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Mh policy powerpoint

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    • 1. MENTAL HEALTH CARE FORUNDOCUMENTED IMMIGRANTS:A GROWING CONCERN*Note: The power of language. The term “undocumented” will be used in place of “illegal” to describe theimmigrant population. Take action and “Drop the I-word” by visiting http://colorlines.com/droptheiword/take-action/charlotte-observer-action.html
    • 2. Issue & Current Status Disproportion between mental  Agencies use sliding scales to health needs and the number determine rates based on of mental health services income level available for undocumented  Services include crisis immigrants intervention, family and Underutilization of services individual counseling, child Undocumented immigrants guidance, and group therapy living in New York State may  The Affordable Care Act will obtain services through the not provide coverage for Department of Health and undocumented immigrants Mental Hygiene (DHMH) and  Addendum prevents public hospitals undocumented immigrants Undocumented immigrants are from for their own health care not eligible for regular through private exchanges Medicaid, but can obtain emergency Medicaid if they meet income requirements
    • 3. Unmet Needs: Prevalence of Mental Illnessamong Undocumented Immigrants 15% of the U.S. Population are undocumented immigrants. Numbers may be higher due to trauma caused by migration, exploitation in the labor force, and loss of social supports.
    • 4. Causes Undocumented immigrants are not valued members of society Limited information is available about the needs of undocumented immigrants as they are not accounted for in census surveys Cultural stigmas of mental illness and mental health treatment Lack of culturally competent providers including translators and general knowledge of immigrant experience  Long waiting lists due to insufficient number of providers to appropriate serve undocumented immigrants The constant fear of being detained, imprisoned, or deported by authorities discourages undocumented immigrants from seeking services Lack of knowledge of available mental health services Work-related migration
    • 5. Macro Effects Emigration struggles exacerbated  Loss of extended family support  Loss of familiar values and language  Psychological distress  New economic challenges  Potential exposure to trauma Excessive use of emergency services due to a lack of preventative services  Drives health care costs up  Misdiagnosis of presenting problem Increased domestic violence and child abuse
    • 6. Macro Effects Continued People with SPMI are a severely under- served sub-population  High cost of medication  Inability to obtain Rx Cyclical generational effects on children due to parent’s untreated mental illness High rates of substance abuse and suicidal ideation among undocumented youth Increased burn out rate for social workers
    • 7. Micro Effects Yanelli Hernandez-Serrano, 22-year- old who was deported in January 2012 after two suicide attempts while in a detention center Joaquin Luna, 18-year-old suffered from depression and anxiety took his own life in November 2011
    • 8. History Devolution and Immigration and Nationality Act Harsher anti-immigrant legislation in the wake of 9/11.  i.e. Arizona’s SB1070 Welfare Reform of 1996  Public Charge Policy NY Immigration Coalition advocates for medical health service, but not mental health services Emergency Medical Treatment and Active Labor Act of 1986 Immigrant Confidentiality Protection  Executive Order 41 prohibits most NYC workers from asking anyone about their immigration status
    • 9. Political ContextOpposition Support In terms of current  In terms of current political parties, political parties, Republicans have Democrats have been opposed immigration more likely to be in favor reforms at state, federal, of immigration reform at and local levels state, federal, and local Those in favor of the levels Border Protection Anti-  Those in favor of the Terrorism Illegal Comprehensive Immigration Control Act Immigration Reform Act of 2005 of 2006, which did not Those in favor of the pass Arizona SB1070 Act of 2009 and the Alabama *In general, better provision of mental health services is not a political priority
    • 10. Conflicting ViewpointsOpponents of Undocumented Immigrant Rights MightArgue… Undocumented immigrants cost taxpayers more money at federal, state and local levels Undocumented immigrants contribute low-level tax payments because they have lower skills and earn lower wages They have a high rate of consumption of governmental services They increase cost of expenditures for education, criminal justice, and emergency medical care 17% of U.S. prisoners are undocumented immigrants They are more likely than taxpayers to use social services New immigrants are unwilling to assimilate to the U.S. *It’s incredibly difficult to retrieve hard data on undocumented immigrants because they are unaccounted for in several systems
    • 11. Conflicting ViewpointsSupporters of Undocumented Immigrant Rights Might Argue… Undocumented immigrants contribute to the U.S. economy through investment and consumption of goods and services This contribution is cited at $800 billion per year in consumption of goods and services and production for employers Undocumented immigrants compose 5% of the labor force They contribute $ 7 billion per year to Social Security, and $1.5 billion per year to Medicare They contribute, but are not eligible to collect anything from Social Security or Medicare programs ¾ of undocumented immigrants pay income taxes using taxpayer IDs or false Social Security numbers Undocumented immigrants earn 20% less than documented residents or citizens that are foreign-born (pro-con.org) Many undocumented immigrants take jobs that other Americans would not take, such as migrant farmworkers, domestic work, or hospitality jobs in restaurants (include a gallup poll)
    • 12. Proposed Solution: PolicyUsing California’s Model (MHSA) In 2004, California passed a measure called the Mental Health Services Act (MHSA) MHSA’s goals were to provide increased funding and expansion of mental health services by raising income taxes by 1% for people earning over 1 million dollars each year MHSA’s definition of expansion included extending coverage to specific populations who need it and are not covered by federal programs Establish a Mental Heath Services Oversight and Accountability Commission (MHSOAC) to ensure efficient implementation of proposed policy
    • 13. Proposed Solution: PolicyNew York’s Proposed MHSA (Joaquin’s Law) The proposed policy in New York would be similar to MHSA, except that expanded coverage would also apply to undocumented immigrants and would be funded through the same mechanism by raising income taxes in New York by 1% for people making over a million dollars per year The policy would include a requirement that when the state asks for additional federal funding for the Disproportional Share Hospital (DSH) program, they (anonymously) count undocumented immigrants already receiving services through mental health providers, which would increase funding from the federal government to reimburse those providers (DSH site) Similar to MHSA in California, the policy would emphasize the importance of cultural and linguistic competence and designate funding for better translation services and better
    • 14. AgendaConcrete Goals Broader Goals Passing the NYS version of the  In order to be successful, we MHSA through the state must reframe why legislature undocumented immigrants Designing a toolkit for deserve access to mental community mental health health services service providers to conduct  We must reframe the better outreach and provide discussion to include how education around mental undocumented immigrants health, reducing stigma contribute to our overall Conducting targeted outreach prosperity by participating in to communities with a high our workforce density of undocumented  Raising awareness about the immigrants and telling them prevalence of mental health why the policy is important issues in order to reduce Supporting citizens who care stigma about this issue to register to vote, sign petitions, and contact their state representatives
    • 15. Strategy & TacticsTargeting Key Decision Partnering OrganizationsMakers  Supporters of the NYS Dream NYS Assembly: Members of the Act Mental Health and Health Committees and the Puerto Rican/  New York Immigration Hispanic Task Force Coalition (NYIC) NYS Senate: Members of the Mental  Pew Hispanic Center Health and Developmental Disabilities, Social Services, and  New York State Immigrant Health Committees and the Puerto Action Fund Rican/Latino Caucus NYS Senators: Bill Perkins, Gustavo  National Latino Evangelical Rivera, Liz Krueger, Toby Ann Coalition Stavisky, Shirley Huntley, Thomas Duane, Tony Avella, Daniel  National Immigrant Youth Squadron and Adriano Espaillat Alliance (NIYA) NYS Assembly Members: Guillermo  Undocumented Students Linares, Rory Lancman, Joseph Action and Resource Network Lentol, Jack McEneny, Carl Heastie, Sam Hoyt, Alec Brook-Krasny, Brian Kavanagh, Matthew Titone, Michael DanDekker, Grace Meng, Francisco Moya and Sam Roberts,
    • 16. Strategy & TacticsActions Attending Lobby Day in Albany with citizen supporters Circulating petitions to constituents and delivering them to their legislators Hosting phone banking events to call constituents and talk to them about these issues Hold voter registration drives Targeting constituents who’s representatives at the state level are against the proposed policy Educate undocumented immigrants about their rights when accessing services Name the legislation after a person who could’ve been helped by it’s passage, (in this case, Joaquin Luna) Engage media organizations to write about Joaquin Luna’s case, in order to publicize the legislation’s importance
    • 17. Evaluation PlanIf it passes… Further action if it doesn’t Anonymously track how pass… many undocumented  Monitoring votes in the NYS immigrants access service Senate and NYS Assembly in each year and see if that order to more effectively number increases due to our target outreach to additional educational efforts legislators and their Survey families to see if they constituents in “swing” are aware of mental health districts services and if they find  Continue to expand outreach expanded access useful efforts through social media Use MHSOAC data to track and by engaging more/ decreased rates of: different advocacy groups for  Homelessness their assistance  School suspension  Incarceration/Arrests  Hospitalization
    • 18. Cost Cost per Medicaid  How much money would enrollee in 2009 in NYS we make by taking 1% is $8,960 more for income taxes Estimated number of  The current tax rate for undocumented people who make over immigrants $1 million a year is Divide it so that we’re 8.82%, which would be only taking 20% of that raised to 9.82% total number of undocumented immigrants; those who will use mental health services This will equal the amount of cost for
    • 19. ReferencesBoozang, P., Dutton, M., Lan, A., & Bachrach, D. (2010). Implementing federal health care reform: A roadmap for New York State. Retrievedfrom: http://www.healthcarereform.ny.gov/research_and_resources/docs/roadmap_for_nys.pdfBryan, K. (2008, Apr 23). Immigrant mental health services and the church. [Video file]. Retrieved from: http://www.youtube.com/watch?v=U3ZL0HVUuuUJones, S. (2012). Working with Immigrant Clients: Perils and Possibilities for Social Workers. Families in Society, 93(1), 47-53.Henry J. Kaiser Family Foundation. (2011). State Medicaid fact sheets. Retrieved from http://www.statehealthfacts.org/mfs.jsp?rgn=34&rgn=1Tax Foundation. (2012). State individual income tax rates. Retrieved from http://www.taxfoundation.org/files/state_individualincome_rates-2000-2012-20120216.pdfNovoa, M. (2011). Beyond Politics: How undocumented youth can find emotional support. Retrieved from: http://colorlines.com/archives/2011/12/joaquin_luna_and_suicide_prevention.htmlSaavedra, M. (2012 Jan 31). Activist race to stop deportation of a suicidal youth. Retrieved from: http://undocuhealth.org/press-release-undocuhealth-org/Varsanyi, M. Lewis, P., Provine, D.M., & Decker, S. (2012).New York Immigration Coalition. (2006). The immigrant and refugee guide to affordable health care in New York State. Retrieved from:http://72.34.53.249/~thenyic/sites/default/files/ImmigrantHealthGuide_FINAL040907.pdfPumariega, A.J. & Rothe, E. (2010). Leaving no children or families outside: The challenges of immigration. American Journal ofOrthopsychiatry, 80(4), 505-515.
    • 20. References Continued20 U.S. Department of Human Health and Services. (2012). Disproportionate share hospital. Retrieved from http://www.hhs.gov/recovery/cms/dsh.html California Dept. of Mental Health. (2011). Mental Health Services Act. Retrieved from http:// www.dmh.ca.gov/Prop_63/mhsa/ California Dept. of Mental Health. (2005 Feb 16). Vision statement and guiding principles for DMH implementation of the mental health services act. Retrieved from http://www.dmh.ca.gov/Prop_63/mhsa/docs/Vision_and_Guiding_Principles_2-16-05.pdf California Dept. of Mental Health. (2004). Mental health services act. Retrieved from http:// www.dmh.ca.gov/Prop_63/mhsa/docs/MHSAafterAB100.pdf New York City Health and Hospitals Corporation. (2012). Immigrant Confidentiality Campaign Public Service Announcement. Retrieved from http://www.nyc.gov/html/hhc/downloads/pdf/immigrant-psa.pdf NAMI California. (2010). Prop. 63 Fast facts for prevention and early intervention. Retrieved from http://www.namicalifornia.org/webbdata/MHSA-DTD-0000-00/mhsaoac%20fast%20facts%202010/ fastfacts_merged_eng.pdf Bajaj, R. (2011). Public hearing testimony. Retrieved from http://www.omh.ny.gov/omhweb/Statewideplan/2006/testimony/507/nyc/bajaj.html