Friday Memo- October 18, 2019

Dear Team:

            In these uncharted political times, there are serious concerns whether the structures of American democracy can hold firm. Let’s remain optimistic.

            Last Friday, federal courts across the country stepped in, unanimously, to rule that the Trump Administration’s “Public Charge” Rule, a dagger aimed at lawfully documented immigrants in this country, was lawless. The Rule, intended to drive documented immigrants and their families from public benefits – think Medicaid and food stamps — was enjoined by each of the courts. Appeals are likely to follow but, for now, there are multiple court orders stopping the federal government from punishing documented immigrants for accepting the benefit to which they are legally entitled.    

            Since 1803, it has been a bedrock principle of American law that courts interpret what the law means, and enforce that meaning. Federal courts in multiple states each condemned the Trump Administration’s expansion of what it means to be a “public charge.”

            This is an important victory for the day to day protection of our communities.  As envisioned by the Trump Administration, the chilling impact of the Rule would drive lawful immigrants away from receiving benefits, and ultimately out of the United States. Civil Rights icon Congressman Elijah Cummings, who died earlier this week, said it correctly:  When we’re dancing with the angels, the question will be asked, in 2019, what did we do to make sure we kept our democracy intact? Did we stand on the sidelines and say nothing?”

            We at Community Healthcare Network do not stand on the sidelines. We submitted commentary assailing the Public Charge Rule when it was still a Trump proposal, and we have been providing counsel to our patients on how to balance their right to Medicaid against this threat to their future immigration status.  With the court injunctions, we and our patients can breathe easier – at least for now.

            The judges were emphatic in issuing their injunctions:  “The rule is simply a new agency policy of exclusion in search of a justification,” Judge George B. Daniels of the Federal District Court in Manhattan wrote. “It is repugnant to the American Dream of the opportunity for prosperity and success through hard work and upward mobility.”

            A California court said that the American dream still exists. The court mocked Trump’s often stated preference for white, highly educated, and affluent immigrants. Quoting Emma Lazarus’ famed poem, the judge wrote:  “Keep, ancient lands, your storied pomp.” Instead, as the inscription in New York Harbor reads:  “Give me your tired, your poor, your huddled masses yearning to breathe free.”

            Less lyrical, more scientific, the same court quoted the Dana Farber Cancer Institute’s condemnation of the Rule: “[R]egulations that will make immigrant families fearful of seeking health care services like primary care and routine health screenings will increase the burden of both disease and healthcare costs across the country.”

            That is what CHN knows, and faith in the beauty of the American immigrant is what we embrace. This is a good win, too rare these days, for justice and decency.


            All this week the Joint Commission, a prestigious accrediting agency that monitors the quality and safety of outstanding health care organizations, has been inspecting our health centers, and reviewing our clinical practices. Thanks to all who worked to prepare for the Joint Commission, and thanks to those who met with the evaluators throughout the week.

            We will report back next week on the outcome of the visit (which is looking very good). Here is a toast to Sharon Kaufman, Vice President of Quality Management, who has led our preparation.

            Boy, this autumn has been a season of inspections. Earlier in the fall, HRSA – CHN’s federal regulator — has its on-site visit. It left giving CHN a glowing report of good health.

            Just law week CHN welcomed a surprise visit (these are random, about once a decade) from the New York State Department of Health (DOH) whose inspectors came to our South Bronx, East New York, and Lower Eastside Health Centers. They were pleased with what they saw.

            After the Joint Commission heads home later this afternoon, we should be done with inspections for a while. But the fact that we are always ready to be inspected is vitally important to the quality of our care at CHN.  Well done, Team, going three for three on successful inspections over the past couple months. Let’s not ever let up. 

            A beautiful weekend ahead, I hope, for all.