scholarly journals Legal Counsel: A Health Care Partner For Immigrant Communities

2021 ◽  
Vol 40 (8) ◽  
pp. 1184-1189
Author(s):  
Rebecca Gale
2021 ◽  
Vol 111 (S3) ◽  
pp. S224-S231
Author(s):  
Lan N. Đoàn ◽  
Stella K. Chong ◽  
Supriya Misra ◽  
Simona C. Kwon ◽  
Stella S. Yi

The COVID-19 pandemic has exposed the many broken fragments of US health care and social service systems, reinforcing extant health and socioeconomic inequities faced by structurally marginalized immigrant communities. Throughout the pandemic, even during the most critical period of rising cases in different epicenters, immigrants continued to work in high-risk-exposure environments while simultaneously having less access to health care and economic relief and facing discrimination. We describe systemic factors that have adversely affected low-income immigrants, including limiting their work opportunities to essential jobs, living in substandard housing conditions that do not allow for social distancing or space to safely isolate from others in the household, and policies that discourage access to public resources that are available to them or that make resources completely inaccessible. We demonstrate that the current public health infrastructure has not improved health care access or linkages to necessary services, treatments, or culturally competent health care providers, and we provide suggestions for how the Public Health 3.0 framework could advance this. We recommend the following strategies to improve the Public Health 3.0 public health infrastructure and mitigate widening disparities: (1) address the social determinants of health, (2) broaden engagement with stakeholders across multiple sectors, and (3) develop appropriate tools and technologies. (Am J Public Health. 2021;111(S3):S224–S231. https://doi.org/10.2105/AJPH.2021.306433 )


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rienna Russo ◽  
Simona Kwon ◽  
Jennifer Tsui ◽  
Stella S Yi

Introduction: Nationally, New York City (NYC) has one of the largest immigrant populations and highest gentrification rates. Satellite ethnic enclaves are increasingly prevalent as residents relocate to more affordable neighborhoods. Ethnic immigrant communities already face unique challenges to accessing health care, including linguistic and cultural discordance regarding health-related beliefs and norms. Residence outside of ethnic enclaves may further hinder health care utilization, as culturally appropriate services may become less accessible. Characterization of immigrants visiting doctors’ offices within and outside of ethnic enclaves may inform efforts to retain these populations in care. Hypothesis: We compared immigrants accessing health care within major ethnic enclaves to immigrants accessing care elsewhere to ascertain differences in 1) demographic characteristics; 2) reasons for choosing health care facilities; and 3) distances traveled for health care. Methods: Data were from the 2018 Examining Norms and Behaviors Linked to Eating (ENABLE) Pilot Study. Chinese American participants were recruited using venue-based and snowball sampling methods, with assistance from NYC community-based organizations. Surveys included detailed questions on demographics and health-related factors. Participants were included in the analysis if doctor’s office and home zip code data were available (n=143). Data were analyzed using RStudio v.1.2.5 and STATA v.15.0. Results: The majority of participants saw a Chinatown-based doctor (64%; 92 of 143); and were not Chinatown residents (81%; 116 of 143). A greater number of individuals who saw Chinatown-based doctor had less than a college education; were living with food insecurity; were on public insurance; and were less acculturated. Individuals accessing care in Chinatown prioritized doctor’s offices where doctors and medical staff spoke their language more so than individuals accessing care elsewhere. Overall, people who saw a Chinatown-based doctor traveled significantly further (β=1.51 miles [approximately 15 minutes via subway]; 95% CI 0.25, 2.77). Of people who saw a Chinatown-based doctor, 75% (69 of 92) were not Chinatown residents. On average, these individuals traveled 5.14 miles (SD=3.38) to the doctor. Conclusion: In conclusion, there is a need to expand in-language services for immigrant communities. Immigrants visiting doctors in ethnic enclaves are demographically different and travel further distances for health care. Accessing in language services is a priority for these individuals. Immigrants may prioritize language access over geographic access when choosing their health care providers. Strategies to strengthen community-clinical linkages, including connecting community members with bilingual community health workers, may increase healthcare access of under-served, ethnic populations.


2006 ◽  
Vol 130 (8) ◽  
pp. 1169-1177
Author(s):  
Roger D. Klein ◽  
Sheldon Campbell

Abstract Context.—Health care fraud and abuse enforcement actions have significantly expanded in number and scope during the past several years. The Department of Health and Human Services Office of Inspector General named review of in-office pathology services a critical priority in its 2005 Work Plan. As providers of pathology and laboratory medicine services, pathologists need to be aware of the potential impact of these laws on their practices. Objectives.—To review the major statutes and regulations underlying most federal investigations and prosecutions of health care fraud, with a special emphasis on their relationships to pathology practice. Design.—The authors reviewed pertinent federal statutes, regulations, and other documents, along with relevant legal literature. Results.—The health care fraud and abuse laws are complicated and potentially impact pathology practice in unforeseen ways. Conclusions.—The health care fraud and abuse laws are complex and often counterintuitive. The penalties for violation of these laws are severe. Because they may impact many areas of pathology and laboratory medicine practice, pathologists are advised to consult experienced legal counsel prior to embarking on potentially suspect health care arrangements.


2008 ◽  
Vol 2 (1) ◽  
pp. 50-56 ◽  
Author(s):  
Montrece McNeill Ransom ◽  
Richard A. Goodman ◽  
Anthony D. Moulton

ABSTRACTHealth care providers and their legal counsel play pivotal roles in preparing for and responding to public health emergencies. Lawyers representing hospitals, health systems, and other health care provider components are being called upon to answer complex legal questions regarding public health preparedness issues that most providers have not previously faced. Many of these issues are legal issues with which public health officials should be familiar, and that can serve as a starting point for cross-sector legal preparedness planning involving both the public health and health care communities. This article examines legal issues that health care providers face in preparing for public health emergencies, and steps that providers, their legal counsel, and others can take to address those issues and to strengthen community preparedness. (Disaster Med Public Health Preparedness. 2008;2:50–56)


2021 ◽  
pp. 233150242110197
Author(s):  
Elizabeth Kiester ◽  
Jennifer Vasquez-Merino

The COVID-19 pandemic has exposed the inequalities facing vulnerable populations: those living in economically precarious situations and lacking adequate health care. In addition, frontline workers deemed essential to meet our basic needs have faced enormous personal risk to keep earning their paychecks and the economy running. Immigrant communities face an intersection of all three vulnerabilities (e.g., economic precarity, health care barriers, essential workforce), making them one of the most vulnerable populations in the United States. We conducted 26 interviews via Zoom with immigrant service providers in Pennsylvania and New York, including lawyers, case workers, religious leaders, advocates, doctors, and educators in order to gain a better understanding of the impact of COVID-19 on immigrant communities. These interviews affirmed that immigrants are concentrated in essential industries, which increases their exposure to the virus. In addition, they lack access to social safety nets when trying to access health care or facing job/income loss. Last, COVID-19 did not adequately slow the detention and deportation machine in the United States, which led to increased transmission of the virus among not only detainees but also others in the detention system, surrounding communities, and the countries to which people were deported, countries that often lacked an adequate infrastructure for dealing with the pandemic. Based on our interviews, we have a series of specific policy recommendations to diminish the vulnerability of immigrants and create social safety nets that will include them and protect them when the market fails to do so. Immigrants of all types have made indispensable contributions to the US economy during the pandemic and before it. First, Congress and states should pass legislation to provide COVID-19 relief payments to all essential workers, regardless of their status, as compensation for putting their lives on the line to keep the economy running. Second, as a public health imperative, federal and state governments should expand coverage of Medicaid and Children’s Health Insurance Programs (CHIP) to include immigrant essential workers and their children, regardless of their status. Third, DHS should not refer essential workers to removal proceedings, and immigration courts should terminate all removal proceedings for essential workers without criminal records. When it comes to issues of health care affordability and access, Congress must continue to revise the Affordable Healthcare Act to expand coverage for those who do not qualify for Medicaid but earn too little to afford insurance on their own. Finally, there must be a review and rigorous enforcement of workplace health and safety standards, particularly when it comes to farming, meatpacking, food production, and food service industries. Our final recommendations are specific to DHS and two of the primary agencies they oversee: Immigration and Customs Enforcement (ICE) and the Border Patrol. First, there needs to be a review of ICE policies and practices, leading to a shift in policy that keeps mixed-status families intact and minor children out of detention centers and that streamlines and expands the asylum process. Second, both Congress and the administration must create additional paths to legal status where none now exist, including for recipients of Deferred Action for Childhood Arrivals (DACA) and for children who have arrived since June 2007.


2020 ◽  
Vol 12 (2) ◽  
pp. 139
Author(s):  
Tanvir C. Turin ◽  
Nashit Chowdhury ◽  
Mahzabin Ferdous ◽  
Ruksana Rashid ◽  
Marcus Vaska ◽  
...  

ABSTRACT INTRODUCTIONUnderstanding primary care access or health service utilisation challenges among immigrant communities is important for tailoring services to community needs, which is the core of precision population health. AIMWe aim to inventory the primary care access barriers faced by immigrant communities through a comprehensive systematic review and develop a conceptual framework to explain the barriers, using a root cause analysis approach. METHODSAcademic databases of primary research articles and grey literature will be searched using appropriate keywords. Relevant information will be extracted into tabular format from finally selected literature. Our proposed approach of framing the barriers to identify the root causes is adapted from the root cause analysis method, which is the process of identifying and understanding the underlying causes to discover the root causes of problems. RESULTSThe study will produce a systematic, quantified and documented list of the barriers faced by immigrants in a solution-oriented approach. DISCUSSIONThe proposed research, as a first step towards determining possible mitigation strategies for health-care access by immigrants, will provide the background needed to devise and test tailored interventions to improve future access to health care for immigrants. We will follow the integrated knowledge translation or community engagement knowledge mobilization approach, where we are engaged with community-based citizen researchers from the inception of our programme. We plan to disseminate the results of our review through meetings with key stakeholders and social media outreach, followed by journal publications and presentations on relevant platforms.


1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.


1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.


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