UHCAN Ohio Endorses U2K

HOW DO WE ASSURE EVERYONE in this country comprehensive, quality, affordable, and publicly accountable health care? Step one: move universal health care onto the radar screens and into the political agendas of our legislators - because it is not there now. This comes prior to program or detailed plan; anterior to strenuous and critical debate on the best way to attain the goal.

Such strategic thinking was part of what prompted three national organizations: UHCAN!, Gray Panthers, and the National Council of Churches to develop "U2K," the Universal Health Care 2000 Campaign.

The Campaign set three goals:

• To increase political visibility of fundamental health care reform nationwide;
• To strengthened local health care coalitions and create new linkages between organizations concerned about America's health care crisis;
• To help create an energized bloc of universal health care supporters in the next Congress.

Joining the U2K Campaign commits an organization both to political action targeting congressional candidates and to ongoing, post-election efforts to ensure health care for all. The statement of endorsement reads, in part, "We call on all candidates running for office in 2000 to commit to making universal health care a goal to be achieved early in the next century." That statement, if endorsed and acted upon by thousands of national, state, and local organizations throughout the U.S. and if coupled with a commitment to use the 2000 elections as the beginning of a sustained effort to ensure universal health care, can rev the engine of political action and establish the ground of a multi-year campaign to bring about, at last, health care as the law of the land.

Suggested campaign activities include inviting organizational engagement at national, state, and local levels; educating the public about the U.S. health care crisis; and collaborating locally to influence Congressional candidates and voters. The U2K Campaign is providing a Campaign Handbook, an Education Handbook, and staff to increase the effectiveness of the Campaign.

UHCAN Ohio has endorsed the Campaign and has moved into U2K action. In November we sponsored a public forum on the Campaign and have already secured endorsements from several local organizations, including Cleveland Jobs with Justice. This is only the beginning. We will keep you posted and alerted to avenues of involvement through Update.

From the Director, Larry Bresler

AS THE NEW EXECUTIVE DIRECTOR of UHCAN Ohio, I am excited about the opportunity to work with others across the state who recognize the importance of health care justice.

We face, however, a daunting reality:

• More than a million people each year enter the swelling ranks of the uninsured.
• Many of those with insurance find themselves unable to access needed medical care or afford prescribed drugs.
• Significant numbers of people eligible for Medicaid remain unaware of their eligibility, are dropped from the rolls because of worker error, or drop out of the program because they incorrectly link cash assistance with Medicaid. Many more working parents who are eligible for Healthy Start do not have their children enrolled.
• Instead of meeting the needs of the community, hospitals and other providers are cutting back on unreimbursed services. These community benefits include free care, preventative services, education, and transportation. Further, they do not collaborate with the communities they are to serve to address unmet health care needs.

We at UHCAN Ohio want to join forces with individuals and organizations to successfully address these and other critical health issues - both on a community and statewide basis. We invite you to call upon us in our Cleveland and Columbus offices for advice, assistance, or opportunities to work together. We also encourage you to further the efforts of UHCAN Ohio by becoming a member, sending a donation, and continuing your work for health care justice.

Crisis invites opportunity for change. As more and more people across state and country recognize the severity of the health care issues they face individually and collectively, we can more effectively sound the call for universal coverage, for quality of care, and for public accountability of our health care institutions.

TOGETHER WE CAN MAKE A DIFFERENCE!

Work in Progress

A report on organizational activities will appear in each issue of Update.

CLEVELAND

Safety net excludes many

Over the last fifteen months, UHCAN Ohio has held more than forty extensive interviews with neighborhood leaders, social service and health care providers, and other knowledgeable community people throughout Cleveland and its inner ring suburbs. The interviews identified unmet health care needs in the community and the barriers people face getting those needs met. Four major needs were raised: 1) preventive care;
2) management of chronic conditions such as diabetes and asthma; 3) affordable prescription drugs, and 4) appropriate health education. Lack of adequate health care is seen to particularly affect adults without children, working poor families, homeless people, the Spanish-speaking community, and recent immigrants including undocumented persons.

UHCAN Ohio decided to focus on the unique situation of undocumented and other recent immigrants, and of the Spanish-speaking residents of Cleveland's Near West Side. One particular issue stands out for immigrants: the exclusion of this population from safety net programs. Undocumented people and those who immigrated after August 1996 are excluded from safety net programs such as Medicaid and the Health Care Assurance Program which provides limited free care for those whose incomes fall below poverty. They are also excluded from the sliding fee scale program of the public hospital. This means that although immigrants will be seen by the public hospital and its clinics, they will also be billed. Knowing this, and fearing bills they cannot pay, patients will avoid seeing a doctor until symptoms become so severe they wind up in the emergency room with advanced and costly illnesses. Other issues in the Spanish-speaking community include the lack of sufficient numbers of appropriately trained translators in area hospitals and clinics, and the need for neighborhood based Spanish language, culturally competent clinics.

Acting on the interest of a number of community leaders on the Near West Side, UHCAN Ohio has begun forming a coalition of community activists. The coalition will approach local hospitals, seeking commitments from them to work together with the community to address the needs of the Spanish-speaking and immigrant communities.

Living Wage includes health care

After a yearlong campaign by Cleveland Jobs with Justice, an historic Living Wage Ordinance for the City of Cleveland was introduced into City Council on November 15. A Living Wage provides a salary necessary to cover a family's basic necessities, including food, clothing, shelter, day care, transportation, and medical needs. At the current Federal minimum wage, $5.15/hour, a full-time worker would earn about $10,700 annually. That is about 65 percent of the poverty level for a family of 4! The proposed Cleveland ordinance, which affects companies who receive significant financial aid from the City or do business with the City, sets the following requirements: (1) Workers must be paid the hourly equivalent of 125 percent of poverty (now about $10); (2) Workers must be given employer-paid family health coverage, based on what is provided in the City's contracts with its own workers; (3) Employers must guarantee not to interfere with workers' rights to organize a union if they wish to have one.

UHCAN Ohio, a member of the Campaign Coordinating Committee, played a major role in assuring the inclusion of health insurance into the ordinance and in proposing conditions of coverage. As stipulated in the ordinance, the employer is to provide comprehensive health coverage, with no more than a 5 percent contribution from the employee's annual salary. The provision includes those who work 18 hours or more per week.

Together with the other members of Jobs with Justice, we intend to promote the ordinance as it makes its way through Council committees and faces opposition from various quarters. If passed into law, the Living Wage Ordinance will directly benefit hundreds of Cleveland's uninsured, working poor. It will also send a clear message that tax dollars, which come from the people, should be used for people's needs.

COLUMBUS

UHCAN Ohio organizes Language Task Force

Through interviews with people in medically underserved communities about barriers to health care, UHCAN Ohio has learned about the tremendous obstacles facing Columbus residents with limited English speaking ability. Residents from the growing Latino, Somali, Russian and Asian, especially new immigrants, sometimes receive inadequate care or go without needed care because of language and cultural barriers. When no medically trained interpreter is available, patients cannot communicate with providers. Providers who are unfamiliar with other cultures may fail to understand descriptions of symptoms or may prescribe a treatment that is not appropriate for the patient.

In response to these barriers, UHCAN Ohio organized a task force of community agency representatives and individuals committed to achieving better interpreter services and culturally competent health care. Local hospitals responded to our efforts by forming a consortium with which we are now collaborating on expanding access to medically trained interpreters and strategies for training providers. UHCAN Ohio's Language Task Force has gained recognition in the health care community for initiating efforts to address language and culture issues. As a result, representatives of other public agencies are approaching UHCAN Ohio for collaboration.

Community Group forms to collaborate with OSU

Last spring, Ohio State University Medical Center purchased the financially-strapped Park Hospital, on Columbus' Near East Side. Park, owned by the for-profit Quorum chain, had been fairly unresponsive to the community's tremendous medical needs. The Near East Side has high poverty and uninsurance rates, leading to poor health status, including the highest infant mortality rate in the city.

OSU's ownership offers new opportunities for the community; thus, UHCAN Ohio is uniting members of the Near East Side community to work on addressing unmet health needs. Having identified health priorities, the group is developing proposals to address unmet needs, such as lack of evening hours for clinic visits, and gaping disparities, such as high heart disease, stroke and infant mortality among the majority African-American population.

Ohio Legislation Highlights

UHCAN OHIO KEEPS AN EYE ON OHIO HEALTH LEGISLATION. For more information on pending bills, either check our website or call the policy director, Cathy Levine, in our Columbus office, (614) 253-4340. Full texts and summaries of bills are available on the state's website:
www. legislature.state.oh.us.

The Mental Health Parity Bill (House Bill 53) remains stuck in the "mandated benefits" subcommittee of the House Insurance Committee. This bill requires health insurers to cover mental illness and substance abuse treatment to the same extent as other conditions. The consumer/provider Coalition for Healthy Communities urges members to write members of the subcommittee (Reps. Buchy, Clancy and Healy) urging them to vote HB 53 out of committee and to contact legislators in support of parity.

Sub HB 470 and HB 471, signed by the governor, creates the Office of Workforce Development by merging the Ohio Department of Human Services (ODHS) and the Ohio Bureau of Employment Services (OBES). The move is intended to strengthen workforce development programs. UHCAN Ohio note: The merger creates the potential to enroll all eligible clients in Medicaid and other supports, but only if pushed.

SB 192, The Tobacco Settlement Bill lays out a blueprint for spending the anticipated $10.1 billion share Ohio will receive over 25 years. Because the tobacco settlement reimburses states for health expenditures caused by smoking, many states plan to use the money for tobacco use prevention and to improve health and health care. However, SB 192, based on the report by the governor's task force on the tobacco settlement, allocated only 15 percent for tobacco use prevention and cessation; and only 10 percent for several "public health priorities," with little money to cover the uninsured. In contrast, over 50 percent was directed to education facilities and education technology, with the rest going to other non-health reasons. Worse, the Senate passed only the first 12 years of the plan, cutting off the bulk of public health funding, which was concentrated in later years of the plan. The House Finance Committee has begun hearings, and negotiations are ongoing. UHCAN Ohio note: state reps. need to hear if voters want more money spent on health care.

Medicaid Managed Care Study Committee: This temporary committee is developing recommendations to improve Ohio's Medicaid managed care program. UHCAN Ohio note: we submitted recommendations, including establishment of 12-month continuous eligibility for low-income families, regardless of change in income. Many enrollees now lose Medicaid either for fluctuating income or failure to complete the 6-month redetermination process.

HB 215, Ohio PASA creates the Personal Assistance Services Program and seeks to give people with disabilities the option of remaining home with personal services, rather than having to enter a nursing or group home to get the same services. Status: pending.