Guest post by Ben Anderson, Director of Health Policy at Children’s Defense Fund – New York.
On February 5, 2018, Children’s Defense Fund – New York (CDFNY) released a new report related to the health needs of and services available to displaced students—namely homeless children and unaccompanied immigration children. The report included survey results from school administrators in high need school districts in New York City. Alarmingly, the report found that many schools continue to call 911 to send students to the emergency room to address disruptive behaviors related to underlying mental health issues. Eighty-four percent of school administrators responding to CDFNY’s survey indicated that they had to refer at least a few students to the emergency room because of mental health or behavioral issues. Students at the schools surveyed are disproportionately students of color.
The survey responses were obtained nearly two years after the New York City Department of Education issued Chancellor’s Regulation A-411, which requires schools to intervene and de-escalate disruptive student behavior prior to calling 911 to send students to the emergency room to address the behavior. Issued in 2015, the regulation requires schools to employ a variety of de-escalation strategies, such as obtaining support from on-campus mental health professionals or mobile crisis teams. The required de-escalation strategies were intended to curtail the practice of calling 911 to address mental health issues.
CDFNY’s concern is that the high percentage of schools sending students to the emergency room suggests that New York City may still be spending millions of dollars on emergency response services and emergency room care, rather than investing more in preventative mental health services that better serve the students and their families. If schools had sufficient resources to address the mental health and behavioral needs of their students, we would expect a lower volume of 911 calls. Without additional investments in mental health services and other behavioral interventions and supports, schools will continue to struggle to achieve the desired results of the regulation.
Other issues addressed in the report are the significant health needs of displaced children, including lack of consistent meals and medical care. In total, the report recommends:
Expanding school-based health centers (SBHCs) and services—particularly mental health services—in medically underserved areas;
Allowing SBHCs to serve as health homes in the Medicaid and Child Health Plus programs;
Increasing support for teachers to implement PBIS in the highest need school districts; and
Expanding access to after-school and weekend meal services in the highest need school districts.
For more information on this report, contact Ben Anderson at email@example.com or (212) 697-0942.
Guest post by Claudia Calhoon, MPH, Director of Health Policy at the New York Immigration Coalition.
On Wednesday, December 13, the Assembly Committee on Health, the Assembly Puerto Rican/Hispanic Taskforce, and the Assembly Taskforce on New Americans convened a public hearing on Immigrant access to healthcare. Coverage 4 All, a campaign of Health Care For All New York led by the New York Immigration Coalition and Make the Road New York was instrumental in advocating for the hearing. The campaign’s goal is to expand insurance eligibility to all New Yorkers to reduce disparities in coverage. Barriers to coverage are just one of the many current threats to immigrant health access and quality.
Agencies that provided testimony included the New York State Department of Health, the New York City Mayor’s Office for Immigrants Affairs, New York City Department of Health and Mental Hygiene, and New York City Health + Hospitals. In addition, fifteen individuals from a range of social service, advocacy, health care, and community settings spoke about the impact of the federal administration on immigrant mobility, health utilization, coverage eligibility, and enforcement of language access regulation. Amid a federal landscape hostile to immigrants, New York State programs and protections are increasingly important.
Critical areas of particular attention included making sure that new mothers know they can safely continue to enroll in Medicaid and get prenatal care regardless of their immigration status, and continue to use the Women’s Infants, and Children (WIC) Food and Nutrition services. Another area of common interest among advocates was the opportunity that the state has to expand the Child Health Plus insurance program to cover young adults up to age 29 at a cost of $81 million. Dr. Alan Shapiro, co-founder of Terra Firma, which works with unaccompanied minors, noted that health needs don’t end when young people turn 19. These individuals “still have comprehensive primary care needs. They need access to immunizations, urgent care, sexual and reproductive health services.” The Child Health Plus Expansion is part of Health Care for All New York’s policy agenda, and the key priority of the Coverage 4 All campaign.
Hearing testimony from multiple stakeholders also highlighted the critical nature of improving enforcement of language access regulations, addressing mental health needs of immigrant communities subject to heightened stress under enhanced federal immigration enforcement, and ensuring that safety net hospitals have the revenue they need to care for all New York State residents.
Guest post by Max Hadler, Senior Health Policy Manager at the New York Immigration Coalition.
Immigrant New Yorkers are under relentless attack from the anti-immigrant forces that wield the levers of control in Washington, DC. In this environment, it falls on New York State to devise solutions to the crisis. Access to health care represents a key element of immigrant inclusion and protection that state and local governments must address. In acknowledgment of the ongoing health access disadvantages that immigrants face and the acute needs related to the current sociopolitical dynamic, the New York State Assembly has called a public hearing on immigrant health for 10am on December 13. Public testimony is strongly encouraged from anyone with a stake in immigrant health access. The hearing will be held at 250 Broadway, New York, NY. This is the official Hearing Notice.
The hearing has been called by Assembly Health Committee Chair Richard Gottfried and cosponsored by New Americans Task Force Chair Michaelle Solages and Puerto Rican/Hispanic Task Force Chair Marcos Crespo. Coverage 4 All, a campaign of Health Care For All New York led by the New York Immigration Coalition and Make the Road New York, has been instrumental in advocating for the hearing. The campaign’s goal is to expand insurance eligibility to all New Yorkers to reduce disparities in coverage (noncitizens are five times more likely than citizens to be uninsured), but coverage is just one of the many current threats to immigrant health access:
- Persistent restrictions on health coverage based on immigration status, exacerbated by the Trump administration’s cancellation of many forms of immigration relief
- Pervasive fear of using health care services because of the dramatic increase in immigration enforcement and threats against immigrant communities
- Acute behavioral health care needs layered on a system that already cannot meet the demand for culturally and linguistically responsive behavioral health services
- Major cuts to uncompensated care funding that threaten the financial sustainability of safety-net health care systems
- Language access laws that lack sufficient monitoring and enforcement mechanisms
We strongly encourage testimony from anyone with a stake in immigrant health access – directly affected community members, concerned citizens, immigrant rights advocates, health care consumer advocates, health care providers, social services providers, legal services providers, local and state health officials, and faith communities, to name a few. This hearing is an unprecedented chance to voice concerns to the New York State Assembly, and to propose solutions the state can undertake to improve immigrant health access. Do not miss this opportunity!
NOTE: You must receive an invitation to testify. If you would like an invitation, please e-mail Claudia Calhoon of the New York Immigration Coalition at firstname.lastname@example.org. If you are unable to attend the hearing in person, you are strongly encouraged to submit written testimony (the email for written submissions is included in the official Hearing Notice).
Guest post by Ben Anderson, Director of Health Policy at Children’s Defense Fund-NY. Here we are 39 days and counting since the September 30th deadline for Congress to fund the Children’s Health Insurance Program (CHIP), and yet families of the 350,000 New York children who depend on CHIP for coverage are still waiting for Congress to act. Sadly, once again children are being held hostage to political debates.
Created specifically for children, CHIP’s benefits and provider networks are designed to ensure children in working families who are not eligible for Medicaid have access to child-appropriate services, providers, specialists, and facilities. Despite bipartisan support for a strong, five-year extension of CHIP in both the House of Representatives and the Senate, debate continues about how to pay for CHIP and the extension of other important health programs.
Last week, the House of Representatives passed the Championing Healthy Kids Act, a bill that includes the same strong, bipartisan five-year extension of CHIP that the House Energy and Commerce and Senate Finance Committees approved and that most child health advocates strongly support. However, the bill passed by the House pays for the extension of CHIP and other critical health programs for vulnerable populations with offsets that would cause undue harm to children and families. These provisions passed over the objections of many in the House and are jeopardizing the bill’s passage in the Senate.
The sad irony is that Congress is bickering over how to fund CHIP and other programs in the bill, when the total cost for these programs is merely 1% of the amount Congress will add to the deficit to provide tax cuts to the wealthiest individuals in America. The senselessness must end. We’re so close to the finish line. There is bipartisan support for CHIP. Senate and House members, Republicans and Democrats alike, agree on what we need to do for children’s health. Congress needs to finish its homework and reach a bipartisan consensus on funding CHIP.