Moving People Forward: 2019 Impact Report

Dear Friend,

It’s been a tremendous year at PRC, and I’m pleased to share PRC’s 2019 Impact Report with you today.

As you’ll learn, PRC’s staff, volunteers, and clients have been hard at work transforming lives and the systems San Francisco has in place to support vulnerable adults. We opened PRC’s new Integrated Service Center in April 2019 to improve the way people affected by mental health issues, substance use, and HIV/AIDS access crisis intervention, stabilizing services, and longer term supports when they’re needed. In 2018, we helped 5,419 adults.

At PRC we’re addressing the nexus of poverty, stigma, discrimination, and isolation head-on to prevent hopelessness and connect people—like John on page 5 or Liliana on page 7—with new and better paths out of poverty and addiction, illness and stigma, homelessness and decline.

Honesty and innovation are key to moving past the status quo. In San Francisco, as across the nation, we are all challenged to reflect on a rising population of homeless adults and redress inequities in health and resource distribution. You and I may have a support network, a safety net, a couch, or access to money for treatment services or prescription medication when it’s needed. For those among us who do not, whether it’s a brief moment of free fall or a life-long health issue to manage and best, PRC is here: a bridge to hope, to health, and to wellness.

I invite you to read on, be inspired, bring your questions, and share with a friend.

In community,

Brett Andrews

Chief Executive Officer

SSI Recipients Can Now Receive CalFresh Benefits

Beginning in June 2019, California residents receiving Supplemental Security Income (SSI) who also receive a State Supplementary Payment (SSP) can get CalFresh benefits. The SSP program was intended to replace the Food Stamp program (now known as CalFresh in California) for SSI beneficiaries when it was implemented in 1974. Over the years, the SSP benefit has remained relatively stable, while CalFresh benefits have increased to reflect inflation. Given the relative loss of value of SSP benefits, the California legislature passed Assembly Bill 1811 to allow SSI/SSP recipients also to receive CalFresh benefits.

This means more opportunities for SSI/SSP beneficiaries to purchase nutritious food

CalFresh is a free nutrition assistance program that enhances the food budgets of low-income individuals. Monthly CalFresh benefits range between $15 to $192 based on household size, income, and monthly expenses. SSI/SSP recipients can apply for CalFresh benefits to purchase food at vendors who accept EBT such as grocery stores, farmers markets participating in the Market Match, and restaurants participating in the Restaurant Meals Program (View Map). SSI/SSP beneficiaries who receive CalFresh will have no reduction to their SSI/SSP payment. Assembly Bill 1811 also resulted in a monthly grant increase of $10 for recipients of the Cash Assistance Program for Immigrants (CAPI) so that SSI/SSP benefits and CAPI benefits are equal. CAPI beneficiaries will remain eligible for CalFresh benefits. Households already receiving CalFresh who had an excluded SSI beneficiary may receive an increase to their CalFresh benefits. However, this change will increase the overall income for some households as SSI/SSP income will no longer be excluded, which may cause a reduction in the monthly CalFresh grant. For those households who would experience a reduction in CalFresh Benefits, the Supplemental Nutrition Benefit (SNB) and Transitional Nutrition Benefit (TNB) programs will provide additional benefits to avoid any reduction to overall nutrition benefits.

There are three ways to apply

Each applicant may need to provide proof of income, residency, and identity. HSA may be able to help with obtaining these required documents. Learn more about benefits and eligibility. NOTE: Due to the high volume of new applicants, applicants may experience extended wait times at HSA service centers and by phone in June and July 2019. Consider applying online or call (415) 558-4700 to schedule an in-person appointment.   

Covered California: Tax Filing Requirement for Consumers Receiving Premium Assistance

Some Californians, individuals, and families enrolled in Covered California (Covered CA) plans are eligible for financial assistance to lower the cost of their health insurance.  Anyone who receives financial assistance with Covered CA is required to file a federal tax return as a condition of eligibility.

Covered CA offers two main ways to get assistance with health care coverage costs:

  • Premium Assistance (formally called the Advanced Premium Tax Credit or APTC) is a tax credit to reduce an individual’s monthly premium.
  • Cost-Sharing Reductions is a subsidy to reduce an individual’s out-of-pocket costs (their copay’s, coinsurance, deductible and out-of-pocket maximum).

Important Information Regarding Premium Assistance and Tax Filing

All Covered CA consumers who receive Premium Assistance/APTC, must file federal taxes for each calendar year they receive the assistance. If they fail to file their taxes, they will lose their eligibility for Premium Assistance/APTC. The consumer will then be responsible for paying the full premium amount and will have a higher cost-sharing for health care services.

Warning Notices

Covered CA has mailed warning notices to those who are at risk of losing their Premium Assistance/APTC. These notices were sent to consumers who in 2017:

  • Received Premium Assistance/APTC in the calendar year but did not file a federal tax return for that year;
  • Filed a federal tax return but did not include IRS Form 8962; or
  • Requested an extension to file a federal tax return but did not end up filing the return.

Covered CA consumers who fall within any of these categories will have until May 15, 2019, to preserve their Premium Assistance/APTC by reconciling their premium assistance and contacting Covered California to attest to having done so.

If consumers fail to take these steps, they will receive another notice, in a pink envelope, that tells them when their financial assistance will end if no action is taken. Covered CA consumers who fail to take corrective action will lose their current financial help starting July 1, 2019.

Latinx LGBTQ+ Mental Health

Each Mind Matters1(EMM) recently collaborated with a group of LGBTQ+ community leaders and stakeholders to come together and create informational materials on mental health issues faced by Latinx LGBTQ+. The materials focus on three key segments: young adults, older adults, and providers working with Latinx youth.

Latinx LGBTQ+ Youth Mental Health Provider Fact Sheet2

This fact sheet helps providers working with Latinx LGBTQ+ youth address the complex connections that can have an impact on a young person’s life, such as sexual orientation, gender identity, race/ethnicity, and immigration status. The fact sheet provides relevant resources and best practices within a culturally responsive framework.

EMM also created a fully bilingual in Spanish and English resource online, which covers key terms for providers working with Latinx LGBTQ+ youth, things to consider as mental health professionals serving Latinx LGBTQ+ immigrant youth, and seeking benefits. At this time there are no printed copies available; however, the pamphlet is available free to download3.

EMM website is a resource for mental health and LGBTQ+ topics:

 

  1. https://www.eachmindmatters.org/
  2. https://emmresourcecenter.org/resources/latinx-lgtbq-immigrant-youthjovenes-inmigrantes-latinx-lgbtq-fact-sheet
  3. https://emmresourcecenter.org/system/files/2018-02/Latinx%20LGBTQ%20Immigrant%20Youth_Provider%20Fact%20Sheet_0.pdf
  4. https://www.eachmindmatters.org/wp-content/uploads/2017/11/Latinx_A_Brief_Guidebook.pdf
  5. http://www.eachmindmatters.org/wp-content/uploads/2017/06/Be-True-Be-You-LGBTQ-Booklet-DIGITAL.pdf
  6. http://www.eachmindmatters.org/wp-content/uploads/2017/06/LGBTQ-Mental-Health-Aging-Guide-DIGITAL.pdf

It Is Tax Time Again

With all the recent tax reform changes, many people have many questions. Intuit has created a nice article that explains how the changes affect 2017 taxes (taxes you actually file in 2018) and changes that take effect next year during the 2018-tax filing season (taxes you file in 2019).  Below are some highlights, important dates, and resources to help you file your taxes.

Tax Penalty for Not Having Health Insurance

Individuals without qualifying health coverage for all or part of 2017 may still have to pay a tax penalty for the tax year 2017. A tax preparer or tax prep software may assist in calculating any penalty for not having health insurance.

For the tax year 2017, the penalty is the greater of 1) 2.5% of total household adjusted gross income, OR 2) $695 per adult and $347.50 per child, up to a maximum of $2,085 per family. The penalty amounts have not been set for the 2018 tax year and beyond.

In limited situations, some individuals may be exempt from the tax penalty.

Medical Expenses

If you itemize deductions in 2017, you may be able to deduct qualifying medical expenses to the extent they exceed 7.5% of your Adjusted Gross Income. See the IRS Publication for a full list of qualified medical expenses.

Deadline to File 2017 Taxes is April 7, 2018

The deadline to file your personal tax return for the tax year 2017 is Tuesday, April 17, 2018. (Why the change? Because April 15 falls on a Sunday, and Monday is Emancipation Day, observed in Washington D.C., the home of the IRS.) If you are not ready to prepare and file your return by the deadline, you may request a six-month extension with the IRS.

Free Tax Filing Assistance in San Francisco

Mission Economic Development Agency (MEDA)

Provides free tax services in English and Spanish. Call 2-1-1 (available 24/7 in 150 languages) to make an appointment.

Volunteer Income Tax Assistance (VITA)

Provides free tax return preparation for qualifying taxpayers. Visit the hyperlink above to locate a VITA or Tax Counseling for the Elderly (TCE) program near you.

Earn it! Keep it! Save it! A program of the United Way

Provides free tax services to qualifying taxpayers. Visit the hyperlink to find out about eligibility, what to bring to your meeting and the program sites near you.

AARP Foundation Tax-Aide

Offers free, individualized tax preparation for low to moderate-income taxpayers – especially those 50 and older – at more than 5,000 locations nationwide. Find a location near you by searching the link.

HEALTH TIP: U = U Got Questions?

U = U means undetectable equals untransmittable. This slogan refers to the fact that there is effectively no risk of sexually transmitting HIV when the virus is reduced to undetectable levels.

An undetectable viral load for people living with HIV means they will not transmit HIV to their partners. Active engagement in treatment as prevention is a key to maintaining an undetectable viral load and preventing HIV transmission. ‘Treatment as Prevention’ (TasP) is defined as any HIV prevention method that uses antiretroviral therapy (ART) to decrease the risk of HIV transmission to a sexual or needle-sharing partner. ART reduces HIV in blood, semen, vaginal fluid, and rectal fluid to very low levels, and as a result, lowers HIV transmission. ART can even lower viral load to undetectable levels.

Evidence from real-world studies including PARTNER and Opposites Attract shows the affect TasP and ART have on preventing HIV transmission in the PARTNER study that there were ZERO transmissions out of 58,000 condomless sex acts between people with undetectable HIV viral loads and their HIV-negative partners. In the Opposites Attract study, there were no transmissions out of 17,000 condomless sex acts between men. Since the advent of combination therapy, there have been no confirmed reports of anyone with an undetectable viral load sexually transmitting HIV.

An important aspect to TasP is regular viral load testing. Testing is recommended about 2-4 times a year for people who have a stable undetectable viral load. More frequent testing may be necessary and it is recommended that people speak with their doctors about appropriate care, treatment, and testing.

Evidence shows that with regular testing and continued treatment, people living with undetectable HIV viral loads may let go of fears about transmitting HIV to their partners. Instead, we can all focus on the fact undetectable does equal untransmitable.

References:

Cohen MS, Chen YQ, McCauley M, et al. Antiretroviral therapy for the prevention of HIV-1 Transmission. New England Journal of Medicine. 2016;0(July 18):1-10. http://www.nejm.org/doi/full/10.1056/NEJMoa1600693#t=article

Del Romero J, Castilla J, Hernando V, Rodríguez C, García S. Combined antiretroviral treatment and heterosexual transmission of HIV-1: cross sectional and prospective cohort study. British Medical Journal. 2010;340:c2205. http://www.bmj.com/content/bmj/340/bmj.c2205.full.pdf

Frieden TR, Foti KE, Mermin J. Applying Public Health Principles to the HIV Epidemic—How Are We Doing? New England Journal of Medicine. 2015;373(23):2281-2287. http://www.nejm.org/doi/full/10.1056/NEJMms1513641#t=article

i-Base. Q&A on the PARTNER study: how to interpret the zero transmission results. 2016; http://i-base.info/qa-on-the-partner-study/. Accessed 07/18/2016.

Loutfy M, Tyndall M, Baril J-G, Montaner JS, Kaul R, Hankins C. Canadian consensus statement on HIV and its transmission in the context of criminal law. Canadian Journal of Infectious Diseases and Medical Microbiology. 2014;25(3):135-140. http://www.hivlawandpolicy.org/resources/canadian-consensus-statement-hiv-and-its-transmission-context-criminal-law-mona-loutfy

Loutfy MR, Wu W, Letchumanan M, et al. Systematic review of HIV transmission between heterosexual serodiscordant couples where the HIV-positive partner is fully suppressed on antiretroviral therapy. PloS one. 2013;8(2):e55747. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0055747

Rodger AJ, Cambiano V, Bruun T, et al. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. Journal of the American Medical Association. 2016;316(2):171-181. http://jama.jamanetwork.com/article.aspx?articleid=2533066

Vernazza P. HIV-infizierte Menschen ohne andere STD sind unter wirksamer antiretroviraler Therapie sexuell nicht infektiös. 2008. http://www.aids.ch/de/downloads/pdfs/EKAF-Statment_2008-05-089.pdf

Vernazza PL, Bernard EJ. HIV is not transmitted under fully suppressive therapy: The Swiss Statement – eight years later Swiss Med Weekly 2016; http://bit.ly/SwissMedWeekly  Accessed Sept. 4, 2016, 146.

Stay the Course, the Fight is Not Over! – – National Black HIV/AIDS Awareness Day

Across the United States on Wednesday, February 7, 2018, there will be individuals and organizations participating in National Black HIV/Aids Awareness Day to promote HIV education, testing, community involvement and treatment in black communities. This year’s theme is “Stay the Course, the Fight is Not Over!”

Education

The statistics show there is a need for this day of awareness. In the United States, there were 972,813 individuals living with HIV, 42 percent of which are African American. Of the 40,040 newly diagnosed cases, 44 percent are African American. In 2016, there were 16,010 individuals living with HIV in San Francisco. Twelve percent of this population was African American. In the same year, there were 223 newly diagnosed HIV cases in San Francisco, 15 percent were African American individuals. Good news—there was a small percentage drop in newly diagnosed HIV cases between 2015 and 2016 in San Francisco.*

Testing

San Francisco Aids Foundation offers free, confidential HIV testing. You can find other testing sites in San Francisco here.  If you live outside of San Francisco, find a testing site near you.

 Community Involvement

National Black HIV/AIDS Awareness Day March & Vigil the Black Brothers Esteem, a prevention and support program of San Francisco AIDS Foundation has planned a march, which starts at 5:00 pm on the steps of San Francisco City Hall, and ends with the vigil at 6:00 pm at the African-American Arts and Cultural Center (726 Fulton Street).

Bayard Rustin LGBT Coalition is planning an event on Wednesday, February 7 at 9:00 am based on a Facebook Event.

In honor of National Black HIV/AIDS Awareness Day, San Francisco AIDS Foundation and Black Brothers Esteem (BBE) invite you to an open soirée celebrating black excellence and resilience in the gay community. The Royal Affair!  For a night of elegance, live entertainment, live music, food, and drinks. The event is entirely free and attendees are encouraged (but not required) to dress up and/ or wear a splash of purple. We will also be offering free on-site HIV testing. All attendees must be 21+

Friday, February 9, 2018, between 6:00 pm-9:00pm @ Mr. Smith’s, 34 Seventh Street, San Francisco

Treatment

HIV Treatment works! The CDC says more than 1.1 million people in the United States are living with HIV, and that staying in care and engaged in treatment helps people stay healthy, protect others, and live healthier lives.

*based on data HIV Epidemiology San Francisco 2106 Annual Report & 2015 Annual Report

HEALTH CARE TIP: Adult Dental Benefits

Adult dental benefits were fully restored to Midi-Cal recipients effective January 1, 2018, as part of the 2017-2018 Budget Act. Now major services such as partial dentures, root canals on back teeth and gum treatment are covered. Along with an array of general maintenance services such as cleanings, x-rays and fillings and more, Western Center on Law & Poverty has a one-page fact sheet on the restored adult dental benefits.

Still, ongoing access to Denti-Cal services and providers is an issue in California. In 2015, the state appointed a State Dental Director to address Denti-Cal access. To access Denti-Cal and take advantage of these adult dental benefits enroll in Medi-Cal through Covered CA.

Reminder: Covered CA open enrollment ends Wednesday, January 31, 2018.

Take Three Actions to Fight the Flu

The Center for Disease Control and Prevention (CDC) has stressed the need to have a defense against the influenza (the Flu) this season. With three more weeks of the regular flu season, here are three ways the CDC recommends to fight the flu.

#1 Get a Flu Shot

This is the first and most important step in the defense of the flu. There are many different flu viruses, the vaccine protects against the most common ones research suggests.  It is important to keep in mind, the flu shot might not prevent every strain of the flu each season; however, it should aid in reducing the flu illnesses and doctors’ visits.

For those who have chronic health conditions and are at a high risk of serious flu complications and it is recommended to get the flu shot each year. If you or someone you know needs help with getting insurance to get a flu shot, open enrollment for Covered CA is open until January 31, 2018, reached out to PRC for more information.

#2 Everyday Prevention Goes Along Way

  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
  • Avoid touching your eyes, nose, and mouth. Germs spread this way.
  • Clean and disinfect surfaces and objects that may be contaminated; such as phones, keyboards, door knobs, etc.
  • Do your best to avoid close contact with sick people, if possible. If you need to help someone, wear protective gear such as rubber gloves, face masks, and wash hands often.

#3 If Your Doctor Prescribes an Antiviral Medication, Take It!

Antiviral medications are different from antibiotics. They are prescription medicines, which may come in pills, liquids or an inhaled powder. These are not available over-the-counter.

Antiviral medication can make illness milder and shorten the time you are sick. They can also prevent serious flu complications, like pneumonia. It is important they are used early to treat people who are very sick with the flu and who have a great risk of complications. Most otherwise-healthy people who get the flu, however, do not need to be treated with antiviral medications. Of course, always speak with your doctor before taking any medication.

Importance of the First Premium Payment for 2018 Health Coverage

First, the deadline to enroll for 2018 health coverage is Wednesday, January 31, 2018, so enroll now.

Once signed up for a 2018 health plan through the marketplace, it is very important to pay the first month’s premium on time to activate coverage. If there are issues paying the first month’s premium payment in full, the Health Insurance Premium Payment Program may be able to provide financial assistance. Also, consider reaching out to the insurance company to understand payment options and/or grace periods. Once again, the first premium payment needs to be paid, or there is a chance of losing 2018 coverage.

If enrollment is not complete by January 31, 2018, there will not be another opportunity to enroll unless you qualify for a Special Enrollment Period. If you or someone you know is HIV+ and a San Francisco resident, PRC may be able to help with problems accessing health coverage.