From:                                                       genelozano4537@gmail.com

Sent:                                                         Monday, March 28, 2022 11:38 AM

To:                                                            Stillson. Cori

Cc:                                                             Bennett. Cheryl

Subject:                                                   RE: Gene's follow-up to "Letter from Sacramento County Disability Advisory Commission (DAC)"

 

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Hi Cori,

 

Thank you for your quick response, and I look forward to the next step.

 

Take care,

Gene

 

 

 

Hi Gene –

 

I think Liz did address your question regarding whether mobile in-home testing. Based on the information that she was able to collect, it does not exist, and the only in-home option currently available is the at-home tests that must be self-administered or administered by someone in the household.

 

I think that the conversation regarding what the barriers are to the division providing that service is a different one that can be started, and I like your idea of having a discussing with them so that we can work toward a possible solution. I can talk to Liz and we can figure out who best to include and will get back to you.

 

 

 

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Hi Cori,

 

I appreciate Cheryl’s inquiry on your behalf with Sacramento County Division of Public Health in seeking clarification to Dr. Olivia Kasirye’s 2-24-22 email “RE: Letter from Sacramento County Disability Advisory Commission (DAC)”.  The clarification had to do with Dr. Kasirye’s statement “Sacramento County Public Health supports testing at several community testing sites (see attached map) those with physical challenges or transportation needs may call 211 to get assistance.”  It could be read into this statement that by calling 211 a person with a disability that is physically homebound can schedule through 211 for someone to administer the COVID-19 test and to provide the test results to the individual at their residence.

 

I was seeking clarification since people with disabilities have reported not being able to schedule through 211 someone to travel to their residence to administer and deliver the results of the COVID-19 test as part of a Sacramento County mobile in-home testing program.  When these individuals have called 211, the operator has told them they could only schedule an appointment for the administration of the COVID-19 vaccination.  Therefore, I was hoping to learn that Sacramento County Division of Public Health does have both mobile in-home testing and vaccination administration programs base on Dr. Kasirye’s email letter.  

 

However, the 3-21-22 clarification response from Liz Gomez, Health Program Manager, Sacramento County Division of Public Health, continues not to recognize or respond to the recommendation to her division for there to be a mobile in-home COVID-19 testing program.  We have heard from Ms. Gomez and Mike Nguy, Human Services Program Planner, Division of Public Health, for more than a year of the division’s commitment of full social justice equity and compliance with applicable disability civil rights laws, such as Title II of the ADA, when providing the administration of COVID-19 testing and vaccination. 

 

Despite the DAC’s efforts to bring forth this issue and recommended solution, the division continues not to recognize that by not providing mobile in-home testing for people with disabilities is a social justice inequity issue and could be a violation of Title II of the ADA, 28 CFR Part 35: Subpart B General Requirements, Section 35.130 General prohibitions against discrimination; Subpart D Program Accessibility, Section 35.149 Discrimination prohibited; and Subpart E Communications, Section 35.160 General.    

 

My understanding, social justice is the overarching societal concern about what is right and wrong, fair and unfair.  Social justice applies these concepts of correctness and fairness with the notion of equality or equal opportunity in society.  Essentially, social justice ensures that every member of society, regardless of race, ethnicity, gender, education, disability, age, etc., is afforded the same opportunities, privileges, and protections as everyone else. 

 

I believe an example of social justice is equal opportunity to public health services, including the administration of COVID-19 testing, effectively communicating testing results, and COVID-19 vaccinations.  Social justice is vast and encompasses equal economic, political, and social rights and opportunities for all, including people with disabilities, even those who are physically homebound, which prevents them from utilizing community walk-up COVID-19 testing sites or the free at-⁠home COVID-⁠19 tests because of their disability-related functional limitations.

 

Justice implies a sense of fairness, equality, and unbiased treatment, and is applicable to the delivery of accessible and usable testing programs. It would be unjust not to provide testing to a person who is homebound because of their disability which intersects with gender, race, ethnicity, religious preference, etc.  So, social justice ensures people with disabilities who are homebound should receive access to testing and the reading of the results from their private residence. 

 

In my opinion, it would be the obvious conclusion since the division has located many of the community walk-up COVID-19 testing sites in geographic equity areas that the next step for the division to take is to define the residence of a homebound person with a disability as a geographic equity area to guarantee full equity for all residents in Sacramento County. 

 

Finally, I believe it can be defended that if the Division of Public Health fails to provide an accessible mobile in-home program for administering COVID-19 tests and reading of results to people with disabilities who are homebound, that this inaction is in violation of 28 CFR Part 35, Sections 35.130 General prohibitions against discrimination, 35.149 Discrimination prohibited, and 35.160 General.  The ADA regulations require local government to ensure that their programs such as COVID-19 testing for people with disabilities are as effective as testing for people without disabilities.  The division’s COVID-19 testing program is not effective for people with disabilities whose functional limitations prevent them from physically accessing community walk-up COVID-19 testing sites and receiving the results. 

 

To conclude, I would like, on behalf of the DAC, a response from the division’s “team” which fully responds to our question/request for the division to implement an accessible mobile in-home COVID-19 testing program for people with disabilities who are homebound and cannot utilize the community walk-up COVID-19 testing sites.  If the division cannot implement such a program, we wish to know the reasons for not being able to provide this service and what needs to take place to have such a program. 

 

If the team’s explanation is that they don’t have the funding, then the DAC recommends to the division that they do the following:

1. They seek during the upcoming budgetary cycle increased funding and support for the existing mobile in-home vaccination administration service to be applied toward continuous operation and to enhance the delivery rate of this service, as well as to expand the program to include a mobile in-home testing service component.
2. These services should be indefinitely funded, staffed, and supported to ensure this segment of the disability population now, and in the future, can receive in-home testing and vaccination services for the reasons stated for the COVID virus and any other virus during a pandemic.

 

I am willing, as chair of the DAC, to meet with representatives of the Division of Public Health and the DCO to have a constructive and transparent meeting to address this issue.

 

Please let me know how we can proceed.

 

Thank you,

Gene

 

 

 

Hello Gene, below is the response we received regarding your question about 211 response to requests for in-home Covid-19 tests and vaccinations. Apologies for the delay in sending this. Take care, Cheryl

 

 

Hi Cheryl,

 

Here is a response from our team:

 

“We have developed an infrastructure to ensure vaccine access to this population that involves several partners and leverages existing resources.  There are currently a couple of communication channels for homebound vaccine registration and scheduling. They can call 211 to get put on a list or register with MyTurn or call the State directly. We get that list each week and send it over to Alpha 1 to schedule the homebound appointments.  We continue to work hard to contact everyone on our current list of people who’ve requested in-home vaccination while she’s still adding names almost every day. At this time it may take 2-4 weeks after the initial request to be contacted by the vaccine provider although are list is much shorter these days so they are probably getting out to each client quicker than in the past few months.

 

I am unaware of any in-home testing options (other than at home test kits) from the County.”

 

I reached out to our lead for testing to confirm that there weren’t any additional testing options available outside of at-home, and testing sites in the community and he did not have any additional information to provide.

 

Thank you!

 

 

 

Hi Liz and Mike, thank you for all of the information and follow up you have provided to date. The DAC greatly appreciates the actions you and your staff have taken to enhance access in Covid-19 service delivery. There are apparently still some lingering concerns. Could you please respond to the Chair’s follow up request in the emails below? Thank you again for your attention to these issues. Best regards, Cheryl

 

 

Hi Gene,

 

I have not followed up with the department since your previous email to Cheryl and I.

 

Cheryl – Can you please follow up tomorrow with the Public Health staff regarding what occurs when someone calls 211.

 

 

 

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Hi Cori,

 

I am writing to inquire if you have yet received a follow-up response from Dr. Olivia Kasirye to obtain clarification as to her expectations when referring in-homebound individuals to 211.

 

As you may recall in my email below, I asked if you would contact Dr. Kasirye prior to the 3-1-22 DAC meeting to inquire “as to what will occur if someone calls 211 with regards in receiving in-home COVID testing and vaccination services”. 

 

I have only anecdotal reports that when someone calls 211, they have not been able to schedule someone to come to their home to administer COVID-19 tests and to provide the results.  Supposedly, the 211 volunteer says they can help them by scheduling someone to administer the COVID-19 vaccination, and that might be as far out as 2 months.

 

Again, I have no factual information to provide to Dr. Kasirye or yourself.  However, based on the anecdotal information given to me, the 211 referral may not be a viable option. 

 

Additionally, of great concern is the information that someone who is in-homebound may have to wait upwards to 2 months to be administered the COVID-19 vaccination and possibly to be tested through the 211 scheduling process.

 

I would appreciate some information, if any, on this clarification for tomorrow’s Executive Committee meeting.

 

Thank you,

Gene

 

 

 

Hi Cori and Cheryl,

 

I do very much appreciate Dr. Olivia Kasirye’s information as to what is occurring on the national level to make accessible the free at-home rapid COVID test kits.  Also, I am appreciate of her forwarding the DAC letter to the California Department of Public Health’s Testing Taskforce for their review.

 

However, I am unclear if someone who is absolutely homebound and is totally blind calls 211, will they have the in-home services for administering the COVID test, the test results read to them, and/or being administered the COVID vaccination? 

 

I still get a sense that the state and county are wanting for the absolute homebound individual to find a way to go to a community testing site, even if it is realistically impossible because of the nature of their disability. 

 

I would appreciate, prior to the 3-1-22 DAC meeting, that the DCO would acquire clarification from Dr. Kasirye or one of her key staff as to what will occur if someone calls 211 with regards in receiving in-home COVID testing and vaccination services.  Again, this is an individual who cannot go to a community testing and vaccination site because of the nature of their disability, such as paralysis, multiple chemical sensitivity.

 

Thank you,

Gene