Government
Bill Introduced to Improve Maternal Healthcare
THE AFRO — Expectant mothers face challenges when seeking quality prenatal care in the District of Columbia. Economic and transportation barriers contribute to the District’s infant mortality rate which is amongst the worst in the nation. In 2018 there were an average of 36.1 deaths for every 100,000 live births while nationally the rate is 20.7.
By Mark F. Gray
Expectant mothers face challenges when seeking quality prenatal care in the District of Columbia. Economic and transportation barriers contribute to the District’s infant mortality rate which is amongst the worst in the nation. In 2018 there were an average of 36.1 deaths for every 100,000 live births while nationally the rate is 20.7.
The D.C. City Council is pondering a bill that pushes for better maternal health care services that would be covered under all forms of insurance in an attempt to provide better prenatal care for expectant mothers in the District.
Ward 6 Councilmember Charles Allen introduced legislation that proposes expanding the list of medical care provisions for expectant mothers. The Maternal Health Care Improvement and Expansion Act of 2019 would also create a Center for Maternal Wellness and includes a travel stipend to aid in transportation so patients can reach their preferred health care provider consistently during pregnancy.
“We know women need more access to health care during and after a pregnancy,” Allen said in his statement. “We know community-centered health care can improve outcomes.”
However, Black mothers are facing more dangerous outcomes during their pregnancies. Figures reported by Allen’s office state Black women are dying at a rate that is three to four times higher than White expectant mothers. Low income mothers are struggling to gain consistent regular preventive, prenatal and postpartum care which is contributing to the D.C.’s high maternal mortality rate also.
“Last year, this Council created a Maternal Mortality Review Committee, but we don’t have to wait for results to make improvements,” said Allen.
The bill, which was co-sponsored by Councilmember Vincent Gray, would require private insurers, Medicaid, and the D.C. Healthcare Alliance to add pre and post natal services to it’s benefits. It would cover at least two postpartum health care visits and home visits for maternal care and fertility preservation services. Currently, Medicaid only includes one postpartum visit after six weeks and ends postpartum medical coverage at 60 days.
Allen’s proposal addresses the barriers facing patients who find it difficult when traveling to their health care provider by offering financial assistance for travel to and from prenatal and postpartum visits. Transportation availability is seen as a vital cog in the hope of improving infant survival rates in D.C.
“We know for some women transportation is a barrier,” Allen stated. “That’s why this bill also includes a travel stipend to get to their preferred health care provider. If we can’t get people there, none of these other changes will make a difference.”
This bill would extend coverage to one full year for extremely low income residents who are living well below the federal poverty line.
The bill also calls for establishing a Center on Maternal Health and Wellness. Allen wants to build community among women who are pregnant and would consolidate a portion of services to be conveniently available in one location. The Center would offer childcare onsite while making its services available through telehealth and online.
At the Center, a group of maternal care coordinators would advise pregnant mothers on how to navigate through the services available in the District during pregnancy and postpartum. It will promote maternal support groups and provide health and nutrition counseling, and distribute prenatal vitamins. Group counseling services would also be available for individuals or family members who have been impacted by an infant’s or mother’s death. This is similar to the District’s comprehensive breastfeeding center.
“We know a sense of community can help pregnant women and new mothers talk through challenges,” said Allen.
This article originally appeared in The Afro.
Activism
Oakland Post: Week of November 20 – 26, 2024
The printed Weekly Edition of the Oakland Post: Week of November 20 – 26, 2024
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Activism
An Inside Look into How San Francisco Analyzes Homeless Encampments
Dozens of unhoused people are camped at Sixth and Jesse streets in San Francisco’s South of Market neighborhood. Tents made of tarps and blankets, piles of debris, and people lounging alongside the allies and walls of businesses are seen from all angles. These are some of the city’s hotspots. City crews have cleared encampments there over 30 times in the past year, but unhoused people always return.
By Magaly Muñoz
Dozens of unhoused people are camped at Sixth and Jesse streets in San Francisco’s South of Market neighborhood. Tents made of tarps and blankets, piles of debris, and people lounging alongside the allies and walls of businesses are seen from all angles.
These are some of the city’s hotspots. City crews have cleared encampments there over 30 times in the past year, but unhoused people always return.
But it’s normal to have tents set up again within less than 24 hours after an encampment sweep, David Nakanishi, Healthy Streets Operation Center Manager at the Department of Emergency Management, says. Sometimes there’s less people than before but often there is also no change.
“Most of the people that were in the encampments that want to go inside, we’ve gotten the majority of those [into shelter],” Nakanishi says. “Many of the people we encounter now, are those who have various reasons to not accept shelter, and some are already in shelter/housing”.
Since the ruling of Grants Pass by the US Supreme Court earlier this summer, which allows cities the authority to ban people from camping or sleeping on the streets, San Francisco has been at the head of the conversation to crack down on encampments.
Where neighboring cities in the Bay Area are clearing encampments a few days a week, San Francisco is sweeping 10 times a week, two per weekday.
Considering the controversy that plagues the city around its harsh policies, the Post decided to tag along on a ride with Nakanishi to show us how he decides what encampments make it on the city’s sweep list.
Nakanishi, having over 20 years of experience in homelessness management, drives around the busiest parts of the city almost daily. He’s tasked with arranging a weekly sweeping operation schedule for city teams to engage with unhoused folks to help get them off the streets.
So what exactly is he looking out for when deciding what encampments get swept?
It depends, he says.
Locations like schools, recreational centers, senior centers, or businesses are places he tends to want to address quickly, especially schools. These are the places where the complaints are highest and access to facilities is important for residents.
He says he also takes into account 311 calls and reports made to him by city staff. On the date of publication, over 100 calls and reports were made about encampments around the city, according to San Francisco data.
Nakanishi made a few 311 reports himself on the ride along, pulling over to take photos and describe the encampments into his 311 app. He says it helps him remember where to possibly sweep next or allows smaller teams in the city to engage quicker with individuals on the streets.
Nakanishi also looks at the state of the encampments. Are there a lot of bulky items, such as furniture, or makeshift structures built out of tarps and plywood, blocking areas of traffic? Is trash beginning to pile up and spill into the streets or sidewalks? Sites that meet this criteria tend to be contenders for encampment sweeps, Nakanishi says.
Street by street, he points out individuals he’s interacted with, describing their conditions, habits, and reasons for denying assistance from the city.
One man on 2nd St and Mission, who rolls around a blue recycling bin and often yells at passing pedestrians, has refused shelter several times, Nakanishi says.
People deny shelter for all kinds of reasons, he says. There’s too many rules to follow, people feel unsafe in congregate or shared shelters, or their behavioral and mental health problems make it hard to get them into proper services.
Nakanishi references another man on South Van Ness under the freeway, who city outreach have attempted to get into shelter, but his screaming outbursts make it difficult to place him without disturbing other people in the same space. Nakanishi says it might be an issue of the man needing resources like medication to alleviate his distress that causes the screaming, but the city behavioral team is in the process of outreaching him to figure that out.
In October, city outreach teams engaged with 495 unhoused people. 377 of those engaged refused shelter and only 118 accepted placements, according to city data. That number of monthly referrals is consistent throughout the entirety of 2024 so far.
Nakanishi has long advocated for the well-being of unhoused people, he explains. In 2004, he was working with the Department of Public Health and told then-Mayor Gavin Newsom that there needed to be more housing for families. Nakinishi was told it was easier to deal with individuals first and the city “will get there eventually.” 20 years later, family housing is still not as extensive as it could be, and the waiting list to get placements for families is a mile long with over 500 names.
In 2020, he was a Senior Behavioral Health Clinician at a hotel in the city during the pandemic. He says in 2021 he collaborated with DPH to provide vaccines to those staying in the makeshift hotel shelters once those became available.
Despite the constant media attention that city outreach is inhumanely treating homeless people, so much so that it has led to lawsuits against San Francisco from advocates, Nakanishi says not a lot of people are seeing the true conditions of some encampments.
He describes soiled clothing and tents, drenched in urine, and oftentimes rodents or bug infestations in places where people are sleeping. He’s asked homeless advocates- often those who are the most critical about the city’s work- who have shown up to observe the sweeps if those are conditions the city should allow people to be subjected to, but not many have answers for him, Nakanishi says.
The city’s “bag and tag” policy allows city workers to throw away items that are “soiled by infectious materials” such as bodily fluids and waste.
Sweep operations are conducted at 8am and 1pm Monday through Friday. People at the encampments are given 72 hour notice to vacate, but some don’t leave the area until the day of the sweep.
City outreach workers come out the day before and day of to offer resources and shelter to those interested. The Department of Public Works discards any trash that is left over from the sweep and washes down the area.
Nakanishi told the Post that the only time the city takes tents or personal possessions from residents is when folks become physically violent towards workers and police take the items as evidence. Other items taken are bagged and tagged in accordance with city policy.
Stories from local newspapers such as the San Francisco Standard and the Chronicle show instances of SFPD handcuffing residents while their items are thrown in the trash or disposing of personal possessions without reason.
Advocates have long been pushing for a more competent and compassionate process if the city is going to choose to continue sweeping unhouse people.
No matter the lawsuits and constant criticisms from allies, the encampment sweeps are not slowing down, even with the cold weather quickly approaching the coastal city.
Nakanishi says there aren’t a lot of large encampments left in San Francisco so now they do runs of streets in order to stretch out the sweeps as much as possible.
It’s calculated strategies and years of first hand knowledge that make this job work, “It takes dedication to the work, caring for the people and the community, and persistence, patience and sometimes good luck to make the positive changes for the people on the street,” Nakanishi says.
Activism
Oakland Post: Week of November 13 – 19, 2024
The printed Weekly Edition of the Oakland Post: Week of November 13 – 19, 2024
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