WELCOME! PLANNING COUNCIL MEETING November 8, 2018 At this moment, - - PowerPoint PPT Presentation

WELCOME!

PLANNING COUNCIL MEETING November 8, 2018

MOMENT OF SIL ILENCE

At this moment, lets take a moment

• f silence in remembrance for those

who came before us, those that are present, and those that will come after us.

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IN INTRODUCTIONS

Please state your name for the record. Alongside your name please state whether you are a new member or incumbent. Please note: You do NOT have to disclose your status during the introduction if you do not want to.

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GROUND RULES

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Be on time No Side Conversations Silence cell phones Presenters represent agencies- no personal attacks Participate Don't ask questions that accuse or assume where someone is coming

• from. Stick to asking questions regarding information.

Be respectful Respect the option for presenters to come back with additional information or answers. Agree to disagree Send questions with more detailed explanations to the Executive Committee or PCS Ask questions Whenever possible, enjoy yourself Speak up so everyone can hear you Don’t assume everything is public knowledge Raise your hand and wait to be acknowledged by the Chair Step up, step back Don't interrupt

APPROVE MEETING MINUTES (H-1) October 11, 2018

Steps in approving minutes:

• 1. Review minutes
• 2. Make a first and second motion to approve minutes
• 3. Vote

All in Favor: Yes, approve minutes Opposed: No, do not approve minutes Abstention: Absent from previous meeting/ Decline to vote

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COMMIT ITTEE REPORTS (H (H-2) 2)

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Each month, the Committee Chair(s) will provide a summary of their committee's activities. You can also refer to a handout in your packet for written updates.

Presenter: Andre Lima

PUBLIC CHARGE PRESENTATION

Anticipated Impact and City Response

Anticipated Changes to Public Charge Ground of Inadmissibility under Immigration Law

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A person seeking admission to the United States or seeking to adjust their immigration status to legal permanent residency (i.e. green card) is considered “inadmissible” (i.e. barred from entry or change of status) if that person likely to become a “public charge."

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What is a Public Charge?

Under (federal) immigration law for the purposes of determining admissibility “public charge” means: A person who is likely to become primarily dependent on the government for subsistence.

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When is public charge applied?

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Serve as the basis for denying admission to intending immigrants

1.

Adjudicating visa application and adjustment of status applications

1.

As grounds for deportation (rarely employed)

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How is public charge determined?

The public charge grounds of inadmissibility is currently determined by a totality of the circumstances test. This means that decisions are based on all available information rather than bright-line rules. A Consular or USCIS officer must consider a range of factors - both negative and positive - in determining the likelihood that an applicant will become a public charge.

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Statutory factors in public charge determinations

Currently, factors used in the public charge test include, but are not limited to:

• Age;
• Health;
• Family status;
• Assets, resources, and financial status; and
• Education and skills (including English language proficiency)

Certain factors represent heavily weighted strikes against an applicant and

• ther factors will, in most cases, override unfavorable elements of an

application.

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Factors in public charge determinations

One negative factor currently considered in the public charge test is the use of certain public benefits programs or government assistance by an applicant, limited to:

• receipt of public cash assistance for income maintenance (i.e.

Temporary Assistance for Needy Families or TANF)

• institutionalization for long-term care at the government’s expense

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Proposed changes to the public charge grounds of inadmissibility

Following rumors and leaks of an executive order last year on public charge, two drafts of a notice of proposed rulemaking (NPRM) were leaked to the press earlier this year. On October 10th, the NPRM was published in the Federal Register. NOTE: these changes have already been made to the Foreign Affairs Manual.

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Proposed changes to the public charge grounds of inadmissibility

DHS proposes to: (a) enlarge the scope of benefits programs considered in making public charge determinations and (b) alter the “totality of circumstances” calculus, heavily weighting use

• f public benefits and other factors as strikes against an applicant.

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What additional public benefits would be considered?

Monetizable benefits:

• Supplemental Nutrition Assistance Program (SNAP)
• Housing Choice Voucher Program (Section 8)
• Certain health insurance programs including Medicaid and potentially the

Children’s Health Insurance Program (CHIP)

• Section 8 Project-Based Rental Assistance (including Moderate

Rehabilitation)

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What additional public benefits would be considered?

Non-cash benefits that cannot be monetized:

• Benefits paid for by Medicaid

(excluding services for emergency medical conditions, those provided under the Individuals with Disabilities Education Act (IDEA) and benefits provided to foreign-born children of U.S. citizen parents)

• Premium and Cost Sharing Subsidies for Medicare Part D

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What factors will be weighed negatively?

DHS proposes to consider the following factors as a heavily weighed negative strikes against an applicant:

a.

Lack of Employability

b.

Current Receipt or Use of One or More Public Benefits

c.

Receipt of Public Benefits within 36 Months of Filing Application

d.

Financial Means to Pay for Medical Costs

e.

Alien Previously Found Inadmissible or Deportable Based on Public Charge

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Who is exempt from the public charge test:

• Refugees
• Asylum applicants
• Refugees and asylees applying for

adjustment to permanent resident status

• Amerasian Immigrants (for their initial

admission)

• Individuals granted relief under the Cuban

Adjustment Act (CAA)

• Individuals granted relief under the

Nicaraguan and Central American Relief Act (NACARA)

• Individuals granted relief under the Haitian

Refugee Immigration Fairness Act (HRIFA)

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• Individuals applying for a T Visa
• Individuals applying for a U Visa
• Individuals who possess a T visa and

are trying to become a permanent resident (get a green card)

• Individuals who possess a U visa and

are trying to become a permanent resident (get a green card)

• Applicants for Temporary Protected

Status (TPS)

• Certain applicants under the LIFE Act

Provisions

Do these changes affect an individual’s eligibility to receive certain public benefits?

• NO. The eligibility criteria for the aforementioned public

benefits programs will remain unchanged. The proposed changes thus force immigrants who are using public benefit programs and who may desire to adjust their status in the future to make a difficult decision:

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Discontinue use of vital public benefits programs at the expense of their health and wellbeing. OR Continue using public benefits programs and jeopardize their application for an adjustment

• f status, and risk potential deportation.

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Immediate Effects

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• Large scale disenrollment of non-citizens from public benefits programs, including

those not directly affected by the rule change due to confusion and risk aversion.

• Reluctance amongst non-citizens to access any form of healthcare, emergency or
• therwise, including those not directly affected by the rule change due to confusion and

risk aversion.

• Impacted immigrants losing status and thus becoming deportable, having been

denied an adjustment of status on public charge grounds.

• Impacted immigrants being detained and deported, having lost status as result of

being denied an adjustment of status.

Long Term Economic Consequences/Costs

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• Loss of workers and associated costs
• Loss of income to the City of Boston
• Loss of talent and associated costs
• Cost of supporting separated children
• Uncompensated care costs to Boston hospitals from the loss of health

coverage

• Increased health expenditures associated with food insecurity

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Boston residents directly affected

35,000

Who will be directly affected?

54,000

non citizens residents

97,000

subject to public charge test

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✖ Receipt of certain public benefits ✖ Not working or going to school ✖ Age below 18 or over 61 ✖ Limited English Proficiency

✖ Household income below 250% of

the poverty limit

Boston residents at risk of being labeled “public charge”

19,392

Who will be directly affected?

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Healthcare Impact Analysis

1,614

children

13,165 adults

Medicaid

1,021

children

7,695 adults

SNAP

Incalculable Health Related Costs

• Disenrollment from immunization services (influenza,

mumps, rubella, etc.)

• Disenrollment preventive services against

communicable diseases (diphtheria, cholera, HIV, etc.)

• Loss of productivity and/or missed work due to health

issues may also result in lost earnings.

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Incalculable Health Impacts

Food insecurity is likely to exacerbate particular health conditions including:

• Depression (in adults)
• Arthritis, gout, lupus and/or fibromyalgia (in adults)
• Iron deficiency (in children)
• Diabetes (in adults)
• Obesity (in adult women)
• Asthma (in adults and children)
• Chronic obstructive pulmonary disease (in adults)

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Timeline

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Proposed rule published in the Federal Register for public inspection

October 5th 2018

Proposed rule published in the Federal register for public comment 60 day comment period begins

October 10th 2018

DHS reads and considers all comments

December 10th 2018

Final rule published in the Federal Register

??? Estimated 2 -4 months

Messaging

• This rule has not yet gone into effect
• With a few exceptions, this DOES NOT apply to Green Card holders
• There are exemptions for most beneficiaries of humanitarian programs and protections.
• This rule is not retroactive
• Our partners advise individuals and households to continue using public benefits programs

that are essential to their health and well being.

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Presenter: Matan Benyishay

FENWAY SPNS HIV HOUSING AND EMPLOYMENT PROJECT

Fenway Health SPNS Housing and Employment Project

PRESENTATION FOR THE BOSTON RYAN WHITE PLANNING COUNCIL NOVEMBER 2018

Who are we?

Fenway Health

• Program staff: Lauren McKnight (coordinator), Kristen Lascoe (director), Michelle Bordeu (principal

investigator)

• Evaluation staff: Matan BenYishay (manager), Sara Rodriguez (assistant), Chris Grasso (lead)

MassHire

• Lina Ramirez (specialist), Judy Sacks (director)

Evaluation and Technical Assistance (Boston University)

• Jessica Flaherty (manager), Serena Rajabiun (principal investigator)

What is SPNS?

• Part of HRSA Ryan White HIV-AIDS Program
• RWHAP “Research & development branch”

What is the purpose of the project?

• Previous projects have demonstrated the link between housing stability and HIV health
• utcomes
• Bring employment opportunities into the mix!
• Learning:
• Direct services:
• How much coordination is required to link clients to employment services?
• What factors determine whether housing and employment improve health outcomes for PLWH/A?
• Systems change
• What is the need for employment services for PLWH/A in the Greater Boston region?
• How can CBOs, Community Health Centers, and funding agencies collaborate to meet these needs?

What does this project involve?

• Coordinated referrals to AIDS Action housing programs
• Housing search and advocacy
• Short-term rental assistance: rental start-up; homelessness prevention; utility assistance
• Coordinated referrals to MassHire employment services
• Resume/cover letter
• Employer partners
• Readiness for work
• Education programs
• Formal study
• Optional and consent-based
• Questionnaires with incentives
• Medical chart reviews

Why do we think employment matters for PLWH/A?

• People Living With HIV/AIDS (PLWH/A) have unique challenges around employment
• Shifting approach from helping people die with dignity to helping people live long, productive

lives

• Working Positive/Getting to Work

What is the value of work for PLWH/A?

From HUD Exchange: https://www.youtube.com/watch?v=hpGQN_qmtfk

How does returning to work benefit PLWH/A?

“Too many New Yorkers living with HIV feel trapped in poverty, with limited opportunity to build futures that are economically secure. For some of us, not working allowed us to focus on improving our health and well-being. Now many of us find that getting help to land jobs that we want may be the only way to escape poverty, build financial security, and improve our quality of life”.

• Mark, Co-Founder of the National Working Positive Coalition and current President of the

Board of Directors

“ When HIV-positive people are working, they are more likely to take care of themselves, monitor their health, adhere to their medical appointments, and take their medications. Returning to work helps prevent the spread of HIV. It keeps PLWHA healthy and improves their self-esteem. In more than a decade working at GMHC, I have seen firsthand the huge impact that this work has on people.”

• AWG, Senior Director of Workforce Development, GMHC

How do referrals work?

• Housing referrals are unchanged
• Can refer separately for housing or to all of SPNS
• Online, secure referral survey
• Release for MassHire

Who is eligible?

• HIV+ individuals, 18+ years old
• Ryan-White eligible
• Not fully engaged in HIV care (not virally suppressed, newly diagnosed, not well connected to

care, or exiting incarceration)

• Homeless, unstably housed, or at imminent risk of homelessness
• Unemployed or underemployed (including people receiving disability and interested in working

part-time)

Presenter: Masill Miranda

PLANNING COUNCIL UPDATE

Planning Council Bylaws Timeline

Description: Per HRSA’s site visit finding A5. Planning Council Bylaws, HRSA found that the Bylaws lacked specificity in some areas as membership, legislatively mandated seats, etc. Since then, the Bylaw’s Working Group have addressed the findings.

Planning Council Bylaws Timeline

Meet once again and add the Nominations Process Executive Committee approval Present the approved Bylaws document to the Planning Council (and timeline) Send to Legal Department for review Send bylaws to HRSA for review Planning Council vote

AGENCY REPRESENTATIV IVE REPORTS (H (H-3) 3)

Each month, each representative will offer policy, legislative, and programmatic updates from their government agency. The agency reps are:

• Mayor's Office of Health and Human Services - André Lima
• MA Department of Public Health, Office of HIV/AIDS - Barry Callis
• NH Department of Health and Human Services, NH Care Program – Sarah McPhee
• MA Office of Medicaid – Alison Kirchgasser
• Boston Public Health Commission – Ryan White Services Division

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Frequently Asked Questions

Questions from 10/11/2018

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Please not that a FAQ document will be uploaded in the Planning Council website.

Question Answer Hi Masill, please share link Barry Callis announced about the campaign. The link has been shared in the Weekly Announcements on Friday. Link: www.carethatfitsyou.org Can we have emails from other members? Please refer to the last handout in your packets. It is the Contact Information Release Form. By filling it out, it will allow for PCS to share PC members emails/contact info. If you want to share it, please complete and hand it to PCS.

Funded VS Not Funded

Oct ctober 11th

th mee

eeting

Funded

• AIDS Drug Assistance Program

(ADAP/HDAP)

• Medical Case Management
• Medical Nutrition Therapy
• Oral Health Care
• Case Management - Non-Medical
• Food Bank/Home-Delivered Meals
• Housing Services
• Medical Transportation Services
• Psychosocial Support
• Substance Abuse Services –Residential
• Emergency Financial Assistance
• Health Education/Risk Reduction

Not Funded

• Early Intervention Services (EIS)
• Health Insurance Premium and Cost Sharing

Assistance

• Mental Health Services
• Outpatient/Ambulatory Health Services
• Substance Abuse Services -Outpatient

CLARIFICATION

OTHER ANNOUNCEMENTS

This is your chance to spread the word about community events, research studies, or other resources that are related to the Planning Council's work.

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EVALUATION AND ADJOURN (H-4)

Please fill out your evaluation forms!

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