Report on Second Annual South LA Health and Human Rights Conference 12/16/2010

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Health Care as a Human Right — in South LA and Nationwide

by Diane Lefer posted on Thursday, 16 December 2010No Comment

[go to the version at LAProgressive.com if you w


On Monday, Judge Henry Hudson of the federal district court in Richmond ruled unconstitutional the provision of Affordable Health Care Act that would require all Americans to carry health insurance. A few days earlier, almost as though he expected such a setback, Jim Mangia, President and CEO of St John’s Well Child & Family Center, said “There couldn’t be a more challenging time to do this work,” as he welcomed almost 1,000 community members and service providers to the LA Convention Center on Friday, December 10–International Human Rights Day–for the second South LA Health and Human Rights Conference.

As reported here last year,  the first conference in June 2009 reframed access to health care, including behavioral health services, as a human right and recognized that access to housing, education, employment, fresh food, environmental and public safety are integral to good health. The Declaration that emerged from that event was released publicly one year ago and this year’s conference was intended to move signatories “from declaration to action.”

Before I go on to the many challenges, I should follow the lead of Second District County Supervisor Mark Ridley-Thomas who reminded us, “Given where we were a year ago, there has been significant progress. We should not allow people to drown out our successes.” Martin Luther King, Jr. Hospital reopens in 2012. This June, South LA will see the opening of a public health clinic, and of a new emergency room suite at Harbor-UCLA — an ER where, incidentally, a woman recently waited 24 hours to be seen while other patients fought for a place to sit as there weren’t enough chairs to go around. These new facilities are at least a step in the right direction for a neighborhood that has been designated by the federal government as MUA/MUP, i.e., a Medically Underserved Area/Medically Underserved Population.

Now, the challenges:

Dave Regan, executive vice president of the Service Employees International Union (SEIU) who also serves on the Health Care Division Steering Committee, said he hopes to train and deploy 5,000 health care workers to do outreach and defend reform against attacks from the incoming Republican Congress.

But defending Affordable Care is not enough. We can’t leave implementation up to others but have to start planning now, said Robert Ross, president and chief executive officer of the California Endowment, a foundation focused on the health needs of underserved Californians and one of the sponsors of the conference. “Get folks enrolled,” he said, aiming for 100% enrollment in California. “We need to educate the public.” In doing public opinion polls, the foundation learned the extent to which people had been deceived or confused.



Wendell Potter

Several days later, on Tuesday, the California Endowment as part of its Center Scene public programming, exposed how deception happens by hosting Wendell Potter, former insurance company executive and PR man, whose new book, Deadly Spin, gives an insider’s view of how insurance companies influence opinion and policy.

Potter sees himself now “making amends,” and has publicly apologized to Michael Moore for trying to discredit him and his health care documentary Sicko. One example of spin: Insurers now get generous subsidies from the federal government for participating in Medicare Advantage plans. Under the Affordable Health Care legislation, these subsidies are reduced, but, Potter explained, the insurance companies mounted a campaign telling seniors that it was their own personal benefits that would be cut.

Potter has an interesting take on Judge Hudson’s decision. He thinks the mandate for individual coverage, in the absence of a competing public option, amounts to a “profit protection and enhancement plan” for insurance companies. He wondered if Republicans will realize they are pushing an agenda that cuts into the profits of the companies that spent millions putting them in office.

During two decades in the health care field, Potter saw nonprofit hospitals overtaken by the proliferation of for-profit businesses. Insurance companies divested themselves of other divisions and focused on health insurance as the most profitable area. Patient care got a smaller share of resources, not only because of astronomical salaries to top executives and the costs of advertising and public relations, but the “relentless pressure from Wall Street.” When you’re for profit “you have to meet Wall Street’s expectations and profit expectations of your investors and you have to report every three months.” It means health insurance corporations focus on the short-term stock prices and profits instead of health care.

This distorted emphasis leads to the transfer of more costs to consumers. At Friday’s conference, Dave Regan reported that some of his union members now face a contract battle at Centinela Hospital which is owned by Prime Health Care–a family business and the second largest hospital system in California. The company wants to increase the employee share of premiums for family coverage by an additional $600/month. Workers can’t afford so substantial an increase and are now looking to a situation where they, as health care workers, won’t be able to afford health care coverage for their own kids.



Orthopaedic Hospital site.

Howard Kahn, instrumental behind the Children’s Health Initiative of Greater Los Angeles and CEO of LA Care Health Plan which serves 800,000 low-income county residents, points out that health care itself only accounts for only about 20% of health outcomes. Genetics are important. But so are environmental factors and individual behavior which underlines again the interrelatedness of all human needs. Housing, education, employment, reliable buses (especially at night), child care, stoplights at dangerous intersections, safe parks where kids can exercise and play–without these, there’s a negative impact on health.

To take Mark Ridley-Thomas’s advice and focus on some success stories, think about conference panelist Robert Smith, an ex-felon who beat his substance-abuse problem and the odds after going through a program at the Midnight Mission. Smith landed a job with Regal Theaters because community organizations including SAJE (Strategic Action for a Just Economy) pressured the businesses at LA Live to hire local workers. Through his own efforts and work ethic, Smith was soon promoted to supervisor.



Violeta Menjivar

We learned that criminal records that so often stand in the way being hired can in some cases be expunged and advice and assistance is available from the Pepperdine Legal Aid Clinic at the Union Rescue Mission. Juvenile records can be sealed, but you must go through a process; it doesn’t happen automatically.

The Community Rights Campaign recently won a concession from LAUSD — a moratorium on truancy and tardiness tickets that led to expensive fines and often juvenile detention and even jail. (Though the school district’s new plan for Attendance Improvement Centers raises concern as parents must pick their children up at the end of the day and if working parents can’t get there in time, the kids are removed by the police.)

An example of hope and possibility came from special guest speaker, Violeta Menjívar, vice minister of public health and welfare of El Salvador, a former member of the FMLN (Frente Farabundo Martí para la Liberación Nacional ) rebel movement. During the civil war, she provided medical care both to the FMLN as well as to government soldiers because, as she said with a sly smile, “the FMLN observed the Geneva Conventions.” Describing her country as “small in territory but not in spirit,” she reported that in the year and half since Mauricio Funes — also formerly of the FMLN — took office after his election as president, the new administration has rebuilt two hospitals which had been left undone due to corruption and the siphoning off of public funds. She is working to reverse the privatization of health care that occurred when public health budgets were cut, leaving care only for those who could pay for it. Her department is now implementing plans for preventive care, expansion of primary care, and expansion of basic free medical services to the rural areas where up until today none were provided.



Sandra Matamoros and Genesis

The progressive administration is instituting price regulation on prescriptions medicines. El Salvador–one of the poorest countries in the hemisphere — has also had the highest prices for prescription drugs which I would say can be traced back to the Central American Free Trade Agreement — CAFTA — with protectionist provisions that benefit Big Pharma by delaying the introduction of generic drugs. (Similar, barely noticed provisions are written into the proposed Free Trade Agreement with Colombia that has fortunately been stalled in Congress for other reasons for several years.)

More international perspective came via Deborah Borden who ended up homeless on Skid Row seven years ago after losing her job and health insurance. Now she’s an organizer with LA CAN (Los Angeles Community Action Network). Deborah recently gave testimony about human rights abuses in Los Angeles to the United Nation’s Periodic Review in Geneva, Switzerland and was part of the team that coordinated the visit of Raquel Rolnick, Brazilian architect, urban planner, and professor, sent by the UN to investigate and report on adequate housing in the United States as a component of the right to an adequate standard of living and on the right to non-discrimination.

Rolnick’s report, presented in March, found “significant cuts in federal funding for low-income housing, the persistent impact of discrimination in housing, substandard conditions such as overcrowding and health risks, as well as the consequences of the foreclosure crisis.” Specifically, she noted that over the past decade there has been a net loss of approximately 170,000 public housing units while “Each year, the federal government spends more than three times as much on tax breaks for homeowners–with a large share of the resulting tax benefits going to upper-income households–as it spends on low-income housing assistance.”

And “housing is not simply about bricks and mortar,” she wrote, “nor is it simply a financial asset. Housing includes a sense of community, trust and bonds built between neighbors over time; the schools which educate the children; and the businesses which support the local economy and provide needed goods and services. Government policy has sometimes resulted in tearing apart this important sense of community, removing a source of stability for subsidized housing residents, and engendering a sense of mistrust of Government regard for their interests.”

Indeed, at the end of the conference, about 200 participants traveled to Flower and 23rd to demand that community interests be taken seriously by the City Council. A young woman named Genesis sat in her wheelchair in front of the parking lot where the Los Angeles Orthopaedic Hospital used to stand and where she saw her doctors until the facility was demolished. Now, explained her mother, Sandra Matamoros, they must take three buses and travel three hours for the specialized care her daughter needs. The site is still zoned exclusively for medical and educational use, however real estate developer Geoff Palmer is asking the City Council to rezone it so he can move forward with the Lorenzo project and build luxury housing on the site. (Palmer is known for suing the city so he could get out of providing any affordable housing in his other faux-Italian developments: the Medici, the Orsini, and Pieri I and II.)

“No to luxury housing!” chanted the crowd. In South LA, the pressures of gentrification and loss of income now have two and three families sharing apartments that would be a tight squeeze for one. Even so-called “affordable housing,” is beyond the reach of most when you consider that Los Angeles considers a living wage to be $12/hour. Though it beats the minimum wage, it still means a monthly income for a fulltime worker that, after taxes, won’t go much further than market rent on a one-bedroom apartment leaving open the question of how to cover transportation to and from the job, food, clothing, utilities, school supplies, medical care for a family and all the other necessities for a normal, healthy life.



Diane Lefer

The challenges for the people of South LA are immense so it’s essential to be, with a nod to Violeta Mendívar, big in spirit. At the contested site, many of the demonstrators were smiling. They had each other, after all, and the support of community organizations like SAJE, like LA CAN, like Esperanza Community Housing.

As Mark Ridley-Thomas told us, “if you want Movement to go forward, you have to celebrate it and not let anybody rob you of your joy.”

Diane Lefer

 

 

Dignity in Schools Campaign Week of Action - My article in LA Progressive 10/15/2010

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Los Angeles: Epicenter of High School Dropouts — Or Are They Pushed?

 October 15, 2010
Over a million US students who start high school this year won’t finish. In Los Angeles, only about half of entering students graduate, earning the city the designation by Education Week  as a “dropout epicenter.” But the National Dignity in Schools Campaign reframes the issue: most kids who don’t finish haven’t “dropped out.” They’ve been “pushed out” by a culture of zero-tolerance, punishment, and removal that disproportionately affects children of color.

In Los Angeles, African American students are two to three times more likely to be suspended than students of other ethnicities. School police in low-income neighborhoods hand out truancy and tardiness tickets–something most middle class parents have never heard of — that carry exorbitant fines mounting into the hundreds of dollars. If unpaid, these turn into arrest warrants and divert young people out of school and into the juvenile and criminal justice systems.

From October 11 through the 17th, as part of the Dignity in Schools National Week of Action, events in 16 cities throughout the US are calling attention to the crisis and promoting alternatives to suspensions, expulsions, and the criminalization of youth. Here in Los Angeles on Tuesday, October 12, a coalition of community organizations held a day-long information session in front of the Los Angeles Unified School District Board on Beaudry Avenue. Young people, mostly from the Labor/Community Strategy Center , decorated the chain link fence across the street with art and posters while parents, students, former students, and their advocates offered personal testimony and called for full implementation of School-wide Positive Behavior Support (SWPBS) — the new approach to discipline that the LAUSD  Board itself mandated back in March 2007.

Districts around the country that have fully implemented this model have seen up to a 60% reduction in disciplinary problems and suspensions. The LAUSD schools that have put it into practice have seen transformation in the school environment. But District 7, in South Los Angeles, arguably the district where youth are most in need of positive behavior support, has lagged far behind according to “Redefining Dignity in Our Schools,” the recently released report based on research by the grassroots organization Community Asset Development Re-defining Education  (CADRE), in collaboration with Mental Health Advocacy Services, Inc., and Public Counsel Law Center . Markham Middle School, for example, entirely failed to implement the policy and also had the highest rate of suspensions. South LA schools continue to have more police, detectives, probation officers, and canine patrols than counselors. (To download the full report or executive summary on-line, please go here )

“Campuses are transformed into hostile territory,” said Claudia Gomez of the Youth Justice Coalition . “The school day is an extension of the violence going on in our communities.” In a six-month period, Gomez attended three different high schools, bringing her ongoing problems with her and getting herself kicked out of each due to fist fights and once for marijuana possession.

It’s a pattern only too familiar to Judy Arriaza, social worker with Public Counsel: “suspension after suspension, transfer after transfer, grades suffer along with attitudes toward school and nowhere do we see any positive intervention” while a kid in trouble for “fighting or doing something wrong that could have been handled by school administration is instead turned over to the police.”

When kids are pulled out of class again and again, they fall further and further behind making them even less able to function properly in class. And where do they go when suspended? With parents working and the school doors closed, kids end up getting into trouble. No doubt LAUSD has faced a daunting challenge when students bring violent or disruptive behavior to class but the district has relied for years on a form of triage — labeling some kids as hopeless cases and throwing them away. “They kicked me out,” Henry Sandoval recalled. “They told me don’t come back.”

SWPBS relies, instead, on the consistent teaching, modeling, reinforcement of appropriate behavior and discourages the reliance on punitive discipline. Intervention is preferred to exclusion. And parents are brought in and welcomed as collaborators.

Gomez landed at last at the Youth Justice Coalition’s charter school, Free LA High School, where gang intervention workers and counselors set her on the road to success. Sandoval, calling himself “a victim of the school to jail track,” also eventually found his way to Free LA High where, he says, “They never gave up on me, even when I gave up on myself. We need motivation, not punishment.”

Arriaza has seen what previously stigmatized youth can do. “We see them pull their grades up and graduate. But we can’t keep putting out fires. There aren’t enough advocates. Change has to come from above.”

We should all care about this, said Laura Faer, attorney with Public Counsel. The status quo “costs all of us a fortune in futures lost” while the alternative — SWPBS — “makes teachers happier and makes schools safer.”

A key component of SWPBS is parent involvement and Roslyn Broadnax is a deeply involved parent who, as a student back in 1979, found herself “pushed out” of Fremont High. Earning Ds in class, never bringing a report card home, she was nonetheless passed from grade to grade while unable to keep up with the work. “I became a young mother and when I had my child, I began looking back at the school system. I didn’t want my child going through what I went through.” Broadnax began volunteering at Fremont. Though she says she was made to feel unwelcome, she was determined to see that her children were treated fairly. “I don’t call my kids graduates. I call them survivors of the system.” She joined CADRE in the fight to win respect, dignity, and a quality education “not just for my child, but to stand up and be there when other parents can’t.”

After public events on Tuesday, the campaigners brought their testimony to the LAUSD Board and requested a meeting to discuss full implementation of SWPBS. Board member Yolie Flores — but not the full board — agreed to meet.

(LAUSD, take note: The Office of Civil Rights for the US Department of Education is now looking at school districts which have failed to reduce disproportionate exclusionary discipline rates. But let’s not reform our system because we’re afraid of legal consequences, i.e., punishment. Why not model for our kids this behavior: do the right thing.)

“Kid face closed doors wherever they look,” said Gomez. “School should be the one place where kids feel welcome.”

And where they are fully seen and respected. Anger mixed with disbelief still breaks through her voice when Broadnax recalls the counselor who told her she could feel proud of her son for being one of only three African American boys who was not classified as special ed. She is indeed proud of him. The young man is now attending law school.