Monthly Archives: November 2013

HJ News and Resource Roundup 11/25/13 (Thanksgiving Edition!)

It’s been a while, but we’re back to give you the latest health justice news and resources in time for Thanksgiving! We’ll be discussing language barriers in the health insurance marketplaces, enrolling the homeless into Medicaid, African American health disparities, and the return of maternity services to a North Bronx hospital. Additionally, this roundup includes a special discussion of the health justice struggles in many Native American communities: as we celebrate with our families this holiday, let us not forget the ongoing oppression of America’s indigenous communities.

The Affordable Care Act

The rollout of the ACA has come under a lot of fire since the launch of the health insurance marketplaces in October. While we’re not ready to let the administration completely off the hook yet, we recognize that the ACA is a huge step forward for expanding health coverage. So here are some handy talking points that will help you win any Obamacare argument over the Thanksgiving holiday.

The Departments of Health and Human Services (HHS), Labor and the Treasury jointly issued final rules on mental health coverage under the ACA. The new rules require that most health insurance plans offer the same amount of coverage for mental health and substance abuse claims as they do for medical and surgical coverage.

The ongoing technical problems on Healthcare.gov, the federal health insurance website, have undermined Medicaid enrollment. States that are expanding their Medicaid programs under the ACA are facing additional challenges to enrolling the homeless.

As for those who will remain uninsured–low-income individuals in states not expanding Medicaid and undocumented immigrants–access to preventive care services will remain a challenge.

New research indicates that since the passage of health reform in Massachusetts (the precursor to the ACA), racial disparities in uninsured rates and access to preventive health services have been reduced. However, racial disparities in disease prevalence and cause of death persist.

The ACA and Immigrant/Language Access

In more ACA-related news, HHS has created a webpage on the Healthcare.gov website devoted to addressing immigrants’ questions about the health insurance marketplaces.

However, language access remains a problem. Language diversity and cultural differences among Asian Americans have made it challenging to enroll this population. Additionally, HHS recently announced that they will be delaying the launch of the Spanish language federal marketplace website, CuidadodeSalud.gov.

Native American Health

A recent research report commissioned by the Oneida Indian Nation demonstrates the harmful psychological impact of ongoing caricaturization and dehumanization of Native peoples.

Check out this lecture by Dr. Maria Yellow Horse-Brave Heart on American Indian women, historical trauma, PTSD, and healing.

In Michigan, a Native American Studies professor is spearheading an effort to reclaim indigenous diets and combat the crisis of diet-related obesity and health issues among Native Americans.

A Stanford student writes about the dire health care needs of the people of Rosebud Indian Reservation.

More on Health Discrimination and Health Disparities

The Centers for Disease Control recently published the 2013 Health Disparities and Inequalities report.

Blacks continue to face a higher rate of infant mortality than other racial/ethnic groups.

A recent study in the New England Journal of Medicine suggests that Blacks are often misdiagnosed with vitamin D deficiency.

Findings from a survey of patients admitted to an urban emergency department in the Midwest show that black patients feel less comfortable asking for lower cost medications than white patients.

Abortion access in red states is a significant challenge for low-income rural women.

Here’s a history of HIV care for the LGBT community in Nevada.

NYC Hospital Closures

The Health and Hospitals Corporation (HHC) of NYC recently announced that they plan to reopen labor and delivery services at North Central Bronx Hospital. However, community groups, advocates, and labor groups plan to keep up the pressure to ensure that HHC brings back services in a timely manner and with community input.

The closure of Interfaith Medical Center has once again been put on hold. A bankruptcy judge deferred making a final determination on closing the central Brooklyn hospital and has instead assigned the case to mediation. Interfaith is a leading provider of psychiatric services in the borough.

More Local NY News

With mayor-elect Bill de Blasio heading to Gracie Mansion in January, everyone is talking transition. Check out this article on one member of de Blasio’s transition team who is thinking about health disparities.

Transgender activists in NY are fighting to repeal a Medicaid restriction that refuses coverage for gender affirmation surgeries.

A Note on Giving to Victims of Haiyan

Finally, in the spirit of giving, here’s a guide on how to give to disaster victims in the Philippines. You can also check this list of Filipino organizations accepting donations.

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Medical Repatriation: Hospitals Deporting Sick Patients

by Christine Chiu, Staff Attorney

Everyone knows to go to the emergency room in a medical crisis. We believe that the doctors there will take care of us and get us the treatment that we need. The emergency room doesn’t turn anyone away, regardless of ability to pay or immigration status. But what many people don’t know is what some hospitals do with seriously injured, undocumented patients once they are stabilized once it is discovered that they are uninsured and cannot pay for ongoing care.

Some bad actor hospitals in this situation take it upon themselves to deport ill or injured immigrant patients outside of the federal immigration process. This practice is known as forced medical repatriation.

By law, hospitals must provide emergency treatment to everyone regardless of immigration status or insurance coverage. However, once the patient is stabilized, hospitals are not reimbursed for any continued care that an uninsured patient may need. This situation may arise, for example, with comatose patients, patients needing regular dialysis, and patients with serious mental illness. The law prohibits hospitals from discharging a patient without arranging for transfer to an appropriate facility that ensures the patient’s health and safety. Yet long-term care facilities, rehabilitation centers, and nursing homes will not accept patients without insurance. In order to avoid continuing to provide care for these patients, then, some hospitals instead send immigrant patients to their home countries, frequently making inadequate or no arrangements for medical care upon arrival.

Only the federal government has the authority to deport immigrants, but these hospitals are taking it upon themselves to contact consulates, obtain passports, buy plane tickets, and even charter private planes to send undocumented patients abroad. In so doing, they are denying these patients both due process in immigration proceedings and the chance to consent to and participate in decisions about their own care.

While this practice may save the hospital some money, it can also come at the cost of the patient’s life. NYLPI and the Seton Hall Law School Center for Social Justice issued a report documenting more than 800 cases of attempted or successful medical repatriations across the United States in the past six 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, and a car accident victim who died shortly after being abandoned on the tarmac at an airport in Guatemala. Just this past summer, a Polish man who had lived in the United States for thirty years was put on a plane by a New Jersey hospital while unconscious; when he awoke, he found himself  back in Poland.

The practice of medical repatriation takes place largely in secret, so it is difficult to estimate the actual number of repatriations taking place around the country. What we do know is that undocumented immigrants will be at higher risk of repatriation starting next year when the federal government reduces charity care funding, making it even more difficult for hospitals to offset the cost of uncompensated care. Hospitals that regularly treat undocumented or uninsured patients may become even more likely to resort to repatriating patients that require long-term care.

It is therefore critical that we address the issue of medical repatriation now. We should call on hospitals and consulates to establish protocols to ensure that patients give informed consent before being discharged and that, in the event that a repatriation is made, they are sent to places where they can get the care they need. We should also urge the Department of Health and Human Services to issue regulations explicitly prohibiting involuntary repatriation of patients and imposing sanctions on hospitals that engage in this unlawful practice. It is high time we face head-on the deficiencies in the system that allow for these unlawful—and in many cases life-threatening—deportations to occur.

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New York City Needs a Mayor Committed to Health Justice

By Sascha Murillo, Community Organizer – Health Justice Program

Today, voters will head to the polls to elect a new mayor of New York City. But what kind of mayor do New Yorkers want? What kind of mayor does this city need?  In a city where the health care landscape is rapidly transforming, we need a mayor who will protect and strengthen our safety-net and prioritize improving health care access for low-income communities, people of color, and immigrants. We need a mayor who will work with residents, health advocates, and labor groups to design a health system that provides high-quality, comprehensive services and is responsive to community needs. We need a mayor who will fight for health justice.

The Affordable Care Act (ACA) will bring thousands of New Yorkers out of the shadows of the uninsured.   However, the current trend of hospital and clinic closures and service cutbacks in NYC is endangering low-income populations whose access to care is already limited due to geography, insurance type, and immigration status. In August of this year, the City’s Health and Hospitals Corporation (HHC) suspended Labor and Delivery and other important maternity services at North Central Bronx Hospital (NCBH), which in 2012 alone was responsible for delivering 1,400 babies in this low-income immigrant community. Similarly, the City’s Department of Health and Mental Hygiene (DOHMH) is planning to reduce hours for nine STD clinics and close down two immunization clinics in Queens and the Bronx by the end of this year.

The next mayor will have the power to reverse the current trend of cutbacks in city health services. Just as important, however, will be the next mayor’s ability to influence decisions at the state level. As the New York health insurance marketplace seeks to enroll millions into insurance coverage, it will be beneficial for these marginalized communities to have a mayor who will advocate on their behalf—for example, by promoting that the insurance marketplace be accessible to the nearly 400,000 eligible New Yorkers who are limited English proficient. And in Brooklyn, where several safety-net hospitals are either slated to close or on the brink of closure, our next mayor should work to save and redesign the health care system by bringing the voices of community members and health professionals to the state Department of Health (DOH), ensuring that Brooklyn’s safety-net and primary care services are both financially secure and inclusive of the diverse health needs  of a medically underserved population.

Everyone has the right to a healthy life. We need a mayor who works to improve public health: not only by fixing our health system, but by ensuring that all New Yorkers have access to healthy food, students have access to physical education, and issues like race and ethnicity, insurance type, citizenship status, and geographical proximity to health centers don’t determine a person’s quality of or access to care.  We hope the next mayor will take this message to heart and work to preserve and promote health—not just for a lucky few, but for all New Yorkers. You can learn more about the NYC mayoral candidates here. Follow election updates and results here.

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HJ News and Resource Roundup 11/1/13

In this week’s edition of the News and Resource Roundup, we’ll be discussing more Obamacare news, racial health disparities in reproductive and sexual health, LGBTQ access to health benefits, and more!

The Affordable Care Act

Advocates are promoting “it’s safe to apply” messaging to encourage immigrants, especially those from mixed-status families, to apply for health insurance through the exchanges.

The Office of Refugee Resettlement at the U.S. Department of Health and Human Services has produced a short video in 6 languages and a fact sheet about refugees and the Affordable Care Act.

The GOP continues its practice of fear-mongering and spreading misinformation on the ACA.

Health Discrimination and Disparities

Altarum Institute and the W.K. Kellogg Foundation (WKKF) released a report detailing the economic impact of racism, and the benefits of advancing racial equity in health, housing, and other areas.

The city of Philadelphia is taking important steps toward creating a more LGBTQ-friendly city by providing tax breaks to companies that extend equitable health care benefits to LGBTQ families.

A study has found that the most common HPV vaccine may not protect against subtypes of the virus that commonly affect black women, possibly due to lack of inclusion of black women in clinical trials.

Proposed federal legislation, the Pregnant Workers Fairness Act, seeks to eradicate workplace discrimination against pregnant workers, an issue that may disproportionately impact low-wage earners and women of color.

Black women face disproportionately high rates of maternal mortality.

A report details the sexual and reproductive health needs of NYC’s immigrant youth.

Here and Now: Local and Timely Issues

November 5th is Election Day!  Here’s where the mayoral candidates stand on public health.

One year after the devastation of Hurricane Sandy, advocates document the lasting toll the storm has taken on health.

October was Domestic Violence Awareness Month. Domestic Violence, or Intimate Partner Violence, disproportionately impacts women of color.

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