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Western Center Submits Comments Opposing Public Charge Rule Change

Western Center has submitted comments to the Department of Homeland Security in opposition to the Trump administration’s proposed Public Charge rule changes, joining over 150,000 others. An excerpt from Western Center’s comments are below, and the full comments are available here.

As California’s oldest and largest legal services support center, we have over
50 years’ experience fighting to reduce poverty in our state through the courts, the
legislature, and by working with state and local agencies to ensure our laws are fair and
justly implemented. We can speak directly to which federal and state policies serve to
reduce poverty in our communities thus benefitting our state and country as a whole
and which policies worsen poverty, penalize families struggling to make ends meet, and
hurt us all.

The recent notice of rulemaking proposes sweeping and very harmful changes to the
current public charge test – the test used to determine which immigrants are
inadmissible when they seek to enter the country or adjust their status to that of
permanent residents. The proposed regulations would punish immigrants, mostly those
who are people of color, for any use of a broad swath of public benefits, including
health, nutrition, and housing assistance, and further punish low-to-moderate income
families solely for their lack of wealth. This would be a radical departure from current
agency guidance that limits public charge determinations to those who are primarily
dependent on cash benefits and long term care medical services, and even then, only
after examining the totality of the circumstances.

Simply stated, laws and regulations that increase barriers to safe and affordable
housing, food, and health care are not only harmful in the short run, they have been
proven to have lasting detrimental effects throughout the lifetime of an individual and
even on the next generation. In other words, harsh and punitive short term spending
cuts generally backfire by decreasing the ability for individuals to support themselves
and their families. People cannot go to or do their best at work or school when they are
hungry or sick.

An open letter to Gavin Newsom: Address California’s poverty



By Western Center on Law & Poverty

California has long stood out as a state that innovates and leads. As you begin your term, we at the Western Center on Law and Poverty are ready to work with you to ensure that California lives up to its ideals — including addressing poverty and its subsequent harms.

We are encouraged by your focus on three issues Western Center has worked on for decades and considers critical to advancing basic human rights: ending poverty, solving the housing crisis, and health care for all.

Each of these issues presents an enduring challenge that can be addressed by your administration. We do not simply wish to raise the alarm about the state’s problems — we offer help and solutions.

Western Center advocates on behalf of individuals with low incomes in all branches of government—from the courts to the Legislature. Our ideas come directly from problems low-income Californians experience every day; we propose practical solutions that can be taken to scale in our large and diverse state.

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Catholic Hospital Mega-Merger Includes Reproductive Health-Care Safeguards in California


California regulators laid out a series of requirements to protect reproductive health care in the state before approving the creation of the largest Catholic health system in the United States on the day before Thanksgiving.

The move puts Catholic Health Initiatives (CHI) and Dignity Health on track to merge by the end of the year into the nation’s largest nonprofit health system, CommonSpirit Health, with 140 hospitals and more than 700 care sites across 21 states, including 31 hospitals in California alone.

Read more here.

Trump’s Latest Assault on Immigrants Shreds a Half-Century of Reforms

For much of the past year, anti-poverty and immigrant-rights advocates have worried that the Trump administration would reshape immigration policy on the sly. In particular, they were concerned that hard-liners in the administration would use an obscure regulatory change about how to interpret the meaning of “public charge” as a way both of slashing the total number of immigrants allowed into the United States and of reimagining which sorts of immigrants gain access.

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California SB 320 Ensuring College Student Access to Medication Abortion Clears Assembly Committee

Following compelling testimony by college students speaking about the importance of improving access to reproductive care on college campuses, the Assembly Health Committee on Tuesday passed important connie m leyva california state senatorlegislation authored by Senator Connie M. Leyva (D-Chino) that will ensure access to medication abortion services on California public university campuses for students who may become pregnant and seek to terminate their pregnancy during the first ten weeks.

Specifically, SB 320 requires public universities with on-campus student health centers to provide medication abortion on campus by January 1, 2022. Many student health centers at public universities in California already offer reproductive health services, including contraception, pregnancy options counseling and other health related services. Denying comprehensive and accessible reproductive care interferes with the well-being and academic success of students and disproportionately impacts students of color and low-income students.

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California Hospitals Must Cough Up Millions To Meet Charity Care Rules

California Attorney General Xavier Becerra has ordered three California hospitals to pay out millions of dollars to local nonprofits, declining their requests to be freed from charity obligations required under state law.

The hospitals, based in the Central Valley and Los Angeles, argued that there isn’t as much need to support charity care because millions more people have health insurance under the Affordable Care Act, and therefore don’t need as much financial help to pay medical bills.

Becerra’s refusal signals his agreement with health consumer advocates, who argue that patients still are struggling to pay their bills, even when they have insurance. While it applies to just a few hospitals, the decision sends a message to hospitals around the state, some of which want similar relief.

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Countering Trump administration, a California legislator wants to ban work requirements for Medicaid

As states led by Republicans prepare to impose tough new conditions for Medicaid recipients with the Trump administration’s blessing, a California legislator wants to ensure no such requirements would be enacted here.

State Sen. Ed Hernandez (D-Azusa) has introduced a bill that would bar the state from asking the federal government’s permission to impose work or volunteer requirements in order for low-income residents to be eligible for Medicaid, known in California as Medi-Cal.

Last month, the Trump administration issued guidance that, for the first time in the program’s history, it would consider allowing states to enact work or community service requirements to qualify for Medicaid.

Whistleblower: Medicaid managed-care firm improperly denied care to thousands

In early October, an executive at one of the nation’s largest physician-practice management firms handed her bosses the equivalent of a live grenade — a 20-page report that blew up the company and shook the world of managed care for poor patients across California.

For years, she wrote, SynerMed, a behind-the-scenes administrator of medical groups and managed-care contracts, had improperly denied care to thousands of patients — most of them on Medicaid — and falsified documents to hide it.

The violations were “widespread, systemic in nature,” according to the confidential Oct. 5 report by the company’s senior director of compliance, Christine Babu. And they posed a “serious threat to members’ health and safety,” according to the report, which was obtained by Kaiser Health News.

Days later, someone sent the report — labeled as a “draft” — anonymously to California health officials. Within weeks, state regulators had launched an investigation, major health insurers swept in for surprise audits, the company’s chief executive announced the firm would close and doctors’ practices up and down the state braced for a tumultuous transition to new management.

Jennifer Kent, California’s health services and Medicaid director, said her agency received the whistleblower’s report Oct. 8 and, working with health plans, confirmed “widespread deficiencies” at SynerMed, which manages the care of at least 650,000 Medicaid recipients in the state.

“I think it’s pretty egregious actions on the part of that company,” Kent said in an interview this week.

In a Nov. 17 order issued to insurers, state Medicaid officials said “members are currently in imminent danger of not receiving medically necessary health care services” due to SynerMed’s conduct. The state ordered insurers to determine how many enrollees experienced delayed or unfulfilled services.

Consumer advocates expressed alarm at the whistleblower’s findings and questioned why these problems went undetected for so long. Some said it underscores a lack of accountability among companies involved in Medicaid managed care — which receive billions in taxpayer dollars and have expanded significantly under the Affordable Care Act.

Linda Nguy, a policy advocate at the Western Center on Law and Poverty in Sacramento, called the situation “outrageous.”

“It raises questions about oversight by the state and the health plans,” she said.

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In Trump Era, the Long Fight Against Hunger is Even Tougher

As the Trump administration sets its sights on cutting federal nutrition programs, millions of Americans could stop receiving aid and millions of undocumented immigrants are afraid to sign up for the help they desperately need. Leaders in the anti-hunger movement in California gathered in San Francisco on November 9 for a discussion, co-hosted by the Food & Environment Reporting Network and the Center for Urban Education about Sustainable Agriculture, of what it takes to fight hunger in the age of Trump.

More than half of adult Americans will receive food assistance through the federal Supplemental Nutrition Assistance Program (SNAP) at some point in their lifetime. In California, more than 10 percent of the state was on SNAP as of 2015. Each year, the program costs taxpayers $53 billion, but every $1 of SNAP benefits generates $1.79 in economic activity, according to the USDA.

By purchasing food, people on federal food assistance create jobs — for grocery store employees, meatpackers, farmworkers, and truckers, said Jessica Bartholow, a policy advocate at the Western Center on Law & Poverty, and one of the evening’s panelists. “Every billion (dollars) we receive in California in SNAP benefits, creates 14,000 jobs,” she said.

But the White House has proposed cutting support for SNAP by 25 percent, while tightening eligibility requirements, especially for so-called able-bodied adults. The administration also hopes to lower funding to the federal food assistance program known as WIC, which serves 7.8 million women, infants and children each year.

“When we talk about more people living below the poverty line as a result of some of the proposals coming out of D.C., we’re talking about our failure to recognize their humanity,” said Bartholow. “When we cut SNAP, it doesn’t mean [people will] find money to go find food in some other way. It means they go hungry.”

But even if they’re eligible for support, many people are hesitant to sign up for it due to heightened fear about Trump’s immigration policies. “Immediately following the election, we had people calling us not to ask for help signing up with CalFresh (California’s food assistance program) or SNAP,” but for help cancelling their benefits, said Elizabeth Gomez, associate director of client services at the Alameda County Community Food Bank, which serves over 300,000 people annually, or one of five residents in Alameda County. The bank fielded at least 40 such calls in the first few weeks after Trump was elected, something Gomez said had never happened before.

Some people are afraid that, by signing up, they will be added to a national database and tracked down by immigration services if they or someone in their family is undocumented. Many also fear that by receiving food assistance they would count as a “public charge,” and thus be disqualified for ever earning citizenship, which Gomez said is one of the many mistruths that shadows food assistance. She made clear that applicants do not have to offer up proof of citizenship or even their names to receive emergency food assistance, and doing so doesn’t bar them from becoming a citizen later on.

At least not yet, noted Bartholow, but the Trump administration is considering adding food benefits and healthcare to the list of government services that designate someone a “public charge.”


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