IN THE LOOP

This week is National Health Center Week, honoring community health centers. APLA Health’s three community health centers are open and serving patients – at the Long Beach Health Center, Gleicher/Chen Health Center in Baldwin Hills, and the Olympic Health Center in mid-Wilshire.

APLA Health’s clinics serve existing and new patients with primary, oral, and behavioral health, HIV and STD testing and treatment, PrEP and PEP. If you need care, please call the clinic of your choice. Our enrollers will help you find health coverage and link you to services.

If you are an existing patient, and you appreciate our care, treatment, and services, please call your Congressional representative and ask them to provide additional funding for community health centers in the next COVID-19 relief bill. It’s easy to do and you’ll find all the information you need on the National Association of Community Health Centers advocacy link.

This week APLA Health and a diverse coalition of healthcare partners are urging Governor Newsom to maintain access to telehealth both during and after the COVID-19 crisis.
Click here to email the Governor and show your support!

The COVID-19 pandemic has upended nearly every aspect of American life, including access to healthcare. Healthcare providers have responded to the pandemic and to the need for safe distancing in clinics for both staff and patients by rapidly shifting to telehealth. Telehealth is now transforming the healthcare system and significantly increasing access to care for vulnerable communities across the country.

Telehealth is the use of digital technologies, such as computers and mobile devices, to provide remote healthcare services. Before the onset of COVID-19, utilization of telehealth was extremely limited in the U.S. But the current crisis necessitated a rapid growth in telehealth as a way to maintain access to care while limiting the risk of exposure to COVID-19, especially for people with chronic conditions and others vulnerable to becoming seriously ill.

The rapid expansion of telehealth over the last several months has demonstrated that providing care in this way is not only safe, but also extremely effective. APLA Health has been able to maintain patients visits at roughly 80% of what they were before the crisis, in large part due to the quick adoption of telehealth. More importantly, telehealth is helping to address key barriers to healthcare access, such as lack of child care and reliable transportation. Still, more work will be needed to address the digital divide and ensure the adoption of telehealth doesn’t exacerbate disparities in care.

State policymakers have taken a number of steps to expand access to telehealth and telephonic care, including allowing community health centers like APLA Health to be reimbursed by Medi-Cal at the same rate as in-person visits. Unfortunately, these telehealth flexibilities are dependent on two federal declarations of emergencies remaining in place. If these emergency declarations are rescinded, tremendous progress in advancing telehealth in California will be undone.

Governor Newsom and the legislature must take action now to maintain telehealth flexibilities during the COVID-19 crisis and beyond. The ability to be reimbursed for telehealth and telephonic care will be key to the ongoing health of our communities as well as the financial viability of community health centers.

Click here to email the Governor and ask him to maintain telehealth NOW!

Public Charge Ban Limited to New York, Connecticut, and Vermont

A New York federal district court on July 29 blocked implementation of the Trump Administration’s “public charge” rules on immigration during the national public health emergency in response to the COVID-19 outbreak in the U.S.

That nationwide injunction was later narrowed by the Second Circuit Court of Appeals to just the three states in the 2nd District: New York, Vermont, and Connecticut. However, the rules have also been challenged in a number of other federal courts and will likely end up at the Supreme Court.

Public charge rules have been used for over a century to exclude immigrants seeking entry to the U.S. or changes in immigration status. Public charge rules are used to determine if an immigrant could end up relying on public benefits, specifically cash assistance programs, either due to lack of income and support or health.

The Trump Administration expanded the public charge rules, effective in late February, to include non-cash benefits like food stamps, Medicaid, or housing assistance. The President also issued a Healthcare Proclamation allowing U.S. embassies and consulates to deny visas to immigrants if they did not have health insurance or enough money to pay for medical care. This action was also blocked by a federal circuit court, and that injunction remains in effect.

The expanded Trump rules also allow immigration officials to broadly question immigrants about health status, income, and education to predict whether they would be likely to become a public charge in the future. These questions raised the possibility that anyone living with HIV or taking HIV medication could be excluded.

Immigration advocates argued that the Trump rules would force some families to forgo lifesaving healthcare and nutrition programs in order to gain entry to the U.S., and that the health insurance requirement would bar all but wealthy immigrants.

In his ruling, Federal District Court Judge George B. Daniels said that efforts to combat the coronavirus epidemic are in conflict with the Administration’s public charge policy which “is intended to discourage immigrants from utilizing government benefits and penalizes them for receipt of financial and medical assistance.”

Public charge rules apply to immigrants entering the U.S. as well as to immigrants residing legally in the U.S. who want to change their visa status, for example to apply for a green card. These rules do not apply to immigrants living in the U.S. without documentation.

If you are travelling or emigrating to the U.S. or want to change your visa status or apply for a green card, please consult an immigration attorney for a legal analysis of your circumstances and how public charge rules might impact your applications. APLA Health’s Benefits Counselors can help you locate attorneys in Los Angeles. Call 213-201-1615 for assistance.

The COVID-19 pandemic has highlighted the severity of the nation’s affordable housing crisis and many are concerned that as eviction moratoriums and rent freezes end, countless people will fall into homelessness in the impending wave of evictions nationwide.

Fortunately, the Judicial Council, the rule making body of California’s courts, voted yesterday to extend eviction protections for Californians through midnight of September 1. The vote extends two emergency rules originally set to expire on August 14 that suspend evictions and judicial foreclosures in California court proceedings and is intended to give the legislature and Governor more time to work on legislation that will address these two issues.

There are currently two bills making their way through the state legislature that would extend the eviction moratorium and the amount of time tenants have to repay rent, and the legislature and Governor now have until August 31 for any legislative solutions to be passed and signed into law.

Locally, the Los Angeles County Board of Supervisors must review the County eviction moratorium and rent freeze currently set to end on September 30 if it is to be extended. According to a recent report by the National Low Income Housing Coalition, 5.4 million Californians could be at risk of eviction. Advocates are urging both local leadership and the state elected officials to come up with a more permanent solution to prevent millions of Californians from becoming homeless during the pandemic.

At a time when government should be strengthening protections to keep people sheltered, the Department of Housing and Urban Development (HUD) recently proposed a rule that would remove protections against discrimination of transgender and gender non-conforming people experiencing homelessness.

Under HUD’s 2016 Equal Access Rule, all federally funded housing, facilities, and services must ensure equal access to programs, benefits, services, and accommodations for all individuals regardless of gender identity, and without intrusive questioning or documentation requirements. This new rule would allow HUD-funded emergency shelters to deny entry or services based solely on gender identity.

HUD has stated that the proposed rule would protect religious freedoms and address privacy and safety concerns, but this proposed rule is simply the latest in a series of attacks by the Trump administration against the LGBTQ+ community. Transgender individuals already disproportionately experience homelessness and discrimination when seeking supportive services, with one in three transgender Americans experiencing homelessness at some point in their lives. The rule would only exacerbate these inequities, and is particularly cruel in light of the global COVID-19 pandemic.

The rule is also counter to federal efforts to end the HIV epidemic by 2030. In 2014, HUD published a report documenting the link between housing instability and poorer HIV-related health outcomes, as well as increased risk of acquiring and transmitting HIV. Emergency shelter is often an individual’s first access point to services that help them begin the transition out of homelessness and access other critical health and social services. Transgender individuals in Los Angeles County – particularly transgender women of color – are disproportionately impacted by HIV and already experience higher rates of harassment and violence.

On a broader scale, Los Angeles County is in the midst of a homelessness crisis that continues to grow, and Angelenos are living through the COVID-19 pandemic. This HUD rule would only worsen both crises and keep more people unsheltered and at risk of COVID-19, HIV, and prolonged homelessness.

The National LGBTQ Task Force, the National Low Income Housing Coalition, True Colors United, and the National Housing Law Project have launched a campaign to oppose this rule, called the Housing Saves Lives campaign. You can take action and help stop this harmful proposed rule by submitting a comment in opposition by September 22. The Housing Saves Lives campaign has created a helpful template to help craft a comment. You can access the template here.