Health Equity

California Sets New Rules for Rationing Medical Equipment if Hospitals Run Out During Pandemic

By | Health Disparities, Health Equity, IN THE NEWS

Sacramento Bee: California Sets New Rules for Rationing Medical Equipment if Hospitals Run Out During Pandemic (June 12, 2020)

The California Department of Public Health has a new plan for that worst-case scenario. On June 9, the CDPH released new pandemic crisis care guidelines, after more than 60 community and advocacy organizations representing millions of Californians objected to the first set of guidelines the department released in April. “We are pleased that California rejected ageist, ableist, and racist approaches for triaging care that have emerged from other states during this crisis,” said Kevin Prindiville, executive director of Justice in Aging. “Instead, California has taken an approach that values the lives and rights of older adults and people with disabilities from diverse backgrounds.”

Aging and Older Adults in the Time of COVID-19

By | Health Care Defense, Health Disparities, Health Equity, IN THE NEWS, Medicaid, Nursing Homes, SENIOR POVERTY

Peace and Social Justice Radio Show: Aging and Older Adults in the Time of COVID-19 (June 5, 2020)

Justice in Aging Senior Staff Attorney Claire Ramsey was a featured guest on the show. She spoke about COVID-19 and older adults in California, particularly the impact on older adults of color. She also talked about how devastating the proposed budget cuts to programs low-income older adults rely on to stay safe during a pandemic. Claire’s segment starts at the 1 hour mark.

Some Nursing Homes Escaped COVID-19-Here’s What they Did Right

By | Health Care, Health Equity, Home & Community Based Services, IN THE NEWS, Medicaid, Medicare, Nursing Homes, Person-Centered Care Planning

Wired: Some Nursing Homes Escaped COVID-19-Here’s What they Did Right (May 29, 2020)

Cmiel’s staff stocked up on personal protective equipment and masks for workers and residents; screened everyone who walked in the door for symptoms; hired more staff to clean bathrooms and common areas; and started educating everyone on best practices for containing the virus. And while nursing homes account for nearly half of California’s coronavirus fatalities, at the SFCJL not a single resident has tested positive for the virus. Not all facilities were so lucky. A better approach to keep older people safe from Covid-19 would be to care for them in their homes, keeping them out of long-term residential settings. “There should be a continuum of care, and institutional care should really be reserved for people who need it, who can’t be successful and safe in their own homes,” said Claire Ramsey, Senior Staff Attorney at Justice in Aging.

Rethinking How America Cares for its Elderly

By | Health Disparities, Health Equity, Home & Community Based Services, IN THE NEWS, Medicaid, Medicare

Street Roots: Rethinking How America Cares for its Elderly (May 26, 2020)

Before COVID-19 sent the United States hurdling toward a devastating economic recession, 37 million adults aged 50 and older were already living in poverty — with another 10 million on the brink. Like it has with so many other social issues in the U.S., the coronavirus pandemic has illuminated the economic hardship and isolation facing many of our nation’s senior citizens, and the lack of value placed on the people who care for them. Executive Director Kevin Prindiville was interviewed for this article. “We’ve underinvested in our Medicaid programs and long-term care programs that help people stay home and in their community, which leaves many families with the only option to move an older family member into an institution,” Prindiville said.

Op-Ed: Revised Budget Puts Older Californians, Communities at Risk

By | Health Disparities, Health Equity, IN THE NEWS, Medicare

Cal Matters: Op-Ed: Revised Budget Puts Older Californians, Communities at Risk (May 26, 2020)

During a public health crisis like this, few things are more important than making sure people can access health care. But somehow in the budget revision, it’s health care that gets the biggest cut; and not just health care for anyone – it cuts health programs that older adults with low incomes rely on. Older Californians are not expendable. They are vital members of our families and communities who built a state strong enough to weather this storm. The governor and the Legislature need to come up with a final budget that respects and protects them. This op-ed was co-authored by Claire Ramsey, Senior Staff Attorney at Justice in Aging, and Linda Nguy, Health Policy Advocate at Western Center on Law & Poverty

California Seniors are Worried About These Cuts in Gavin Newsom’s New Budget. Here’s Why

By | Health Disparities, Health Equity, IN THE NEWS, Medicaid, Newsroom

Sacramento Bee: California Seniors are Worried About These Cuts in Gavin Newsom’s New Budget. Here’s Why (May 26, 2020)

Newsom’s revised budget plan, announced earlier this month, seeks to close a projected $54.3 billion budget deficit brought on by the coronavirus pandemic. It includes about $646 million in proposed cuts that worry seniors and their advocates because they would reduce health care options and access to programs that allow elderly residents to stay at home and out of nursing homes, which have been hotbeds for COVID-19 outbreaks. Claire Ramsey, senior staff attorney at Justice in Aging, said the May budget plan in all “proposes severe and devastating cuts to the very programs that keep older adults and people with disabilities living safely in their home.”

“Just” Old People Are Dying: Ageism and the Coronavirus Response

By | Health Equity, IN THE NEWS, Long Term Care, Medicaid, Newsroom, Uncategorized

KQED Forum: “Just” Old People Are Dying: Ageism and the Coronavirus Response (May 21, 2020)

Nearly 80% of those who have died from COVID-19 in California were over the age of 65, yet health care for seniors was slashed in the Governor’s proposed state budget. Advocates for the elderly say its just another example of ageism, which has been exacerbated during the pandemic. From suggestions that old peoples lives be sacrificed for the sake of the economy to the struggle to get PPE and tests in nursing homes, guests on the show discussed the role ageism is playing in the coronavirus response. Justice in Aging Executive Director, Kevin Prindiville was a guest on the show.

How Newsom Budget Yanks Back Medi-Cal Health Care Gains for Low-Income Residents

By | Health Disparities, Health Equity, IN THE NEWS, Medicaid, Newsroom

Cal Matters: How Newsom Budget Yanks Back Medi-Cal Health Care Gains for Low-Income Residents (May 18, 2020)

The state’s revised budget released last week shows that the Golden State’s new economic reality will almost certainly hit the Medi-Cal program with cuts in services and provider rates, as well as rescinded expansions. The list of proposed changes is sweeping, from canceling coverage expansion to more older Californians – including undocumented seniors – to cuts in some adult dental services.

“I think there will be a huge effort within the next few weeks to see whether we can push back on this,” Ramsey said. “If we don’t get to go forward now, it will likely take years.”

Llegar a la tercera edad como inmigrante, sin pensión y sin seguro médico

By | Health Care, Health Disparities, Health Equity, IN THE NEWS, Language Access, SENIOR POVERTY, Uncategorized

La Opinion: Llegar a la tercera edad como inmigrante, sin pensión y sin seguro médico, (March 28, 2020)

This article talks about how difficult it is for older adult immigrants who have no pension or health care to meet their basic needs during the COVID-19 pandemic, especially if they lost their jobs due to the pandemic. Justice in Aging attorney, Denny Chan, was interviewed for this article.

Se estima que de 2.2 millones de personas sin documentos que viven en California, el 2% son mayores de 65 años, según un informe del UC Berkeley Labor Center. “Muchos trabajadores inmigrantes han perdido su trabajo y están luchando para satisfacer sus necesidades para vivir; una catástrofe como una hospitalización de un miembro de la familia, los podrá en dificultades económicas”, agregó. “Un seguro médico protege a los estadounidenses de los costos médicos altos e inesperados, pero sin esos beneficios, las familias inmigrantes enfrentan altos riesgos de muerte y desesperación”. Denny dijo que, “en estos momentos la comunidad inmigrante, documentados o no, viven situaciones muy complicadas por las políticas antiinmigrantes por parte de la administración Trump.”

Life at the Intersection: Older Adults Need a Response to COVID-19 Grounded in Equity

By | BLOG, Health Equity, Home & Community Based Services

Dorothy is in good spirits, but tired and growing increasingly impatient. In January – well before life for most Americans had been dramatically disrupted by COVID-19 with stay at home orders and the shut down of non-essential businesses – the 72-year-old Chinese American living in Seattle, Washington’s Chinatown began to see signs that her community’s life was slowing down. She’d been reading the daily headlines in the Chinese newspaper about the virus in Wuhan and other parts of China. But when the dim sum parlor across the street was only about a quarter full on a normally busy Saturday afternoon, and her building’s annual Lunar New Year celebration was cancelled, it all became real.

Dorothy’s story, and the stories of her community, highlight the importance of intersectionality in our response to the coronavirus. An intersectional framework considers the ways that various forms of inequity operate together, exacerbate each other, and sometimes create unique challenges. It can lead to better policies that recognize the different ways the older adults in our communities are experiencing the crisis.

During the period described above, Dorothy was heart-broken to learn that her neighbor, Mr. Zhang, had been attacked while riding a local bus. Mr. Zhang was riding the bus home after doing some errands, while wearing a face mask, not because he was sick but because he was aware of the asymptomatic nature of the virus; he wanted to protect himself and others. Several passengers on the bus began harassing him and threatening him. They told him to go back where he came from and threw garbage at him. Others in the Asian American Pacific Islander (AAPI) community have reported a surge in verbal and physical assaults in the wake of what President Trump has repeatedly labelled the “Chinese virus.”

Considering all the circumstances, Dorothy – like many of her neighbors – decided to self-quarantine beginning in early February. She stopped going to the nearby temple, and her local bakery in Chinatown has suspended business operations through the end of April. In the wake of the pandemic, AAPI seniors are experiencing unprecedented levels of loneliness and isolation. But the implications for older adults like Dorothy extend far beyond social – even the home and community-based services (HCBS) that keep her healthy and living in the community are affected. She has asked her caregiver to stop coming and avoids her local adult day health center.

Adding to her fears, getting local and accurate information about the pandemic has been difficult. Aside from her Chinese newspaper, information about the coronavirus in Dorothy’s native language has been limited, particularly local news with Washington-based resources and guidance. Many AAPI older adults across the country are language-isolated, which further debilitates their ability to fight the virus. Like many older adults, Dorothy is not on social media and does not regularly use mobile technology, so information is even more limited.

Supporting older adults who may be isolated, experiencing discrimination (or even hate crimes), who may be limited English proficient (LEP), in addition to being low-income, and whose cultural background is not reflected in the mainstream requires a comprehensive and intersectional COVID-19 response strategy. For Dorothy and other older adults in her community, such a strategy begins with acknowledging that her experiences and needs during the pandemic may look different from other older adults or other AAPI individuals, and is informed by her life at the intersection of multiple identities.

At a minimum, an intersectional response should:

  • Denounce Racism. Importantly, intersectionality-informed policies identify the racism and xenophobia spurred by the coronavirus and require local, state, and federal leaders to denounce it and couple their statements with providing ample support to hate crime prevention resources. For a community that lives with the trauma from the experiences of Vincent Chin, Joseph Illeto, Navrose Mody, and others, efforts to curb hate crimes and xenophobia are crucial. In response to a problematic rise of hate crimes in the wake of the virus, the New York Attorney General created a hotline to report coronavirus hate crimes and xenophobia.
  • Acknowledge Heightened Needs. COVID-19 policies must recognize Dorothy and others like her may have already started self-quarantining well in advance of any state or federal directive, and that accordingly, their needs for socialization, food security, and home and community-based services are perhaps heightened relative to those who began staying at home much later.
  • Be Culturally Competent. Policies have to be created with all communities in mind. For example, even calls from our nation’s health experts to not buy and wear masks fails to recognize the ways in which such a message may be received in AAPI communities, informed by their experiences with Severe Respiratory Syndrome (SARS) less than 20 years ago. Another example of cultural competency is around food. During this outbreak, while the need for home-delivered meals to older adults has skyrocketed, it is just as important that those meals are prepared using culturally familiar ingredients and cooking methods.
  • Include Outreach Strategies for Various Language and Cultures. At a minimum, intersectionality requires in-language resources to reach LEP older adults like Dorothy. In 2020, government agencies cannot rely solely on Google translate, tweets via social media, or employ a one-size-fits-all approach. Outreach to AAPI older adults and other communities must include partnerships with local community-based organizations and ethnic media who have the expertise to communicate with these populations.

For those older immigrants, language-isolated older adults or older adults of color, the harms of the coronavirus will undoubtedly be compounded. Dorothy, Mr. Zhang, and so many others like them are not adequately served by policies that only partially address their lived experiences. If they are going to survive this pandemic and in order for them and their communities to thrive, our response to the coronavirus must be intersectional.

*Dorothy and Mr. Zhang are not real people but their stories are based on real accounts from on-the-ground advocates, the media, and loved ones.