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In July and August 2019, CPEHN worked with six partner organizations, including Disability Rights Education and Defense Fund, Black Women for Wellness, Latino Coalition for a Healthy California, Asian Americans Advancing Justice-Los Angeles, Consortium for Urban Indian Health, and Diversity Collective of Ventura County to host six focus groups across the state to gather data for the Health Equity System Transformation (HEST) project. These focus groups sought to engage consumers with diverse identities and backgrounds, including race/ethnicity, sexual orientation and gender identity, primary language, disability status, age, and marital status. Discussions were around key areas including accessibility and quality of care, health care costs, doctor-patient engagement, and cultural sensitivity. As a result, we heard many voices and stories reflecting a diversity of health care experiences. We were also able to identify the following common themes shared among many focus group participants.
 
Barriers Accessing Care
Many reported challenges accessing health care, even when they had health coverage or insurance. 
  • Wait times for appointments and at visits were long. Participants reported that it could take weeks before getting an appointment, and sometimes hours on the day of the visit to be seen by a doctor. 
  • Language access was inadequate. Many reported they had never been informed of their right to an interpreter. Those who received interpretation complained about its poor quality.

California now has more conclusive data on the uniquely different experiences of communities of color in their interactions with system of mental health care. In 2017, CPEHN sponsored AB 470 (Arambula), which required the Department of Health Care Services (DHCS) to improve the Statewide Performance Outcome System for specialty mental health services (SMHS) to identify mental health disparities at the county or statewide level. DHCS now provides publicly available data on disparities in mental health utilization, access, and outcomes. Assembly Bill 512 builds upon the findings from AB 470 and requires the California Department of Health Care Services and local county mental health departments to use this conclusive data to set performance goals to reduce disparities in California’s communities of color.

Despite California’s investments in mental health care, several key findings from the improvements to the Statewide Performance Outcome System show the need of communities of color for great quality and access in mental health care.

Racial Disparities

Central Valley Residents Discuss Health Priorities with Congressman Harder

On February 21, advocates held a community listening forum on health with newly elected Central Valley Congressman Josh Harder. Nearly 100 community members—including residents, health care providers, non-profit leaders, and city council officials—attended the forum to listen and share their health care stories.

Hosted by the Having Our Say Coalition, California Rural Legal Assistance Foundation, Mi Familia Vota, and the West Modesto Community Collaborative, the forum invited Congressman Harder to listen to personal stories and concerns around health from members of the community. Residents raised a variety of issues related to:

  • Access to health care for all residents in the community;
  • Health care that is affordable, high-quality, and culturally relevant;
  • Health care that is comprehensive, including mental health, oral health, and preventive care; and
  • Ensuring that communities have the social, economic, and environmental infrastructure necessary to live healthy lives.

Community residents shared stories highlighting challenges in accessing culturally competent health care, care for undocumented populations, mental health services, affordable prescription drugs, and more.

The California Pan-Ethnic Health Network (CPEHN) applauds Governor Newsom for proposing historic investments to achieve health equity. While the Governor’s budget proposal is a great first step, we call on the Governor and Administration to work with local, regional and state leaders to prioritize action on the key health equity recommendations outlined below in order to improve health outcomes for ALL Californians.

Who we are: CPEHN is a statewide multicultural health advocacy organization. Founded over 25 years ago, CPEHN unites communities of color to achieve health and wellness, and to eliminate persistent health inequities. We derive our strength from our mobilizing arm, the Having Our Say (HOS) coalition which consists of over 30 community-based organizations across California working together to improve access to care and health outcomes as well as through our Behavioral Health Equity Collaborative (BHEC) and California Oral Health Network (COHN) partners.

The Stockton community mobilizes to reduce mental health disparities for the city’s most vulnerable population.

Advocates held the Stockton Reducing Disparities Public Hearing on December 11th 2018 from 10 AM- 3 PM at the historic Stockton Masonic Temple to showcase programs that reduce stigma for mental health and to bolster cultural pride among vulnerable population. Attendees also strategized how different stakeholders and community leaders should work together to reduce mental health disparities.

Stockton has gained much media attention since the city rolled out a pilot Universal Basic Income (UBI) in 2018, a bold program proposed by Stockton’s 27-year old mayor Michael Tubbs. This represents tremendous progress due to a deep economic and health disparities that exist even within the city, with Stockton City South underperforming compared to Stockton City North. Even with the progress the city has achieved, many still face barriers in accessing quality health care in Stockton and the greater San Joaquin County, especially for communities of color and LGBTQ population.

On Thursday, January 10th, Governor Gavin Newsom released his FY 2019-2020 State Budget. The $209 billion spending plan proposes an historic investment in health equity and health care quality, providing millions in funding to tackle disparities in pre-natal and post-partum care, chronic conditions and mental health. The budget also includes new funding to expand access to health care for undocumented young adults and improves affordability assistance in Covered California for low to middle income individuals earning between 250-600% of the Federal Poverty Level ($30,350 and $72,360 for a single individual) by strengthening and expanding subsidies.

CPEHN supports the additional investments proposed by the Newsom Administration that will prioritize the health of our most vulnerable communities. To view the full budget proposal click here.

Within the first week of his tenure, Governor Newsom announced a number of health care actions, including an executive order to establish a California Surgeon General. We applaud the Governor's decision to establish the position focused on a comprehensive approach to addressing health risks and challenges, including identifying social determinants of health and persistent inequities in the health of communities.

Recommendations

Today, CPEHN sent a letter to the Governor thanking him for his bold vision and outlining recommendations in order to make the most of this opportunity. We believe that the California Surgeon General can provide much needed leadership to eliminate inequities that have existed for far too long. While California has instituted components of this work across state government, including the Office of Health Equity, statewide vision and implementation is sorely needed. In order to actualize this vision, we recommend the following considerations for the California Surgeon General:

Dignity in Discharge Law: What You Need to Know 

CPEHN was proud to sponsor Senate Bill (SB) 1152 in 2017-2018. Thank you to author Senator Ed Hernandez and to all of our community partners who helped lobby for this bill. CPEHN stands committed to seeing a successful implementation of the law surrounding this important issue. Read below to find out more about the changes we will see this year.

Beginning January 1, 2019, all hospitals in California must develop a plan for safely discharging patients without homes. This law prohibits hospitals from engaging in previously reported tactics, such as discharging patients in hospital gowns, leaving patients at unsafe locations, and failing to make necessary mental health referrals.

Specifically, hospitals must do the following:

  1. Attempt to secure a sheltered discharge location, resource permitting, or discharge a patient to the location of their choice.
  2. Provide transportation to the discharge location, within 30 miles or 30 minutes of the hospital.
  3. Offer the patient weather-appropriate clothes.
  4. Offer the patient a meal.
  5. Provide referrals to health and mental health resources.


Note for homeless services providers: The law directs hospitals to receive your agreement to discharge a patient to your facility. The law states a preference for this arrangement in order to best coordinate care. However, in order to protect the rights of the patient, if a patient specifically requests to be discharged to your facility, the hospital may do so regardless of your agreement or the appropriateness. If the patient has not specifically requested your facility and the hospital transports the patient there without your agreement, that hospital is in violation of the law and you should report the violation as directed below.

New UCLA/CHIS Data Shows Declines in Racial/Ethnic Disparities in Health Coverage

Additional Data on Mental and Oral Health, Marijuana Use, Voter and Civic Engagement, Highlights Disparities as well as Opportunities for Action

The UCLA Center for Health Policy Research released new data from the 2017 California Health Interview Survey (CHIS) findings. The largest single-state health survey in the United States, the 2017 survey includes responses from children, teens and adults in nearly 21,300 households on wide-ranging topics including health care coverage, mental health, marijuana use, adult dental coverage, voter registration and civic engagement.

CPEHN reviewed the findings and found important implications for the health and wellbeing of communities of color in California. Below are some highlights from the survey as well as recommendations from CPEHN for what local and state advocates should do to address remaining disparities for California’s communities of color.


Health Coverage:

Finding #1: The ACA has significantly reduced the uninsured rate in California by half, from an average of 14.8% in 2013 to just 7.4% in 2017, and has produced historic declines in racial disparities in health coverage rates (see table below). However, despite these gains, Latinos still have the highest uninsured rates in the state (12%) compared to all other racial/ethnic groups (4.4% - 7.3%). These findings are consistent with CPEHN’s analysis of newly released U.S. Census Bureau statistics.

Last month, the California Pan-Ethnic Health Network (CPEHN) convened over 200 community and healthcare leaders at our biennial conference Voices for Change: Mobilizing for Health Equity. At a time when we have seen attack after attack against the health and well-being of our communities, we came together to discuss how we can leverage our collective power to organize, advocate, and vote for equity.

To kick off the day, our keynote speaker, Maria Hinojosa, shared her inspiring personal stories around immigration, mental health, and being the first Latina in numerous newsrooms. Maria reminded us that we each have our own unique stories of resilience and that our stories have power.

“As people of color tell their stories, we build power, and we can change the larger narrative around us.” – Maria Hinojosa, Emmy-winning journalist

With Maria’s stories of resilience in mind, we shifted to the morning plenary where leading advocates discussed strategies for mobilizing around an intersectional health equity agenda. From reproductive justice, to LGBTQ rights, immigration, and climate change—the barriers that communities color face are multifaceted and complex. Panelists discussed all that is at stake for communities in the upcoming November midterm election, in 2020 and beyond. Zahra Billoo of CAIR-SFBA implored participants to ask themselves three guiding questions as we consider the sustainability of our work:

 “Who is not at the table and how can you invite them? How can we work smarter not harder because this is a marathon? [And] how can we can make civic engagement and activism part of our community’s lifestyle?” - Zahra Billoo of CAIR-SFBA

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