Call for California Asians and Hispanics to Show United Front on Health4All

SAN FRANCISCO — Even as health care advocates are celebrating California’s recent “landmark victory” in getting its undocumented children health care, Latino and Asian and Pacific Islander (API) communities should show a united front and make sure that all of the state’s undocumented residents get the same benefit, urged Sen. Ricardo Lara, D-Bell Gardens.

“The API and Latino communities have similar backgrounds and we both believe in giving back to community,” said Lara at an ethnic media briefing hosted by New America Media on July 21, 2015, with his “partner in crime” as he referred to Assemblymember Rob Bonta, D-Oakland, at his side. “We’re fighters. There’s something in our DNA that wants us to go forward.”

Lara’s Health for All bill (SB 4), was originally intended to provide health care to the state’s nearly 2.6 million uninsured residents, regardless of their immigration status. That would have been done either by enrolling them in Medi-Cal, (California’s name for Medicaid, the insurance program for its low-income residents) or by allowing them, after getting a federal waiver, to buy health insurance on Covered California, the state’s health insurance marketplace, with their own money.

But last month, Governor Jerry Brown approved a $40 million budgetary allocation for providing Medi-Cal for the state’s 170,000 undocumented children, a significant victory for SB 4 supporters.

Brown’s move would reduce the cost of SB 4 significantly, but would still leave nearly 1.5 million undocumented adults uninsured.

Lara’s is optimistic that his other health care coverage bill, SB 10, will close the gap by providing those left uninsured full-scope Medi-Cal benefits if they meet eligibility requirements and if funding is available. If it’s not, they will get limited scope benefits. SB 10, like SB 4, has passed the Senate and is now before an Assembly committee.

Both bills, Lara said, will stand a good chance of passage if the AAPI and Latino communities campaign together.

The health care bills are “about inclusion, collaboration and partnership,” Bonta agreed, as he addressed the packed room of reporters and some health care advocates. For his part, he will inspire all Asian Americans to campaign for the bills, he said.

Lara once again slammed President Obama for excluding undocumented immigrants from benefiting from the 2010 Affordable Care Act (ACA). ACA was designed to provide affordable health care for all legally residing U.S. residents.

SB 4 will seek a federal waiver to allow California’s undocumented immigrants to purchase insurance on Covered California, but without providing them subsidies. An estimated 390,000 people will benefit from the waiver, Lara said.

He pointed out that it’s in the state’s financial interest to pass his bill. Without it, undocumented immigrants will continue using hospital emergency rooms even for their basic care, currently costing the state $1.7 billion annually.

Lara said he can understand the plight of undocumented and uninsured immigrants because his Mexico-born parents were at one time in that situation themselves.

Bonta, the co-author of the bill in the Assembly and chair of its health subcommittee, observed that when Lara first introduced his bill last year, the odds were stacked against its passage, especially given that a similar bill the senator introduced the previous year did not get out of committee because of its $1.3 billion annual price tag. This year’s bill would cost a lot less because no state subsidies will be given to those who purchase insurance on Covered California.

Three California undocumented immigrants – two from the API and one from the Hispanic community — shared their own personal stories that brought home the importance of having access to health care.

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Amy Lin testified about being undocumented and uninsured. 

Amy Lin, who came with her mother to the United States from Taiwan as a 12-year-old, said it was hard for her to watch her 50-something-year-old mother slog as a domestic worker and not have health care.

“She suffered lower back pain and joint pain that became chronic,” Lin, now 23, and a Deferred Action for Childhood Arrivals (DACA) beneficiary said. “She relied on over-the-counter pain relievers. We bonded over the massages I gave her.”

Lara’s bill, she asserted, means a lot to the hundreds of thousands of undocumented immigrants who face a similar situation.

Jesus Castro, 20, who immigrated to the United States with his parents from his native Mexico in 2001, recalled how as a young boy he once dislocated his elbow playing baseball. The curandero his father took him to told Castro a story to distract him as he popped the elbow back in place.

His 44-year-old mother, Christine Marquez, told how she too had to rely on such remedies to treat her frequent nosebleeds and other health issues. She recently quit her job because of a slipped disc.

Twenty-seven-year-old Samoan native Tali Seumanutafa recalled how she went through some 25 surgeries to treat a crippling bone disease. The Shriner’s Hospital paid for her surgeries and hospitalization until she turned 18 and aged out of its charitable care program. When the disease recurred in 2011, she checked in at San Francisco General. She was left with a half a million dollar bill that she has not paid.

“I’m unsure of where me and the bill stand,” Seumanutafa said, noting that she now feels more secure because she has Medi-Cal, thanks to her DACA status.

One of the issues many of the state’s lawmakers are concerned about is whether providing Medi-Cal to the state’s undocumented will give them access to health care given the shortage of doctors in the Medi-Cal network. Asked about this, Lara said that both he and Bonta are working on addressing this issue.

Last month, Bonta was appointed chair of the Public Health and Developmental Services Committee that was set up to convene extraordinary sessions to discuss, among other things, how the state can allocate more money for its Medi-Cal program.

“It’s always good to have the chair of the health committee support your bills,” Lara said, turning toward Bonta with a smile.

Both lawmakers agreed that if California, which Bonta called “the most progressive state in the nation,” succeeded in getting health care for all its residents, the rest of the country would likely follow suit.

“California is coming to a neighborhood near you, whether you like it or not,” Lara said.

Connecting the Uninsured

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News Report, Ann Bassette | Richmond Pulse

Rosa Garay is a mother of 8-year-old twins and like tens of thousands of Contra Costa County residents she’s uninsured and worried about her health.

“I’ve been struggling with losing weight and need to check my thyroid,” Garay said. “I’m a single mother of two and I have to be in good health but if I’m not OK, who’s going to be with them?”

Garay, 35, said she first applied for healthcare through Covered California at the beginning of year but was told she didn’t qualify. (Her kids are covered by Medi-Cal.)

“I applied for Covered California, they sent me a letter saying I didn’t qualify for them as well because I’m low income so they automatically sent my application to Medi-Cal,” she said, “but I’ve been waiting for this answer since February, and I haven’t received anything.”

Garay was one of nearly a thousand people who attended a health care fair last month in Richmond to learn more about healthcare options through the state and get questions answered in person.

The event, titled “WE Connect Health Care Enrollment & Resource Fair,” was held on Saturday, June 27 at the Richmond Memorial Auditorium. It offered Contra Costa residents a chance to come and sign up for Medi-Cal and Covered California, participate in free health screenings and learn better practices to maintain a healthy lifestyle. According to a press release put out by We Connect following the fair, there are 86,000 people in Contra Costa who are still uninsured.

WE Connect is a statewide project of The California Endowment. The Richmond event was hosted in partnership with Healthy Richmond, Contra Costa Health Services, LifeLong Medical Care, Community Clinic Consortium and Brighter Beginnings.

In addition to healthcare education, attendees could also learn about housing, immigrant resources, legal aid and more.

Booths dotted the inside of the auditorium, offering fun and free goodies to increase health awareness. The U.S. Department of Agriculture handed out “Best Bones Forever” card decks, emblazoned with graphics and fun facts about calcium intake, as well as suggestions on how to incorporate fitness and healthy food choices into everyday life. LifeLong Medical Care gave away jump ropes, water bottles and reusable ice packs to spread awareness about their services. And, WE Connect volunteers were busy replenishing wooden baskets filled with potatoes, onions, spaghetti noodles and rice as guests stocked up on the free food.

Meanwhile, in the Kids Fit Zone, young ones boxed, bowled and played tennis. Some chose to take advantage of the coloring stations and had their face painted by a fairy princess from the children’s entertainment group Happily Ever Laughter.

“WeConnect has connected all of us,” said Rochelle Rawls Shaw, Administrative Assistant with Healthy Richmond.

Garay said she received more information about her health care status at the event. “The person who helped me today told me my application was good, but they asked me for certain things,” she said, adding that she didn’t know before the event what other information she should send in. “We did it again, so we’ll see if they need anything else. I’m excited. I hope it’s good news,” she added.

Edith Alonso also attended the event, along with her mother and teenage son. She is insured but said she wanted to learn more about healthcare service options.

“I’m covered through Kaiser Permanente but you need to know other options – you could lose your job,” she said. “When you don’t have insurance you’re between a rock and a hard place. We have to be informed about every thing that happens with health care, immigration and housing.”

Tracee, who wouldn’t give her last name, is a student from Trinidad who has lived in Richmond for the last five years. She is covered through Medi-Cal, and wanted to take advantage of the free vision screening. While there she also had her glucose and blood pressure checked. For her, an event like this is more than educational — it’s a way to show support for the service itself.

“Free healthcare is important,” she said, “and when people don’t attend these events, they think we don’t care about our health. But we do.”

Undocumented Kids to Get Health Coverage in State Budget

Calling it one of the “best” budgets the state has ever had, California Gov. Jerry Brown said the $167.6 billion dollar budget the legislature passed Tuesday would pump more money into child care and education, pay down the state’s debt by $1.9 billion and provide health care for its undocumented children.

“This is just one step and we need to do more,” Brown said during a press conference, referring to the $40 million budgetary allocation for providing health insurance to an estimated 170,000 undocumented children in the state  through Medi-Cal – California’s name for Medicaid, the health insurance program for low-income people.

A jubilant Sen. Ricardo Lara, D-Bell Gardens, called the $40 million allocation a “modest investment in health care that will be transformational in the lives of not only children,” but also their families and the community as a whole.

He noted that the budget deal “affirms our commitment to embrace and integrate our immigrant community, to lead where the federal government has failed and to acknowledge the hard work and sacrifice of a community that contributes billions of dollars” to the state’s economy.

“This expansion of coverage to all children regardless of immigration status would make California’s children healthier, our health system stronger, and our families and communities more financially secure,” asserted Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition.

Lara’s own Health for All bill (SB 4) will provide health insurance for all Californians regardless of their immigration status. It is now before the Assembly, after it cleared the Senate last month. If it is signed into law, California would be the first state in the country to provide state-funded health insurance to its undocumented residents.

The original intent of SB 4 was to provide health care for the state’s nearly 1.5 million undocumented residents, both adults and children, either through Medi-Cal or by allowing them to purchase health insurance on the state’s exchange. But the state must first seek a waiver from the federal government to allow them to purchase health insurance on the state’s exchange, Covered California. The Affordable Care Act prevents undocumented U.S. residents from any federally funded health insurance program. The waiver will be sought if SB 4 passes.

According to researchers at the University of California at Berkeley and University of California in Los Angeles, expanding Medi-Cal to undocumented California residents, under Lara’s bill,  would  have cost the state between $353 and $369 million annually, representing a 2 percent increase from what it currently spends. But now that the state has approved $40 million in its budget to provide insurance for its undocumented children, the Medi-Cal cost in Lara’s bill will go down.

“It would also provide the momentum for SB 4 to move forward,” Wright said.

Senate President Pro Tem Kevin de Leon, who participated alongside the governor in the press conference and had backed SB 4 since it was introduced in the Senate late last year, said Washington’s inaction has caused “financial consequences throughout the country.”

Lara’s bill, he said, will send a “very strong message” to lawmakers in Washington who have “dithered” on immigration reform.

The governor’s remark that more needs to be done, including how to address the low Medi-Cal reimbursement rates – among the lowest in the nation — will be discussed in a special session in a few weeks.

Brown said that his office would be hiring an immigration coordinator to assist youth who have been granted temporary relief from deportation under President Obama’s executive action of 2012. One million more California residents could become eligible for deportation relief if the federal courts allow Obama’s 2014 executive action to move forward.

Family Justice Center Opens at New Location

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News Report, Keisa Reynolds | Photo,  Ann Bassette

After breaking ground in 2013, the West Contra Costa Family Justice Center held its grand opening this month at 256 24th Street. In the first year at its new location, the center is expected to help an estimated 2,000 survivors of domestic violence, family violence, elder abuse and human trafficking.

The center moved from its temporary location at Richmond Police Department’s substation at Hilltop Mall, where it had operated since 2011.

Mayor Tom Butt, who spoke at the opening reception, said the center was the first community construction project to impact the lives of victims and survivors of domestic violence. Other speakers included Police Chief Chris Magnus, Andrea Bailey from Chevron Richmond, and Jodi Ravel and Karen Kruger from Kaiser Permanente. Fourteen-year-old spoken word artist Sukari Wright from RYSE opened the ceremony with an inspirational poem.

County Supervisor John Gioia told the audience that the center “demonstrates what could happen when community and government do well working together.”

In 2001, Contra Costa County became the first Zero Tolerance for Domestic Violence County in California. As a part of the initiative, two centers have opened here in West County and Central County (Concord) with a third in East County underway.

Survivors of violence often have to speak with multiple agencies in order to get assistance. The center aims to eliminate this by offering dozens of on-site and off-site providers. Its partnerships give clients access to local organizations including Monument Crisis Center, Children and Family Services, Bay Area Community Resource, Bay Area Legal Aid, Community Violence Solutions, County Mental Health, Familias Unidas, Native American Health Center, and many more.

“We see that at about 50 percent of our clients identify as Hispanic or Latino. Our next biggest demographic is African American: About 30 percent of our clients identify as African American. We also see a significant number of Asian Americans,” said Elizabeth Wilmerding, director of Project Connect at West Contra Costa Family Justice Center.

Between its staff and partners, the center is able to offer services in 10 languages including Spanish, Korean, Lao, and Thai. The center also offers services for victims of many other demographics including children and youth, elders, veterans, and Lesbian Gay Bisexual Transgender Queer or Questioning (LGBTQ) individuals and families.

Clients work with navigators who help them create goals and connect them with services for long-term solutions. Clients can receive assistance from myriad services such as civil legal services, health care, mental health, housing, job training, tutoring, and prosecution.

Menbere Aklilu, owner of Salute e Vita Ristorante in the Marina, shared a personal story of her experience as a survivor of domestic violence. “Today, I fully love Richmond more, especially when I see this type of thing coming together,” she said.

Aklilu encouraged the community to invest in the center and, leading by example, she said she donated $15,000. “I am doing this for my mother, for me, my sister, brother, for all domestic violence survivors,” she said.

Chevron Richmond followed suit and donated $80,000 to the center.

Family Justice Center Alliance (FJCA) President Casey Gwinn praised the center for “creating a beacon of hope that will impact survivors for generations to come.”

“This is where you break the cycle,” he said, noting that many incarcerated people come from homes where child abuse and other forms of violence are present. “We end up locking people up instead of saving them.”

FJCA donated $65,000 at the beginning of stages of the project. Gwinn acknowledged project director Jennifer Anderson, who had recommended opening a family justice center in Richmond six years ago, and Gloria Sandoval, director of STAND! For Families Free of Violence, one of the center’s on-site partners.

“There isn’t a person listening to my voice who can’t involved in the family justice center going forward. Everybody here can do something to invest in this. This is how we can change the world.” Gwinn urged. “Twenty years from now it will matter that you were standing in this parking lot. It will matter Zero Tolerance was created. It will matter John Gioia said we’re going to make this countywide. It will matter that we invested ourselves here in changing the endings for survivors and their children.”

Residents can get involved with the work of the center by donating, volunteering, or participating in workshops offered by the Family Justice Institute.

Grand Opening of the West Contra Costa Family Justice Center from Alive & Free/ Street Soldiers on Vimeo.

Richmond’s Native American Health Center Hosts Children’s Mental Health Day

by Malcolm Marshall

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More than 15 years after a landmark Surgeon General’s Report on Mental Health brought attention to mental illness as an “urgent health concern,” many youth and adults with mental illness are still not getting the treatment they need.

To begin tackling this issue, and expand awareness of mental health issues, the Native American Health Center in Richmond hosted its third annual Children’s Mental Health Awareness Day on May 8. This year’s free community event featured guest speakers and youth workshops aimed at developing a community definition of mental health.

“I looked up the definition of mental health, because I didn’t know it,” said Michael Dyer, program manager at the health center, as he welcomed youth and families to the event. “It said ‘a state of well-being’. It’s very vague and you don’t quite get the meaning from that. We can define mental health together.”

The lack of a working definition means youth aren’t always able to identify their problem, Dyer said, so they don’t seek treatment.

According to the National Alliance on Mental Illness, 20 percent of youth ages 13-18 live with a mental health condition nationwide. In California the children with the highest rates of serious mental illness include Latinos, African Americans and Native Americans, according to a 2013 study by the California HealthCare Foundation.

The Native American Health Center serves Native American youth and adults, offering crisis prevention and early intervention services like support groups and counseling. It’s also a cultural hub for Native Americans, where people can learn about their culture through traditional art and music classes.

“When we were asking the youth [what mental health meant], during the planning stages for this event, no one knew what it meant,” said Dyer. “The one person that did raise their hand to answer said, ‘mental health is when you go crazy.'”

As part of the day’s activities, the center’s media team set up a video booth to interview people about their own personal definition of mental health. In another room, the center asked people to write on a wall what mental health meant to them.

Some of the phrases written were, “loving yourself and others,” “friends and family,” “listening to your body and heart,” “being positive,” and “keeping your mind fit.”

The center’s event was part of a national movement to increase awareness of mental health issues. This year marked the 10th anniversary of a national awareness day, meant to raise awareness of mental health in children and advocate for comprehensive care.

Newly appointed Surgeon General of the United States, Vivek Murthy, told the Washington Post that he believes in improving public health by creating a prevention-based society. And, he said he has included emotional and mental well being in his top four rules for health.

In Richmond, Dyer said he hoped to also highlight the things that go into having a strong mental state.

“We want to show the community that it’s ok to reach out,” he said. “Being able to check in with yourself, and acknowledge that you’re sad or depressed and that you need a support system.”

 

 

The Great Tomato Sale

Photo Essay • David Meza

Did you know that Russia has its own special tomato? How about Japan? Kentucky?

If you attended the Great Tomato Plant Sale, “Heirlooms Of The World,” at the AdamsCrest Urban Farm in East Richmond Heights Apr. 11, you would have seen all of them and more. University of California Master Gardeners,
along with city environmental officials and local agricultural advocates, all collaborated to host the annual event, now in its fourth year.

The sale featured high-quality heirloom tomato and vegetable plants, each for $3. More than 200 attendees chose from over 50 varieties of tomatoes, raised by master gardeners from the university and recommended to grow well in home gardens in this area. Also for sale were varieties of vegetable plants, grown on the farm by Urban Tilth, which advocates for healthy food and cultivates agriculture in the county.

The tomato plant sale proceeds will go to support community education classes and the community gardens at the university. Master gardeners from the university were also on hand to answer questions on plant selection, planting, fertilizing, pruning, harvesting and protecting plants from insects.

In partnership with the master gardeners, the city of Richmond’s Environmental and Health Initiatives gave away free compost to community members at the event. Traditionally, the city hosts its own annual compost giveaway, but this year joined forces with the university and Urban Tilth for a community collaboration.

“Instead of hosting [the compost giveaway] independently like past years, we felt the event and donation would be more effective if we collaborate with groups already leading gardening and urban agriculture initiatives in the community,” according to Richmond Health and Sustainability Associate Mike Uberti.

Republic Services donated the compost from its Richmond facility. Richmond remains one of the only cities in the Bay Area with a closed-loop composting program, in which it transforms food scraps from residents into compost and returns it to them.

Along with offering vegetable and locally made honey, staff from Urban Tilth coordinated their monthly volunteer day, in which community members can learn hands-on about sustainable methods for growing food while harvesting fresh fruits and vegetables.

AdamsCrest Farm, formerly a field of the recently closed Adams Middle School, was repurposed by Urban Tilth into an operational farm in 2009.

DMC to Close April 21

By Nancy DeVille

It’s the decision that many hoped would never come: Doctors Medical Center is closing April 21.

The board of West Contra Costa Healthcare District, which governs DMC, made the decision Thursday after they were advised the hospital is running out of money and has exhausted opportunities to borrow additional funds.

“This is a very sad day and a huge loss for our community and for all of us who have worked so hard to keep our community hospital open for all our residents in [a] time of need,” Eric Zell, chairman of the board of directors, said in a statement.

“We have exhaustively pursued every alternative over the past weeks, months and years. Unfortunately, we have completely run out of viable and responsible options.”

Once the hospital closes, West Contra Costa will lose 79 percent of its inpatient hospital capacity, and an Emergency Department that historically has provided 59 percent of emergency treatment in this portion of the county—including all severe heart attack care. DMC also has provided vital outpatient services such as cancer treatment, dialysis and free breast-cancer screening for low-income women.

“The impact is going to be catastrophic,” said Maria Sahagun, an emergency room nurse at DMC, who spent months urging the board to come up with a viable solution to save the hospital.

Since DMC stopped accepting patients, those needing emergency care are being transported to Richmond’s Kaiser Permanente, Contra Costa Regional Medical Center in Martinez or Alta Bates Summit Medical Center in Berkeley.

But an increase in transportation time could have “devastating” effects on their health, warned Sahagun. Former DMC patients are now riding public transportation to chemotherapy appointments at Richmond’s Kaiser Permanente three times a week, she said, while others have complained about relatives being transported to Berkeley.

“If you have a stroke or heart attack, every minute counts,” she said.

Sahagun, who lives in Richmond, started working for the hospital seven years ago. Despite its financial woes, she said, she always believed DMC played a crucial role in the community.

“After all, we do serve some of the poorest communities within the Bay Area,” she said.

Sahagun said the decision to close the hospital sends “a clear message that we, the residents of West County, do not matter.”

County health officials are working with other West County healthcare providers and hospital systems to provide primary, urgent and emergency care alternatives for residents.

Dr. William Walker, Contra Costa Health Services Director and a member of the DMC Governing Body, said health officials are working with Lifelong Medical Care of the East Bay to establish an urgent care center across the street from DMC on Vale Road in San Pablo. The county’s health center, just two blocks from DMC, is also adding more evening and Saturday appointments to see patients.

The hospital, which opened in 1954 as Brookside Hospital, has been teetering on the verge of closure for years. Last spring, voters in the district failed to approve a $200 parcel tax, which would have directed $20 million to eliminate its annual operating deficit.

“Continuing further operations would only put the hospital deeper in debt, and jeopardize its legal and fiduciary obligations to pay its employees, physicians and vendors,” said Contra Costa County Supervisor John Gioia.

ER Nurse: Closure of DMC Will Be ‘Catastrophic’

By Nancy DeVille | Photo by David Meza

As the threat of Doctors Medical Center’s shutdown draws closer, Maria Sahagun says she still hasn’t given up hope.

An emergency room nurse at DMC, Sahagun and her colleagues have spent months urging the West Contra Costa Healthcare District to come up with a solution to save the financially strapped hospital from closing. She posts updates on Facebook to inform residents of the latest hospital news and she regularly attends community and city council meetings advocating for resources to keep DMC afloat.

Her latest campaign is a series of YouTube videos offering warnings of the dire effects the hospital’s closure will have on the San Pablo and Richmond communities.

DSC_0048“I cannot let this go without turning [over] every stone,” she said recently following her shift in the hospital’s ER. “There are so many families out there that will be affected because of the lack of access if this hospital closes.”

For Sahagun, the fight for quality accessible health care is personal. She vividly remembers watching her ailing mother, who was battling terminal cancer, wait for 12 hours in a Compton, CA. emergency room just to see a doctor. That experience is the drive that keeps her fighting, she said.

“If this hospital closes,” she said, “there will be increased waiting times at area hospitals. And it hit me that so many families with a great matriarch will be affected like I was because of lack of access to the medical system.”

“The impact is going to be catastrophic,” she said.

Sahagun says residents are already seeing an impact since services at DMC have been discontinued. Former DMC patients are now forced to ride public transportation to chemotherapy appointments three times a week, she said, while others have complained about relatives being transported to Alta Bates Hospital in Berkeley since DMC no longer accepts ambulance service.

Shuffling these residents around could have “devastating” effects on their health, Sahagun said.

“Because of the increase in transport time, there will be death and disability,” she said. “If you have a stroke or heart attack, every minute counts.”

Sahagun, who lives in Richmond, started working for DMC seven years ago. Despite its financial woes, she said, she believed that the hospital played a crucial role in the community.

As the hospital’s board continues to debate its future, Sahagun says she has no plans of walking away.

“We’re really serving a population in need,” she said. “I am committed to staying until the end.”

Study Shows Gaping Holes in Safety Net for California’s Uninsured

The safety net for uninsured Californians is full of holes – and those holes are much bigger for the state’s undocumented people.

That’s one of the main findings of a new study by the statewide health care advocacy coalition Health Access. The organization’s executive director Anthony Wright says the “uneven safety net” puts the state’s remaining uninsured in a position to “live sicker, die younger, and be one emergency away from financial ruin.”

“Counties should maintain strong safety nets for the remaining uninsured, through the county-led programs that provide primary and preventative care,” Wright said on a press call last week. “Counties that do not serve the undocumented should reconsider this policy, and focus their indigent care programs on the remaining uninsured population that actually has the most need for a safety net.”

Over a year into the full implementation of the Affordable Care Act, some 3 million Californians still lack health insurance. For many, that’s because coverage is still unaffordable. And almost half of the 3 million are undocumented, and thus shut out from federal health programs.

By law, counties have to provide care to low-income individuals who are uninsured and don’t qualify for other programs. But, says Wright, “Counties interpret this responsibility widely and wildly, in very different ways.”

For example, of the state’s 58 counties, only 10 “explicitly serve the undocumented in their programs for those who meet other qualifications such as income,” says Wright. “The rest do not serve the undocumented outside of emergency care.”

The study found that the number of people enrolled in county-based care programs for the uninsured varied widely according to different counties’ eligibility requirements.

Counties that have more inclusive eligibility requirements, in terms of income and immigration status, still have thousands of people using their indigent care programs – in Los Angeles, for example, over 80,000 people are enrolled in the My Health LA program, which is open to undocumented immigrants, and assigns individuals to community clinics.

But counties that have more stringent eligibility requirements have far fewer people enrolled. Counties like Merced, Placer, and Tulare report that they now serve no one in their health care programs for the poor and needy.

That’s not because there isn’t a need, according to Wright, but because “those programs aren’t geared to the remaining uninsured that are left.”

Sacramento County is one of the 48 counties that don’t provide care to undocumented immigrants. It used to, but stopped in 2009 during the financial crisis.

Carlos Garcia, who spoke on the call along with Wright, is undocumented and recently moved to Sacramento from San Mateo. He hurt his leg in an accident and now the leg is infected. He says he was prescribed antibiotics instead of more comprehensive treatment because he doesn’t have health coverage, but he can’t even afford the medication.

He’ll need to drive back to San Mateo for further treatment – San Mateo is one of the 10 counties that provide care to the undocumented – but he’s worried about being able to pay for gas.

“I haven’t been able to work because of this,” he said through a translator. “I feel desperate.”

The proposed “Health For All” bill (SB 4) could help Garcia if it passes this year. The legislation, originally introduced in 2014 and re-introduced in 2015 by Senator Ricardo Lara (D-Los Angeles), would guarantee health coverage to everyone in the state, regardless of immigration status.

“County-based programs should be a bridge to a statewide solution, as being discussed here in the state capital, that would extend affordable coverage to all Californians,” says Wright.

“Our health system is stronger when everyone is included,” he says.

Ceasefire Walks, Rain or Shine

Commentary, Leslie Basurto

It was 7 p.m. on a Friday night and I was attending my first Ceasefire night walk — a weekly trek where members of the community walk together through streets where gun violence has occurred in the hopes of putting an end to it. In recent years Ceasefire has received a lot of credit for Richmond’s reduction in crime and violence, and I wanted to learn about their approach.

The night was dark and pouring rain, I was thinking maybe they’d call it off because of the weather. But, I figured I would at least knock on the door of the Bethlehem Missionary Church — the meeting point — in case anyone was there.

To my surprise, the door opened and I was greeted by a group of people sitting in a circle. The mood was palpably serious. Rev. Donnell Jones, Community Organizer for the Contra Costa Interfaith Supporting Community Organization, was telling them about recent deaths in the area involving gun violence. The men involved in the shootings were between 18 and 23 years old. “Babies,” Jones said, “robbed of the ability to dream.”

Jones explained the purpose of the walks and the strategy to end gun violence including “call-ins” where parole officers meet one-on-one with perpetrators, which has proven successful. Members of the group discussed the lengths they would go to get these youth help. Before we headed out, we gathered in prayer “for a generation of people that have been lost.”

After grabbing candles and signs reading a variety of things like, “Peace for Richmond” and “Honk to end gun violence,” we hit the streets, heading towards Cutting Blvd.

The signs we held suffered in the rain, but the enthusiasm and perseverance of the group persisted.

“I almost thought that maybe I wouldn’t come out to walk tonight because of the rain,” said Jane Eisenstark, a Richmond resident. “But then I realized that it was that much more important that I do.”

Throughout the trek the group chanted, “Ceasefire: Alive and Free,” and despite the poor visibility, drivers passing by honked in support.

We reconvened at the initial meeting point at the end of the walk, drenched from the rain. The gathering closed with a prayer and some words from Jones about taking the work to the next level outside of walking. The goal, he said, is getting at risk youth help through any means.

I left feeling overcome with emotion. I thought about peers who had been lost too soon and how senseless these deaths always are. Gun violence does not occur everywhere. We do not need it. It is hurting our community.

I also felt intense gratitude for the people who walk weekly, as well as those who are involved in the fight against violence in other ways. It is clear that these people have unconditional love for their community. Any of them would help if someone who needed it reached out.