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St. John’s Well Child & Family Center expanding healthcare

Staff trained to protect undocumented and trans clients

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St. John’s Well Child & Family Center President and CEO Jim Mangia (fourth from the left) with staff (Photo courtesy Mangia)

For Los Angeles County’s undocumented immigrants and transgender residents, a recently approved expansion of funding by the LA County Board of Supervisors for the My Health LA program comes as welcome news. After months of deliberations, the Department of Health Services reached an agreement with community clinics, including the county’s largest clinical system, St. John’s Well Child & Family Center, to support countywide universal coverage in a historic expansion of immigrant health services and access to care.

My Health LA is a partnership between the County and local community clinics and health centers aimed at providing healthcare for every county resident. Clinics provide primary care services like screenings, physicals, chronic disease management and prescription medications. The Supervisors’ Nov. 20 action addresses the healthcare needs of undocumented immigrants who are ineligible for coverage under the Affordable Care Act because of their immigration status.

Supervisor Hilda Solis said it was “one of the very few in the entire nation that exists that provides this kind of service.”

While the Department of Health Services offers specialty care and more acute services, Jim Mangia, the openly gay President and CEO St. John’s Well Child & Family Centers, points out that non-profit healthcare service providers are critical to the over 150,000 county residents who are dependent on free or low cost healthcare. The Board action raises the cap to 165 thousand residents.

“The 17 St. John’s Well Child & Family Centers currently serve over 25,000 residents enrolled in My Health LA and with an overall client base of 100,000 patients of all ages through the network of health centers and school-based clinics in Central, South LA and Compton, is the largest single provider,” Mangia told the Los Angeles Blade.

Mangia said that under the new My Health LA partnership terms, “patients must be able to get an appointment for routine care within 21 days.” Currently some people wait up to three months for a visit. But, he adds, “urgent primary care must be made available within 96 hours.”

With the omnipresent threat of enforcement actions by the U. S. Immigration & Customs Enforcement agency, (ICE), some in the immigrant community eschew even basic healthcare out of fear of being caught up in an ICE raid, followed by deportation. Mangia said that his staff is trained to ensure the protection of their immigrant clients. Additionally, they are culturally and language competent  to better serve patients and their families.

“Rather than just wait and react, we figured we would equip our staff,” Mario Chavez, director of government affairs at St. John’s, told Healthcare Dive Magazine last September. “We had to have a game plan, given all the fear in the community. We couldn’t be reactionary.”

St. John’s makes sure its front desk staff and clinicians are “made clear” on the rights granted to them and their patients by the Fourth Amendment protection against unreasonable search and seizure. Front desk employees are also given a script to prepare them for questions they may be asked by ICE agents. Managers are trained in how to read warrants.

Staff have also learned how to form a human shield to prevent apprehension. If the worst situation arises, St. John’s staff have a protocol for keeping ICE agents in place while patients are locked in their rooms.

“We shouldn’t have to compromise our constitutional rights as citizens or residents in this country in the name of national security when there’s clearly a due process,” Chavez told Healthcare Dive Magazine.

Another area of much needed funding expansion is an increase for the funding of pharmaceutical drugs, which St. John’s is required to provide at no cost to patients enrolled in the program.

“There’s now an agreement to look at increasing grants targeted for pharmaceuticals,” Mangia tells the Los Angeles Blade, “which would include hormone treatments for trans patients that weren’t previously allowable.”

St. John’s has been working with LA LGBT Center volunteers to target care for trans and homeless sex workers. “Currently only Los Angeles and San Francisco have such targeted programs,” Mangia says. 

Teanna Herrera, a Victims Advocate for St. John’s Transgender Health Program who connects undocumented trans women of color to healthcare, was recently profiled by INTO Magazine. Rizi Timane, the manager of the Transgender Health Program at St. John’s and founding director of the Happy Transgender Center, sees Herrera as a vital part of his team, and an asset in community outreach.

“Teanna brings a vast knowledge about trans women and trans patients,” Timane told INTO. “[Patients] are more inclined to listen and to trust her advice on how to possibly find a way into mainstream employment, as well as how to stay safe while still in the sex work life. … She goes out into the community to present and share her story and attends important community meetings where she advocates for the community as well.”

St. John’s Well Child & Family Center healthcare provider and client (Photo courtesy St. John’s Well Child)

Although the agreement reached to increase the trans healthcare program is verbal, Mangia tells the Los Angeles Blade that he feels strongly that county officials are acting in good faith.

“St. John’s Well Child and Family Center, which is the largest provider of services to undocumented immigrants in the country and the largest My Health LA provider, was able to get assurances from the County that services would be expanded to include transgender health services,” a grateful Mangia tells the Los Angeles Blade.  “At this time of unprecedented attack by the Trump administration against immigrant families and individuals, this expansion in the largest county in the United States sends a clear message of support for the right of everyone to healthcare services, regardless of immigration status.”

Trans care also includes a healthcare reentry program for offenders leaving County detention facilities. Currently St. John’s has the only certified reentry program for trans offenders, staffed by former offenders, Mangia says.

The additional approved funding expansion will also supplement St. John’s HIV-Prevention and Treatment program, especially in the PrEP and PEP pharmaceuticals program. Mangia notes that St. John’s is working with the Black AIDS Institute, which last April opened A Clinic for Us (C4U), a free and or low-cost community primary care facility in Crenshaw’s Leimert Park neighborhood.

Phill Wilson, out-going Founder, President and CEO of the Black AIDS Institute, pointed out in a BAI release that Blacks account for 64 percent of recently diagnosed HIV/AIDS cases in Leimert Park and surrounding areas. According to AIDSVu, interactive online map displaying HIV/AIDS prevalence in America, 1,377 out of every 100,000 Black Angelinos is living with HIV, compared to 591 out of every 100,000 white Angelinos.

“These numbers speak to the need for additional resources and services within Black communities, particularly communities in south Los Angeles,” Wilson said. “Clearly, health disparities between Black and other racial ethnic groups in this county continue to exist and there are still enormous unmet needs in this community. It is our hope that ‘A Clinic for Us’ will help mitigate those issues and extend much needed free or low-cost prevention and treatment services to those most in need in this community.”

Mangia echoes Wilson’s sentiments, saying that under-served minority communities must be better served by efforts such as the increased funding from the County.

Access to medical care is always an ongoing concern he adds. St. John’s clinics are located near bus lines and the clinics offering free MTA tokens and free parking. Additionally, care is provided through two state- of-the-art medically equipped two-room mobile clinic vans. For homeless HIV patients, these vans can be literal lifesavers, even transversing the County’s dry concrete riverbeds to serve the folks living there.

But many issues remain. “Of particular concern is addressing mental health issues, for which, at this point, there currently is no funding for undocumented Angelos,” Mangia says. 

Supervisors Sheila Kuehl and Supervisor Kathryn Barger have also recommended that the County also look at expanding access to substance abuse treatment and mental health care for My Health LA patients. Free substance abuse treatment is available under the plan but is underutilized, so the supervisors directed staff to find out why. Options are also limited for treating less severe, but prevalent mental health issues such as depression and anxiety and the board also directed staff to look at sources of funding to expand available treatment.

“Healthcare is and should be a fundamental right,” Mangia tells the Los Angeles Blade. He hopes to improve St. John’s Well Child & Family Center’s  holistic approach to providing the County’s residents with  better comprehensive services.

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NBC Universal cancels Golden Globe awards broadcast for 2022

NBC Universal announced the network would not broadcast the 2022 Golden Globes awards ceremony

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Screenshot NBC coverage of the Golden Globes from previous years on YouTube

BURBANK – In the wake of an in-depth investigation into the Hollywood Foreign Press Association (HFPA), the organization responsible for the Golden Globes by the Los Angeles Times, which revealed a lack of racial diversity among its voting members and various other ethical concerns, NBC Universal announced Monday the network would not broadcast the 2022 Golden Globes ceremony.

This past February ahead of the HFPA’s 78th Annual Golden Globes ceremony, HFPA board chair Meher Tatna told Variety magazine that the organization that the organization of international journalists which covers the film, television, and entertainment industry has not had any Black members in at least 20 years.

Actor Sterling K. Brown,  a Golden Globe winner and two-time nominee, posted to Instagram; 

Criticism of the HFPA, which puts on the Globes and has been denounced for a lack of diversity and for ethical impropriates, reached such a pitch this week that actor and superstar celebrity Tom Cruise returned his three Globes to the press association’s headquarters, according to a person who was granted anonymity because they weren’t authorized to speak publicly about the decision, the Associated Press reported.

“We continue to believe that the HFPA is committed to meaningful reform. However, change of this magnitude takes time and work, and we feel strongly that the HFPA needs time to do it right,” a spokesperson for NBC said in a statement.

“As such, NBC will not air the 2022 Golden Globes,” the spokesperson added. “Assuming the organization executes on its plan, we are hopeful we will be in a position to air the show in January 2023.”

NBC’s decision comes as Vogue reported that the backlash to the HFPA came swiftly and decisively. Some of Hollywood’s biggest studios, including Netflix, Amazon, and WarnerMedia, announced they were severing ties with the organization until efforts were made to increase diversity and stamp out corruption, while a group of more than 100 of the industry’s biggest PR firms released a statement in March in which they pledged to boycott the ceremony for the foreseeable future. 

The HFPA did not immediately respond to inquiries by media outlets requesting comment about NBC’s decision.

In February, the organization said it was “fully committed to ensuring our membership is reflective of the communities around the world who love film, TV, and the artists inspiring and educating them.”

“We understand that we need to bring in Black members as well as members from other underrepresented backgrounds, and we will immediately work to implement an action plan to achieve these goals as soon as possible,” it said.

HFPA also announced a full timetable through this summer for implementing promised reform initiatives in response to NBC’s decision.

“Regardless of the next air date of the Golden Globes, implementing transformational changes as quickly — and as thoughtfully — as possible remains the top priority,” the HFPA board said in a statement. “We invite our partners in the industry to the table to work with us on the systemic reform that is long overdue, both in our organization as well as within the industry at large.”

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Coronavirus

LA County expected to hit herd immunity by mid summer

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Photo Credit: County of Los Angeles

LOS ANGELES – Los Angeles County could reach COVID-19 herd immunity among adults and the older teenagers by mid- to late July, public health officials announced Monday. Over the weekend LA Mayor Eric Garcetti announced that appointments are no longer needed for Angelenos to get COVID-19 vaccinations at any site run by the city.

Garcetti’s move is intended to give people who don’t have the time or technological resources to navigate online booking platforms a chance to get the shot.

The percentage of the population the County needs to vaccinate to achieve community immunity is unknown, however Public Health officials estimate it’s probably around 80%. Currently, 400,000 shots each week are getting into the arms of L.A. County residents, and there are over 2 million more first doses to go before 80% of all L.A. County residents 16 and older have received at least one shot.

At this rate, Public Health expects the County will reach this level of community immunity in mid- to late July and that assumes the County continues to at least have 400,000 people vaccinated each week. That would include both first doses that people need as well as their second doses.

This news came as Los Angeles Unified School District officials announced that attendance numbers at all grade levels in the District have been considerably lower than expected as extensive safety measures have failed to lure back the vast majority of families in the final weeks of school.

Only 7% of high school students, about 30% of elementary school children and 12% of middle school students have returned to campuses.

As of May 7, more than 8,492,810 doses of COVID-19 vaccine have been administered to people across Los Angeles County. Of these, 5,146,142 were first doses and 3,346,668 were second doses.

On Monday the U.S. Food & Drug Administration (FDA) expanded the emergency use authorization for the Pfizer COVID-19 vaccine for adolescents 12 to 15 years of age. The Pfizer vaccine is already authorized for people 16 years old and older.

Pfizer’s testing in adolescents “met our rigorous standards,” FDA vaccine chief Dr. Peter Marks said. “Having a vaccine authorized for a younger population is a critical step in continuing to lessen the immense public health burden caused by the COVID-19 pandemic.”

In a statement released Monday by the White House, President Joe Biden the FDA’s decision marked another important step in the nation’s march back to regular life.

“The light at the end of the tunnel is growing, and today it got a little brighter,” Biden said.

Los Angeles County will offer the Pfizer vaccine for 12 to 15-year-olds once the Centers for Disease Control and Prevention (CDC) affirms the FDA recommendation, which can happen as early as Wednesday. All adolescents 12-17 will need to be accompanied by a parent or guardian to get vaccinated.

To find a vaccination site near you, to make an appointment at vaccination sites, and much more, visit: www.VaccinateLACounty.com (English) and www.VacunateLosAngeles.com (Spanish). If you don’t have internet access, can’t use a computer, or you’re over 65, you can call 1-833-540-0473 for help finding an appointment or scheduling a home-visit if you are homebound. Vaccinations are always free and open to eligible residents and workers regardless of immigration status.

In the meantime, the Los Angeles County Department of Public Health and the Centers for Disease Control and Prevention say that unvaccinated people — including children — should continue taking precautions such as wearing masks indoors and keeping their distance from other unvaccinated people outside of their households.

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Health

HHS takes steps to reverse Anti-LGBTQ+ healthcare policy

The announcement came minutes before a scheduled hearing before the U.S. District Court for Equality California’s lawsuit challenging the Trump-Pence Administration’s “Rollback Rule”

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HHS the Hubert H. Humphrey Building (Photo: GSA)

WASHINGTON – The U.S. Department of Health and Human Services announced Monday morning that the Biden-Harris Administration will interpret and enforce Section 1557 of the Affordable Care Act (ACA) and Title IX’s prohibitions on discrimination based on sex to include discrimination on the basis of sexual orientation and gender identity.

The announcement came minutes before a scheduled hearing before the U.S. District Court for the District of Massachusetts in BAGLY v. HHS, Equality California’s lawsuit challenging the Trump-Pence Administration’s “Rollback Rule.”

The Trump-era policy undermines the ACA’s nondiscrimination protections on the basis of sex — including pregnancy, gender identity and sex stereotyping — as well as protections for patients with limited-English proficiency and those living with chronic illnesses, including HIV. Because the issues in BAGLY v. HHS are broader than what the Administration announced today, the Court scheduled a hearing on the government’s motion to dismiss for June 3rd at 2:30 PM EST.

In reaction to the HHS announcement, House Speaker Nancy Pelosi issued a statement Monday:

“Today, the Biden Administration has taken essential and potentially life-saving action to affirm that all people in America have the right to quality, affordable health care – no matter who they are or whom they love.  During this time of pandemic and always, it is vital that the most vulnerable have access to care, including LGBTQ Americans, who have long suffered injustice and discrimination that has left them dangerously exposed to health risks.
 
“The Trump Administration’s decision to greenlight anti-LGBTQ discrimination in health care in the middle of a pandemic was an act of senseless and staggering cruelty, made in blatant defiance of our values and a Supreme Court ruling made just a month prior.  
 
“Congressional Democrats together with the Biden Administration are proud to uphold the equal right of every American to access the care that they need to pursue a life of dignity and health.  We must now build on this progress and enact the House-passed Equality Act to fully ban anti-LGBTQ discrimination in our nation.”

In addition to Equality California, co-plaintiffs in BAGLY v. HHS include Darren Lazor, The Boston Alliance of Gay, Lesbian, Bisexual and Transgender Youth (BAGLY), Callen-Lorde Community Health Center, Campaign for Southern Equality, Equality California, Fenway Health, and Transgender Emergency Fund.

Lazor is a transgender man near Cleveland, Ohio, who experienced numerous counts of discrimination from healthcare providers on the basis of his gender identity from 2012 to 2017. He is a member of Equality California. Plaintiffs are represented by National Women’s Law Center (NWLC), the Transgender Law Center (TLC), the Transgender Legal Defense & Education Fund (TLDEF), the Center for Health Law and Policy Innovation (CHLPI) of Harvard Law School and law firm Hogan Lovells.

The lawsuit asserts that the new rule violates the Administrative Procedures Act by being contrary to law, arbitrary and capricious and a violation of the Equal Protection Clause of the 14th Amendment. Notably, it was published on June 19,  just days after the June 15, 2020 U.S. Supreme Court ruling in Bostock v. Clayton County, which found that it is unlawful sex discrimination to fire employees based on sexual orientation or gender identity.

The lawsuit also asserts that the new rule will embolden discrimination and harm LGBTQ+ patients and people seeking reproductive health care, further stigmatize abortion and other pregnancy-related care, harm patients with limited-English proficiency, especially immigrants, and harm people with chronic illnesses, including those living with HIV. The rule will also create confusion about the scope of protections against discrimination under federal law. 

Trans people, like plaintiff Darren Lazor, already face disproportionate discrimination in health care settings, including mistreatment by insurers and humiliation and harassment by doctors – problems that are exacerbated for trans people of color and trans people living in rural regions and the U.S. South. In seeking to deny trans people access to the healthcare they need, the Trump Administration had placed trans people, and especially Black trans women, in danger through deliberately harmful governmental action.

“We are thrilled by the news that the Biden-Harris Administration will take initial steps to reverse President Trump’s dangerous, discriminatory Rollback Rule, which undermined healthcare nondiscrimination protections critical to the LGBTQ+ community, and trans people in particular,” said Equality California Executive Director Rick Chavez Zbur.

“As the world recovers from a global pandemic, it’s more important than ever that every American have access to quality, affordable healthcare without fear of harassment and discrimination. We remain hopeful that under Secretary Becerra and Assistant Secretary Levine’s leadership, HHS will continue to take further steps to rescind the Trump-era regulation and address the harms that it has caused,” he added.

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