October 8, 2015
Plan follows recommendations by the Mayor’s Task Force on Immigrant Health Care Access
New program aims to expand access to health care beyond the Affordable Care Act
NEW YORK— Mayor Bill de Blasio announced a plan to improve health care access for the city’s immigrant population, making New York City one of the first major U.S. municipalities to expand health care access after the enactment of the Affordable Care Act. The plan includes the new “Direct Access” health initiative to provide reliable and coordinated access to affordable care for immigrants who are excluded from federal and state support. The plan also includes recommendations from the Mayor’s Task Force on Immigrant Health Care Access for a set of programs to expand public education about affordable health care options, support health care providers serving immigrant patients, and improve medical interpretation services.
“New Yorkers should not be prevented from accessing health care because of a broken federal immigration system. While some in Washington continue to fight against the Affordable Care Act, we are going to expand on it by providing truly universal access to care,” said Mayor Bill de Blasio. “We have the greatest public health system in the country, and we will build on the work HHC has been doing for immigrants since its founding to ensure that every New York City resident – young or old, rich or poor – can access the care they need for themselves and their families.”
Launched in June 2014, the Task Force convened City officials, immigrant advocates, public health experts, and health care providers to address disparities in health care access for the immigrant community in New York City.
The Task Force’s full report and recommendations can be found here.
The Task Force found that major barriers to immigrant access to care include lack of affordable care, limited service delivery and provider capacity, inadequate cultural and linguistic competency among health care providers, lack of knowledge and understanding of care and coverage options available for immigrants, lack of access to high-quality interpretation services, and lack of knowledge and understanding of language and translation services available to immigrants and health care providers. To address these obstacles and improve New Yorkers’ ability to access much needed health care services, the Task Force developed four recommendations:
- Create a direct access health care program to provide uninsured immigrants and others with access to coordinated primary and preventive health care services
- Expand the capacity of the New York City health care system to provide culturally and linguistically competent primary and preventive health care services to immigrants
- Conduct public education and outreach on health care and coverage options for immigrants and the organizations that serve them
- Increase access to high-quality medical interpretation services
The new “Direct Access” program is designed to address the fact that many foreign-born residents remain uninsured and vulnerable to poor health outcomes, despite the robust expansion of health care access since the passage of the Affordable Care Act. While not insurance, “Direct Access” builds on the City’s existing health care system by providing for greater care coordination and efficiencies in accessing care. Improved access to primary care can help prevent disease, lead to better health outcomes and help lower health care costs.
The “Direct Access” program will be launched in the spring of 2016 as a year-long program to coordinate access to care for approximately 1,000 uninsured immigrant New Yorkers to start. Guided by successful models from around the country, including programs in San Francisco and Los Angeles County, New York City’s “Direct Access” program will provide access to primary and preventive care with a dedicated network of health care providers and care coordination services. The initial launch will enable the City to collect necessary data to design a successful citywide model for the future. Development of “Direct Access” has already started. The estimated cost of the initial launch is $6 million to be partially financed with dollars secured by the Mayor’s Fund to Advance New York City. The Robin Hood Foundation has already committed to support the Direct Access initiative, and details of additional private funders are forthcoming.
Much of the data analysis for the report was supplied by the City’s Center for Economic Opportunity (CEO) and Center for Innovation through Data Intelligence (CIDI). CEO will also be providing ongoing support in the evaluation of the Direct Access program’s evaluation.
“We are committed to health equity and to ensuring that all of New York City’s immigrant communities are able to get primary and preventive care so they can avoid medical emergencies. The “Direct Access” program will show the powerful effects of affordable access to care,” said Nisha Agarwal, Commissioner of the Mayor’s Office of Immigrant Affairs. “The City’s actions today are the first step in our efforts to develop a fully inclusive health care system that protects all of our residents, regardless of immigration status.”
“Every New Yorker, regardless of immigration status, has a right to access the health care they need. The Health Department is proud that New York City is poised to set a national example and lead the way in providing immigrant populations with better access to comprehensive health care,” said Health Commissioner Dr. Mary T. Bassett. “We have made great progress in connecting New Yorkers to coverage and care since the Affordable Care Act was passed, but there is still work to be done to eliminate inequities in our health care system. This program will help move New York City closer to universal health care.”
“NYC Health and Hospitals proudly has extended high quality medical services to all New Yorkers – regardless of income, regardless of insurance, regardless of immigration status – for decades,” said HHC President Dr. Ram Raju. “Under the leadership of the Mayor, this innovative new program allows for expanded access, care coordination, and deeper public-private partnerships. I applaud the Mayor and the Administration for bringing this bold, new initiative to fruition.”
“Making sure that all New Yorkers are aware of the benefits and services available to them and can access them from providers that understand their language and culture is a key priority for our city,” said HRA Commissioner Steven Banks. “Our plan to improve health care access for the city’s immigrant populations is essential to our overall plan to address health disparities and income inequality for the most vulnerable among us.”
“One of the priorities of the Mayor’s Fund is to discover and implement innovative programs that have the potential to improve the lives of New Yorkers. Evaluating new ways to guarantee affordable, reliable and timely health care services for our immigrant community is exactly in line with our mission,” said Darren Bloch, Executive Director of the Mayor’s Fund. “We look forward to once again partnering with City agencies as well as the philanthropic community to work toward our joint goal of meeting the vital needs of our most underserved residents – and in doing so, setting the stage for a more inclusive health care system for all.”
“Robin Hood is honored to partner with Mayor de Blasio on this important initiative,” said Veyom Bahl, Senior Program Officer for the Robin Hood Foundation. “As a seed funder of the direct access initiative, we are proud to be able to help the City move toward providing comprehensive, high-quality care for all low-income New Yorkers, regardless of immigration status.”
“New York has made major improvements in access to health care for underserved and uninsured people in recent years,” said Elizabeth Swain, President and CEO of the Community Health Care Association of New York State. “But in spite of this, we struggle with large numbers of folks who are either ineligible for these benefits or unable to get the care they need or both. This pilot program is a critical first step in reducing the barriers encountered by this extremely vulnerable population, and CHCANYS looks forward to working with our partners at HHC and the de Blasio administration to address this priority.”
“The creation of a direct access program for uninsured immigrants, using existing safety-net resources, is a major step toward closing health care gaps for New York City’s remaining uninsured and will spur fresh thinking about local solutions to this national problem,” said Nancy Berlinger, a Research Scholar at The Hastings Center and the lead author of an independent study by The Hastings Center and the New York Immigration Coalition that informed the Task Force process.
“The primary care medical home model and innovative use of IDNYC reflect lessons learned from innovators in other cities,” said Hastings Center Research Scholar Michael K. Gusmano, a study co-author and expert in comparative urban health policy.
Steven Choi, Executive Director of the New York Immigration Coalition said, “The New York Immigration Coalition applauds the de Blasio administration on the work of the Mayor’s Task Force on Immigrant Health Access and its ambitious roadmap for making New York City’s health care system truly immigrant-friendly. We look forward to working with the city to improve access for those who remain uninsured because of their status, to ensure that all immigrants take advantage of the benefits to which they are entitled, and to improve cultural competence and language access in all New York City health care settings.”
“All immigrants, regardless of immigration status, should have access to the health care they need. Make the Road New York applauds the Mayor’s Office for their groundbreaking work developing recommendations to increase access to health care for all immigrants in New York City. MRNY members who are undocumented face many barriers accessing care including language barriers and lack of health insurance coverage. We were proud to participate in the Mayor’s Task Force on Immigrant Health Care Access, and we know that the recommendations and report it produced are great first steps at improving the health of immigrants across the city. We look forward to working together with the Mayor’s Office to ensure healthcare access for all New Yorkers,” said Becca Telzak, Director of Health Programs at Make the Road New York.
“We commend the de Blasio Administration for recommending that coverage options be extended to all State residents, regardless of immigration status,” said Elisabeth R. Benjamin, MSPH, JD, Vice President of Health Initiatives at the Community Service Society of New York. “A Direct Access Program will provide meaningful access to health care while New York State considers options for providing coverage to all its residents – even those left behind under the Affordable Care Act.”
“It is terrific that the Mayor’s Task Force is focusing attention on the health care needs of a uniquely vulnerable and diverse group of New Yorkers who have been excluded from many federal health reform initiatives,” said Andrea G. Cohen, Senior Vice President for Program at United Hospital Fund. “As the report points out, immigrants are underserved not only because many adults are not eligible for public health insurance, but also because they face non-financial barriers. This is an important priority for anyone who cares about the health of New Yorkers, and we welcome this initiative to move the discussion forward.”
“Hispanic Federation was proud to help shape the work of the Mayor’s Task Force on Immigrant Health Care Access and we strongly believe that the implementation of the recommendations contained in the final report are vital to building health equity and maintaining New York’s legacy as a leader in healthcare,” said Hispanic Federation President Jose Caldérón.
“Immigrants in New York City are the most vulnerable, and we are thankful for the City's Task Force and the help they have provided us in serving this population,” said Greg Mann, the Interim Executive Director of Grameen PrimaCare.
“Cultural competency is the essential foundation for serving our nation’s diverse population and nowhere is this more important than in New York City, which is the mecca of immigration from around the world, “ said Cheryl Hall, Executive Director of Caribbean Women’s Health Association. “In addition, the new federal CLAS standards indicate that one of the best ways to reduce health disparities is to improve cultural and linguistic competency among providers which is addressed in this report.”
Dr. Francesca Gany, Chief of Immigrant Health and Cancer Disparities at the Memorial Sloan Kettering Cancer Center, said “The recommendations in this report are a huge step towards health equity in NYC-ensuring quality health care for ALL New Yorkers, including the vital immigrant community that makes New York City such a vibrant metropolis.”
“The Asian Pacific American community greatly benefited from the Affordable Care Act and plans on the Marketplace including the expansion of Medicaid – however, there are still large segments of the population that still do not have coverage,” said Sheelah A. Feinberg, Executive Director of the Coalition for Asian American Children & Families. “Many in our communities still have not been able to access health care coverage due their immigration status. However as vital segments that contribute to the vibrancy of NYC, we should support programs and initiatives that aim to fill the gaps and ensure that all communities know their rights and have access to quality, affordable, culturally competent, and language accessible care. CACF was honored to be part of the Mayor’s Task Force to explore options such as ‘Direct Access’ for NYC’s undocumented immigrants and their families.”
Laura F. Redman, Director of the Health Justice Program at New York Lawyers for the Public Interest, said, “In partnership with immigrant communities to ensure meaningful access to health care, NYLPI has worked to eliminate barriers to coverage and language access. The Mayor’s Task Force report builds on this vital work by providing sound strategies for bridging additional gaps in immigrant healthcare. From launching a direct access healthcare program targeting those left behind by federal and state efforts to expanding the supply and usage of language interpretation services, these recommendations are critical to providing all New Yorkers, regardless of language or origin, with the access to healthcare they deserve. We implore the Mayor to adopt these recommendations and put them into practice.”
“Recent studies have reported the increasing trends in immigrants from Asia,” said Jo-Ann Yoo, Executive Director of the Asian American Federation. “The major challenge of reaching Asian immigrants has been the many languages and cultures represented in our communities. The Federation and our member agencies look forward to working with the Administration to ensure all immigrants in our city know their rights to health care services.”
“Mayor de Blasio’s Task Force on Immigrant Health Care Access has taken a holistic approach to addressing the problem of access to affordable healthcare for immigrants, who struggle with language disparities and a host of other barriers to living healthy lives. This new report provides a comprehensive and thoughtful vision of what city agencies, community leaders, advocates and healthcare professionals can do to ensure that New York’s immigrants receive the essential healthcare services they deserve,” said Beth Goldman, President and Attorney-in-Charge of the New York Legal Assistance Group.
“Through the Direct Access program, thousands of immigrants who were left out of health reform and who have suffered as a result of our broken federal immigration system will be able to access quality affordable care,” said Shena Elrington, Director of Immigrant Rights and Racial Justice Policy at the Center for Popular Democracy. “We applaud the Mayor, once again solidifying New York City’s reputation as a welcoming and inclusive city committed to ensuring that its residents thrive, regardless of immigration status.”
Task Force Participants:
Asian American Federation
Caribbean Women’s Health Association
Center for Economic Opportunity, Office of the Mayor
Center for Immigrant Health and Cancer Disparities, Memorial Sloan Kettering Cancer Center
Center for Innovation through Data Intelligence, Office of the Mayor
Center for Popular Democracy
Coalition for Asian American Children and Families
Community Health Care Association of New York State
Community Service Society of New York
Greater New York Hospital Association
Legal Aid Society
Make the Road New York
New York City Administration for Children’s Services
New York City Department of Health and Mental Hygiene
New York City Health and Hospitals Corporation
New York City Human Resources Administration
New York City Mayor’s Office of Immigrant Affairs
New York Lawyers for the Public Interest
New York Legal Assistance Group
The Hastings Center
The New York Immigration Coalition
United Hospital Fund