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San Diego Refugee Forum Minutes
Tuesday, January 20, 2015, 10:30 a.m.-12:00 p.m. Alliance for African Assistance, 5952 El Cajon Blvd., San Diego, CA, 92115
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1. Call to order at 10:30 am
Present: Bonnie Copland, Neda Rivera, Abdi Abdillahi, Lorna Strang, Angel Lopez, Kim McDermott, Kathi Anderson, Nao Kabashima, Deona Dorsey, Nawar Yousif, Rita Shamoon, Kristen Aster, Jason Martinez, Aileen Gulan, Renee Nasori, Ayan Mohamed, Brittney Yackley, Besma Coda, Genevieve Caston, Bill Sutton, Eric Miller, Alexiz Martinez, Mohammed Tuama, John Marcin, Carin Anderson, Mohamed Ilad, Carlos Mendez, Jane Hoey, Al Thomas, Nadine Pedusseau, Dalia Mohammad, Celia Balistreni, Brenda Quezada, Afrah Abdulkader, Diode deDios, Vanessa Peters, Amy Hines, Dianne Bourgue, Jo-Ann Julien, Vernita Gutierrez, Ute Maschke 2. Executive Committee Announcements and Participant Introduction:
• Kathi Anderson (Chair) opened the Forum meeting and introduced the new officers.
• General Introductions
• Ute Maschke (vice-chair) welcomed new members. As of today, we have 9 renewed or new
memberships. All attendees and supporters of the refugee community are encouraged to become
members of the forum. Members will be featured on the website and can participate as co-chairs in the
task forces.
• Refugee Forum Officers Kathi Anderson and Ute Maschke are in attendance. Nawal Alkatib (Treasurer)
and Carmen Kcomt (Secretary) are absent due to vacation and illness, respectively.
3. Task Force Updates:
• Health Task Force: The task force met for a review of last year’s activities (including the very successful
“Happy & Healthy” health fair) and for some preliminary planning of new activities. Enlarging the
health fair is one of those plans, and there are some other plans. So please join the task force to learn
more and to contribute with ideas. The next meeting is scheduled for February 6, 3:30pm, at the Karen
Organization. At that time, task force members will determine the agenda for the year and have a chance
to determine the best meeting time (since Friday afternoons might not work for everyone). Please
contact Bonnie Copland, if you want to be on the task force’s email list.
• Employment Task Force: We are looking for new co-chairs and new members. Please contact Carlos
Mendez if you are interested.
• Domestic Violence: The task force met last week (as always, on the second Monday of the month) and
reviewed the achievements of 2014. Members are currently setting the agenda for the year which will
include raising awareness, strengthening the role of advocates, reaching out to agencies that work with
refugees, and preparing flyers for service providers. Please send volunteers A curriculum for a short
training module for selected candidates is also being developed.
• Asylee/Asylum Seeker Task Force: The asylum seeker/asylee task force met for and continued their
San Diego Refugee Forum Minutes
Tuesday, January 20, 2015, 10:30 a.m.-12:00 p.m. Alliance for African Assistance, 5952 El Cajon Blvd., San Diego, CA, 92115
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work on asset mapping, a gap analysis and a priority/feasibility matrix for asylum seekers. This project
will continue into the next meeting and lead to a decision what to do next in response to the analysis.
Please keep an eye on forum email announcements for the next meeting.
• World Refugee Task Force: Nao (chair) is currently looking for a co-chair. The task force should start
meeting in February and needs all the help possibly available. World Refugee Day is June 20th (a
Saturday).
5. Other Updates
Resettlement Agencies (formerly VOLAGs)
• Alliance for African Assistance: arrivals from (mostly) Iraq but also from Afghanistan. We also
welcomed some parolees, and there is talk that Syrians will be coming.
• Catholic Charities: arrivals are lower; much lower than anticipated. Arrivals are primarily from the
Middle East. We had some arrivals from Burma and Afghanistan.
• Jewish Family Service: No one present to comment
• IRC: We have been busy and resettled a rather high number of refugees (251) during the first quarter. So
far, we have 50 arrivals for January, from Iraq, Somalia, and Afghanistan.
County Agencies/Committees
• County: The county is working on a new initiative focusing on Mental Health, including strengthening
the health assessment, training on trauma-informed care, and developing activities. At this point in time,
we are focusing on training for RHAP health navigators (2 hours, at Catholic Charities), but this is only
the first step. We could bring the training to the forum is there were enough interest. The county’s child
welfare services are reaching out to work with refugees more directly through presentations on childcare
laws. We are also available for direct training at our office in El Cajon.
• State Advisory Committee: No one present to comment.
6. Focus: Covered California – ACA and impending deadlines/penalties. Jan Spencley, Executive Director, San
Diegans for Healthcare Coverage
Jan Spencley provided an in-depth look at the current state of things and outlook on things to come. Please
consult the pdf file attached to the minutes for details.
Q&A: The best way to apply for coverage is in person. We know the ins and outs of the system and can help
avoid detours and extra challenges. We can also connect applicants to the right resources right away. 211 San
Diego is now also doing enrollments online. Coverage needs to be based on the 10 points of minimal coverage,
San Diego Refugee Forum Minutes
Tuesday, January 20, 2015, 10:30 a.m.-12:00 p.m. Alliance for African Assistance, 5952 El Cajon Blvd., San Diego, CA, 92115
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so dental insurance in itself is not enough. Penalties for lack of coverage will go up drastically within the next
year(s). The biggest challenge in the next year(s) will be taxes and tax credits related to health coverage.
7. Spotlight: San Diego Refugee Forum
• The presentation has been postponed until February (to allow more time for the Focus discussion).
8. Community Updates
• Nao – KOSD – proudly announced that a newly established Japan Association for Refugees will visit
San Diego to learn from San Diego resettlement programs for Karen Refugees – and from the Karen
Organization. Japan will be the first resettlement country in Asia (soon to be followed by Korea), and
the association heard about San Diego and its well-developed collaborative network supporting refugees.
They will visit February 9 – 11, and want to meet with representatives from the community February 9th,
10 am (building across from the Karen Organization, where IRC is, too). Please join us in learning from
each other.
• Nile Sisters has an upcoming Health Insurance Enrollment event January 31sr, 10 AM – 4 PM. We will
have counselors ready to work one-on-one, in several languages: English, Arabic, Spanish, Burmese,
and Swahili. Location: 6035 University Ave, Suite 22. Contact lbom@nilesisters.org for more
information.
• The Legal Network of San Diego County is providing legal assistance to Filipino, Middle Eastern,
Vietnamese and Mixteco immigrant and refugee victims of sexual assault, domestic violence, date
violence, and stalking. Please contact Anne S Bautista (858) 560-0871 for referral to weekly confidential
legal intake clinics.
• The Urban League of San Diego County is offering Pathways of opportunities for youth between the
ages of 16 and 21. There are training sessions on job readiness, resume writing and interview
preparation, job and internship placement assistance, completing High School or GED as well as
financial coaching. Contact Kea Hagan for more information: kea@sdul.org (619) 266-6265
• On February 13th, loveyourheartsd.org will offer free blood pressure screenings at various locations
countywide. For more information contact the organization or call 2-1-1
Kathi Anderson encouraged attendees to complete the survey: https://www.surveymonkey.com/s/XGSQXVB.
Adjournment: 12:00 pm
Next Meeting: Tuesday, February 17th, 10:30 – 12:00 pm @ Alliance for African Assistance
San Diego Refugee Forum
January 19, 2014
Jan C Spencley, Executive DirectorSan Diegans for Healthcare Coverage
j @ dh 619 231 0333jan@sdhcc.org 619‐231‐0333
Topicsp
Share a little about San Diegans for Healthcare Coverageg g
Before and After Profiles – Who Enrolled Last Time
Remaining UninsuredRemaining Uninsured
Open Enrollment – February 15th Deadline
Targeted Outreach and Focused MessagingTargeted Outreach and Focused Messaging
Consumer Resources
January 20, 2014 SD Refugee Forum 2
Who We Are: A not‐for‐profit, 501(c)3 organization, formed in 2002.
With a Mission:A Coalition for HealthSan Diegans for Healthcare Coverage advances meaningful coverage care and health for all San Diegans We serve as acoverage, care and health for all San Diegans. We serve as a trusted community leader, unbiased resource and catalyst for action and collaboration, while connecting and amplifying our ll i d icollective resources and voice.
Activities:Convene ‐ Bridge ‐ Educate ‐ Advocate ‐ Enroll ‐ Access ‐ ContinuityConvene ‐ Bridge ‐ Educate ‐ Advocate ‐ Enroll ‐ Access ‐ Continuity
January 20, 2014 SD Refugee Forum 3
San Diegans for Healthcare CoverageHistoryHistoryYears Organizational Status‐Activities
1998‐ •Project Management Committee (PMC)2001 •Improving Access to Healthcare (County Project)
•Worked on Waiver Proposal for Expanding Coverage (overtaken)•AB1547 – Business Healthcare Connection Demo (Alpert/Zettel)
l h k•Pilot Business Outreach and Networking•Governor Vetoed After 100% Yes Votes
2002‐ •SDHCC Formed from PMC – 501(c)3 Established2004 •Subsidiary BHC Formed as Separate Entity/Board of Directors
•Vision – Mission – Values – Strategies – Board Orientation•Operational Entity ‐‐ Business Outreach and Networking
2004‐2005
•Consensus Building (Roundtables to Achieve Consensus on Plans)•Who covered – How Premiums Paid•Benefits Package and Cost Sharing
HC O i l O h d N ki•BHC Operational Outreach and Networking
January 20, 2014 4SD Refugee Forum
San Diegans for Healthcare CoverageHistory – Page 2History Page 2Years Organizational Status‐Activities
2005‐ •SB103/SB51 – SD Healthcare Connection Demonstration Project2007 (Ducheny)
•Three‐Share Pilot Demonstration (Employer‐Employee‐Government)•Overtaken by Governors Health Reform Proposal (Died)
2006‐2009
•Advocacy and Health Reform Forums •Series of Community Forums Building on Past Work•San Diego Principles and Key Elements of Reform (adopted)
BHC O ti l (N t ki O t h d Ed ti ) Cl d 2009•BHC Operational (Networking, Outreach and Education)‐ Closed 20092010‐2011
•SD Roadmap to Coverage and Care (Workgroup ‐ Draft)•Board Strategic Planning Retreat (Roadmap ‐ Priorities – SDHCC Role)d d h d d i•Advocacy and Outreach and Education
2011‐2013
•Outreach and Communications Collaborative – Connector Program•ACA Implementation Advocacy•Primary Link Care Transitions Pilot (2013)•Outreach and Education Activities – Collaborative Proposal
January 20, 2014 5SD Refugee Forum
San Diegans for Healthcare Coveragei i i i iOrganization ‐ Initiatives
January 20, 2014 6SD Refugee Forum
Our ActivitiesOur Activities
Outreach and Education• Outreach to Targeted Audiences (Vets, Students, Employees)• Presentations to Organizations• Business OutreachEnrollment Assistance – Advocacy• Convene Certified Enrollment Counselors with SMEs• Convene Certified Enrollment Counselors with SMEs• Navigator with 211 San Diego/ Certified Enrollment Entity • Document Front Line Issues (CCHEA/County)Access – Coordination ‐ Continuity of Healthcare• Workgroups
Ad• Advocacy
January 20, 2014 SD Refugee Forum 7
SDHCC Collaborative – ForumsP d Obj tiPurpose and Objectives
To share information and resources that will assistTo share information and resources that will assist Enrollment Counselors with • Submitting “complete” applications that result in successful
eligibility and enrollment• Resolving issues encountered by applicants/enrolleesTo bring subject matter experts together with EnrollmentTo bring subject matter experts together with Enrollment Counselors to review protocols and share and resolve issues and concerns (County – Legal Aid – Others)To identify issues and resource needs to assist counselors and consumers with efficient/effective enrollment
January 20, 2014 SD Refugee Forum 8
SDHCC CEC I f W h (D B )SDHCC CEC Info Warehouse (Drop Box)
Resources and Desk Aids• Access to Care• Citizenship/Immigration Status• Community ClinicsCommunity Clinics• Covered CA Renewals• Income
G• MAGI• Medi‐Cal Renewals• Presumptive Eligibility• Special Enrollment• VerificationsReferencesReferences
9January 20, 2014 SD Refugee Forum
To Maximize and Stabilize Coverage R S t C ll b ti I l iResources – Systems – Collaboration – Inclusion
ExchangeExchangeBusinessCommercial Public
Public
Individuals & Families
BusinessMarket Programs
Individuals & Families
Education/Sales ‐ Enrollment – Retention ‐ Transitions ‐ RenewalEducation/Sales Enrollment Retention Transitions Renewal
January 20, 2014 SD Refugee Forum 10
Health Insurance Status (2011‐2012)S Di C t N Eld lSan Diego County Non‐Elderly
January 20, 2014 SD Refugee Forum 11
Challenging SD Target PopulationsChallenging SD Target Populations
Income22%
14%134‐200% FPLEX ‐ Subsidy
200‐300% FPLEX ‐ Subsidy
9%0‐133% FPL300‐400% FPL
40%15%
Medi‐Cal
15%400% + FPLEX ‐ No subsidy
January 20, 2014 SD Refugee Forum 12
Challenging SD Target Populationsg g g p
OtherEthnicity
4%3%
7% 4%
Afr‐Am
Nat‐AmAsian
4%
56%
27%
Latino
White27%
January 20, 2014 SD Refugee Forum 13
Uninsured Population ProfileLi i i Ch llLinguistic Challenges
Speaks Another LanguageAt Home How Well Is
English Spoken?
23%
32%
Very Well
Well32%
45%
50%NO
Well
Not Well orN All
50%YES
Not at All
January 20, 2014SD Refugee Forum 14
Uninsured Population Profiled ilAge and Family Type
Age Family Type88%
Age Family Type
Single/h ldM i d /
%33%
No ChildMarried w/Child
12
42%
%
0 18 19 64
16%10%
Single w/Child Married/No Child0‐18 19‐64 a ed/ oC d
15January 20, 2014 SD Refugee Forum
Most Uninsured Individuals and Families Qualify for Coverage Affordability ProgramsCoverage Affordability Programs
Program Eligibility by Annual Income/Family Size Federal Poverty Level (FPL)Federal Poverty Level (FPL)
No CostEligible for Premium Assistance (PA)
C Sh R d dHousehold
Size
No Cost Medi‐Cal Eligible
Cost Share Reduced
Medi‐Cal Kids Eligible
Health Coverage Expansion ‐ 2014Individuals and Families – Small Employers
ACAACA
Covered C lif i Medi‐Cal
Privately InsuredAll 222,000Under 400% 122,000
EligibleNot
E ll dCalifornia(CA Exchange) Expansion
Under 250% 60,000 Enrolled200,000
Small Business Health Options
Program
Individuals and Families
(>138% FPL)
Adults 19 – 64 (
Covered CA Enrollment by Metal TierSan Diego: October 1 to March 31
January 20, 2014 SD Refugee Forum 19
Covered CA Enrollments M th d P thMonth and Pathway
January 20, 2014 SD Refugee Forum 20
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Uninsured Targets by EthnicityC d CA E ll d (M h 2014)Covered CA Enrolled (March 2014)
Uninsured
7% 4%Nat‐Am
Asian Other
Uninsured
4%3% LatinoAfr‐Am
56%
27%
White
27%
January 20, 2014
SD Refugee Forum 26
January 20, 2014 SD Refugee Forum 27
Messaging and Strategiesg g g
Focused Consumer Messaging• Lead with Immigration Status Assurances• Lead with Affordability examples• Promote Phone/Online Application Assistance/ pp• What is coverage? How to use coverage?
Channels to Consumers (not businesses)Channels to Consumers (not businesses)• Focus on Small Employers (to employees)• Focus on Trusted Associates/Agencies (immigrants)• Trade Associations (to small employers)• Life Event Agencies (births, marriages, lost job/hours, etc)• Coverage Connector (online assistance appointmentsCoverage Connector (online assistance appointments
January 20, 2014 SD Refugee Forum 28
d lif i llCovered California Enrollment
Open Enrollment for 2015:p• November 15, 2014 – February 15, 2015• Enroll by December 15th for January 1 Effective DatePlease ‐ Do Not Wait Until Last Minute!• System and Counselors Become Overloaded• One‐third of uninsured individuals reported inability to get• One‐third of uninsured individuals reported inability to get
through last yearSpecial Enrollment (February 16 – November 14, 2015)• Qualifying Life Event (within 60 days)• Birth, Death, Job Loss, Loss of Coverage, Moved , EtcMedi Cal Available All YearMedi‐Cal Available All Year
January 20, 2014 SD Refugee Forum 29
Health CoverageIndividual ResponsibilityIndividual Responsibility
• All Citizens ‐ Legal Residents are required to maintain coverage thatrequired to maintain coverage that meets minimum standards
E ti (fili TBD)• Exemptions (filing TBD):▫ Religion Prohibits/Provides▫ Native Americans▫ Undocumented▫ Incarcerated▫ Financial Hardship: Below
The Individual Mandate applies to adults and children.
There is a tax penalty associated with a Financial Hardship: Below federal tax filing level
▫ Financial Hardship: Coverage offered is unaffordable (exceeds
lack of health coverage :
2014: $95/adult or 1% of income (9mo)2015: $325/adult or 2% of incomeoffered is unaffordable (exceeds
8% of income)30
2015: $325/adult or 2% of income2016: $695/adult or 2.5% of income
January 20, 2014 SD Refugee Forum
Why to Enroll in Health Coverage?y g
It is the Law. Invest in health, not in penaltiesSecurity. Nobody plans to get sick. Insurance protects you and your family from the unexpectedYour Health is Precious You owe it to yourself and yourYour Health is Precious. You owe it to yourself and your family to protect it• Free preventive care (mammograms, colonoscopies, etc)
Add h l h b f h h l h bl• Address health concerns before they are health problemsProtect Your Credit. Healthcare is expensive. You Have Options. It is now easier to shop and compare and p p peasier to enrollAffordability. There are more affordable options with better rates than you can negotiate to “pay as you go”rates than you can negotiate to pay as you go
January 20, 2014 SD Refugee Forum 31
Consumer Resources
How Consumer Center Can Help p(1‐877‐734‐3258)• Partnership with Covered California – DMHC ‐ DHCS
I d d i• Independent consumer assistance• Addresses barriers to accessing health insurance and health
care benefits (eligibility & services) • All consumers, regardless of income• Both public programs and private insuranceWh i M di C l A li i ?Where is my Medi‐Cal Application?(1‐866‐262‐9881) – ACCESS Line for Consumers
January 20, 2014 SD Refugee Forum 32
Questions & AnswersQ
January 20, 2014 SD Refugee Forum 33
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