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Top #5Actions of the Past Week: December 7, 2018

Family smiling

Happy December! And what a month it's been. Thank you once again for the tremendous work getting out the vote this fall. We were so amazed and inspired by the thousands and thousands of actions MomsRising members took to get friends and family to the polls. From texting voters to writing postcards, it all made a big difference! 

We're back with our list of top, urgent, hot and important actions from the past week, featuring important actions on immigration, gun safety, paid leave, and more. This list is your activist cheat-sheet, making it easy to catch up on actions you might have missed. And remember: sharing the link with friends and family makes a big difference too! 

Thank you for all you do, and here we go! => 

1. Say NO to Funding for Family Separation and Imprisonment

BACKGROUND: As many of us were winding down holiday celebrations, we were horrified to see photos of our government tear gassing mothers and toddlers who are seeking asylum at our border. The cruelty is breathtaking. Our country has the capacity and policies in place to process asylum seeking families in a humane manner. Instead, the Trump administration is asking Congress for more money so that they can implement increasingly cruel practices to target immigrants both inside the U.S. and at our border. Tell the U.S. Congress to stand up against these cruel practices and to hold the Trump administration accountable by not financing the administration’s cruelty to immigrant families! #ProtectFamilies

-> ALSO: Send a letter to your local paper about family separation. We make it easy: click here to get started

2. Pledge to Continue to Fight for Gun Safety in 2019

BACKGROUND: Every year, more than 100,000 people in the United States die or are injured by firearms. America’s moms mourn every person killed and every child victimized and traumatized by the epidemic of gun violence that is plaguing our country, and we must do better in 2019. Stand with MomsRising to let leaders know that we demand they act to advance gun safety and community safety immediately. We will deliver pledge signatures to every member of Congress so they know that we are paying attention, watching their votes, and counting on them to prioritize families over the gun lobby.

3. Make Sure You’re Covered for 2019 Open Enrollment! (And help make sure others #GetCovered too!)

BACKGROUND: Healthcare.gov is open for business now through December 15th. With only days left during open enrollment, time is short and we need YOU to be a #HealthcareHero by helping us spread the word! Since President Trump has gutted funding for outreach efforts, it’s up to us to help get the word out. A recent Kaiser Family Foundation poll found that a majority of those most affected by open enrollment are unaware of the current open enrollment deadlines. We’ve created a handy bilingual Open Enrollment toolkit that you can use to spread the word about open enrollment and be a #HealthcareHero. Take action and help get the word out about open enrollment in health care. Use our Open Enrollment toolkit to help spread the word! https://moms.ly/OE6Toolkit #GetCovered, #EnrollByDec15

4. Why is Paid Family Leave Important to You? Please Share! 

BACKGROUND: Nearly everyone at some point needs to rearrange their lives to recover from their own serious illness, provide care for a loved one, or to care for a new or adopted child. Whether it’s to care for a newborn you swear already smiles, a mom who is ill, or a spouse battling cancer, being there for family is what matters. You shouldn't have to give up a paycheck to do it. Lawmakers and decision-makers need to know just how important paid family leave is to families. What has your experience been? Share it here and we'll deliver it to lawmakers to help them understand why paid leave is so important!

 

5. #KeepMarching: It’s a Year-End Match!

BACKGROUND: As we head into 2019, we’re facing some of the greatest challenges of our movement — protecting health care, reducing gun violence, fighting for immigrant families’ rights, shining a bright spotlight on the maternal mortality crisis, and so much more. To win for moms and families, we must get stronger. Can you help? Please help us hit the ground running in 2019 with the most generous contribution you can — and your gift before Dec. 31 will be MATCHED! Thank you. Your gift means so much to us, to our movement, and to all the people who benefit from your generosity.

Thanks for all you are doing this election season and beyond! Together we are more powerful than the forces seeking to divide us. 

 

FAQ on Public Charge - December 2018

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FREQUENTLY ASKED QUESTIONS

Proposed Changes to the Public Charge Rule

On October 10, 2018, the Trump administration published a proposed new rule that would change how immigration officials inside the United States decide who is likely to become a “public charge.” Earlier this year, the Trump administration changed the public charge–related instructions that officials in U.S. embassies and consulates abroad use to decide whether to grant a person permission to enter the U.S.

If the rule published in the Federal Register by the U.S. Department of Homeland Security (DHS) on October 10 is finalized in its proposed form, it would mark a significant departure from the government’s current policy. For over a hundred years, the government has recognized that programs that help people get health care and food are necessary to help families remain productive and thrive. Entire households and communities would be harmed by the proposed new policy, since there’s no way to target individual immigrants without hurting children, families, and communities. 

BACKGROUNDWhat or who is a “public charge”? How does the government decide who is likely to become a public charge? What is an “affidavit of support”? When does the public charge test apply? To whom does the public charge test apply? Who is currently considered a public charge? How do I prove that I’m not likely to become a public charge? 

PROPOSED CHANGES TO PUBLIC CHARGE POLICY: What are Trump’s proposed changes to the public charge rule? Which government programs would be added to the list of programs considered as part of the public charge test? Which programs are not included in the proposed rule’s list? When could the proposed rule be approved and take effect? 

INFORMATION FOR NONCITIZENS APPLYING TO ENTER THE U.S. OR TO ADJUST STATUS TO LAWFUL PERMANENT RESIDENCE: I am applying to enter the U.S. from abroad. What changes to public charge policy apply to me? | I have a green card and am planning to travel outside the U.S. What changes to public charge policy apply to me? | How do the changes to public charge policy affect me if I’m sponsoring a family member who is applying abroad for a green card? | I am applying in the U.S. for adjustment of status and will have to be interviewed at a consulate outside the U.S. before I can get my green card. What should I do? | If I used government programs in the past, does that mean I may not be able to get a green card? | What if my family members use health care, nutrition, education, or other programs? | Should I or my family stop using the government programs we are using now? | If a child is receiving health care coverage through a public program, how will that affect their application for a green card? | What if I am serving in the military? | What if I receive a benefit that’s not listed? | If I use Medicaid or food stamps, will I be considered likely to become a public charge? | If I use Obamacare, will I be considered likely to become a public charge? | If I get WIC, will I be considered likely to become a public charge? | If my child goes to Head Start or Early Head Start, will I be considered likely to become a public charge? 

INFORMATION FOR LAWFUL PERMANENT RESIDENTS AND U.S. CITIZENSWhat if I am a lawful permanent resident (I have a green card) and am receiving help from government programs. Can I lose my green card? | I have my green card and need to renew it soon. Can the government deny my renewal application because I am receiving Medicaid, food stamps, or housing assistance? | If I have a green card and get medical care through a government program, does that mean I cannot become a U.S. citizen? | If I am a U.S. citizen, does the public charge test apply to me? | Can naturalized U.S. citizens lose their U.S. citizenship if they use programs like Medicaid or food stamps? | What if I am U.S. citizen or lawful permanent resident and want to sponsor or am sponsoring someone for a green card? 11

WAYS TO GET INVOLVEDThe rule process takes months, so you have time. | What can I do now? | How can I help? | What if I have more questions?

***

BACKGROUND

What or who is a “public charge”?

Public charge is a term used in immigration law to refer to a person who is primarily dependent on the government for support. The proposed new rule would broaden the definition of who is to be considered a public charge so that it includes immigrants who use one or more government programs listed in the proposed rule.

How does the government decide who is likely to become a public charge?

The government uses a public charge “test.” The public charge test is based on several different factors. An immigration officer must look at the “totality of circumstances” by looking at the person’s age, health, family status, financial status, education and skills, and the “affidavit of support” filed by their sponsor (if they have one). The government must look at the person’s whole situation to decide if they are likely to depend on public programs in the future.

What is an “affidavit of support”?

An affidavit of support is a legally enforceable contract that a person (called a sponsor) signs to accept financial responsibility for another person, usually a family member, who is coming to the U.S. to live permanently.

When does the public charge test apply?

The test applies in two situations: (1) when a person applies to enter the U.S. or (2) when a person applies to adjust immigration status to become a lawful permanent resident (to get a green card). You apply for a visa or green card by submitting information on a form. Using the information from that form and from the interview that follows, the government decides if you are likely to become a public charge. The test is not used when a permanent resident applies for U.S. citizenship. 

To whom does the public charge test apply? 

The public charge test does not apply to all immigrants. Some immigrants are not subject to the public charge test. Certain “humanitarian” immigrants are either exempt from having to show that they are not likely to become a public charge or can qualify for a public charge “waiver.” These immigrants include refugees; people who are applying for or have been granted asylum (asylees); women, men, or children applying for a green card under the Violence Against Women Act (VAWA); people who have or are applying for U or T visas; children seeking Special Immigrant Juvenile status; and people in some other protected categories.

If you are in any of these categories, you can use any government programs you are eligible for — including cash aid, health care, food programs, and other noncash programs — without worrying that doing so will harm your chances of getting a green card or improving your immigration status.

Public charge does not apply to people with green cards when they apply for U.S. citizenship.

Who is currently considered a public charge?

Currently, immigration officials may consider your use of the following programs in deciding whether you are likely to become a public charge:

  • Cash assistance programs, including:

– state and local cash assistance programs
– Temporary Assistance for Needy Families (TANF), which has different names in different states
– Supplemental Security Income (SSI), which helps people with limited income and who have disabilities, are blind, or are age 65 or older
– General Assistance or other local cash assistance programs

  • Long-term institutional care paid by the government (for example, Medicaid to stay at a nursing home).

How do I prove that I’m not likely to become a public charge?

Make the best case for yourself (with documentation, your interview, etc.). You can explain why you are not likely to become a public charge in the future. For example, you can present information about your employment.

PROPOSED CHANGES TO PUBLIC CHARGE POLICY 

The rules for public charge may change for people who are applying in the U.S. to become a lawful permanent resident.

What are Trump’s proposed changes to the public charge rule? 

If the rule is finalized, the proposed change in policy would:

  • Add more programs that could be considered when determining if someone is likely to become a public charge, including certain health care, food, and housing programs.
  • Establish income levels that would be weighed against or in favor of applicants in the public charge test. For example, if a person earns less than $31,000 per year to support a family of four, this would be considered a negative factor in the public charge test. And a person who supports a family of four would have to earn more than $63,000 per year for their income to be considered a heavily positive factor in this test.
  • Apply a similar test to (1) requests to extend a nonimmigrant visa (for example, to receive permission to stay longer in the U.S. on a visitor’s visa) and (2) requests to change to another nonimmigrant status (for example, change from a student visa to an employment visa).

The proposed new rule also:

  • Lists other standards for immigration officials to consider when evaluating an individual case. For example, having limited English-speaking skills or physical or mental health conditions that could affect the person’s ability to work, attend school, or care for themselves would be viewed negatively in the “totality of circumstances” test.
  • Could allow some people applying for a green card to post a public charge bond in order to enter the U.S. To be allowed into the U.S., a person deemed likely to become a public charge because of their income, a health condition, or certain other factors may be required to buy a bond for a minimum of $10,000. They might then lose that money (forfeit the bond) if they used certain government programs.

Which government programs would be added to the list of programs considered as part of the public charge test? 

The programs that would be considered in the public charge test, in addition to the cash and long-term care programs already considered under current policy, are:

  • health care coverage through Medicaid, except for treatment for emergency medical conditions (Medicaid programs run by the states have different names in different states. To see what Medicaid is called in your state, visit https://www.healthcare.gov/medicaid-chip-program-names/.)
  • Supplemental Nutrition Assistance Program (SNAP, sometimes called food stamps)
  • low-income subsidy (LIS) for prescription drug costs under Medicare Part D
  • rental assistance under Section 8 housing vouchers, Project Based Section 8, and Public Housing

(The cash and long-term care programs that are already considered under current policy are listed above under the question “Who is currently considered a public charge?”)

Which programs are not included in the proposed rule’s list?

The following programs are not included in the proposed rule’s list of programs that would be considered as part of the public charge test:

  • disaster relief
  • emergency medical assistance
  • programs that are entirely state, local, or tribal (other than cash assistance)
  • benefits received by the immigrant’s family members
  • any other benefit not specifically listed in the proposed rule

Government programs not listed in the proposed new rule include school-based services for children, education, child development, and employment and job-training programs. In its request for comments on the rule, DHS asks for input on whether benefiting from the Children’s Health Insurance Program (CHIP) should be considered. CHIP is not currently listed as a program considered. However, it could be included in the final rule because DHS is asking for comments on whether to include it. 

When could the proposed rule be approved and take effect? 

We do not know for sure. The government must follow a long process before the rule becomes final and effective. Before the proposed rule can become final, the government must

  • allow the public to submit comments on the proposed rule (the deadline to submit comments is December 10, 2018)
  • read all of the public’s comments
  • draft and publish responses to the public’s comments

INFORMATION FOR NONCITIZENS APPLYING TO ENTER THE U.S. OR TO ADJUST STATUS TO LAWFUL PERMANENT RESIDENCE

I am applying to enter the U.S. from abroad. What changes to public charge policy apply to me?

The U.S. government’s policy about public charge has already changed for people who are seeking a visa or a green card at consular offices outside of the U.S. In January 2018, the U.S. State Department revised its Foreign Affairs Manual (FAM) to institute new policies on public charge. The FAM provides guidance to government officers at U.S. embassies and consulates who decide whether to grant a person permission to enter the U.S.

If you are seeking a visa to enter the U.S., you may be subject to the public charge test and will have to show why you should not be deemed likely to become a public charge.

For more information on this, see the National Immigration Law Center’s publication Changes to “Public Charge” Instructions in the U.S. State Department’s Manual.

I have a green card and am planning to travel outside the U.S. What changes to public charge policy apply to me?

If you have a green card, you may be subject to the public charge test when you try to reenter the U.S. if you travel abroad for more than six months. We suggest that, before you leave the U.S., you discuss your travel plans with an immigration attorney.

How do the changes to public charge policy affect me if I’m sponsoring a family member who is applying abroad for a green card? 

If you are sponsoring a family member for a green card who lives outside the U.S., be prepared to answer questions about your relationship to that person. 

I am applying in the U.S. for adjustment of status and will have to be interviewed at a consulate outside the U.S. before I can get my green card. What should I do?

We recommend that you consult with an immigration attorney before you go to your consular interview. 

If I used government programs in the past, does that mean I may not be able to get a green card? 

The public charge test is forward-looking.  It would not consider any newly listed benefits used prior to the date the proposed new rule takes effect. If you previously received help from government programs but your situation has changed, you can show that you will not need those services now or in the future (for example, because you now have a job). 

What if my family members use health care, nutrition, education, or other programs?

Generally, it is benefits received by you, the applicant for a visa or green card — not benefits received by your family members — that are to be considered in the public charge test. If the proposed rule goes into effect, the government should not count your children’s use of noncash benefits (for example, health insurance or food stamps) against you when it reviews your immigration application. However, if your children’s cash benefits are your only source of support, that can affect whether you are deemed likely to become a public charge. Be sure to speak with an immigration attorney about your case. 

Should I or my family stop using the government programs we are using now? 

If you or your family are getting help to get medical care or to pay for food or rent, you do not need to stop receiving this help. The proposed rule has not been finalized. If it does eventually become final, it won’t take effect until months from now. The proposed rule says that it will apply only to programs you use after the rule goes into effect. 

If a child is receiving health care coverage through a public program, how will that affect their application for a green card?

Children who are applying for a green card could be affected by the proposed new rule. If they are receiving Medicaid, this could be considered in the public charge test, along with their age, income, and other factors. The government has asked for input on whether to include the Children’s Health Insurance Program (CHIP) as a program whose use should be considered in the public charge test. But CHIP is not included as such a program in the proposed rule published on October 10. 

What if I am serving in the military?

The new proposed rule would exclude from the public charge test consideration of benefits received by active duty servicemembers and their spouses and children. 

What if I receive a benefit that’s not listed?

When it applies the public charge test, the government should consider only the programs listed in the proposed rule. Help received through programs that aren’t listed, such as education, child-development, employment, and job-training programs, are not part of the public charge test. For example, Pell Grants, child care, or other benefits that are not listed will not be considered. 

If I use Medicaid or food stamps, will I be considered likely to become a public charge? 

If you are living in the U.S. and applying for a green card, it’s still OK for you to use Medicaid or SNAP (food stamps). And remember, the government will look at your whole situation to decide if you are likely to depend on government programs in the future. If you received support in the past but no longer will need it, you can show that you no longer use or need these programs. For example, you can show that you have a job or other health insurance now.

Even if the proposed rule goes into effect, your U.S. citizen children can still receive SNAP (food stamps) or Medicaid if they are eligible, without affecting your application for a green card. 

If I use Obamacare, will I be considered likely to become a public charge?

Under both the current public charge policy and the proposed rule, it is OK for you to use Obamacare (Affordable Care Act health insurance) with financial help if you are eligible. Using it should not hurt your ability to adjust your immigration status. 

If I get WIC, will I be considered likely to become a public charge? 

Under both the current public charge policy and the proposed rule, it is OK to get help from WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children). Receiving WIC should not hurt your ability to adjust your immigration status. 

If my child goes to Head Start or Early Head Start, will I be considered likely to become a public charge? 

Under both the current public charge policy and the proposed rule, it is OK for you to use educational programs such as Head Start or Early Head Start.

INFORMATION FOR LAWFUL PERMANENT RESIDENTS AND U.S. CITIZENS

What if I am a lawful permanent resident (I have a green card) and am receiving help from government programs. Can I lose my green card?

You cannot lose your green card just because you, your child, or other family members use benefits properly. And you cannot be denied U.S. citizenship for lawfully receiving benefits. But you may have a problem if you leave the U.S. for more than six months and then try to reenter the country, because at that point you are requesting “reentry” into the U.S. If you’re planning an extended trip outside the U.S., speak with an immigration attorney before you leave.

I have my green card and need to renew it soon. Can the government deny my renewal application because I am receiving Medicaid, food stamps, or housing assistance? 

No. The public charge test does not apply when you renew a green card. The renewal application may not be denied based on your use of programs for which you are eligible. 

If I have a green card and get medical care through a government program, does that mean I cannot become a U.S. citizen?

No. The public charge test does not apply to lawful permanent residents (people with green cards) when they apply for U.S. citizenship.

If I am a U.S. citizen, does the public charge test apply to me? 

The public charge test does not apply to U.S. citizens. If you are a U.S. citizen receiving help through public programs, you should continue receiving the benefits you need for which you are eligible.

Can naturalized U.S. citizens lose their U.S. citizenship if they use programs like Medicaid or food stamps?

No. U.S. citizens cannot lose their citizenship based on their lawful use of public benefits. Once you become a U.S. citizen, the government may not deport you and must always let you return to the U.S. after you travel outside the country.

What if I am U.S. citizen or lawful permanent resident and want to sponsor or am sponsoring someone for a green card?

Getting help through public programs should not prevent you from sponsoring someone (such as a family member) who is applying for a green card in the U.S. But it could be considered if your family member is applying for a green card from outside the U.S. or needs to go abroad for a consular interview before being granted permanent resident status. You will need to file an “affidavit of support” to show that you or a cosponsor or joint sponsor have enough money or resources to support the person you’re sponsoring.

WAYS TO GET INVOLVED

Fight back! Anyone — your doctor, your neighbors, your relatives, your community’s leaders, and you — can speak up to oppose the policy changes proposed in the new rule. Make a difference. 

The rule process takes months, so you have time. 

The public has 60 days from the time the proposed rule was published (until December 10, 2018) to submit comments, and the government then must review all the comments. This could take weeks or months. If the government decides to change the rule in response to the comments, it will be at least another month before the rule takes effect. Congress does not have to approve the rule for it to take effect, but Congress should also review the rule. Review of the rule by Congress could further slow its implementation or block it.

What can I do now? 

Think through the impact this proposed rule may have on you and your family. We recommend having these conversations now, as you continue taking care of your needs, such as going to your medical appointments. 

You should discuss these issues: 

  • Are you using any programs that may be considered in the public charge test?
  • Are you working, or will you be able to find other ways to meet your basic needs if this rule goes into effect?
  • Is there a way you could apply for a green card in the near future?

How can I help?

We need to be strong because the stakes are high. Let the government know that this rule would harm you, your family, your community, and the country. 

  • Join us in submitting comments to oppose the proposed changes to public charge policy. Find out how by visiting www.ProtectingImmigrantFamilies.org.
  • Organize your networks, your neighbors, and your family to submit comments about the proposed rule.
  • Share your own story.

Click here to send your message about why this proposal is a bad idea. To submit a comment, you do not have to provide your contact information or your immigration status, just your name. If you do not want to give your name, you can ask a friend or representative to share your story for you.

What if I have more questions? 

Talk to someone who knows the rules. Contact trusted sources of information, including:

  • a trusted nonprofit that serves immigrants
  • a community health clinic or social worker
  • your immigration lawyer or Board of Immigration Appeals–accredited representative

Groups all over the country are monitoring and planning to fight the changes to public charge policy in the proposed rule. For more information and to sign up to receive the latest information, visit www.ProtectingImmigrantFamilies.org.


This page contains general information based on what the Protecting Immigrant Families Campaign knows to date and is not legal advice. Please take the time to consult with an immigration attorney or Board of Immigration Appeals–accredited representative about your own situation to help you decide what’s best for you and your family. For free or low-cost options near you, visit the National Immigration Legal Services Directory at www.immigrationadvocates.org/nonprofit/legaldirectory/

Maternity Care in the United States Remains Separate and Unequal

[IMAGE DESCRIPTION: Purple background with the title "Black Maternal Health Conference and Training Institute" with a picture of a Black mother kissing an infant's head.]

This past weekend, birth workers convened in Atlanta for the first Black Maternal Health Conference and Training Institute. The Institute brought together doulas, midwives, nurses, doctors, public health advocates, researchers and mothers with a singular commitment to address a national crisis: Black mothers are three to four times as likely to die from pregnancy complications as White mothers.

 

The Black Mamas Matter Alliance convened the Institute, and advisory committee members noted that Congress has introduced 20 different bills this session to address maternal mortality. However, these bills do not sufficiently address a fundament problem: racism, not race, is a key contributor disparities in maternal mortality. And after almost two decades as a practice obstetrician,  I have come to appreciate that as a health care provider, I am complicit: I practice in a system that is designed to deliver unequal care.  This unequal care perpetuates structural and institutionalized racism – the “differential access to the goods, services, and opportunities of society by race” for Black, Indigenous and other People of Color. 

 

Consider prenatal care. During pregnancy, 2 in 3 White pregnant individuals have private insurance, while 2 in 3 Black pregnant individuals have Medicaid. This difference in income and insurance coverage is the legacy of racist policies such as redlining and segregation, that have caused a yawning gap in wealth between Black and White Americans. As Jessica Roach noted in her opening plenary, these racist policies are the underlying cause of adverse social determinants of health, such as unstable housing, lack of transportation, food insecurity and poverty, that disproportionately impact people of color. And yet, despite the complex challenges facing patients living in poverty, patients with Medicaid are typically seen by doctors-in-training, while privately insured patients receive care from board-certified physicians. Why is it acceptable for patients to receive care from inexperienced trainees? If trainees are well-supervised and just as capable as fully trained doctors, then both private and publicly insured patients would be seen by trainees, with faculty supervision. And if care by a fully-trained physician is superior, would a just society not demand that its highest-risk patients see our most experienced providers?

 

In part, these differences in care provided are about money – specifically, the enormous gap between Medicaid and private payer reimbursement. In North Carolina, Medicaid pays providers just $1327.53 for global OB care, which includes up to 14 prenatal visits, delivery, and postpartum care. For the same services, private insurance where I practice reimburses more than $2800. Why is it considered acceptable to pay half as much for a Medicaid patient? 

 

This gap reflects the value our society places on reproduction, depending on who is reproducing – a phenomenon known as “stratified reproduction” that impacts people of color regardless of income or education. As Mama Shafia Monroe put it in the opening plenary, “We need to reclaim that our black babies are welcome and wanted in this world.”   We need that reclaiming because Black mothers are too often disrespected and disbelieved, even when they are privately insured. In a blog post, Denene Millner describes how she paid for the "deluxe" package at a New York City hospital, but her nurse refused to believe that she had paid for the luxury package, or that she had a husband.  Similar disbelief confronted Serena Williams, who had to fight her nurses and doctors to be treated for a life-threatening blood clot in her lungs. These implicit biases contribute to stark differences in outcomes: in New York City, Black patients with a college degree have higher rates of life-threatening birth complications than patients of other race/ethnicities who never graduated high school. 

 

The diminished value placed on the reproduction of people of color is pervasive. Consider a recent video celebrating the successes of a quality collaborative in a South Carolina: A professionally-produced film describes five initiatives, set against soaring music and soft-focus images of moms and babies. In a state where 28.8% of birthing women are Black, there were only three Black women in the 10-minute video – two clinicians and a patient, all in a segment on postpartum Long-Acting Reversible Contraception (LARC). A Black mother describes how getting a Nexplanon implant immediately after birth enabled her to get a driver’s license, enroll in a training program, and get a better job to support her family. It was an uplifting argument for access to contraception – access that is an essential component of reproductive autonomy. And, as the only image of a Black mother in a state where 16,000 Black women give birth each year, it was an insidious reinforcement of the narrative that if Black women could just keep their legs crossed, they could pull themselves out of poverty. 

 

I shudder to think how many times in my 17 years of obstetrics practice I have high-fived a colleague for “talking her into Nexplanon.” It is tidy to think that if we can just control the fertility of marginalized people, they can transcend institutionalized racism and realize the American Dream -- as though a birth control implant will somehow compensate for the fact that a Black mother earns $0.51 for every dollar earned by a non-Hispanic White father. We must recognize that coercive contraception does not correct institutional racism – it perpetuates it. 

 

As Dr. Joia Crear Perry noted in the opening plenary, our system of unequal care reflects the roots of obstetrics and gynecology in centuries of mistreatment of Black women. That mistreatment spans Marion Sim’s experimental surgeries on unanesthetized enslaved women through the forced sterilization of “undesirable” women that extended well into the 20th century. Only by understanding these racist legacies can we take steps to redress wrongs and dismantle the bias within our unequal health care system. This unequal system is perfectly designed to get the results that it gets:  Black infants die at twice the rate of White infants, and Black mothers die at three times the rate of white mothers. 

 

And yet, as Deray McKesson argues, if the system is perfectly designed for the results it achieves,  “… it was designed...people made this up, and because people made it up, we can make something different." So let’s commit to something different. We can begin by celebrating the strength of Black families with events like Black Breastfeeding Week’s “Lift every baby.” We can support organizations like the Black Mamas Matter Alliance, SisterSong and Black Women Birthing Justice to lift up the voices of Black women as leaders in state quality collaboratives, community advisory boards and quality improvement initiatives. We can center solutions on the lived experiences of people of color. We can enact the Black Mamas Matter Standard for Holistic Care of and for Black Women, with approaches that support families with a collaborative team of community health workers, doulas, midwives, family and clinicians.

 

We can name and dismantle the structural and institutional racism impacting our healthcare practices, policies and systems. We can demand payment schedules that provide equitable reimbursement for care of marginalized people, including coverage for doulas and other birth workers. We can ensure that patients with the most complex needs are seen by the most experienced medical providers. We can mentor diverse trainees and commit to foster communities that support them to become part of a workforce that looks like the patients we serve. We can tailor care to the needs of each pregnant and parenting family. And every day, we can own our implicit biases and practice cultural humility. Before we enter a patient’s room, we can pause and prepare to see them as an individual, listening more than we speak and recognizing their unique strengths and vulnerabilities.  As Ancient Song doula Chanel Porchia-Albert put it, “Be humble. That’s it.”

 

And we can raise the bar. As Dr. Crear Perry said, “What would it look like for women to not only survive pregnancy, but to thrive?

 

Alison Stuebe is a Maternal-Fetal Medicine physician practicing in Chapel Hill, North Carolina. She is a member of the board of the Society for Maternal-Fetal Medicine.

Be a #HealthcareHero for Open Enrollment!

It’s time to use our outside voices for health care!

Healthcare.gov is open for business now through December 15th. With only 10 days left during open enrollment, time is short and we need YOU to be a #HealthcareHero by helping us spread the word!

Take action and help get the word out about open enrollment in health care. Use our Open Enrollment toolkit to help spread the word! https://moms.ly/OE6Toolkit

We need your voice! While the marketplaces are stable, enrollment is down 11% so far. Considering President Trump cut the marketing budget for open enrollment by 90% this comes as no surprise—which is why we are looking for YOU to be a #HealthcareHero and help people learn about their health care coverage options on www.healthcare.gov!

Since President Trump has gutted funding for outreach efforts, it’s up to us to help get the word out. A recent Kaiser Family Foundation poll found that a majority of those most affected by open enrollment are unaware of the current open enrollment deadlines. We’ve created a handy bilingual Open Enrollment toolkit that you can use to spread the word about open enrollment and be a #HealthcareHero.

**Help spread the word about open enrollment using our toolkit!

What’s happening? The Trump Administration’s attempts to undermine the Affordable Care Act have left millions of Americans confused about whether or not they can, or even should, sign up for health care coverage. A lot of uninsured people won’t know that they have coverage options if we don’t spread the word.

If we #KeepMarching for health care, even small gestures will help to increase awareness. With a quick share on your Facebook page or a simple Tweet, you might be the person responsible for helping your high-school friend, old roommate, or second cousin get the health care coverage they desperately need for their family! Our toolkit is bilingual, too, so you can share info in both English and Spanish!

#KeepMarching and be a #HealthcareHero by helping us spread the word about open enrollment!

We’ve made speaking out easy! The toolkit includes a flier you can print and post around town, as well as, sample social media posts and graphics. Don't worry: MomsRising will give you all the information you need to be a #HealthcareHero. Studies show that family (moms!) and friends are among the most trusted sources for information—and that people trust moms as much as doctors, for information about health coverage options. So, your voice matters!

Our Favorite Hanukkah Books

This week, Jewish families around the world are celebrating the holiday of Hanukkah. Hanukkah is an eight-night "festival of light" that celebrates the the miracle of the Jews, led by the Maccabees, defeating one of the mightiest armies on earth, the Greeks, against all odds. Many families light a menorah (adding a candle each night), play games with a dreidel, eat foods made with oil (latkes and sufganiyot!), and spend time with loved ones.

When I was growing up there weren’t a ton of Hanukkah books available. They were fairly basic, mostly about latkes or Maccabees. But all that has changed recently. There are now more books than ever available for us to read to our little ones about the story, celebration, history, and fun that is Hanukkah.

My nieces celebrate Hanukkah and Christmas and one of their favorite books is Light the Lights! by Margaret Moorman, which tells the story of a little girl named Emma who celebrates both holiday, just like so many kids in America now.

My friend Lauren Ranalli just wrote a book called The Great Latke Cook Off about family tradition, competition, and of course latke recipes.

The Jewish Book Council just released a list of favorite Hanukkah books for kids of all ages (including The Hanukkah Hamster, which I can’t wait to get my hands on!).

MomsRising staff have their own favorite Hanukkah books as well. Check them out:

 

Ruby Sinreich, MomsRising Web Developer and Senior Technologist:

When my son was younger I was often invited to his preschool class to help teach the kids about Hanukkah. Along with my menorah and dreidel show and discussion of how humans from many cultures have observed and celebrated the winter solstice, I loved to read How Do Dinosaurs Say Happy Chanukah?

This book has beautiful, semi-realistic illustrations of dinosaurs behaving badly at first (blowing out the candles on the menorah, being rude to family, stealing gelt and dreidels) but then they correct their behavior and act like good dinosaurs. It’s very playful and a fun read for little kids.

As my son has gotten older he can now join me appreciating Lemony Snicket’s humor in The Latke Who Couldn’t Stop Screaming. This story of a Hanukkah potato pancake getting fed up with people who only seem to understand Christmas is quite relatable for me! Fortunately, I am able to not scream about it, and I don’t have to try to escape an unpleasant fate in a frying pan.

Also popular in our house is The Shortest Day which teaches about the winter solstice and shows how cultures from across world have learned about and celebrated the returning of the light throughout human history. It’s a great way to bring friends together in a celebration of our universal human experience of the earth’s tilt away from the sun.

 

Jessica Burroughs, North Carolina Hunger and Food Insecurity Campaign Director  

When my boys were younger, I gave Hanukkah presentations in their elementary school classes (once, when I was in the school cafeteria during a different time of year, a student ran up to me, gave me a hug, and told her friends that I was the Hanukkah lady!).  I often read stories along with playing dreidel and lighting the menorah. One of the kids’ favorite stories was The Chanukkah Guest, by Eric Kimmel.  This funny story stars an older, hard-of-seeing woman, called “Bubbe,” who mistakes a bear for her rabbi. The story always got a lot of laughs while also teaching that Hanukkah is about welcoming in others and being generous about what we have.  

When my son was in the first grade, I read Nine Spoons: A Chanukah Story, by Marci Stillerman, to his class.  This story tells of a miracle that happened on Hanukkah to a Jewish man in a concentration camp. After I read the story, the first grade teacher’s assistant was moved to share her own story about her recent homelessness. She shared that she and her young daughters had spent months living in their car, and taking showers whenever people were kind enough to offer. She then told the class about her miracle of finding an affordable, safe place to live.  After her story, other students in the class shared their personal miracles.

Also by Eric Kimmel, and a favorite of my sons, is Herschel and the Hanukkah Goblins.  But I will warn you that it is a little scary-- my youngest son could not look at the pictures until he was in the third grade! So please look at the book first before reading it to your kids.  Once they get into it though, they might find it as gripping and suspenseful as we did!

 

We would love to know what some of your favorite Hanukkah books are. Please share your recommendations for all ages in the comments section!

Let’s not lose ground on children’s health now

Mom walking down a rode with a child holding each hand.

Last week we got some sobering news on children’s health in North Carolina: After years of progress, the rate of children with no health coverage in our state has reversed course. Nearly 5% of kids in North Carolina now have no health insurance (that’s 119,000 children) – despite the fact that our economy is on an upswing.

The Georgetown Center for Children & Families released a new report that showed an uptick in the rate of children without health insurance nationwide – for the first time in nearly a decade. Having health insurance means that children can get the well checks they need, starting at birth. Catching potential problems early, screening for developmental concerns, dealing with treatable conditions before they cause lasting damage, ensuring that children are properly vaccinated – these are basic steps that ensure kids are healthy, ready to start school and succeed throughout life.  

How did this happen? Three-quarters of the children who lost coverage between 2016 and 2017 live in states that have not expanded Medicaid coverage to parents and other low-income adults. The uninsured rates for children increased at almost triple the rate in non-expansion states than in states that have expanded Medicaid.

So what can we do about it? One important step is to make sure that parents are covered. When parents have health insurance, kids are much more likely to be covered and get the care they need. There are over 100,000 parents in North Carolina without health insurance because they earn too much to qualify for Medicaid, but not enough to buy private health insurance. This “coverage gap” contributes to a wide range of expensive problems, including this startling news on children’s coverage.  

North Carolina is one of only 14 states that have not acted to close this “coverage gap,” so our citizen’s dollars are going to the 36 other states who have expanded Medicaid under the Affordable Care Act.  Medicaid Expansion is a top priority for Governor Cooper and NC DHHS Secretary Mandy Cohen, but so far the NC Legislature hasn’t made any promises.

Love Works

Intense does not begin to describe last week's staff retreat. Anti-oppression and anti-semitism training, visits to the The Legacy Museum: From Enslavement to Mass Incarcerationand and The National Memorial for Peace and Justice exploring enslavement and lynching, and a dance party (because sometimes you just have to release) stirred all the emotions. From visceral and raw sorrow to heart-exploding love to pure exhaustion, I mean all. the. Emotions!

I am grateful to be apart of an organization that is committed to growing and continually examining its own practices to ensure that it is living its values. It’s not easy, we certainly do not always get it right, but failure is not an option. I am eternally grateful to work alongside powerful women and men everyday who are not afraid to be vulnerable or stand in humility as we learn from and with each other.

When historians write about this moment, I will be grateful that I stood shoulder to shoulder with my MomsRising colleagues in support of women and families. Love works.

Safety In Our Kids' Schools: Providing Social & Emotional Support

As a parent, I believe that it is essential that my children feel not just physically safe, but also socially and emotionally safe in their schools. As a mental health professional who has worked in both elementary and high schools, I have seen that physical safety is often the primary focus in schools. However, I have also seen that young people need just as much, if not more, socioemotional support.

Socioemotional support occurs when a student participates in interventions that offer positive reinforcements between peers and adults, all while learning how to manage and process their own emotions. In today’s digital world, an increasing number of the young people that counselors like me serve are expressing the need for face-to-face social connection. Instead, in most schools, there is hyper-focus on academic data, the “metrics” behind school ratings, and a school’s “image.” In environments driven by data and test scores, socioemotional support is not valued as an end in itself, but turned to when students begin to wear down under stress.  

Many of my students complain that they are seen as just a student ID number instead of as a whole person. Like most of my colleagues, I chose this field because of my interest and desire to understand and impact the world around me through my socioemotional intelligence. To be skilled in socioemotional intelligence is to have the ability to monitor, value, and acknowledge one's own emotions and those of others, and to appropriately use and manage emotional information to guide thinking and behavior. Every day, I work with resilient and beautiful young people to enhance their socioemotional intelligence, as they try to navigate in this world we adults have helped to create.  When counselors, psychologists, social workers and administration come together for “Care Team” meetings, our job is to provide interventions that support students as whole people.  A Care Team is a team of professionals skilled at socioemotional interventions. We plan and implement best-practice interventions for students in need of additional support for their well-being and academic success. The interventions might relate to anger management, trauma, anxiety, or depression.

This thoughtful and proactive approach to addressing root causes of the issues affecting students, however, is unfortunately not the case for the many police within our schools. Police are by nature reactive, and their interventions usually consist of arrest and incarceration. During the tenure of Mayor Richard M. Daley, there was an increase in the use of metal detectors, security, and police within Chicago Public Schools. In particular, the 2009 beating death of Fenger High School student Derrion Albert led to a closer relationship between CPD & CPS. Derrion Albert’s death was seen across the world, and, from the mayor’s perspective, put the city in a very bad light. His turn to the CPD was an immediate and visible response that did nothing to address the underlying issues that had caused that eruption of physical violence. His decision was not made with insight from experienced youth professionals skilled in addressing trauma in a systematic manner.

In 2009, I was a counselor at another south side high school when Derrion Albert was killed. Before CPS had established its current “crisis team” response, neighboring schools would send extra counselors to an affected school to help grieving students. I was among those extra counselors temporarily reassigned to Fenger High School. Our work there was short-lived. We were sent back to our schools after just two days at Fenger. In retrospect, it was actually counterproductive. Youth with chronic exposure to violence need more than a counselor to come for a few hours to console them. They need a full counseling staff  that can build a rapport with them and connect their family members with outside support. I was simply there to place a bandage on a gaping hole. Schools with the most visible CPD presence, such as Fenger, are predominantly in neighborhoods that have a history of trauma, poverty, and a lack of resources. There is rarely sufficient funding to provide proper mental health resources to these students.

Counselors develop a repertoire of skills to advocate for students and their families. Police are there to finalize a situation that is no longer solvable. Counselors empower, police intimidate. Counselors are trained in recognizing triggers, police are trained to pull them. Counselors can mediate between a school staff member and a student, police write reports and often exacerbate the issue. I understand that not all police are defective humans hiding behind a badge. Some are actually skilled in a way that mirrors a counselor. And some counselors are hiding behind a caring image while their words and actions may be tainted by racism, classism, sexism, heterosexism, or adultism. However, as parents who want the best for our children, we should work to ensure that the counseling staff at our children’s schools are adequate and effective at serving all of their varying needs. This will have a much greater impact on our children than trying to make sure that there are  “good cops” at their school.

We, as parents, are the ones with the real power to make things happen. We are the ones that can demand change because there is strength in numbers. We are what makes the LSC consider parents’ perspectives. We are what bridges community to school and what makes the phrase “community school” have actual meaning. We are the ones that can help decrease police presence in the school and  demand more counselors and social workers.

As a mental health professional and as a parent, I am asking you  to reach out and connect with other parents at your child’s school. The more parents are involved in the LSC, PAC, BAC, PTA and other parent-friendly organizations, the more power we will have  to increase the resources and interventions that support our children’s emotional, psychological and physical needs.

Here are some suggested questions to ask your principal so that you can  begin to increase socioemotional supports in your child’s school:

  1. What are the different options for parents to be involved in our school? (LSC, PAC, etc.)

  2. What is the current status of socioemotional programs in the school? Is there a plan to expand them?

  3. What can we do to increase the number of socioemotional programs, activities, etc?

  4. What is the counselor student ratio at our school?

  5. How can we hire additional  counselors and social workers, or have them spend more days at our school?

  6. Is there a committee to help raise more money for the school? How can I join?

 

As a very involved mom, I know without a shadow of a doubt, that it has been and will always be the parents who blaze the trails toward true progress in expanding socioemotional interventions and growth for our children.

 

Keisha J. Mathew is a mother of two kind, free-thinking young leaders she cheers on regularly. She holds a master’s degree in clinical social work with a concentration in community schools from the University of Chicago. Her work with youth is a life-long passion that continues to take on different forms through her love for the arts and social justice. She is married to a CPS teacher and proud CTU member. She tries to squeeze in writing between running around the city with her family, hanging with beloved girlfriends, and practicing some well deserved self-care.

#PowerUp With Risers Radio

On the radio show this week, we hear about power of YOUR word and YOUR story; how to stop voter suppression and voter intimidation, the fight to end gun violence, and what you can do to stop human rights abuses on our southern border.

 

*Special guests include:

 

How to Listen:

Remember to join the conversation by using the hashtag, #RisersRadio, on Twitter!

Hashtag: #RisersRadio #KeepMarching

9 Ways to Avoid the Rampant Consumerism of the Holidays

Now that Black Friday starts at many stores on Thanksgiving night itself, holiday shopping madness is in full swing even before you put away the leftovers. And many of the season's strongest sales pitches are directed right at kids.

If you want to enjoy the holiday on your terms, it'll take a concerted effort to replace holiday marketing messages with your own. Start training yourself and your kids now to think more critically about the rampant consumerism on display during the holidays.

 

Before Things Get Too Crazy

Be on ad alert. This holiday season, marketers will be using social media, websites, and viral ads to capture your kids' attention and even try to get your kids to do their marketing for them. Kids under 7 can't distinguish between ads and other content, and even older kids can be tricked by ads masquerading as games. Help your kids identify ads by pointing out how they're designed to get your attention and sell you something.

Teach kids to look at ads critically. Shiny trucks, winking dolls -- all made possible by special effects. Help your kids identify the tricks of the trade that make products seem better than they really are.

Break the brand habit. Lego, Nike, Nintendo -- brand names are big in kids' worlds. But they're not always the best. Be on alert for name-brand items on your kids' wish lists. Talk about how companies develop brand loyalty by selling an image. Does the item they want really do what they think it does?

At the Store

Think through tech purchases. From the Nintendo Switch to the latest iPhone, handheld electronics are the hot new toys for kids this year. But many families get talked into expensive products their kids may not want or need. If there's any doubt in your mind, consider giving your kid an IOU for a gadget of their choice (with a price maximum) so you can shop for it together later when the pressure's off (and prices might be lower).

Make use of retailers' "give back" programs. Many retailers-–from Safeway to Macy's-–offer customer-donation programs that turn small donations–-a dollar or two at checkout–-into big amounts for charities. These programs provide a convenient way for you and your kids to help out at the holidays.

Buy books. Publishers release special books around the holidays that often get overshadowed by flashier, pricey presents. But the gift of reading-–from picture books to box sets of popular series--are an ideal way to work reading into your kids' winter vacation. Check out our guides to the best books of 2018 for little kids and for tweens and teens

At Home

Be careful with unboxing videos. YouTube is full of clips of people--both kids and adults--narrating their actions while opening toys, games, electronics, and other kids' products. Unboxing videos can be harmless fun, but they may also whet your kid's appetite for stuff that they didn't even know existed -- especially as these videos ramp up around the holidays. Unboxing videos glorify consumer culture, so take precautions to lesson their influence. 

Focus on what matters. Get your kids into the holiday spirit (and override consumerist messages) with homespun fun. Take a trip to see your town's lights and decorations. Plan a totally device-free dinner. Take time to talk about what the holidays mean to your family and why they're special. And try these ideas to cultivate your kids' sense of gratitude

Play "giving" games. At sites like We Give Books and Free Rice, your kids can actually make a difference in the lives of children around the world just by reading and playing! Also check out our running list of charitable apps and sites