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Good News: As You Renew Your Health Care Coverage, Don’t Expect New Restrictions

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Californians can rest easy. With a little over two months to go until the state’s open enrollment period for 2021 ends on Jan. 31, 2021, expect no new restrictions to your health care coverage options.

It is not likely that the latest challenge to the Affordable Care Act (ACA), also known as Obamacare, will be successful. It occurred on November 10, when the U.S. Supreme Court heard arguments against the national health care law passed under the Obama administration in the case California v. Texas, No. 19-840.

Although some Obamacare supporters, including California Attorney General Xavier Beccera – who led the Democratic defense of the ACA — expressed some caution about the nation’s highest court’s 6-3 conservative majority, they largely remained confident.

After the hearing, a majority of justices indicated that the ACA is still safe.

California v. Texas mainly focused on the ACA’s mandate requiring insurance. It was filed by 18 Republican attorneys general backed by the Trump administration. They argued that the mandate became unconstitutional after Congress eliminated the penalty for not having health insurance in Congress’s 2017 tax reform bill.

They also argued that since the mandate was a crucial feature of the law, and as they deemed it unconstitutional, the entire law should have been thrown out.

Although an official decision in the case will not come until the middle of next year, at least five Supreme Court justices have indicated that they would reject the attempt to kill the ACA.

Two members of the court’s current Republican majority, Chief Justice John G. Roberts Jr. and Justice Brett M. Kavanaugh, noted that striking down the individual mandate portion of the ACA did not require overturning the rest of the law.

“It does seem fairly clear that the proper remedy would be to sever the mandate provision and leave the rest of the act in place — the provisions regarding pre-existing conditions and the rest,” Kavanaugh said.

The court’s inferred support of the ACA comes at a time when unemployment across the United States is still at record highs due to the COVID-19 pandemic.

The Covered California healthcare marketplace began open enrollment November 1, and many newly unemployed or self-employed Californians will need to apply for either subsidized insurance, Medi-Cal or an individual medical plan.

In a virtual conference November 9, the day before his Supreme Court oral arguments, Becerra spoke about the importance of the ACA during the COVID-19 pandemic, which he called a national health crisis.

“We need the ACA more than ever now. COVID-19 has infected more than 10 million Americans, it has cost 12 million American workers their healthcare, and it’s disproportionately hurting communities of color,” he said. “Because of the ACA, in states with expanded Medicaid, workers who have lost their jobs and with that their employer-based health insurance, are still able to get healthcare and support that they need.”

California has supported the ACA since its inception in 2013, expanding the Medi-Cal program for low-income residents, and creating the state-based Covered California marketplace, which offers both federal subsidies and state-based aid. According to Census records, the rate of uninsured Californians dropped from 17.2 % in 2013 to 7.7 % in 2019.

According to Covered California, 271,820 people signed up for health care coverage through the marketplace during its special open enrollment period between March 20 and August 20 this year, more than twice the number of people who signed up during the same period last year.

Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, spoke about the importance of the ACA for the community she treats as an OB-GYN.

“I take care of people, real people who deserve to have access to the healthcare they will want and need access to — provided by the Affordable Care Act. The health of my patients has improved. The health of our communities has improved. I know that the Affordable Care Act has been a safety net for many communities and undermining or eliminating it will disproportionately impact those who need care,” said Perritt.

After presenting the arguments for keeping the Affordable Care Act, Becerra was optimistic.

“The ACA has withstood numerous legal and political challenges. It’s been upheld by the Supreme Court as constitutional twice before. And we are optimistic that it will withstand this challenge as well,” said Becerra.

Bay Area

What Oakland’s Homeless Audit Says About Evictions, Policing, and Fire

Although the audit was vast in its analysis, this guide attempts to outline key points from the audit related only to evictions and hygiene services, police response and costs, and fire department response and costs.

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A tent in Oakland that serves as a home for a resident, October 2, 2019 Photo Credit: Zack Haber

On April 14, Oakland’s City Auditor Courtney Ruby released an audit of the city’s homeless encampment management interventions and activities for the fiscal years 2018-19 and 2019-2020. The 95-page report includes data and estimations about interventions, populations, costs, and availability of services related to homeless people and their communities. 

Claiming that the city “lacked an effective strategy…and did not provide sufficient policy direction or adequate funding,” Ruby also included recommendations for better addressing homeless communities. Although the audit was vast in its analysis, this guide attempts to outline key points from the audit related only to evictions and hygiene services, police response and costs, and fire department response and costs.

Evictions and hygiene services

The audit’s data on evictions and hygiene services is limited to the 2018-19 fiscal year and the first eight months of the 2019-20 fiscal year, when the city suspended most homeless evictions and cleaning interventions due to the COVID-19 pandemic in March 2020. During this timeframe, the city evicted 181 homeless communities. Of these evictions, 123, or about two-thirds of the total, were classified as “re-closures,” which the report defined as occurring “when homeless individuals return to a previously closed [homeless community].”  In the fiscal year 2018-19, about 60% of evictions were re-closures. From July 2019 through February 2020, this ratio increased, and about 77% of evictions were re-closures.

The audit reports 1,599 interventions classified as “hygiene and garbage services,” and defines such interventions as “providing portable toilets, hand-washing stations, regular garbage service, and/or traffic barriers.” For each of these services performed per homeless community, the audit counts one intervention. These interventions are lumped together and lack individual data, meaning that the audit did not report precise data on how often the city provided trash pick-up to homeless communities.

The audit reports that the city increased its hygiene and garbage interventions. From 2018-19, the city provided 797 such interventions, or about 66 per month. During the first eight months of 2019-2020, the city performed 802 such interventions, or about 100 per month. After March 2020, in response to COVID-19, the audit claims the city increased the number of homeless communities that receive hygiene interventions from 20 to 40, but the vast majority of homeless communities in Oakland still do not get hygiene and/or trash services with any regularity. The audit estimates that there are at least 140 homeless communities in Oakland but acknowledges “that this estimate may be conservative.”

Police response and costs

Data recorded in the audit shows police response to 911 calls in homeless communities was not timely. While over 99% of 911 calls were classified as “Priority 2,” which the audit claims “ideally should be responded to in 10 to 15 minutes,” data provided by OPD showed the median police response time to Priority 2 calls was two hours in 2018-19, while the mean response time was four hours. In 2019-20, response time slowed by about 50%, with the median response time being about three hours, while the mean response time was about six hours. Data OPD listed related to response time range show the department took over two days to respond to at least one 911 call in 2018-19 and over six days to respond to at least one other 911 call in 2019-20. Although OPD recorded 1,458 calls to homeless communities during the two years of the audit, the audit only analyzed 988 of these calls, claiming that “response data was incomplete” for 470 calls.

The audit records OPD using about $3.1 million in costs associated with homeless communities. But that $3.1 million does not include an accurate account of overtime pay. OPD only started recording overtime pay related to homeless communities in February 2020, just before the frequency of interventions, notably evictions, declined dramatically.

About $1.7 million, a slim majority of OPD’s recorded costs related to homeless communities, are recorded as labor costs that went to the three members of The Homeless Outreach Team. The Homeless Outreach Team consists of one sergeant and two officers who dedicate 100% of their time to homeless community work. 

    The Abandoned Auto Unit incurred over $800,000 in labor costs to provide support at moderate to large homeless community evictions. They were responsible for “traffic control and tagging and towing vehicles at [homeless communities] when necessary.”  About $600,000 went to labor costs incurred by Patrol staff responding to 911 calls.

Fire Department response and costs

The audit reports that The Oakland Fire Department responded to 988 fires in homeless communities in 2018-19 and 2019-20, which is more than one a day. The data recorded shows that the OFD response times for such fires were timely, arriving in just over seven minutes and 50 seconds to over 90% of calls. Such responses were slightly faster than responses to non-homeless community related calls, which, in 90% of cases, OFD responded to in about eight minutes and 10 seconds. OFD has recorded no injuries to firefighters fighting fires at homeless communities. One homeless resident died in 2020 as a direct result of a fire. The audit did not record fire-related injuries to homeless people or their lost possessions.

OFD-related costs accounted for an estimated $1.8 million in funds related to homeless communities in 2018-19 and 2019-2020. About $676,000 went to “fire prevention labor,” which includes labor costs associated with fire hazard inspections, investigations related to fires, and removal of hazardous waste. Over $ million went to both labor and equipment costs related to “fire suppression.” Fire suppression costs include costs related to fighting fires and rescue activities. OFD costs related to homeless communities rose over 40% from 2018-19 to 2019-20 while total fires at homeless communities increased about 17% over these years.

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Community

Marin City Gets Vaccinated

Nearly 900 of the 3,000 residents have received at least one vaccine dose.  Dr. Matt Willis, Marin County’s Public Health officer says: “vaccination rates among African Americans are the same or higher as other groups in that community.” 

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Yes or no on vaccinations? Education and outreach are so important to share  about getting the #covid19vaccination.    See what happens when community leaders and local committed volunteers work with health officials! They not only wrapped their arms around Marin City to get #covid19vaccinations to those who want them and information to those who are nervous about getting vaccinated, they actually made sure they received their own vaccination to urge community residents to get theirs. 

The April 7 edition of the Marin Independent Journal report does a great job explaining the comprehensive approach. Nearly 900 of the 3,000 residents have received at least one vaccine dose.  Dr. Matt Willis, Marin County’s Public Health officer says: “vaccination rates among  are the same or higher as other groups in that community.” 

California has a program called “Together Toward Health,” which gave a grant to six local non-profit organizations –Performing Stars, First Missionary Baptist Church, Marin City Health and Wellness Center, Sausalito Marin City School District, Marin City Community Services District and Community Development Corporation and Marin County Health and Human Services — also provided additional  funds for outreach to low-income and multicultural communities.

If you are interested in getting your vaccine, contact Marin City Health and Wellness Center at 415-339-8813 or Performing Stars at 415-332-8316.

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Bay Area

Non-Profits, Faith-based Groups to Get Expert Advice on Re-Opening When COVID-19 Restrictions End

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Ana-Marie Jones

The San Francisco Foundation FAITHS Program the Master Class Series, 2021 draws on the knowledge of experts in their fields with decades of experience. Sessions will prepare nonprofit and faith-based leaders to navigate five key areas critical to more than surviving the season of COVID-19, by preparing for whatever comes next.  It’s time to THRIVE!

The second of the five interactive sessions,From the Experts – Rolling Out Your Reopening: The Right Way to the New Normal,” is scheduled for April 29, 2021 from 10:00 a.m. to 12:00 p.m. This training addresses what faith and nonprofit organizations should consider, plan for, and do before re-opening. 

Master teacher Ana-Marie Jones, a nationally recognized expert in community readiness and resilience, will share concrete approaches and easy-to-implement solutions that will help keep congregations and communities safer throughout the reopening process. 

Jones will be joined by Master Teacher John McKnight a community branch manager for the San Francisco Department of Emergency Management, Emergency Operations Center in response to COVID 19. Participants will learn:

The key considerations for reopening safely; the importance of maintaining diverse community contacts; effective partnering with public health entities; advice for managing staff, volunteer, consumer, and community expectations; how to make physical environments support new messaging, assigning new roles and responsibilities for staff and volunteers; and how to best leverage available community resources such as updated health information, recommendations, and other free resources.

Future THRIVE! topics include – “Pivot into Tomorrow: Tech Savvy;” “Building a Strong Health Ministry or Department;” and “Where to Find COVID-19 Recovery Resources.”

To register, go to:  https://sff.zoom.us/meeting/register/tJEuceCuqj4uHtwIx2ffv0vC1N9SOuyf884T

For more information contact: Michelle Myles Chambers at mmc@ssf.org or (415) 733-8539

Or Sayron Stokes at sstokes@ssf.org  or (415) 635-3319.

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