Public Policy Priorities

The 340B Drug Discount Program allows Equitas Health to offer a broad range of services to our patients, as well as certain prescription drugs at discounted prices.

At Equitas Health, we work to not only protect the existence and integrity of this program, but also to ensure appropriate medication distribution/access from manufacturers and nondiscriminatory 340B reimbursement practices by all payors. This helps guarantee that our patients can get the prescriptions they need at an affordable price.

We will continue to advocate for policies at the state and federal level to protect the 340B program. Through direct conversations with policymakers and their staff, Equitas Health can be a valuable source of information about how covered entities like Equitas Health reinvest savings from the program in patient care and supportive services.

We will advocate for state and federal measures to rein in the rising cost of prescription drugs. As a distributor of specialty medications, we know that patients managing chronic conditions can find themselves facing a difficult decision – paying the bills or paying for necessary and lifesaving medications. We are committed to supporting informed policy proposals that reduce costs for consumers and covered entities.

We also support legislation to end copay accumulator policies implemented by insurance companies and pharmacy benefit managers. Copay accumulator policies are programs that prohibit copay payments made using a manufacturer-issued copay savings program or other assistance programs from counting toward a patient’s annual deductible.

Ohio’s House Bill 135 (HB 135), introduced in the first half of the 134^th General Assembly, will prohibit this practice. Equitas Health supports HB 135 and like legislation, and we continue to advocate for its passage.

The Affordable Care Act (ACA) was enacted to ensure access to affordable healthcare coverage for all Americans. Central to the ACA’s success is the fact that it has expanded health coverage to more than 27 million Americans, including almost 1.5 million Ohioans. Aside from working to ensure access to affordable care, the ACA aims to address health equity by prohibiting discrimination against members of the LGBTQ+ community in certain health programs and activities.

Equitas Health supports the expansion of the transformative policies embodied in the ACA, particularly those aimed at ensuring nondiscrimination in the healthcare setting and ensuring access to and coverage of essential healthcare services.

In early 2021, the American Rescue Plan Act (ARPA) extended eligibility for ACA health insurance subsidies to people who purchase coverage through the Marketplace and have incomes above 400% the federal poverty level. Additionally, ARPA lowered the average cost of insurance for those with Marketplace coverage – building on the success of the ACA. We continue to encourage Congress and the Biden administration to work toward a solution to ensure coverage for all.

The Community Health Center program is a federal program that provides primary healthcare services to medically underserved populations. Because of this program, Equitas Health is able to support its community-based programs, through which we aim to reach underserved populations where they live to provide them with necessary and accessible healthcare. An integral part of this work is prioritizing attention to providing such services to underserved people, particularly those living in communities of color, who live in our existing service areas.

Community Health Centers provide access to basic health care services to communities most in need. As a federally qualified health center look-alike (FQHC look-alike), Equitas Health is able to provide services and support to historically underserved communities whether they are uninsured or under-insured, and regardless of their ability to pay.

According to the Ohio Department of Health, dental care has remained the top unmet health need in this state for nearly 20 years—particularly among children and low-income adults. In an attempt to help address this issue, Equitas Health began offering dental services in two of our medical centers (Dayton and in the King Lincoln neighborhood of Columbus).

Ensuring continued access to affordable dental services is crucial to the overall health of our patients. Equitas Health will continue to advocate in support of preserving the Adult Dental Benefit under the Medicaid Program. We are committed to working across the state to expand access to affordable, culturally humble dental care.

Many of our patients depend on crucial safety net resources, like Medicaid, to access affordable healthcare services. Medicaid is the avenue through which many of our patients access these services— particularly those who were afforded coverage through Ohio’s Medicaid expansion program.

Ohio’s Medicaid expansion afforded coverage to Ohioans age 19 through 64 with incomes at or below 138% of the federal poverty level ($17,774 for a single individual in 2021). It also guaranteed coverage for people living with HIV without first requiring an AIDS diagnosis.

Through the implementation of Medicaid expansion in 38 states, including Ohio, thousands of people living with HIV/AIDS gained insurance coverage they otherwise would not have had. This includes many patients utilizing Equitas Health.

At Equitas Health, protecting Medicaid as an entitlement and ensuring the retention of the Medicaid expansion program in Ohio are top priorities. We strongly oppose block granting Medicaid and the implementation of so-called personal responsibility measures, including work and education requirements that negatively affect our patients.

Mental health and substance use plays an integral role in a person’s overall health. This is even more imperative for members of the LGBTQ+ community. Over 63 million LGBTQ+ adults have identified and often-unmet mental health and recovery needs. Only 7.4% of treatment programs around the nation provide competent evidenced based LGBTQ+ care that contributes to lower health outcomes for LGBTQ+ patients seeking recovery services.

At Equitas Health, we know that ensuring access to high quality, appropriate and culturally competent healthcare is a necessity for our patients and for members of the communities we serve. We work actively to support mental health parity, increased access to recovery treatment options, harm reduction services and safe syringe access programs, and coverage for mental and behavioral telehealth services.

In order to achieve this parity and increased access, Equitas Health supports an increased enforcement of the Mental Health Parity and Addiction Equity Act of 2008. This piece of federal legislation requires health insurers and group health plans to provide the same level of coverage benefits for mental health and/or recovery services that they do for medical and surgical care, if the coverage in fact provides mental health coverage. We are also planning the expansion of mental health and recovery service offerings to our patients both in-person and through telehealth.

Equitas Health supports the Mainstreaming Addiction Treatment Act (HR 1384), which was introduced earlier in the 117^th Congress. The legislation will expand access to evidence-based treatment by removing a requirement that healthcare providers receive an X-waiver from the Drug Enforcement Administration (DEA) to prescribe buprenorphine to treat opioid use disorder. Expanded access will help providers address the rising overdose crisis in Ohio and across the United States.

Additionally, Equitas Health will advocate for the expansion of community psychiatric support and treatment options to ensure community members with critical mental and behavioral health needs receive the care they need in affirming and accessible environments.

We are committed to supporting a person’s reproductive rights. The fight for reproductive justice and bodily autonomy is essential to the fight for LGBTQ+ healthcare and full legal equality. LGBTQ+ individuals need access to reproductive healthcare and services such as family planning services, fertility treatments, inclusive breast/chest examinations, and other reproductive health services.

The Ryan White program provides a comprehensive system of care, including primary medical care and vital support services for people living with HIV/AIDS (PLWH/A) who are either uninsured or underinsured. Central to the program is providing an important source of continuing access to medication that can help PLWH become and remain virally suppressed, and live close to normal lifespans.

As the largest Ryan White grantee in the state of Ohio, Equitas Health is committed to protecting the Ryan White program including support for services for our patients who are HIV-positive. Equitas Health will continue advocating on the federal level for additional investment in the Ryan White HIV/AIDS program to support communities most impacted by HIV/AIDS. We believe Congress should increase funding for essential services such as transportation, access to food and nutrition, and case management for program recipients.

Additionally, we will encourage Congress to invest in HIV/AIDS education and training programs for healthcare providers through the AIDS Education and Training Centers (AETCs) program as part of Part F of the Ryan White HIV/AIDS program. To ensure PLWH/A have access to quality care, we must educate the next generation of healthcare providers.

We will continue to advocate for public policies that facilitate development of infrastructures and funding to support COVID-19 testing and continued vaccine production and distribution.

We will continue to advocate for public policies that facilitate development of infrastructures and funding to support MPX testing and continued vaccine production and distribution, while focusing on disparities affecting gender diverse communities and communities of color. We will remain prepared for other emerging viruses that disproportionately impact the broader LGBTQ+ community.

As a steward of public health, it our mission is to provide an affirming health care home for all- and to admit when we have fallen short of our stated mission. We recognize that structural and interpersonal racism in healthcare has historically affected, and continues to affect, Black, Hispanic, Indigenous or Native, and other people of color. We aim to eliminate bias and discrimination in our models of care and uproot white supremacy in our organization and in the communities we serve. To advance racial justice as a society, we must remain engaged in the continued work necessary to create safe and affirming spaces for all. Our commitment to addressing the ways in which we have contributed to or benefited from White Supremacy has resulted in significant action over the last few years. Equitas Health continues to seek and implement remedies to injustices in our continuum of care, our hiring practices and internal policies, in our pursuit of public policy, and the way in which we engage with the communities we serve.

Racism, as defined by the American Public Health Association, is a social system wherein opportunity and value is assigned based on social interpretation of how one looks. Both systemic and interpersonal racism have historically affected and continues to adversely affect the health, safety, and economic opportunities of Black Ohioans and other people of color in Ohio. It is incumbent upon Equitas Health as a direct service provider to mitigate the impact of racism on the communities we serve and to advocate for policies that acknowledge racism as a public health crisis and direct local, state, and federal dollars to addressing the inequities created and perpetuated by interpersonal and systemic racism.

We continue to urge the Ohio General Assembly to pass House Concurrent Resolution (HCR 6) and Senate Concurrent Resolution 4 (SCR 4), as introduced in the 134^th General Assembly, to acknowledge racism as a public health crisis in Ohio.

The reality of policing in America is that state-sanctioned violence is deeply rooted in American history – we continue to bear witness to the over-policing and underinvestment in Black, Hispanic, Indigenous or native, and other communities of color, resulting in fear, intimidation, and murder without accountability. These violent acts too often go unpunished, leaving calls for justice unmet. We stand in solidarity with the Black Lives Matter movement and all who seek accountability and reform for injustice at the hands of the state. We work to promote the adoption of transparent civilian review boards, the appropriate allocation of funds between police departments and community-based services and programs, and the end of qualified immunity.

We are committed to fighting violence and discrimination based on race in all forms.

Environmental justice, as defined by the United States Environmental Protection Agency (EPA),¹ is the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development and implementation and enforcement of environmental laws, regulations, and policies.

We support environmental policies that protect the health and safety of all individuals, while also ensuring that all of our patients and clients have healthy environments to live and to thrive.

The mission of the Buckeye Region Anti-Violence Organization (BRAVO) is to work to eliminate violence perpetrated on the basis of sexual orientation and/or gender identification, domestic violence, and sexual assault through prevention, education, advocacy, violence documentation, and survivor services, both within and on behalf of members of the LGBTQ+ community. BRAVO is a program of Equitas Health, and we share this same mission. We will continue to work to ensure implementation of policies at the federal and state levels that protect members of the LGBTQ+ community – particularly transgender people of color – from higher than typical levels of violence.

We support the state and federal legislation to eliminate violence including the following:

• Continued reauthorization of the Violence Against Women Act (VAWA) at the federal level.
• Enforcement of H.R. 55 – Emmitt Till Antilynching Act, which formally recognizes the history and bans the practice of lynching in the United States.
• Increased funding for the Victims of Crime Act (VOCA) program.

Equitas Health has a longstanding commitment to ending the discrimination and stigma against PWLH/A that are codified in both state and federal law.

As a member of the Ohio Health Modernization Movement, Equitas Health is working with a coalition of other community partners dedicated to repealing or reforming Ohio’s regressive and discriminatory HIV criminalization statutes. There are six statutes within the Ohio Revised Code that criminalize PLWH/A—often enhancing penalties for people simply because they are HIV-positive—and they heavily rely on stigma, not science.

These statutes include not just the felonious assault statute, which broadly criminalizes HIV, but also multiple statutes that specifically target and enhance penalties for those engaged in sex work and behaviors that do not pose any risk of transmitting HIV. These laws are enforced disproportionately in communities that face over-policing, like communities of color and in low-income areas, and they do nothing to decrease the risk of HIV transmission. The existing statutes discourage people from knowing their status so as not to be at risk for legal liability, and further stigma around HIV/AIDS.

Equitas Health is committed to helping lead the charge to modernize Ohio’s laws so they no longer criminalize people’s HIV status and instead reflect evidence-based practices aimed at decreasing HIV transmissions and encouraging safe and healthy sexual relationships.

In 2023, we are committed to advocating for the following:

• The introduction and passage of legislation to modernize the six HIV criminalization statutes and ensure that Ohio’s Revised Code recognizes and reflects science over stigma. We are working alongside the Ohio Health Modernization Movement (OHMM) to fight for modernization in Ohio.
• Reintroduction and passage of Ohio House Concurrent Resolution 39 (HCR 39), which formally acknowledges December 1 as World AIDS Day and recognizes the many advances in HIV/AIDS treatment and prevention over the last four decades.
• Reintroduction and passage of the REPEAL HIV Discrimination Act of 2021 (H.R. 1305), which would address HIV criminalization at the federal level.

Members of the LGBTQ+ community are more likely to face discrimination in various facets of their lives, including in spaces that extend far beyond the walls of a doctor’s office. We work actively to support laws and policies that extend legal protections to members of the LGBTQ+ community and work against the passage and implementation of those that do not.

As a healthcare organization, Equitas Health aims to ensure equitable access to nondiscriminatory healthcare services for all. We call on the Biden administration and the Department of Health and Human Services to implement rule changes proposed to Section 1557 of the Health Care Rights Law in late 2022, which would remove rule changes conducted under the Trump administration and restore non-discrimination protections for LGBTQ+ individuals.

In 2021, the Biden administration issued an Executive Order extending application of the U.S. Supreme Court’s decision in Bostock v. Clayton County, which extended protections from discrimination to LGBTQ+ people under Title VII of the Civil Rights Act of 1964. While the Biden-Harris administration’s actions in 2021 and 2022 offer some additional protections for LGBTQ+ people, state and federal legislation is still necessary to achieve equal protection under the law.

As such, we continue to advocate for the passage of the following:

• The Equality Act, which previously passed out of the U.S. House of Representatives extends legal protections to members of the LGBTQ+ community in all aspects of their lives, including housing, employment, and public accommodations.
• The Ohio Fairness Act would extend Ohio’s existing nondiscrimination law to cover sexual orientation and gender identity, and efforts to modernize Ohio’s hate crime law to include crimes against people on the basis of their sexual orientation and gender identity. Equitas Health also supports legislation to ban “LGBTQ+ panic” as a legal defense strategy.

We are committed to standing up for members of the LGBTQ+ community and fighting harmful legislation or administrative rule changes. We will not tolerate discrimination in any form, and we will continue our advocacy on behalf of LGBTQ+ individuals.

Members of the transgender, non-binary, and gender expansive community face discrimination, stigma, and systemic inequality in various facets of their lives. Our commitment to fighting for equality for all members of the LGBTQ+ community includes working to ensure that Ohioans who are gender expansive are afforded access to the same legal protections, public accommodations, and services as everyone else.

To better serve and support our transgender, non-binary, and gender expansive patients, clients, and community we must:

• Expand current legal protections afforded to transgender, non-binary, and gender expansive individuals in federal law, such as those protections found in Title IX and those enforced by the US Departments of Health and Human Services, Education, and Justice.
• Advocate for equity in healthcare access for transgender, non-binary, and gender expansive patients.
• Work with the Ohio Department of Medicaid and the managed care plans to expand coverage for gender-affirming care and related services for transgender, non-binary, and gender expansive Ohioans, who are enrolled in Medicaid managed care.
• Expand the benefit package for state employees to ensure equitable coverage and access to gender-affirming care for transgender, non-binary, and gender expansive state employees.
• Fight back against legislation like the 134^th General Assembly’s Ohio House Bill 454 (HB 454), which, if passed, would prohibit gender-affirming care for transgender, non-binary, and gender expansive youth and force school officials to out LGBTQ+ students to their parents or guardians.
• Advocate for applications of Title IX that affirm the rights of transgender, non-binary, and gender expansive students, while also supporting their wellness in educational settings.
• Continue our opposition to the so-called “Save Women’s Sports Act” (introduced under various SB and HB numbers in the past), which, if passed, would prohibit Ohio’s transgender, non-binary, and gender expansive youth from participating in high school and collegiate sports on teams that affirm their gender identity and expression.
• Eradicate transmisogynoir² by pursuing public policy solutions that uplift the experiences and center the needs of BIPOC trans women.
• Advocate for justice in public safety for transgender, non-binary and gender expansive people, while paying particular attention to the intersection of race and ethnicity.

2 https://transgenderlawcenter.org/black-trans-women-black-trans-femmes-leading-living-fiercely

As with gender expansive people, intersex people also face discrimination, stigma, and systemic inequality in various facets of their lives. Our commitment to fighting for equality for all members of the LGBTQ+ community includes working to ensure that Ohioans who are intersex are afforded access to the same legal protections, public accommodations, and services as everyone else.

To better serve and support our intersex patients, clients, and community we must:

• Expand current legal protections afforded to intersex individuals in federal law, such as those protections found in Title IX and those enforced by the US Departments of Health and Human Services, Education, and Justice.
• Advocate for equity in healthcare access for intersex patients.
• Fight for a ban on unnecessary and malicious medical interventions on the bodies of intersex newborns and youth, as this practice is widely acknowledged as a human rights abuse.
• Work with the Ohio Department of Medicaid and the managed care plans to expand coverage for intersex-affirming care and related services for intersex Ohioans, who are enrolled in Medicaid managed care.
• Expand the benefit package for state employees to ensure equitable coverage and access to intersex-affirming care for intersex state employees.
• Fight back against legislation like the 134^th General Assembly’s Ohio House Bill 454 (HB 454), which, if passed, would protect medical providers who harm intersex youth.
• Advocate for applications of Title IX that affirm the rights of intersex students, while also supporting their wellness in educational settings.
• Continue our opposition to the so-called “Save Women’s Sports Act” (introduced under various SB and HB numbers in the past), which, if passed, would affect participation for Ohio’s intersex youth in high school and collegiate sports.
• Advocate for justice in public safety for intersex people, while paying particular attention to the intersection of race and ethnicity.

Having access to stable housing is not only associated with better health outcomes for PLWH, it also means that PLWH are more likely to be virally suppressed. Additionally, people who are homeless or experiencing housing insecurity face HIV infection rates five to ten times higher than those who do have access to stable housing.3

Equitas Health is committed to providing access to the essential care and services that PLWHA need to live stable and healthy lives, which inherently includes providing access to housing.

We will advocate for increased funding for federal housing programs for PLWHA, like the Housing Opportunities for People with AIDS (HOPWA) in federal FY23 appropriations and beyond.

We support the development and implementation of laws and policies that support adequate access to culturally competent and nondiscriminatory services provided at shelters frequented by PLWHA.

LGBTQ+ youth confront homelessness at disproportionately high levels as compared to other youth. Facing alienation and rejection from family at home or at school, LGBTQ+ youth often run away and, facing further societal discrimination like LGBTQ+ adults, have particular difficulty finding stable housing, including in homeless shelters.

Equitas Health is committed to addressing the disproportionately high rates of homelessness experienced by LGBTQ+ youth in Ohio. We will work to expand existing state, local, and federal resources that support programs that not only aim to improve family relationships, but also reduce rates of homelessness among LGBTQ+ youth. Additionally, Equitas Health continues to support the development and implementation of laws and policies that facilitate access to culturally competent and nondiscriminatory services provided at shelters frequented by LGBTQ+ youth.

Many of our clients face significant barriers to stable and secure housing – including discrimination based on the individual’s source of income when applying to rent a house or an apartment. Landlords can refuse to rent to a person who receives a form of rental assistance including housing vouchers or other subsidies– this practice prevents PLWH who are HOPWA recipients and others, who are in need of assistance from being housed. Recently, Ohio municipalities are taking action, in lieu of state and federal legislation in an effort to stop this discriminatory practice. Unfortunately, current enforcement and reporting mechanisms do not sufficiently address or deter the practice.

To ensure our clients and community members can access affordable, safe, and secure housing, Equitas Health supports:

• Local ordinances that ban the source of income discrimination, which include strong reporting and enforcement mechanisms. These ordinances must be inclusive of HOPWA.
• State legislation, such as House Bill 182 (HB 182) as introduced in the 134^th General Assembly, that would prohibit landlords from taking certain actions based on a tenant’s or prospective tenant’s lawful source of income including housing assistance, housing vouchers, public assistance, emergency rental assistance, veterans benefits, social security, and other programs administered by any federal, state, local, or nonprofit entity.
• Federal legislation, such as the Credit Reporting Accuracy After a Legal Name Change Act of 2022 (H.R. 8478), that would ensure that transgender, non-binary, and gender expansive people have access to an accurate credit report that does not disclose their deadname and/or transgender status.

Equitas Health is committed to our role in implementing the Ending the HIV Epidemic Initiative to reduce the transmission of HIV in the United States by 75% by 2025 and by 90% by 2030. We are determined to do our part to make this goal a reality by providing prevention, treatment, and care services and programs, and by working with policymakers to ensure that these services and programs are appropriately funded and that they are accessible to all who need them. Ending the AIDS epidemic by 2025 inherently requires a strong effort to reduce and prevent any transmission of HIV. For our part in this mission, Equitas Health engages in evidence-based prevention strategies to further reduce the number of people who acquire HIV, particularly in communities, including communities of color, that are disproportionately faced with higher rates of HIV/AIDS.

Equitas Health’s specific prevention strategies include providing access to essential prophylactic medications (like PrEP and PEP), implementing statewide education initiatives about transmission (including the U=U campaign), and providing harm reduction services. You can read more about each of these below.

Using pre- and post-exposure prophylaxis (PrEP and PEP, respectively) are proven prevention tools that help prevent transmission of HIV.

At Equitas Health, we know that one of the most crucial pieces of the prevention puzzle is to ensure that there is access to, coverage of, and reimbursement for PrEP medications. We work with policymakers at the state and federal level to ensure that these types of medications remain accessible to our patients— no matter their insurance coverage status. Utilizing telehealth, Equitas Health continues to expand healthcare access and ensure that anyone in Ohio who wants PrEP, can get it. This is particularly important for vulnerable populations who cannot get to an Equitas Health medical center for treatment.

We will advocate for Congress to re-introduce and to pass the PrEP Access and Coverage Act of 2021 (H.R. 6117 and S. 3295) which will permanently expand access to cost-free PrEP and ancillary services for all individuals including individuals who do not have health insurance.

The science is clear: undetectable = untransmittable. PLWH/A who are on effective treatment and whose viral loads are undetectable cannot transmit HIV to their sexual partners. By taking their anti-retroviral treatment (ART) as prescribed to keep healthy, PLWH/A are a key part of the solution to ending the HIV/AIDS epidemic. As a proud U = U community partner, Equitas Health has launched a statewide campaign to raise awareness about U = U, and to ensure that the groundbreaking science behind the campaign is accessible to as many people as possible.

Increasing access is the number one goal of the Ending the HIV/AIDS Epidemic plan and one tool that we have in Ohio to increase access is Prevention Assistance Program Interventions (PAPI), a program that helps cover the medical costs associated with taking PrEP.

The U = U campaign is crucial for a number of reasons, not least of which is that it helps shift the conversation to science, not stigma. Since our inception, Equitas Health has been committed to ending stigma against HIV/AIDS and ending the HIV/AIDS epidemic. Through our U = U campaign, we will not only educate our patients and communities about the importance of staying healthy, but also about the importance of becoming an advocate to help spread U = U’s message as much as possible. Additionally, it is our goal to work with municipalities to introduce resolutions recognizing the U=U campaign.

As a result of the new Ending the HIV/AIDS Epidemic resources, Equitas Health has launched the Ending the HIV/AIDS Epidemic Task Force in Columbus, it’s an elite team of health navigators, tasked with one goal: eliminating all barriers to care for PLWH/A and ending the spread of this virus in Ohio through any means necessary. Launching more programs like this throughout Ohio will be crucial in reaching the ending the epidemic goals.

We are committed to supporting and providing access to evidence-based and evidence-informed care and treatment interventions that produce optimal HIV/AIDS care continuum outcomes and can be easily adapted to the ever-changing healthcare environment.

We work with policymakers at the state, local, and federal level to maintain funding for the supportive services and programs that Equitas Health offers to PLWH/A.

One factor that continues to drive the HIV/AIDS epidemic in the US is drug use—including both the sharing of injection equipment and the risky sexual behavior often associated with drug use.

In order to maintain decades-long gains in preventing HIV among people who inject drugs (PWID), it is imperative to ensure access to preventive services to the people who need it most. Syringe services programs (SSPs) are community-based prevention programs provide access to sterile syringes and safer use materials, linkage to care, and a variety of additional services to the community. Equitas Health, with support from Columbus Public Health (CPH), operates Safe Point – Central Ohio’s only SSP.

Safe Point uses comprehensive harm reduction to educate the community about safer drug use, provides sterile syringes and safer use materials, and provides linkage to care including mental health and substance use disorder services, testing and prevention services for people at risk of a new HIV transmission and viral hepatitis, and access to treatment and care services for PLWH/A.

Equitas Health also supports policies that reduce the use of shared syringes and ensure their safe disposal. We understand that providing linkage-to-care activities through syringe services programs are a critical part of HIV/AIDS prevention, and we work actively to ensure funding for and access to this type of care. We continue to advocate for funding for the Safe Point program and for the increase in comprehensive harm reduction programs and services across the state.

We are committed to pursuing policy solutions that will allow Safe Point and other SSPs and harm reduction organizations and coalitions across the nation to end the overdose crisis and met the needs of people who use drugs (PWUD). These policies include:

• Ending the prohibition on the use of federal funds to purchase sterile syringes for SSPs.
• Increased funding for Safe Point and other SSPs.
• Increased funding to the Ohio General Revenue Fund (GRF)’s harm reduction line item in the FY2024-2025.
• Legislation to establish safe consumption sites to help prevent overdose and improve health outcomes for people who use drugs.
• Opposing the 134^th General Assembly’s Senate Bill 216 (SB 216) and like legislation, which would further stigmatize and penalize people who use drugs or are experiencing substance use disorder.
• Streamlining operational flexibility of mobile syringe services to best meet the needs of underserved communities and populations.
• Advocating for the needs of PWUD in discussions about funding from opioid settlement funds, such as those within the Ohio Recovery Foundation.

To minimize negative interactions with the criminal justice system, Equitas Health supports the development and implementation of local, state, and federal law and policies that prohibit discriminatory policing practices and unfair law enforcement that disproportionately target members of the LGBTQ+ community, particularly those who are people of color, low-income, and/or who are transgender, non-binary, and gender expansive.

Some of this work overlaps with Equitas Health’s efforts to curb heightened criminalization of LGBTQ+ people that result from Ohio’s numerous HIV criminalization statutes. Additionally, Equitas Health is committed to ensuring that current programs aimed at providing support services to members of the LGBTQ+ community upon re-entry are maintained, including those aimed at providing access to affordable healthcare and housing.

Over the last 50 years, the “war on drugs” has led to disproportionate sentencing and incarceration of BIPOC Americans. The decriminalization of drug use and possession is necessary to address the racial disparities in arrests and convictions and to take into consideration the changing public policy landscape across the United States. Many states, including Ohio, have legalized marijuana for medicinal purposes yet still maintain criminal penalties for possession for those who do not qualify for the medical marijuana program. Cities like Columbus have passed ordinances reducing the penalties for possession and have collaborated with legal aid societies to seal the criminal records for those with low-level marijuana crimes

– but a state and federal solution are both necessary to eliminate penalties and commute sentences for those convicted of low-level drug use and possession violations.

As we know from our HIV criminalization work, a criminal conviction can prevent someone from voting, securing safe and stable housing, and from future employment. We will advocate for the removal of criminal penalties for low-level offenses and the decriminalization of use and possession to ensure equitable policy and health outcomes for the communities we serve.

In Ohio and many other states around the nation, PLWH/A face enhancement penalties for sex work, loitering, and solicitation. Such penalties are often disproportionately applied to people of color and/or transgender people. These statutes, along with many others, are barriers to our work in ending the HIV/AIDS epidemic and in protecting those who engage in sex work. The HIV criminalization laws, and the criminalization of sex work, reinforce stigma and threaten the safety of sex workers and clients.

We must call for laws that protect those who choose to engage in sex work from coercion, violence, arrest, and abuse. Equitas Health supports policies that decriminalize sex work and provide individuals who choose to engage in sex work with the healthcare and supportive services they need.

LGBTQ+ youth often face specific barriers that increase their likelihood of entering the criminal justice system. Working to minimize some of the most common forces that steer LGBTQ+ youth into the criminal justice system, such as societal and familial rejection and discriminatory and harsh disciplinary practices in their schools, is crucial.

Equitas Health supports the development and implementation of local, state, and federal law and policy that prohibits such discriminatory practices in schools and seeks to provide welcoming and supportive spaces, programs, and services for those LGBTQ+ youth who face family rejection at home.

To achieve equitable public policy outcomes, we must elect policy makers who understand the diverse and emerging needs of the LGBTQ+ and BIPOC voters and others at the intersection of identities historically and intentionally marginalized by elected officials and institutions. As a trusted service provider, it is imperative that we empower our patients and clients to consider their civic health and the impact that their vote can have on our ability to provide service and their ability to live healthy and empowered lives.

To drive civic participation and improve the civic health of our community members, we must continue advocating for policies that increase access to the ballot and reduce barriers to voting and civic participation.

We will continue advocating for federal legislation to protect and expand voting rights, and given the continued barriers to voting, we will continue to provide voter registration and engagement resources, while especially focusing on the needs of voters who are BIPOC; transgender, non-binary, and gender expansive; and/or disabled. Our ability to provide quality, affordable, affirming services and the health of our patients and clients is dependent upon our continued and unfettered access to the ballot.