Monthly Archives: March 2014

This Week in Immigration Reform – Week Ending March 28

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Week Ending March 28, 2014

This week in immigration reform: House Democrats release a “Demand a Vote” petition, seeking to pressure House Republican leadership into giving the country a vote immigration reform; the Congressional Budget Office scores the House bipartisan immigration reform bill HR 15 and finds that it will cut the deficit by $900 billion over 20 years; and a new poll finds that Texas Republicans have no electoral consequences to fear if they were to vote in favor of immigration reform.  NCLR kept the community informed in a number of news pieces this week, with staff quoted in the Associated Press, Fox News Latino, BuzzFeed, El Diario, Hispanically Speaking News, and the Miami Herald.

–House Democrats release discharge petition in attempt to advance immigration reform.  House Democrats, seeking to break through House Republicans’ refusal to give America a vote on immigration reform, released a discharge petition this Wednesday in an attempt to force a vote on their immigration reform bill HR 15.  NCLR applauded the move and called out House Republican leadership as being the foremost roadblock to immigration reform.

The petition would need 218 signatures to bring HR 15 to a vote on the House floor.  You can check here to see if your Representative has signed the petition.

NCLR is telling House Republican leadership that they need to put reform legislation up for a vote.  Join us by using our Twitter tool here!

–CBO scores HR15, finds it will cut deficit by $900 billion over 20 years.   This week the nonpartisan Congressional Budget Office (CBO) reported that the House bipartisan immigration reform bill, HR 15, would cut the deficit by $900 billion over 20 years.  The CBO’s findings confirm, yet again, that passing immigration reform is a no-brainer.  As La Opinion, the largest Spanish language newspaper in the U.S., points out in its editorial: “The CBO, with its independent analysis, is showing a path to cutting federal spending and improving the economy. Not taking it into account reflects irresponsibility when it comes to seeking solutions to economic challenges.”

–Poll finds that voting in favor of reform wouldn’t hurt Texas Reps.  A new poll, commissioned by the Partnership for a New American Economy, finds that for three Texas Congressmen – Reps. Sam Johnson R-Texas), Lamar Smith (R-Texas), and Kevin Brady (R-Texas) – voting in favor of immigration reform wouldn’t hurt their approval among likely voters.  These results debunk certain Republicans’ claims that passing immigration reform would hurt their electoral fortunes in November.

Health Care Navigators Work Hard to Get Latinos Covered

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Health Care Navigator, Maria Jimenez, has been working diligently to sign up Floridians.

Health Care Navigator, Maria Jimenez, has been working diligently to sign up Floridians for health care.

It has been a long six months since the Affordable Care Act healthcare exchanges opened back in October. During the open enrollment period, there were early setbacks that made enrolling difficult, including website issues for both English and Spanish speakers. It was a frustrating time for many who tried to log on in the beginning, but the government addressed the issues with the websites as quickly as they could. And, the work has paid off. In the past six months, six million people have managed to make it through the process of getting insurance, a goal the White House set and reached.

Most of those who have signed up so far used one of the two most common methods for enrolling: the website and the telephone. But there is a third option that has not received nearly as much media attention or criticism, the Health Care Navigator option. Health Care Navigators each go through a certification process that prepares them to walk anyone who wants through the process. It is more labor intensive, but for the Latino community, the Navigator option has shown to be the preferred method for getting coverage.

This has certainly been the case in Florida. The Sunshine State is home to one of the country’s largest Latino populations, making it a hotspot for signing folks up, many of them for the first time.

Hispanic Services Council (HSC), an NCLR Affiliate, is one of the organizations working to engage Florida’s Latino community with health care navigators. These dedicated professionals are definitely busy, often working well into the evening in most instances. On average, navigators can enroll up to 60 people a month, according to Maria Jimenez, a navigator with HSC.

“It really depends on the community. I’m working every weekend and I have appointments back-to-back, sometimes working late at night,” said Jimenez, who says she became a navigator out of a desire to help her friends and neighbors. “We have a real need for this work in our community,” she said.

Jimenez’s work has indeed been helpful since she can sometimes answer client questions more effectively than the website, she said.  In fact, many of the people Jimenez has signed up are getting coverage for the very first time.

“They [Latinos] like face-to-face contact. They like someone they can see so they know what is exactly going on,” said Jimenez. “They chose Hispanic Services Council because we’ve been in the community a long time. They know if they come to us, we’ll have assistance for them. “

That face-to-face contact has been vital, according to Jimenez, especially since so many have never had insurance before. Many of the questions she is asked have to do with basic understanding of how insurance coverage works in general. Jimenez often spends a lot of time talking and educating clients about things like co-pays, deductibles, and premiums. For someone who has never had insurance, these can be daunting and confusing ideas to process.

Many of the folks Jimenez has signed up also work during the day, so being able to sit with an actual person and ask these questions at night has been especially important for them.  And, it can be a lengthy process, sometimes lasting as long as 3 hours.

Still, Jimenez says the time spent educating her community has been well worth it. Many of the people she has signed up are surprised by just how much is covered.  One of Jimenez’s clients included a 19 year-old student who was skeptical about signing up. After some convincing, she was able to get him to take a closer look.

“He was really excited to learn he could afford it,” said Jimenez. “He was shocked when he found out that he could get dental and medical for about $30. It’s something that really makes me feel good about what I’m doing.”

Jimenez will continue working to sign up as many as possible before the March 31 deadline and encourages those who do choose to see a navigator to be prepared when they arrive. One needs proof of income, proof of status and information about the household, such as who is applying and who already has insurance. She’s looking forward to the end of the enrollment process, and more free time, but she is looking forward even more to the time when her whole community is covered.

“It’s really about personal responsibility,” said Jimenez. “If you’re healthy, it’s important to keep yourself healthy.”

Health Policy Spotlight: A Step Forward for Community Health Workers in Illinois

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(This was originally posted to the Peers for Progress blog.)

HEALTH CR School 3By Clayton Velicer, MPH, Peers for Progress

As the United States healthcare system evolves under the new insurance exchanges and Affordable Care Act, more states are implementing programs that incorporate community health workers and peer support workers in an effort to reduce medical costs.

A number of programs in different states have recently been highlighted in our blogs, including a case study in New York that demonstrated cost-savings by integrating community health workers (CHWs) into patient centered medical homes, and Georgia’s statewide initiative to secure Medicaid reimbursements for peer support services in mental health.

In February, the state of Illinois took a step towards expanding the CHW workforce by proposing a bill to formalize their work and increase their funding. This blog will review the steps that led to this bill and look at some of the reactions from across the state.

Proposed Policy Changes in the Illinois Healthcare System

In January 2014, the Illinois Healthcare Reform Implementation Council produced a 43 page report filled with recommendations for policy changes in the state’s healthcare system. The importance of increasing the recognition and roles of CHWs is summarized in 5 of the 11 policy development recommendations that explicitly mention CHWs:

  1. Adopt the American Public Health Association’s definition of a Community Health Worker
  2. Establish a CHW State Advisory Board at the Illinois Department of Public Health to assist in the development of training, curriculum, and certification of CHWs. Members of the board should include: CHWs (at least 50% plus 1), CHW employers, educators, social services professionals, members of public health associations, health researchers, and members of the public.
  3. Support legislative action to formalize and standardize CHW training, curriculum and certification.
  4. Once developed, provide training at various levels of education and in diverse geographic settings, consider a tiered system of classifications within the CHW field, develop a “grandfathering” protocol for existing CHWs to ensure adequate levels of competency, and identify positions in the healthcare career ladder (nursing, physicians, consultants, etc.) that CHWs can transition into.
  5. Educate the spectrum of health professionals about the roles of CHWs. Many professionals are unclear about the roles of CHWs and how the ACA encourages the development and utilization of this workforce.

These recommendations are important because they establish a standardized definition (1), incorporate multiple stakeholders (2), propose advocacy steps (3), provide concrete examples of policies to advance the CHW workforce (4), and establish a campaign to build support for CHWs within the healthcare system (5).

Reactions to the Bill in Illinois

Media coverage of the bill shows support from a variety of key stakeholders. In an article in the Chicago Healthcare Daily, Dr. Lamar Hasbrouck, Director of the Illinois Department of Public Health, stated the value of CHWs:

“We need some foot soldiers in the community that are embraced, that are understood, that are familiar and can translate the jargon into real, actionable items”

Denise Bockwoldt, Director of Diabetes and Endocrinology Services for Sinai Health System, also affirmed the importance of CHWs, citing that they live in the same neighborhoods as their patients, can tailor care plans and give the system overall credibility. Sinai Health System treats a large uninsured and poor population and recently released a Best Practice Guidelines for Implementing and Evaluating Community Health Worker Programs.

Many hope that the proposed bill may create new funding opportunities. Under the current system, hospitals, clinics and other providers often pay for CHWs through short-term grant funding. Dr. Hasbrouck believes that creating a formal certification process will help providers understand the resources they’re getting and may make them more likely to fund workers from their own operating budgets. This may be even more convincing if insurers and government payors provide incentives to health care providers for improving care coordination.

Final Thoughts

We will be closely following this bill as it moves forward in Illinois, and we look forward to seeing how it impacts funding for CHWs and community health outcomes. We encourage our readers to share resources and media coverage of other states that are formally integrating CHWs and peer support workers into their state healthcare systems.

Give America a Vote on Immigration Reform!

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HouseImmigrationBill_picDemocrats in the House of Representatives have revealed their latest move in the fight to pass immigration reform, a legislative tactic known as a “discharge petition.” To put it plainly, a discharge petition allows a bill to be moved out of committee and to the House floor regardless of objections, as long as 218 House members, a majority, sign it. The Democrats are calling it the “Give Us a Vote” petition and it is aimed at pressuring their Republican colleagues, many of whom have said they would vote for reform, to show they mean it by forcing them to vote on it.

NCLR President and CEO, Janet Murguía, in a statement, had this to say about the House Democrats most recent maneuver:

“When it comes to immigration reform, House Republican leadership isn’t doing any leading at all; they remain the biggest roadblock to Congress delivering a permanent solution that will bring order and stability to our immigration system, and economic growth to our country. It is time for the coalition of the willing to step forward. Our community demands relief from the humanitarian crisis caused by deportations, and we will remember who intervened to resolve it. House Republican leadership is not fooling Latino voters. By stalling on legislation, they are directly contributing to this crisis. They have a chance to move forward, or they will lose the Latino vote for generations to come.”