed NOW

As many of you know, Governor Cuomo has created a “Medicaid Redesign Team” to help him cut New York’s Medicaid program by $2 billion and redesign it for the long-term.  This 27-member team is made up of only one statewide community organization and has little representation from the public sector. It is primarily dominated by the hospital industry and is led by two men with ties to large, private hospitals. Given the imbalanced composition of the Redesign Team, we are concerned that the “savings” and “reforms” it will propose will also be imbalanced, resulting in cuts to Medicaid benefits, long-term and primary care services in the community, and safety net providers. In New York City, people of color are more than twice as likely to be publicly insured than whites. This means that cuts and bad decisions about reforms to the Medicaid program will have a bigger negative impact on immigrant populations and communities of color.

What can you do in response?

1. Make your voice heard! The Medicaid Redesign Team is hosting a series of public hearings across the state, including two in New York City on Thursday, January 27th. The focus of the hearings is to solicit input on how to achieve savings in the Medicaid program. Consumer advocates and allies must be out in full force at both of these hearings to provide testimony about how savings can be achieved without breaking the backs of low-income New Yorkers who depend on Medicaid for critical health benefits. Click here for more information about time & location for these hearings.

2. Join the campaign! The Save Our Safety Net-Coalition (SOS-C) is mobilizing to keep the voices of consumers and labor front-and-center during the redesign process. If you would like to get involved or simply keep informed about what is happening, please contact the Commission on the Public’s Health System at 212-246-0803 or email soscny@gmail.com.

3. Spread the word! Please tell your friends, colleagues and fellow fighters about the upcoming public hearings, encourage them to attend and provide testimony, and urge them to join SOS-C. Important public policy decisions should not be made without the active involvement of the people most impacted. Click here to download a flyer about the Medicaid Redesign Team hearings to share with your networks.

We look forward to working with all of you to ensure that New York’s Medicaid reform is humane, just and participatory.

Making Separate and Unequal Illegal

For those of you who’ve been following our campaign to eliminate separate and unequal health care delivery in New York City’s academic medical centers, we’ve got some good news!  This morning legislation was introduced in the New York State Senate that would make it explicitly clear that private academic medical centers in New York City must provide care to all patients in the same place at the same time.  In other words, they are not allowed to steer Medicaid patients to one section of the hospital, where they provide them with lesser quality of care from privately insured patients, who are seen in another part of the hospital.  To read the text of the bill, click here.  A clearer summary of and justification for the legislation can be viewed here, in what is called the “sponsor memo.”  We will keep you posted as this campaign progresses!

Run On and See Where It Ends: Fighting to Make Health Equality a Reality

This post, by Health Justice Director Nisha Agarwal, has also appeared on Race-Talk, Huffington Post and AlterNet.

Saturday morning, April 17^th, the auditorium of Junior High School 22 in the Bronx was crowded with community residents who had gathered for a town hall meeting. Health care reform had passed, but these folks knew that their problems were not over. Ensuring that most Americans have health insurance, while important, will not be enough to eliminate the racial and ethnic disparities that have been dyed deep into the U.S. healthcare system and that reveal themselves, vividly, in the Bronx.

To save black and brown lives and to improve the vibrancy of those lives requires looking beyond access and focusing on quality. It requires, among other things, an examination of the practices of major health care institutions, which deny low-income people of color the highest quality of care they have to offer even when those people have health insurance.

The specific issue that community members had gathered about is this: in New York City, prominent private hospitals–facilities like New York-Presbyterian, Montefiore Medical Center, Mount Sinai–operate two different systems of care for patients with the same kinds of health problems but with different types of insurance. There are, for example, cardiology “clinics” for patients with Medicaid, a public insurance program, and there are cardiology “faculty practices” for patients with private insurance. Sometimes the clinics are right next door to the faculty practices, but Medicaid patients won’t be allowed into the faculty practices, and privately insured patients are not sent to the clinics.

What is more, the hospitals allow valuable and finite resources to be allocated unequally between the two systems of care. For instance, clinics often do not have enough financial support from the hospital to perform basic care coordination tasks like sending notes back to the patient’s primary care physicians, while faculty practices often receive administrative and other forms of support so that such tasks are routinely able to be done.

More significantly, board certified faculty physicians, the top docs, spend only a fraction of their time in the clinics–a mere half a day a week for four months out of the year in one case–even though they are required by law to spend the bulk of their time supervising resident doctors and caring for patients in the clinic setting instead of in the faculty practice. Hospitals do nothing to shift the balance and, as a result, Medicaid patients do not have a single, board-certified physician who is ultimately responsible for their care, whereas privately insured patients do. Here is a chart summarizing some of the main inequalities:

The impact of these differences are felt on the bodies and backs of low-income patients. At the town hall meeting, Medicaid beneficiaries spoke of being bounced from one doctor-in-training to the next within a fragmented clinic system, where fingers and toes were almost amputated and cancer remained undiagnosed until dangerously late. And they spoke of how these outcomes were not race neutral. In New York, people of color are far more likely to have public insurance than whites, which means that when hospitals create two systems of care based on insurance they are also perpetuating a de facto segregation based on race. (For more background and helpful stats on this issue, please see this excellent monograph on medical apartheid in New York City by the Bronx Health REACH coalition, the group that first brought this problem to light.)

Representatives of health care institutions have argued publicly that community residents are missing the point. The source of the problem, they claim, is with the Medicaid program and not with the hospitals. Doctors’ offices are reimbursed at extremely low rates through Medicaid and therefore can’t afford to see publicly insured patients in their faculty practices. The clinics have been set up to provide an avenue for care that otherwise wouldn’t exist.

But it is the hospital representatives who are missing the point. The provision of care to Medicaid patients is not something hospitals are choosing to do out of the goodness of their hearts. Under federal law, hospitals are required to open their doors to Medicaid beneficiaries, and provide them care without discrimination, in exchange for accepting millions of dollars of government funding to modernize and upgrade their facilities.

Moreover, while Medicaid reimbursement rates for doctors’ offices are very low, they are much higher for clinic-based services. In order to integrate care, hospitals could simply shift their resources to the clinic and ensure that all patients, public and private alike, are seen in that setting, instead of siphoning off the privately insured patients to the faculty practices. The increased resources and mixed patient population would help ensure that the quality of clinic care would improve dramatically and that this high-quality care would be accessible to all on equal terms.

Of course, hospitals are choosing not to do this and, given the dubiousness of the financial arguments, one is left to presume that their motives are more suspect: one cannot attract wealthy, white patients from the Upper East Side and Westchester if those individuals will have to sit in the same waiting room as people of a different class or race. The fight to integrate our health care system and to reduce racial and ethnic health disparities is therefore going to be just as messy as the historic battles to integrate our educational system or our housing. But fight is what Bronx residents will do, even in the face of uncertainty and resistance. As one faith leader said at the town hall meeting, quoting a song from the civil rights movement of deep South, we must “run on and see where it ends.”

To learn more about Bronx residents’ efforts to eliminated segregation in New York City’s healthcare system, please click here or visit the website of Bronx Health REACH.

4/17 Townhall Event: Make Health Equality A Reality

NYLPI  will be teaming up with Bronx Health REACH to put on a community townhall event in the Bronx on Saturday, April 17th.

We will convene community residents to learn from doctors, lawyers, and health advocates how the healthcare system is FAILING the Bronx and what we all can do to change it for the better.

Health Justice Director, Nisha Agarwal, will serve as one of the panelists.

Event is open to everyone! We hope to see you there.