Community
Telehealth Increases Access to Care for Medi-Cal Patients – Let’s Keep It OPINION
Telehealth may not make for a good Norman Rockwell painting, but it does make for good medicine. It’s an improvement, a step forward that helps us get healthier and close gaps in care.
Nearly a century ago, a Norman Rockwell painting titled “Doctor and Doll” was published on the cover of the Saturday Evening Post, a popular American cultural magazine.
It depicted an older gentleman wearing a suit, doctor bag at his feet, pressing a stethoscope to the chest of a little girl’s toy doll. A cluttered desk and worn chair sit atop a forgettable rug. It’s an old image of health care in America. A country doctor caring for his neighbors via a “house call.”
Of course, we know it was not that simple. Healthcare was rudimentary compared to today’s standards – that is if you had access to care at all. Average life expectancy reflected that. If you were born white in 1929 you would be lucky to reach your 60s. If you were Black, you weren’t likely to reach your 50s.
While things are far from perfect, at least they have improved. Healthy lifestyles and modern medicine have made living into your 80s commonplace. Significant racial disparities remain, but the gap is closing. And the number of people with health coverage has never been higher. But while Medi-Cal (the state sponsored coverage for people who have low-incomes) now covers nearly 14 million people, many still lack appropriate access to care.
Access to care is a complex issue, but sometimes it’s as simple as geography. Taking an hours-long bus ride across town to visit the doctor isn’t practical for most people. Add lost wages, a lack of childcare, and the fact that you don’t feel good, and it’s downright impossible.
Solutions available in employer-based health insurance for years, like virtual care through an app or over the telephone, haven’t been an option for people on Medi-Cal.
Until the pandemic.
When the federal and state governments declared emergency last Spring, federally qualified health centers like WellSpace Health were able to provide care virtually via telephone and video, a practice that had been prohibited previously.
Virtual care is wildly successful. Over the past two weeks, 5,015 patients accessed care remotely rather than visiting our health centers. Half of primary care visits and 85% of behavioral health visits were virtual. According to a statewide survey of community health centers, which serve 1 in 5 Californians, there has been a 75% decrease in no-show rates since the implementation of telehealth. A study conducted by the California Pan-Ethnic Health Network reported a significant number of patients from communities of color engaging in telehealth and having a high level of patient satisfaction.
As an internal medicine doctor and the chief medical officer WellSpace Health, it makes sense. Technology has given us the ability to conduct a modern day “house call.” We can go to the patient and break down significant barriers to care. If the patient requires a hands-on assessment or treatment, we can take that step. But frequently, especially in behavioral health, hands-on care is not necessary.
Our ability to provide virtual care under the emergency order will expire soon. Permanent authorization will require action by the Legislature and the governor through the budget process. Assembly Bill (AB) 32 by Assemblymember Cecilia Aguiar-Curry (D- Winters) provides the template for action.
In this budget cycle, the governor must take advantage of a once-in-a-lifetime opportunity to address inequality in our health care delivery system. By adopting the provisions of AB 32 into the FY21-22 final budget, it will guarantee that all Medi-Cal beneficiaries – regardless of where they seek care – can use all telehealth modalities, including telephonic care, indefinitely.
Telehealth may not make for a good Norman Rockwell painting, but it does make for good medicine. It’s an improvement, a step forward that helps us get healthier and close gaps in care.
It even brings back the house call.
Dr. Janine Bera is the chief medical officer for WellSpace Health and chair of the California Primary Care Association Telehealth Clinical Task Force.
Activism
Oakland Post: Week of October 30 – November 5, 2024
The printed Weekly Edition of the Oakland Post: Week of October 30 – November 5, 2024
To enlarge your view of this issue, use the slider, magnifying glass icon or full page icon in the lower right corner of the browser window.
Activism
“Two things can be true at once.” An Afro-Latina Voter Weighs in on Identity and Politics
“As a Puerto Rican I do not feel spoken to in discussions about Latino voters… which is ironic because we are one of the few Latino communities who are also simultaneously American,” Ortiz-Cedeño says. Puerto Ricans born in Puerto Rico, a U.S. territory, have American citizenship by birth but they do not have the right to vote for president if they live on the island. “I think that we miss out on a really interesting opportunity to have a nuanced conversation by ignoring this huge Latino population that is indigenously American.”
By Magaly Muñoz
On a sunny afternoon at Los Cilantros Restaurant in Berkeley, California, Keyanna Ortiz-Cedeño, a 27-year-old Afro-Latina with tight curly hair and deep brown skin, stares down at her carne asada tacos, “I’ve definitely eaten more tortillas than plantains over the course of my life,” says Cedeño, who spent her childhood in South Texas, among predominantly Mexican-American Latinos. As she eats, she reflects on the views that American politicians have of Latino voters.
“As a Puerto Rican I do not feel spoken to in discussions about Latino voters… which is ironic because we are one of the few Latino communities who are also simultaneously American,” Ortiz-Cedeño says. Puerto Ricans born in Puerto Rico, a U.S. territory, have American citizenship by birth but they do not have the right to vote for president if they live on the island. “I think that we miss out on a really interesting opportunity to have a nuanced conversation by ignoring this huge Latino population that is indigenously American.”
Ortiz-Cedeño, an urban planner who is focused on disaster resilience, homelessness and economic prosperity for people of color, says that political conversations around Latinos tend to shift towards immigration, “I think this ties back into the ways that our perception of ‘Latino’ tends to be Mexican and Central American because so much of our conversation about Latinos is deeply rooted in what’s happening on the border,” she says. “I don’t think that the Afro-Latino vote is frequently considered when we’re talking about the Latino vote in the United States.”
As Ortiz-Cedeño sifts through childhood photos of her as a happy teen dancing with the Mexican ballet folklorico group in high school and as a dama in quinceñeras, she reflects on growing up in South Texas, an area with a large population of white and Mexican-Americans. The Black population was small, and within it, the Afro-Latino population was practically nonexistent.
“It was interesting to try to have conversations with other Latinos in the community because I think that there was a combination of both willful ignorance and a sort of ill intent and effort to try and deny my experience as a Latino,” she says. “There are a lot of folks in Latin America who experience a lot of cognitive dissonance when they think about the existence of Black Latinos in Latin America.
Ortiz-Cedeño comments on the long history of anti-Blackness in Latin America. “Throughout Latin America, we have a really insidious history with erasing Blackness and I think that that has been carried into the Latino American culture and experience,” she says. “People will tell you, race doesn’t exist in Latin America, like we’re all Dominicans, we’re all Puerto Ricans, we’re all Cubans, we’re all Mexicans. If you were to go to the spaces with where people are from and look at who is experiencing the most acute violence, the most acute poverty, the most acute political oppression and marginalization, those people are usually darker. And that’s not by accident, it’s by design.”
Because of the lack of diversity in her Gulf Coast town, as a teenager, despite being the only Spanish-speaker at her job in Walmart, Latinos refused to ask for her help in Spanish.
“Even if monolingual [Spanish-speaking] people would have to speak with me, then they were trying to speak English, even though they could not speak English, versus engaging with me as a Latina,” she says.
“I think that the perception of Latinos in the United States is of a light brown person with long, wavy or straight hair. The perfect amount of curves and the perfect combination of Indigenous and white genes. And very rarely will people also consider that maybe they also have a sprinkle of Blackness in them as well,” she says. “Over 90% of the slave trade went to the Caribbean and Latin America.”
Ortiz-Cedeño remembers when a Cuban family moved in next door to her in Texas. The teen daughter had blue-eyes, blonde hair and only spoke Spanish, which caused neighboring Latinos to take pause because she didn’t fit the Latino “look” they were used to.
“People didn’t have an option to try and negate her [Latino] identity because they had to acknowledge her for everything that she was,” Ortiz-Cedeño says.
Later on, the girl’s cousins, a Black, Spanish-speaking Cuban family, came into town and again locals were forced to reckon with the fact that not all Latinos fit a certain criteria.
“I think it forced everybody to have to confront a reality that they knew in the back of their mind but didn’t want to acknowledge at the forefront,” Ortiz-Cedeño says.
Having gone through these experiences as an Afro-Latina, Ortiz-Cedeño says it’s easy for her to understand Kamala Harris’ mixed Indian and Jamaican heritage, “It comes really naturally to accept that she is both Indian and Black. Two things can exist at the same time,” she says. “I had a long term partner for about seven years who was South Indian, from the same state as Kamala Harris, so if we had had a kid, they would look like [Harris],” Ortiz-Cedeño jokingly shares.
She says she can relate to having to walk the road of people only wanting to see Harris as a Black American. The talking point about [Harris] not being Indian or not being Black, just deciding to be Black, is really disingenuous and cheap,” she says.
Ortiz-Cedeño believes that the Harris campaign has not capitalized on the vice president’s mixed identity, which could be vital in bringing together different communities to understand each other on a new level and allow for improvements on America’s racial dynamics.
As she rushes into a Berkeley Urban Planning Commission meeting straight out of Ashby BART station, Ortiz-Cedeño explains her love for talking about all things infrastructure, homelessness, and healthcare access. The topics can be dry for many, she admits, but in the end, she gets to address long-standing systemic issues that often hinder opportunities for growth for people of color.
Having lived through the effects of Hurricane Katrina as a child, with the flooding and mass migration of Louisiana residents into Texas, Ortiz-Cedeño was radicalized into issues of displacement, emergency mitigation, and housing at nine years old.
“I remember my principal had to carry her students on her shoulders and swim us home because so many parents were trying to drive in and get their kids from school [due to] the flooding that was pushing their cars away,” she recalls.
Her family relocated to Houston soon after Katrina, only to be met with a deadly Hurricane Rita. They wound up in a mega-shelter, where Ortiz-Cedeño says she heard survivors stories of the unstable conditions in New Orleans and beyond, which got her wondering about urban planning, a term she wasn’t familiar with at the time.
“I think that when you put people in the context of the things that were happening in this country around [these hurricanes], a lot of us started to really think seriously about who gets to make decisions about the urban environment,” she adds.
Watching the heavy displacement of disaster survivors, hearing stories of her Navy veteran father’s chronic homelessness, and her own mother’s work and activism with homeless communities in the non–profit sector put her on the path to progressive politics and solutions, she says. After attending college on the East Coast- where she says she was finally recognized as a Puerto Rican- and working in housing, economic development, and public policy, she returned to California to earn a Master’s in City Regional Planning from UC Berkeley.
Her vast interest in the urban success of underserved communities even took her abroad to Israel and Palestine when she was an undergraduate college student. “I’ve seen the border with Gaza, I’ve had homestays with farmers in the West Bank,” she says. “For me personally, Palestine is an issue that is really close to the heart.”
“I have a very intimate understanding of the conflict and I’m very disturbed by the way in which the [Democratic] party has not been willing to engage in what I would perceive to be a thoughtful enough conversation about the conflict,” Ortiz-Cedeño says. “The issue of Palestine is going to be one of those that is a make or break issue for her. It has not been one that has been taken seriously enough by the party.”
Ortiz-Cedeño is not under the illusion that one candidate will address every policy issue she wants to see tackled by the president. But she believes it’s better than what former President Donald Trump has to offer.
“Trump has made it very clear what his intentions are with Palestine, and what his relationship is with [Benjamin] Netanyahu,” Ortiz-Cedeño says. “I understand the political strategy that many people are trying to engage in by withholding their vote, but I would also encourage them to re-engage in the political process.”
Casting her vote for Harris is a decision grounded in calculation rather than outright support. “I think I can vote in this election in order to have harm reduction… because I have deep care and concern for other communities that are going to be impacted by a Trump presidency,” Ortiz-Cedeño says.
She also hopes that American politicians will consider the nuance and perspective that Afro-Latinos bring to the table when it comes to politics, policy, and race in America, “When we don’t think expansively about who is Latino in the United States, the breadth of Latino experiences in the United States, we miss an opportunity to capture how diverse Latinos interests are politically.”
This story was reported in collaboration with PBS VOCES: Latino Vote 2024.
California Black Media
Ahead of Nov. Election, Event to Check Pulse of California’s Political Landscape
The Public Policy Institute of California is hosting a “2024 Speaker Series on California’s Future,” a preview event outlining the political landscape of the state and the nation ahead of the upcoming November elections. The event, which will be held Sept. 26 from 12 noon to 1 p.m., will include a panel of prominent political journalists who will assess the mood of the electorate and discuss themes and issues that are likely to shape the election outcome in November.
By Bo Tefu, California Black Media
The Public Policy Institute of California is hosting a “2024 Speaker Series on California’s Future,” a preview event outlining the political landscape of the state and the nation ahead of the upcoming November elections.
The event, which will be held Sept. 26 from 12 noon to 1 p.m., will include a panel of prominent political journalists who will assess the mood of the electorate and discuss themes and issues that are likely to shape the election outcome in November.
The welcome and opening remarks of the event will be led by Tani Cantil-Sakauye, the president and chief executive officer of the PPIC. The discussion will be moderated by FOX 11 news anchor Elex Michaelson, journalists joining the conversation include senior political writer Joe Garofoli of the San Francisco Chronicle, national politics reporter Astead Herndon of the The New York Times, political correspondent for KQED Marisa Lagos, and senior political reporter POLITICO Melanie Mason.
A statewide survey by the PPIC revealed key findings that highlighted people’s concerns regarding candidates of choice for the 2024 presidential election, the 10 state propositions on the ballot, and the financial direction of the state in the next 12 months.
Since Vice President Kamala Harris replaced President Joe Biden as the Democratic Party standard bearer, 6 in 10 California likely voters support the Democratic presidential ticket compared to the Republican party and other candidates.
“Californians’ support for the Democratic presidential candidate — and partisans’ overwhelming preference for their party’s candidates — were the consistent trends before Harris replaced Biden,” the survey report stated.
Among the 10 ballot measures, approximately 71% of voters are expected to vote yes on Proposition 36, allowing felony charges and increased sentences for some drug and theft crimes.
According to the survey, the majority of voters, “think it is a good thing that a majority of voters can make laws and change public policies by passing initiatives.” Voters agree that initiatives on the ballot, “bring up important public policy issues that the Governor and Legislature have not adequately addressed.”
The survey also revealed that nearly half of voters think the state and country are headed in the wrong direction and expect financial struggles in the next 12 months.
The event will be held at the Sheraton Grand Hotel in Sacramento.
The PPIC Speaker Series on California’s Future invites thought leaders and changemakers to address challenges in the state. Residents can visit the PPIC website for more information and register for the event available online and in person.
-
Alameda County5 days ago
Alameda County District Attorney Pamela Price Announces $7.5 Million Settlement Agreement with Walmart
-
Activism2 weeks ago
COMMENTARY: DA Price Has Done Nothing Wrong; Oppose Her Recall
-
Activism2 weeks ago
OP-ED: Hydrogen’s Promise a Path to Cleaner Air and Jobs for Oakland
-
Activism2 weeks ago
Barbara Lee, Other Leaders, Urge Voters to Say ‘No’ to Recalls of D.A. Pamela Price, Mayor Sheng Thao
-
Activism3 weeks ago
Oakland Post: Week of October 9 – 15, 2024
-
Community2 weeks ago
Terry T. Backs Oakland Comedy Residency by Oakland’s Luenell at Jimmy Kimmel’s Comedy Club in Las Vegas
-
Business2 weeks ago
Study Confirms California’s $20/Hour Fast Food Wage Raises Pay Without Job Losses
-
Activism2 weeks ago
Surge of Support for Vote ‘No’ on Recall of Mayor Sheng Thao