Big Changes in Medi-Cal Programs for 2022!

By Jason Cinq-Mars, Esq.

The State of California has made some significant changes to the Medi-Cal program in 2022. As of May 1, 2022, eligibility for full-scope Medi-Cal has expanded to include adults who meet Medi-Cal eligibility requirements and are aged 50 or older, regardless of immigration status. This expansion will immediately impact individuals who are on restricted scope benefits, also known as emergency Medi-Cal. These individuals will not need to take any action to receive full-scope Medi-Cal, but will automatically be transitioned to it. If you are not on restricted scope Medi-Cal, then you will need to complete and submit an application to apply. However, while a social security number and/or immigration status may be requested, it is not required to complete the Medi-Cal application.

Additionally, as of July 1, 2022, the State of California has increased the asset limit for non-MAGI Medi-Cal programs. Non-MAGI Medi-Cal programs include the Aged, Blind and Disabled, Medi-Cal with a share of cost, 250% Working Disabled Program, long-term care, and Medicare Savings Programs. Eligibility for these programs require participants to meet an asset or resource limit in order to qualify for benefits. Effective July 1, 2022, the asset limit will be increased from $2,000 for a single person and $3,000 for couples to $130,000 for a single person plus $65,000 for each additional family member. This substantial increase in the asset limit will allow beneficiaries on these programs to save and build their resources without jeopardizing their Medi-Cal enrollment.

Alisa Jackson, An Advocate for All!

“I get to see clients grow, access benefits, find housing, and become stable. It’s been really gratifying to work for PRC this long.” 

For many of PRC’s clients, Alisa Jackson is the first person they interact with on their quest for support. Having advocated for herself and countless others for nearly two decades, she’s appropriately earned the nickname Queen Bee of the legal team. She’s the go-to person when anyone has a question, and she does it all with compassion and a warm welcoming smile.  

A true San Francisco native, Alisa was raised in the Bayview and later in Pacifica, the result of her grandparents moving her family to the Bay Area from North Carolina in the 1960s. Following her roots, Alisa studied at the University of North Carolina but returned to San Francisco to pursue an additional degree in Paralegal Studies. Today Alisa lives in Oakland with her nine-year-old son, who shares her passion for philanthropy and social justice. Prior to the pandemic, Alisa and her “little buddy”, as she calls her son, were highly active in community service, delivering fresh produce from a friend’s co-op to the homeless encampments in East Oakland. When the world transitioned to working from home, her son got to witness Alisa working with clients firsthand. Since then, he has become an advocate in his own right in being respectful of people’s correct pronouns and does not hesitate to speak up and protect his friends. To Alisa and her son, no one is a stranger, and everyone is a friend.

What brought you to PRC? 

“While I was in college, I noticed that there weren’t many services in North Carolina, and I wanted to get involved. The variety of services in San Francisco was another aspect that stood out to me.  I decided that if there’s a way for me to be involved in the services that are helping my community, then I can also share this knowledge with friends and family members outside of San Francisco. With this information at my disposal, I can say: these are the resources that are out there. You may not have them in your state but in San Francisco, we have everything, so let me help you to navigate and find those resources in your community.

“Initially, my plan was to go to law school. I volunteered at the Eviction Defense Collaborative and thought, before I go to law school, I should find a job in the field and make sure this is what I want to do. I completed my paralegal certificate at City College and began looking for work at a nonprofit. PRC’s mission really spoke to me. I liked the idea of helping people who are HIV positive or living with mental health struggles. At that time, people with HIV weren’t living as long.  The mission is close to my heart because I have family members who have passed away from HIV. When I saw the posting for PRC, I thought, that sounds like something I can do. I decided to pursue more of a legal assistant role and try to earn some money before acquiring law school debt. I’ve done really well utilizing the skills I earned with my paralegal certificate, but law school is still on the table in the near future.”

Can you describe your role as the Supervising Legal Assistant? 

“Essentially I’m the go-to resource for all the different departments. I supervise a total of five legal assistants, and I work closely with the supervising attorneys and the managing legal director. I’m the gatekeeper because I navigate the calls that come in. Whether clients need help with social security, health care, or other legal needs, those calls come to me. I have a plethora of knowledge regarding PRC and the community members that we work with. My function is to support the attorneys in their role with helping people get their claims approved.“

How long have you been the Supervising Legal Assistant? 

“It’s been a solid six years now as the Supervising Legal Assistant. I advocated for a Senior Legal Assistant title by writing a letter explaining why I deserved the promotion after the first six years with PRC. Prior to that, the Senior title didn’t exist. I love my job and I enjoy helping others. I like to think that I help advocate for both staff and clients as well. I advocate for a lot of things. But I don’t try to force my way. I choose my battles. If I feel like something is wrong, I’m going to speak up about it.” 

What aspects of your job do you find rewarding?

“Clients who accessed services way back when our offices were located on Market Street are frequently surprised that I’m still here after so many years, and they are always so happy to see me. When I greet our African American clients, I get to see the pride and joy in their faces knowing that someone that looks like them will be representing them. I’m in a position of power and also a position of help. Representation is incredibly important. These types of connections are really special to me.”

There tend to be a lot of stigmas surrounding homelessness and mental health issues. For anyone who holds these feelings, what would you tell them to help change their perspective? 

“I was raised to respect all people, no matter what. There’s a lot of stigma or bias for people of color, African American women, the LGBT communities, or simply being part of certain groups. I say be respectful of all people, no matter what, because at the end of the day, when it comes to being homeless, especially in San Francisco, it can happen to anyone. One day you may lose your job. And you’ll be in the same position. My main objective is to put things in perspective. You never really know what a person has gone through, so be mindful of that.” 

For somebody who wants to help out, what’s the best way for them to get involved?

“Find an organization whose mission is dear to your heart and volunteer. There are so many organizations and many of them were created during COVID as people either lost their job or saw that there was a need and wanted to help. Do an online search. Look on Instagram. Find a local organization and volunteer once a week or month. Then spread the word and tell your community: hey, I’m helping such and such organization with a, b, and c, and try to bring friends. Start somewhere close to where you live. That way you’ll be making a direct impact on your local community. And if you have the means, please donate.”

What do you do to combat compassion fatigue? 

“I remind myself frequently that it could be me in the client’s shoes. There have been so many times where I’ve had a rough day, then I go to talk to a client, and they tell me that I just made their day. I gave them information that they didn’t know. Then I feel a lot better, and that puts me back on track. Sometimes I get overwhelmed, and then the phone will ring, and I think, should I take it? Then someone will tell me that they’re so thankful and grateful that I took the time to talk to them, and that always reminds me of why I’m here, and it makes it all rewarding.”

You’ve seen PRC grow for nearly 17 years. Do you see a difference in how clients feel coming into our new office building compared to how they felt when they accessed services at the Market Street location? 

“Due to COVID, we’re no longer in the office five days a week like we were, but we strive to help as many people as possible. We try our best, and I feel that for the most part, we succeed. For clients who received services at the old building, when they come into our new office and I see the expression on their face, they love it. I hope they see the new building as our commitment to them and providing a comfortable home-like atmosphere where they feel appreciated and valued.”  

Is there anything that you feel that our readers should know about the work being done here by you and your colleagues?

“Keep believing in PRC because we’re here for the long run. I know a lot of nonprofits don’t survive, but we’re still here. And there are still a lot of great people coming in and out. We serve San Francisco’s most vulnerable population, and they need your help too. Be kind, give smiles instead of judgment, and do the right thing, even if it’s the harder option. If you can, give back when you are able.” 

If you enjoyed getting to know Alisa and the impactful work she does for PRC’s clients, please consider making a donation to support our mission. If you would like to learn more about Legal Advocacy, PRC’s programs, or the wonderful staff at PRC, you can read more stories on our blog or visit our website.

In History: Medicare and Medicaid Celebrates the 55th Anniversary

On July 30, 1965, Medicare and Medicaid programs were establish when President Lyndon B. Johnson signed the legislation them into law. This year marks the 55th anniversary of these important healthcare programs and they have continued to protect the health and well-being of millions of families, saving lives, and improving the economic security in the United States.

To learn more about Medicare and Medicaid in San Francisco follow this link: https://www.cms.gov/media/405741

Resources:

https://www.medicareresources.org/basic-medicare-information/brief-history-of-medicare/

Congratulations to SF HIV FOG for acceptance of their AIDS2020 Abstract

PRC would like to congratulation the San Francisco HIV Frontline Organizing Group (SF HIV FOG) for the acceptance of their AIDS2020 abstract: CREATING A PROFESSIONAL COMMUNITY OF FRONTLINE WORKERS AS AN INNOVATIVE METHOD TO IMPROVE THE CARE OF PEOPLE LIVING WITH HIV/AIDS.

Below is the poster which was shown at the virtual AIDS2020 conference, July 6 thru 10.

What is PrEP?

Have you heard of PrEP and wondered what it stood for?

PrEP stands for Pre-exposure prophylaxis. PrEP is a daily HIV prevention pill for those who are HIV-negative and want to reduce their risk of exposure to HIV.  Research shows that, when taken consistently, PrEP provides protection from contracting HIV in a high percentage of individuals.

The California Department of Public Health Office of AIDS offers assistance to those without insurance to cover PrEP. You may be eligible to receive PrEP free of charge as part of the Patient Assistance Program, known as PrEP-AP.  The program provides assistance with PrEP-related medical costs and other medications for the prevention of HIV and the treatment of sexually transmitted infections.

PrEP-AP Eligibility:

  • California resident
  • At least 18 years old
  • Negative HIV/AIDS test result (dated within six months of the PrEP-AP application)
  • Annual Modified Adjusted Gross Income (MAGI) cannot exceed 500% of the Federal Poverty Level
  • Medication expenses are not fully covered by Medi-Cal or other third-party payers
  • Enrolled in the manufacturer’s assistance program (if eligible)

If an individual is HIV+, the California Department of Public Health Office of AIDS has other programs to help pay for medication and health coverage related expenses:  AIDS Drug Assistance Program (ADAP),  Health Insurance Premium Payment program (OA-HIPP),  Employer-Based Health Insurance Premium Payment (EB-HIPP), and Medicare Part D Premium Payment (MDPP) Assistance.

References and Resources:

PrEP Facts

Getting to Zero SF PrEP

And All That Pride…

Some things don’t have to change. We are who we are. Thank god.

While this pandemic will prevent us from marching down Market Street in colorful mass to mark the 50th anniversary of the first Pride parades held in San Francisco and New York City, it does not prevent us from coming together to celebrate ourselves, our hard-fought achievements, our rampant creativity, and our strength in community.

(As published in  the San Francisco Bay Times, May 21, 2020)

On the contrary, it should inspire us to do so regardless – safely, of course, with smart adherence to in-person social distancing guidelines, and plenty of aplomb.

I have long admired my good friends Donna Sachet and Gary Virginia—the most dynamic of duos—giving, doing, organizing, giving, convening, inspiring, doing, (did I mention giving?), entertaining, celebrating, and bringing it over and over again in big and small ways to meet community needs. So, I am not surprised that they will outdo themselves again this year.  

Their legendary Pride Brunch—the event of the seasonwill go on, June 27th, and everyone is invited!  

Donna and Gary's Brunch ChallengeFrom the comfort of your living room, kitchen, or dining room, Gary and Donna will bring you the Grand Marshals of the Pride Parade at high-noon on Saturday June 27th, honor the rich history of LGBTQ culture and liberation, and celebrate 50 years of San Francisco Pride with a saucy kitchen battle. The two will share their favorite brunch recipes and you will be the judge yourself, crowning the winner “Pride Brunch Queen.” 

We can sit back and relax with hosted cocktails and a delicious brunch delivered right to our respective doors. Or you can dance, parade, and sing along to live entertainment, live auctions, and special surprises in the privacy of your own home. This longstanding PRC fundraiser honors individuals and organizations fighting for LGBTQ equality, while raising critical dollars for PRC’s lifesaving services like legal advocacy, emergency financial assistance, residential treatment, and employment services. 

Celebrating 50 years of San Francisco community Pride, parading, and action, it is hard to believe how far the LGBTQ movement has come since the Stonewall riots eruptedawakening a new generation of legal and social advocacy. In retrospect, this turning point brings new lessons today amid this evolving era of worldwide COVID-19 public health emergency. We are all connected, and we are stronger when we stand together. 

As public consciousness is rising about that interconnectedness and our Country’s glaring health, income and access inequities, I am proud of San Francisco, our LGBT and allied communities. We’re on the frontlines, showing up for the most vulnerable again and again. And while there is still plenty of work to doI look forward to celebrating the contributions and opportunities brought by this year’s Grand Marshals—The LGBT Asylum Project, Founder of the Spahr Center Rev. Dr. Jane Spahr, and Executive Director of the LGBT Historical Society Terry Beswick—at this year’s virtual Pride Brunch.  

PRC, Pride Brunch’s beneficiary, has long fought for the most disenfranchised and health-challenged in our community on the frontlines of HIV/AIDS and LGBTQ advocacy for access to basic and critical resources. Today, these efforts are even more important as the impact of longstanding fissures in health status and experiences by race, geography, income, and identity are laid bare by the novel coronavirus. PRC is providing emergency funds for rent, medication, and connectivity; legal advocacy to preserve healthcare and subsistence income through job loss and upheaval; and emotional support and employment services to keep people moving forward; while also sheltering nearly 300 adults in place through a substance use and mental health treatment continuum prioritizing health, safety, and wellness.  

As a 55-year old African American gay man, I am both deeply familiar with the disconnection between legal equality and lived equality and deeply indebted to the collective advocacy of so many courageous individuals who were willing to hold the line, never back down, and stand in harm’s way. So, let’s come together on June 27th and celebrate what’s good and great about San Francisco Pride.

Inspired again by Gary and Donna, I think the dire issues of the day will continue to galvanize us – a  Inspired again by Gary and Donna, I think the dire issues of the day will continue to galvanize us – a strongereven more compassionate community. I choose joy, love, honesty, empathy, compassion and service along with a hint of leather, lipstick, and humor. So, let’s brunch 

How could we not celebrate Pride’s 50th anniversary. I’m already planning my outfit. Don’t miss the Battle of the Queens, Gary Virginia and Donna Sachet’s legendary Pride Bruch, streaming live at 12pm on June 27th. Tickets are on sale, so get yours today, and prepare to give big. See you there. 

HIV Prevention Starts with Each of Us:Women and Girls Awareness Day and Let’s End the HIV Epidemic Together

Every year on March 10th,  the U.S. observes National Women and Girls HIV/AIDS Awareness Day. HIV prevention and treatment are critical to reducing new HIV cases among women and girls.  Women and girls – as well as their partners, friends, and family members who care about them – are encouraged to learn more about how they can take control of their own health to prevent and treat HIV. HIV/AIDS is an equality opportunity virus. Any woman or girl who is sexually active can contract HIV/AIDS regardless of race, ethnicity, age, or sexual orientation. However, statistics show that African American and Latinx women and girls have a higher chance of acquiring HIV than their counterparts. [Facts https://www.cdc.gov/hiv/group/gender/women/index.html] There is great news! With today’s advancements in HIV/AIDS research and treatment it is possible to prevent HIV infection or passing the virus on to a partner or baby.  Some unique challenges women and girls face are related to STDs, which may increase the risk of HIV infection. Ending the HIV Epidemic (EHE) is addressing the specific needs of women and girls who could be exposed to the virus or living with HIV. Please take a minute to view this important message from Rear Admiral Sylvia Trent-Adams, Ph.D., R.N., F.A.A.N., Principal Deputy Assistant Secretary for Health in the Office of the Assistant Secretary for Health. Follow these links to: Learn more about National Women and Girls HIV/AIDS Awareness Day Find a local HIV testing or a healthcare provider, visit locator.HIV.gov. Find out more about PrEP at HIV.gov/PrEP and see if you qualify for the Ready, Set, PrEP at GetYourPrEP.com Together, we can stop HIV.

Computer Learning Center Expands Opportunity

Inside PRC’s buzzing 24-station Computer Learning Center, more than 100 people like Marilyn, Kim, and Sam are building digital literacy and skills to grow their income and workforce engagement.

“I’m so excited to move forward and into the workforce again.”

Outdated skills and gaps in employment can be hard to face, so PRC Workforce Development offers skill and community building opportunities that get people trained-up, confident, and back on their feet. Two accredited programs—Next Step Computer Training and Step Up Administrative Training—provide 64 combined hours of digital literacy and office skills readying people with mental and physical health disabilities for competitive internships and employment opportunities. Last year, PRC ran 20 cycles graduating 106 trainees!

“I have a better grasp on how this [technology] works…finally.”

The results speak for themselves. In 2019, employed graduates saw their annual incomes increase 337%.

People with disabilities experience three times the unemployment rate of the general population. But PRC is getting people into the workforce at more than double the statewide rate. When PRC opened the Integrated Service Center’s doors in April 2019, our computer lab’s capacity more than doubled, and the Workforce Development team began to ramp up classes, programs, and skill building opportunities. In less than one year, with the same high quality, high impact instruction, enrollment is up 30%.

“I can’t place a value on this experience. It was motivational, personally uplifting, and I learned so much in such a short time.”

Graduate
December Graduates: Marilyn (above); Kim (top), flanked by PRC volunteer Troy Kondo and Computer Training Associate (and former graduate) Tomas Llorence; and Sam (left).

PRC also launched LIFT UP SF – Lifting Up Peers for a Brighter Tomorrow – a 64-hour curriculum putting real life experience with mental health and substance use services to work for graduates as peer professionals across public health and social service fields. The first cohort just entered paid traineeships, the final step in advance of competitive employment placements at PRC and partner health agencies across San Francisco. The second cohort is double in size, with 15 students gaining competencies to put their lived experience to work advancing community health.

Graduate

For graduates like Phil (not pictured), opportunities like Next Step, Step Up, and LIFT UP SF are transformational. A longtime PRC client, Phil has overcome drug addiction and homelessness. Fifteen years ago, when he was newly diagnosed with HIV, Phil accessed PRC’s legal services to secure disability benefits. Most recently he’s moving forward with PRC workforce development. “I feel really good right now in my recovery; I’m mentally stable and poised to be able to go off of disability [benefits] and back into the workforce…But the highlight of [LIFT UP SF] is the overall realization that my life experience is worth something. I can connect with that person going down a certain pathhelp people who are drug addicted, homeless, and in health crisis to get from that place—from where I was stuck—to where I am now.”

“My objective is to find a place where I’m happy and a place to grow”

On top of skills-based training and practice in the lab, clients work with PRC specialists to accessed tailored supports in resume and cover letter writing, skills inventories, vocational assessments, interview preparation, and post-placement counseling. PRC partners with some of the largest employers in San Francisco including the University of California at San Francisco, the City and County of San Francisco, the State of California, Apple, Genentech, Target, H+R Block, Starbucks, Blue Apron, Hyatt, Genentech, Uber, Alaska Airlines, Salesforce, Apple, Old Navy, and Whole Foods. The average wage of clients placed in employment was $20.66 per hour in 2018, 38% higher than the local minimum wage.

Congratulations to all our participants and graduates! We’re proud to stand with you, moving forward.

Learn more about PRC’s Workforce Development trainings and services here or reach out about hiring partnerships and putting graduates to work for you.

Check out the new ADAP Client Portal!

On September 3, 2019, the California Department of Public Health, Office of AIDS released the AIDS Drug Assistance Program (ADAP) Client portal.

Using the portal, clients enrolled in ADAP can:

  • View their client ID, enrollment site, enrollment worker contact information, eligibility status, and eligibility end date
  • View the Insurance Assistance Program information if enrolled, including program type (OA-HIPP, EB-HIPP, or MDPP), insurance carrier, eligibility status, and eligibility end date
  • Elect to receive automatic notifications about eligibility and re-enrollment
  • Recertify if there are no changes to residency or health insurance and annual household income is within program limits

To request access to the Client Portal, contact the ADAP Call Center at 1-844-421-7050, Monday-Friday, 8:00 AM – 5:00 PM. After requesting access, the client will receive an email with a URL to the client portal. Using the link, the client will enter their email address as the username and a temporary password, and then be prompted to create a new password. Contact the ADAP Call Center, with any issues accessing the Client Portal.

For more information about ADAP, go to California Department of Health Office of AIDS webpage.

If you are interested in ADAP and not yet enrolled, contact an ADAP Enrollment Worker to apply. To find an Enrollment Worker in your area, go to ADAP Enrollment Site Locator.

Lift UP SF: A win-win-win for San Francisco

We’re proud to introduce a new pathway to personal and economic growth for the thousands of people overcoming mental health, HIV or substance use challenges each year in San Francisco. One of five California programs selected, the Office of Statewide Health Planning will invest nearly $500,000 over two years in PRC’s award winning workforce development model. The result? We’re scaling up a peer-to-peer occupational training pathway recently launched in partnership with San Francisco’s Department of Public Health. Lifting Up Peers for a Brighter Tomorrow or Lift UP SF is a win for consumers, a win for behavioral health services providers, and a win for San Francisco.

Lift UP SF readies consumers—people in and exiting mental health and substance use treatment programs, family members, and caregivers—to put their lived experience to use on a competitive career path. It spans a 64-hour comprehensive training curriculum designed by advocates and consumers, individualized placement support, and peer group services to prepare graduates for volunteer, part-time, and full-time peer positions in the most common health settings: Social and Human Service Assistants, Case Workers, Case Managers, Client Advocates, Family Self-Sufficiency Specialists, and Independent Living Specialists among others.

Leveraging the experience of people with lived experience in mental health, substance use, and public health systems doesn’t just make sense, it’s proven to result in better outcomes for consumers on both sides of the interaction.

Beyond professional skill delivery, peer specialists in health settings share the same vocabulary as those they help, have credibility, and embody an accessible vision of success. Paid or volunteer employment is also a key component of recovery from mental health and substance use disorders, particularly methamphetamine addiction. The act of going to training, getting placed in employment, and accessing a supportive community support throughout this process dramatically improves an individual’s ability to maintain their recovery.

This pathway is timely, right here and right now. San Francisco has very low unemployment (1.9%) overall, but prosperity and stability are not shared equitably across our community. A high cost of living, driven primarily by housing expenses, strains many long-time residents and the populations PRC serves. African Americans and other communities of color, LGBTQ+ individuals, people with disabilities, people with behavioral health disorders, and people living with HIV are overrepresented among the unemployed and have lower than average salaries, placing them at high risk for displacement and homelessness. People with lower incomes also have higher rates of mental health disorders.

It’s a circular argument Lift UP SF seeks to disrupt.

The training program specifically reaches into these under-employed consumer groups to provide more than a living wage. An increasing economic outlook seeds hope, and a career trajectory positions consumers—people like those exiting PRC’s 30/60/90 day treatment programs or in our co-op living around the city—to progress through the continuum of care and transition successfully to independent living.

As a result, not only do we expect to decrease unemployment among Bay Area residents impacted by mental illness, substance use disorder, and/or HIV/AIDS and to expedite treatment program exits making room for more people to access needed treatment services, Lift UP SF will develop a diverse, representative pool of qualified, culturally competent staff to help alleviate the worker shortage in behavioral health settings across San Francisco and beyond. PRC’s program launches with more than 17 partners—from Castro Country Club and the City of San Francisco Community Behavioral Health Services to Native American Health Center, Mission Neighborhood Health Center, and Alameda and Contra Costa County Behavioral Health Programs—already signed on and seeking to fill already identified peer staffing shortages across public mental health services.

Want to know more? Contact our Workforce Development team.
Want to contribute to support innovate solutions, like Lift UP SF? Donate here.
Keep Reading the Fall 2019 Frontline