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Voices for Health Equity

Voices for Health Equity

Covered California’s Board met on October 27, 2016 where they provided an update on the preparation for the exchange’s fourth open enrollment period. Covered California’s Executive Director, Peter Lee, acknowledged there will be higher premiums this year. However, he also noted that most exchange enrollees (87.5%) are eligible for and currently receiving financial assistance. Thus they are protected from spending more than a set share of their income on premiums. Other topics covered included an update on the new verification process for special enrollment, and re-adoption of Covered California regulations governing outreach and enrollment entities, remote identity proofing and small business eligibility and enrollment assistance. You can find a recording of the board meeting, links to the presentations, reports, proposed regulations, attachments, and other materials here.

Open Enrollment Began on November 1st!

Covered California’s fourth open enrollment period launched officially on November 1st and runs through January 31, 2017. For coverage effective on January 1, people must enroll by December 15, 2016. As always, Medi-Cal enrollment is open year-round and individuals experiencing any life transitions (losing a job or moving, among many qualifying events for special enrollment) may enroll anytime, even after January 31, 2017. 

New Marketing Efforts. Covered California has several marketing efforts planned around the new open enrollment period. The open enrollment bus tour will run from November 12-19, 2016 throughout eight cities in California to promote the need to get covered.

California’s Office of the Patient Advocate just released new 2016-17 health plan report cards to help guide and inform consumers as they shop for coverage during the open enrollment season which is set to begin: November 1, 2016.

The report cards rate California’s 10 largest HMOs, five largest PPOs and over 200 commercial medical groups on quality and patient experience. In addition, county-level ratings of medical groups with newly added cost ratings are also included. This on-line tool makes it easier for employers and consumers to make side-by side comparisons for choosing the right plan.  

What do the Report Cards Measure?

OPA uses data from the National Committee for Quality Assurance (NCQA), a non-profit that that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. To arrive at these ratings NCQA analyzes scores on clinical performance and patient satisfaction data.

Earlier this week in Sacramento, the California Strategic Growth Council approved $289.4 million in grants to 25 housing developments and transit-friendly infrastructure projects that aim to help reduce greenhouse gases in the communities the projects are located. The grants awarded were made available through the Affordable Housing and Sustainable Communities Program (AHSC), which is overseen by the California Department of Housing and Community Development as well as the Strategic Growth Council and the California Air Resources Board.

The AHSC Program is aimed at providing competitive grants to projects that would benefit Disadvantaged Communities through a number of criteria. The law requires half of the AHSC funding be dedicated to building affordable housing, and states that 50% percent of grants must be invested to benefit Disadvantaged Communities directly.

However, there has been ongoing discussion that the grant process does not consider objections community members may have to the proposed projects. Despite the program’s intent to support sustainable, affordable housing, some have raised concerns about displacement and gentrification caused by the new developments.

Still, the projects funded through the AHSC Program provide much needed affordable housing as well as transportation improvements that encourage walking, bicycling, and transit use that result in fewer passenger vehicle miles traveled (VMT). The reduction in VMTs will directly benefit the disadvantaged communities in which the projects are located by reducing the amount of greenhouse gases that these vulnerable populations are susceptible to.

To be [Black] in this country and to be relatively conscious, is to be in a rage almost all the time.
-James Baldwin

If you’re in a rage all the time, what does that do to your blood pressure? What does it do to your health? I was talking to my own doctor recently about my blood pressure, which is higher than either of us would like, and he was running through the various medical treatment options to lower blood pressure when I asked him, “Isn’t it possible that this crazy election with the racist Trump campaign has me really stressed out? And couldn’t that explain my high pressure?” We set another appointment for after the election, and my fingers are crossed, but the whole experience has heightened my appreciation for the health impacts of America’s racial realities.

America is coming to the realization that we are going through a demographic revolution that has profound implications for government, non-profits, businesses, media, and academia. And it also has transformative implications for our public health. Fortunately, the transformation of the racial composition of our society also provides the potential political power to pass public policies to make life better for people of all racial and cultural backgrounds.

Frustrated. Mad. Those were just two of the ways I felt as I toured the recently opened Smithsonian National Museum of African American History and Culture in Washington, D.C.

It was a homecoming of sorts for me. I live in California, but I was born and raised 10 miles from the museum, in Alexandria, Va., in a black neighborhood affectionately referred to as Mudtown.

As I walked the halls of the beautifully curated museum, the exhibits brought back vivid — and painful — memories of my childhood in the early 1960s. Memories that made me angry about how much we sometimes take our hard-won rights for granted.

For decades, Virginia chose a path of massive resistance to civil rights, putting up barrier after barrier to disenfranchise its black residents. One of the state’s most effective tools was the poll tax, a shameful policy whose sole purpose was to keep people — African Americans specifically — from having a vote or a voice.

I remember eavesdropping on election-time conversations at church or around the dinner table as my parents and their friends and neighbors talked about the tax. Many said they couldn’t afford it and wouldn’t vote. Others talked about refusing to pay in a show of protest. A few advocated compliance, citing the importance of voting at any cost. But even those with money in hand were often denied the right to cast a ballot as new requirements were dreamt up to shut them out.

In general, Virginia was a tough place for black people to live back then. Not only was there a state-sanctioned campaign to keep blacks from voting, segregation was firmly entrenched. I was born in a segregated hospital. My mom was so outraged by the shoddy treatment she received that when it came time to deliver my younger siblings, she made the trek across the river to D.C., to Howard University’s Freedmen’s Hospital, founded in 1862 to aid in the medical treatment of former slaves.

Today, Governor Brown signed into law SB 1139 (Lara), which will prevent medical degree and healing arts training program programs from discriminating against students on the basis of immigration status and will open up state loan repayment and scholarships to undocumented individuals. 

CPEHN is proud to have co-sponsored the bill with Pre-Health Dreamers and to have Senator Ricardo Lara champion this measure.

Right now, bright, qualified Californians are ready and willing to care for our most medically-underserved populations. Today’s signature clears a path for our communities’ aspiring health professionals to pursue their dreams and help meet the cultural and linguistic needs of our state.

We can’t thank enough Pre-Health Dreamers and MedDreamers for their incredible leadership and enthusiasm. Together, we were able to highlight the passionate young Californians willing to pursue a healthcare career to meet our state’s provider shortages and show the incredible support our aspiring undocumented students have from those practicing in the medical field.

Thank you to everyone who supported the bill!

On Sunday, Governor Brown signed Assembly Bill 1726, the AHEAD Act, into law. This new policy will provide California's Department of Public Health with more granular data on the diverse Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations it serves. Better data on the different needs of our communities translates to more effective public health strategies that save lives.

We applaud the Governor for furthering California's leadership in AANHPI data disaggregation. In 2011, Assemblymember Mike Eng's legislation, AB 1088, was signed into law, requiring the Department of Fair Employment and Housing and Department of Industrial Relations to collect data on additional AANHPI sub­groups. AB 1726 expands this by including the Department of Public Health, and empowering previously invisible communities, like Hmong and Tongan, with the tools  they need to advocate for their own good health. We look forward to working together with the Department of Public Health to implement the law. We also extend our deep appreciation to Assemblymember Rob Bonta for championing this issue as the author of this bill.

We also commend the University of California and the California State University systems, which have agreed to voluntarily implement expanded data disaggregation and reporting that were previously included under AB 1726. We are committed to working with the California Community Colleges and Department of Health Care Services to collect and report disaggregated data for those entities. We also maintain our dedication to comprehensive data disaggregation at all public institutions and agencies. We look forward to working with policymakers to ensure visibility, equity, and justice for our communities.

Our biennial conference Voices for Change: Seizing the Momentum for Health Equity is a month away! The speakers and workshops are set, and CPEHN is busy preparing for a fantastic day of dynamic discussions with our friends, colleagues and allies.  We see our statewide conference as the time for us to step back and reflect on our unified goals for the health of our communities across California. As a conference attendee, you will be the first to receive a copy of our report called, The Landscape of Opportunity - Cultivating Health Equity in California. This labor of love is published every three years and we are excited to share our third edition of the report with you!

The Landscape of Opportunity uses current data and research to examine health across a broad spectrum of factors and social conditions. Inequities in socioeconomic status, education, the physical environment and access to resources can limit our ability to achieve optimal health. Throughout the report, we describe the complex relationship between structural factors and health outcomes. Building on CPEHN’s 25 years of advocacy, the Landscape of Opportunity proposes a policy framework for health equity focused on creating just systems and structures for better health.

Today is a special day for me. It marks my 2-year anniversary as CPEHN’s Executive Director. And even more, it marks an important turning point in my leadership journey. When colleagues and friends ask me, “How does it feel?” or “How is it going?” I can’t help but compare my leadership trajectory to Max’s development, my three-year-old son. When I was hired as a brand new ED, Max was 10 months old. He wasn’t talking or walking. He would point and grunt when we saw something he liked or wanted. He was standing up but couldn’t take steps on his own. I often felt like that in my early days. I didn’t know exactly what to say and at times stood a little sheepishly, and even needed the company of others in important meetings. Over the course of two years, he and I have learned how to talk and walk together. For Max, he has literally learned to talk, my husband and I often stare at each other in amazement at some of the things he says. And he is now walking, mostly running around, like a whirling dervish, especially on Friday nights after a long week.

The latest issue of our Health Equity Forum newsletter came out today and it includes several great articles and dozens of resources.

CPEHN’s Executive Director, Sarah de Guia, opens the newsletter reflecting on her two years as CPEHN's Executive Director! 

Our Ethnic Partner Spotlight features an article from the The California Rural Indian Health Board (CRIHB) on an upcoming child passenger safety course designed to reduce injuries. This programis a part of CRIHB's dedication to provide safety and injury prevention services to California’s rural Indians.

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