Support Healthcare Services for LGBTQ+ & People Impacted by HIV | Equitas Health

Providing Access to Healthcare for All

At Equitas Health, we prioritize advocating for policies that are rooted in the pursuit of health justice. We hold true the understanding that health justice policies promote equitable access to health care services and coverage, funding for services and programs that support our patients and clients, and civil rights and legal protections for all people. Our mission is to be a gateway to good health for all, which can only happen with the essential government programs and public policies that help us provide quality, affordable, and affirming care and services.

Our primary public policy priorities include the following:

Public Statements

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Equitas Health Votes

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Advancing Racial Justice

Equitas Health acknowledges racism as a public health crisis in America. As a steward of public health, it is incumbent upon us to create an affirming health care home for all. We recognize that Black, Hispanic, Indigenous or native, and other people of color experience institutional racism in the provision of health care and supportive services, and we aim to eliminate bias and discrimination in our models of care.

Equitas Health is committed to addressing the ways in which we have contributed to, or benefited from, White Supremacy and remedying these injustices in our continuum of care, our hiring practices and internal policies, our pursuit of public policy, and how we engage 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.

Breonna Taylor. George Floyd. Tamir Rice. Henry Green. Casey Goodson. Andre Hill. 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.

Equitas Health stands 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.

We will continue to advocate for public policies that facilitate development of infrastructures and funding to support COVID-19 testing; vaccine production and distribution; telehealth; direct financial assistance to individuals and families; rental assistance, including relief for missed or late payments; an extension on the eviction moratorium; and supplemental funding for community health centers and direct service providers.

Addressing Social Determinants of Health

According to the Center for Disease Control (CDC), social determinants are the conditions in the places where people live, work, and learn that affect a wide range of health and quality-of life-risks and outcomes. SDOH can be grouped into five categories: economic stability, education access and quality, health care access and quality, neighborhood and built environment, and social and community context.

We are committed to addressing SDOH in clinical spaces and in our policy and advocacy work. We will support legislation to advance access to quality health care, education, community development, social connectivity, and economic stability.

Healthcare Programs

We will advocate for state and federal measures to rein in the rising cost of prescription drugs. As the nation continues to navigate the COVID-19 pandemic, many who rely on specialty medications to manage chronic conditions find themselves facing a difficult decision – paying the bills or paying for necessary and lifesaving medications. We are committed to supporting policies that promote affordability and ensure no one has to go without care.

We also support legislation to end co-pay accumulator policies implemented by insurance companies and employers. Copay accumulator policies are programs that prohibit all copay payments made using a manufacturer-issued copay savings program from counting toward a patient’s annual deductible. We are actively working alongside community partners to reintroduce legislation during the 134th General Assembly to prohibit this practice and promote affordability practices for our patients and clients.

The Ryan White program provides a comprehensive system of care, including primary medical care and vital support services for people living with HIV (PLWH) 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.

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 that there are nondiscriminatory 340B reimbursement practices for our patients by all payors, including Medicaid, Medicare, and commercial insurers. This helps guarantee that our patients can afford the prescriptions they need.

The Affordable Care Act (ACA) was enacted to ensure access to affordable healthcare coverage for all Americans. The ACA has has expanded health coverage to more than 20 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 healthcare settings and ensuring access to and coverage of essential healthcare services.

We implore the Biden administration and the 117th Congress to pursue policies that build upon the success of the ACA and work toward achieving universal coverage.

Many of our patients depend on crucial safety net resources, like Medicaid, to access affordable healthcare services. Medicaid is the avenue through which a number of our clients 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 ($17,236 for a single individual in 2019). It also guaranteed coverage for people living with HIV without first requiring an AIDS diagnosis.

Through the implementation of Medicaid expansion in 26 states, including Ohio, thousands of people living with HIV gained insurance coverage that they otherwise would not have been able to afford. Many of our own patients at Equitas Health benefitted from Medicaid expansion.

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 personal responsibility measures, including work and education requirements, that negatively impact our patients.

We support the Biden administration’s actions in late January to require the Department of Health and Human Services to thoroughly review and provide changes to Trump administration directives on Medicaid, including a review of the burdensome and discriminatory actions to institute work requirements.

Mental Health and Recovery

Mental health and substance use play an integral role in a person’s overall health. This is even more imperative for members of the LGBTQ+ community. 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. This, and other health disparities contribute to lower health outcomes.

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, syringe access programs, telehealth, and other support 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 live and through telehealth options.

Dental Health

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. We support increased access to and coverage of dental services.

Community Health Centers

The Community Health Center program is a federal program that provides primary healthcare services to populations who have been underserved by traditional healthcare systems. Because of this program, Equitas Health is able to support its community-based programs that offer care in communities with the most need in order to provide necessary and accessible healthcare. An integral part of this work is prioritizing the healthcare needs in communities of color within our existing service areas.

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

Although we do not receive federal funds through the Community Health Center program, we advocate for funding for this program, so that our federally funded counterparts can continue to be providers of choice in communities across the country. As we have observed throughout the COVID-19 pandemic, community health centers have been instrumental in continuing service delivery – allowing our hospital systems to care for those most severely affected by COVID-19.

Working to End the HIV Epidemic through Prevention and Care

Fighting HIV has been at the center of Equitas Health’s mission since our organization’s inception, and we are committed to ending the HIV epidemic in the U.S.

To achieve this goal, we must prevent transmission of HIV, provide treatment and care for those affected by HIV, and ensure that people living with HIV/AIDS (PLWHA) have access to the support services necessary to maintain their treatment and to guarantee a stable and healthy life.

Equitas Health is committed to 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, we seek to ensure that these services and programs are appropriately funded and accessible to all who need them.

Prevention

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 ensuring that there is access to, coverage of, and reimbursement for medications like Truvada and Descovy for PrEP, and new generic forms of the medication that have recently hit the market. We work with policymakers at the state and federal level to keep these types of medications accessible to our patients—no matter their insurance coverage status or ability to pay. We have launched a Tele-PrEP effort to ensure that anyone who wants PrEP, no matter where they are located, can get it. This is particularly important for vulnerable populations who cannot get to an Equitas Health medical center for treatment.

The science is clear: undetectable = untransmittable. People living with HIV who are on effective treatment and whose viral loads are undetectable cannot transmit HIV to their sexual partners. By taking their medication as prescribed to keep healthy, people living with HIV are key to ending the HIV 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 to PrEP and PEP is the number one goal of the Ending the HIV Epidemic plan. The Prevention Assistance Program Interventions (PAPI), a program that helps cover the medical costs associated with taking PrEP and PEP, is critical to increasing access to HIV prevention medications in the state of Ohio.

The U=U campaign is crucial to ending HIV for a number of reasons. One of the most important reasons is that U=U helps to shift the conversation from stigma to science. Since our inception, Equitas Health has been committed to ending stigma against people living with HIV and ending the HIV epidemic. The U=U campaign empowers our patients and the communities we serve to stay healthy and to become advocates, spreading the U=U message. 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 Epidemic resources, Equitas Health has launched the Ending the HIV Epidemic Task Force in Columbus. The Task Force is an elite team of health navigators, tasked with two goals: eliminating all barriers to care for people living with HIV 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.

One factor that continues to drive the HIV epidemic in the U.S. 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, it is imperative to ensure access to preventive services to the people who need it most. These services include syringe service programs, mental health and substance use disorder services, testing and prevention services for people at risk of HIV and viral hepatitis, and access to treatment and care services for PLWHA.

Equitas Health also supports policies that reduce the use of shared syringes and that ensure their safe disposal. We understand that providing linkage-to-care activities through syringe services programs are a critical part of HIV 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.

Treatment and Support Services for People Living with HIV/AIDS

We are committed to supporting and providing access to evidence-based and evidence-informed care and treatment interventions for PLWHA. Such services produce optimal HIV 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 PLWHA.

Guaranteeing Equality and Dignity for the LGBTQ+ Community

Members of the LGBTQ+ community are more likely to face discrimination in various facets of their lives 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 overturn the changes made to Section 1557 of the Health Care Rights Law under the Trump administration in order to restore non-discrimination protections for LGBTQ+ individuals.

Recently, 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. We support the Biden administration’s Executive Order and call upon Congress to codify these protections by passing the Equality Act.

Policies like the Equality Act, which passed in the 116th Congress, extend legal protections to members of the LGBTQ+ community in all aspects of their lives, including housing, employment, and public accommodations. Equitas Health also supports bills like the Ohio Fairness Act, which 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 will continue our advocacy on behalf of LGBTQ+ individuals.

Equitas Health has a longstanding commitment to ending the discrimination and stigma against people living with HIV 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 people living with HIV—often with enhanced penalties—and they rely heavily on stigma, not science. These statutes include the felonious assault statute, which broadly criminalizes HIV, and multiple statutes that target and enhance penalties for people engaged in sex work and other behaviors even if they pose no risk of transmitting HIV. The state disproportionately enforces these laws in over-policed communities of color and low-income areas that 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 stigmatize HIV and PLWHA.

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

In 2021, we will work alongside members of the Ohio Health Modernization Movement and the Ohio General Assembly to introduce legislation to modernize these statutes and ensure that Ohio’s Revised Code recognizes and reflects science over stigma.

Members of the transgender community face discrimination, stigma, and systemic inequality in many aspects of their lives. Our commitment to fighting for equality for all members of the LGBTQ+ community includes working to ensure that Ohioans who are transgender have access to the same legal protections, public accommodations, and services as everyone else.

This includes protecting current legal protections afforded to transgender and gender non-conforming individuals in federal law, such as those found in Title IX and those enforced by the US Departments of Health and Human Services, Education, and Justice. We are also committed to ensuring equity in access to healthcare for patients who are transgender. We are working to abolish the Ohio Medicaid and state employee benefits package policies that explicitly exclude transition-related healthcare and transgender health coverage. Equitas Health is also committed to helping clients navigate the newly overturned prohibition on altering gender markers on birth certificates.

We also stand in solidarity with the movement to protect Black trans women. We will work diligently to uplift the experiences of Black trans women, listen and respond to their needs, and advocate for policies that award them the safety and dignity to which they are entitled.

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 following state and federal legislation to eliminate violence against vulnerable communities:

  • Reauthorization of the Violence Against Women Act (VAWA) as passed by the House of Representatives in the 116th
  • Reintroduction of R. 35 – Emmitt Till Antilynching Act to formally recognize the history and ban the practice of lynching in the United States.
  • Increased funding for the Victims of Crime Act (VOCA) program.

Providing Housing for PLWHA and LGBTQ+ Youth

Equitas Health is committed to providing access to the essential care and services that PLWHA need to live stable and healthy lives, which must include access to housing. Having access to stable housing is not only associated with better health outcomes for PLWHA. Because PLWHA with access to stable housing are more likely to be virally suppressed, they also cannot transmit the virus to other people.

We work to maintain or expand funding for federal housing programs for PLWHA, like the Housing Opportunities for People with AIDS (HOPWA). Additionally, we support the development and implementation of laws and policies that support culturally competent and nondiscriminatory services at shelters accessed by PLWHA . We are also committed to promoting and advancing policies that address the severity of the housing crisis across the country. We will advocate for policies to end discriminatory eviction practices and ensure all people can find and retain appropriate, affirming, and affordable shelter or housing.

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. People who confront homelessness, or lack access to stable housing, also face HIV infection rates that are a staggering five to ten times higher than people with stable housing.1

This is why 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, which aim to improve family relationships and reduce rates of homelessness among LGBTQ+ youth. Additionally, Equitas Health supports the development and implementation of laws and policies that support culturally competent and nondiscriminatory services at shelters accessed by LGBTQ+ youth.

[1] Suzanne M. Dolwick Grieb, et al., Housing Stability, Residential Transience, and HIV Testing Among Low-Income Urban African Americans, AIDS Education and Prevention: Vol. 25, No. 5, pp. 430-444, 431 available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4116750/.

Minimizing Negative Interactions with the Criminal Justice System

To minimize negative interactions with the criminal justice system, Equitas Health supports the development and implementation of local, state, and federal laws 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 and gender nonconforming.

Some of this work overlaps with Equitas Health’s efforts to abolish Ohio’s numerous HIV criminalization statutes. Additionally, Equitas Health strongly believes all funding for current programs that provide support services to members of the LGBTQ+ community upon re-entry must continue, including those aimed at providing access to affordable healthcare and housing.

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, like 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 laws and policies that prohibit such discriminatory practices in schools and seek to provide welcoming and supportive spaces, programs, and services for LGBTQ+ youth who face family rejection at home.

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