November 13, 2013

NYHealth President and CEO James R. Knickman moderated a panel discussion, “Meeting the Health Needs of All New Yorkers: Priorities for Vulnerable Populations,” which highlighted the key health issues facing the most vulnerable New Yorkers, including immigrants, people with mental illness, and lesbian, gay, bisexual, or transgender (LGBT) people. At the event, panelists shared priorities and opportunities for improving the health of these groups and all City residents. Speakers included:

Wendy Brennan, Executive Director, National Alliance on Mental Illness-NYC

Jay Laudato, Executive Director, Callen-Lorde Community Health Center

Noilyn Abesamis-Mendoza, Health Policy Director, Coalition for Asian American Children & Families

Theo Oshiro, Deputy Director, Make the Road New York

Mr. Oshiro gave an overview of what many immigrants face when interacting with the health care system—an experience that is often fraught with fear and confusion. The inability to afford services, fear of deportation, and language access barriers prevent many immigrants from seeking health care. Increased education and outreach to immigrant communities is needed to help immigrants understand what services are available to them, as well as how they can access care more effectively. Making sure that undocumented immigrants—who are ineligible for obtaining health insurance on the online marketplace under health reform—know they have safe and reliable access to health care is another important undertaking. “The City can send a clear message to immigrant New Yorkers that our hospitals are open to you and you won’t get deported,” said Oshiro. He also urged the mayor-elect to pay close attention to how the City’s new paid sick leave law, which goes into effect in April 2014, is implemented and that businesses properly adhere to it.

Ms. Abesamis-Mendoza on the particular challenges confronting Asian American New York City residents—a diverse population consisting of more than 40 ethnic groups who speak more than 100 different languages and dialects. Ms. Abesamis-Mendoza noted that one out of eight Asian American residents are uninsured, and that many Asian American New Yorkers work for small businesses that don’t traditionally provide health insurance for workers. Documentation status and language barriers also have prevented this population from engaging with the health care system. Another challenge to overcome is the stigma many Asian Americans feel when applying for health benefits assistance, even if they qualify for it. Among the recommendations for the mayor-elect to consider is to include more Asian Americans in the planning process for health initiatives and to develop a commission at the City level to understand the unique issues facing this population. Ensuring that the health care system is culturally competent to deal with diverse groups and strengthening the safety-net system and federally qualified health centers are also key priorities. “That you will be protected is an assurance that is needed from this new administration,” said Abesamis-Mendoza.

Mr. Laudato discussed ways for the City to address the health issues of the LGBT community and its ability to access sensitive and culturally competent health care services. Many LGBT people are hesitant or scared to seek out health care; consequently, they face greater health disparities than their heterosexual counterparts. Laudato noted that 19% of New York City doctors reported being uncomfortable treating LGBT patients. Laudato recommended that amendments be made to the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey to include LGBT as a demographic category to ensure that the voices of this population are heard and captured. Administered by the New York State Department of Health to Medicaid managed care plan members, the CAHPS survey is used to assess consumers’ experiences with access to care, health care providers, and health plans. He also urged for Medicaid coverage of transgender surgeries and services. More resources and work on HIV and AIDS prevention are also critical. “We really have a public health crisis that’s been with us for a long time and we need the government to take action,” said Laudato. He echoed the other panelists’ message of strengthening the City’s health safety-net system for anyone who may fall through the cracks.

Ms. Brennan concluded the panelist discussion by outlining the difficulties people with mental illness have in getting treatment for their conditions—only 40% of those with diagnosed mental illness receive minimal care and the rest go untreated. The stigma attached to mental illness prevents people from seeking and accessing care; as a result, this population suffers from worse health outcomes. “It’s time to make mental health a public health priority in the City,” she said. Her recommendations included improving primary care services to diagnose and treat mental health disorders; educating students and educators in the New York City school system on mental health and signs, symptoms, and treatment; and mobilizing crisis intervention teams in the City to work with police departments and mental health providers.

Following the panelist presentation, the audience had the opportunity to participate in a town hall-style discussion, asking questions and offering comments on the evening’s main themes. Topics ranged from how to encourage healthy living and behaviors among New Yorkers to better outreach for informing residents of free health services and initiatives in their communities.

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