San Francisco Immigrant Forum - Regular Meeting

Hi, everyone, I'm going to start over because I didn't start recording, but welcome in welcome to the SF immigrant forum. It's our regular webinar. Today is Wednesday, May 27th. I'm going to give folks a minute to trickle in today. As you do that, I want to introduce myself. My name is Jamie Richardson, and I'm here as the host of today's SF Immigrant Forum, but also as a representative of the Office of Civic Engagement and Immigrant Affairs. And as folks trickle into the meeting, I wanted to invite anyone that needs interpretation to join our interpretation channels. The instructions are on the screen right now in Spanish and Cantonese and English. And we also have Arabic interpretation available today. I'll give folks a minute to do that. If you navigate to the bottom of your screen, you can find the option to join the interpretation channel. All right, let's get started. So today's agenda, if this is your first time or you've attended many SF Immigrant Forum webinars, we have updates from our steering committee at the beginning and followed by our special topic presentations. Today we're doing two presentations from Healthy San Francisco. So we're excited to have our guest speakers here today to talk about that program. as well as the San Francisco Health Plan. Each presentation will be followed by a short Q&A. So if you have questions throughout the presentations or at any time during the webinar, please use the Q&A function at the bottom of your Zoom screen. We will collect responses and answer as many questions as we can. But if you are inquiring about whether or not you'll have access to the slides or if this meeting is recorded, the answer is yes. We are recording this meeting as well as all of our other SF Immigrant Forum meetings, and those are posted on our website, sf.gov slash immigrants. We'll share the link in a moment. And all of the slides are sent to attendees after this presentation. So have no fear, you will get access to the information. And then we'll close out with some reminders. But before we get into our steering committee updates, I just wanted to give an overview of what the SF Immigrant Forum is. This is a collaboration between several city departments that are, you'll hear updates from in a moment, but we manage a resource website on the city's website. That's sf.gov slash immigrants. There's also a email listserv that folks can join and receive updates, but also share their own from their own spaces of work and events and information. And then we have community forums like the webinar you're participating in today. So just to reiterate that resource website is jam packed with resources from housing to immigration legal support, to know your rights information, and a lot of other regional resources. So if you aren't already familiar with sf.gov slash immigrants, please bookmark it. Check it out. We list upcoming events, immigration legal clinics, and more on this website. We also encourage everyone, if you're not already on the listserv, to join. It's a Google group. So anyone that joins can both post and receive messages. If you're having difficulty joining or you need some extra assistance, you can always email OCIA with the email address on the screen and we can add you directly. And just a plug for our next Immigrant Forum regular meeting. We host these every other month, so we hope you'll join us for the one in July. We will be discussing housing resources and tenants' rights for immigrant communities along with our regular updates, so please join us on Wednesday, July 29th at the same time, and you can find that information on sf.gov slash immigrants. And with that, we are always looking for folks to present at future Immigrant Forum meetings. There's a QR code on the screen if your organization is interested in participating in the future. We ask that those presentations are 15 minutes in length and are informational service base for immigrant service providers in the Bay Area. So if you're interested, please do fill out that form and let us know. And with that, we're going to get into our updates from our steering committee from the departments listed here. Okay, and so I will start on behalf of the Office of Civic Engagement and Immigrant Affairs. The first update is a celebration. So on behalf of OCEA and the San Francisco Immigrant Rights Commission, we'd love if you could attend and join us in celebrating our annual Immigrant Leadership Awards at City Hall on June 8th in the North Light Court. We'll be honoring individuals and organizations from entrepreneur leaders to youth leaders and special recognitions. So the RSVP link is there and we hope you can join us. And if you need interpretation, that will also be available. An exciting thing that's happening at this event is that we are pleased to announce that San Francisco has received a five-star certified welcoming designation from a nonpartisan nonprofit called Welcoming America. This is years in the making, but we are going to be announcing this five-star certification. San Francisco is the first ever city to receive the highest level of certification for welcoming for immigrant and all community members. So please come and learn more about what this means and celebrate with us at the Immigrant Leadership Awards. I'd also like to share that OCIA also has an open RFP for immigrant assistant program grants that nonprofits and community-based organizations can apply to. I cannot answer any questions about this today, but you can learn more on our website. and applications are due on June 10th. So if you have any questions, you can email us as well. The email is on the screen. And just a couple more updates before I'll pass it over to MOHCD, but I also wanted to share that language access is expanding in San Francisco. Vietnamese is to be certified as a required language. on June 23rd of this year. And that's part of the language access ordinance. And Vietnamese will be joining Spanish, Chinese and Filipino as a required language. So more to come on that. But we're really excited about this expansion of language access. And just as a reminder, all residents have the right to request free language help when accessing city services, not just those from those language groups, but Vietnamese is being added as a required language. All right, lots of updates from OCIA, but with that, I'll pass it to Vicky Castro from MOHCD. Take it away, Vicky.

Good afternoon, everyone. My name's Vicky Castro. She, her, Asia pronouns from MOHCD. Nothing new to add I just we are finalized we're coming to the end of the fiscal year, so a lot of. Contracting stuff and new contracting for new fiscal year so only administrative updates but that's as much as I can share hope everyone's well. i'll pass it to Andy.

Hey, thanks Vicki. Yeah, my name is Andy Beatley-Hegler. I'm with the San Francisco Human Services Agency and happy to be here with you all. The one update that I wanted to highlight this month was some changes to the CalFresh program, you know, otherwise known as food stamps. And so starting April 1st, CalFresh eligibility ended for certain immigrants without lawful permanent resident, which is LPR green card status. And so those categories included refugees, asylees, parolees, and other groups of non-citizens that were previously eligible. So, we recognize that that is going to have negative impact on some of our population. And this is due to the HR1, the big bill that passed in Washington, D.C. So what we are working on to try to minimize the You know, the negative effects of the of these changes is we've been given permission by the state. It's the California Department of services and the refugee programs bureau. And so they have authorized counties to use refugee support services or funding to provide time limited food assistance. um to eligible populations and it's basically the same uh groups of immigrant status that are that are losing their or at risk of losing their cal fresh so you know again that's like people who have asylum people who've been approved for refugee status and parolees people who've been given parole there's exceptions to the rules. And so I see that my colleagues are putting some helpful information in the chat. There's links to our website there where we talk about all this in detail. But just to summarize, you know, most folks will not be affected by this. And unfortunately, you know, right now, the population that's Coming into San Francisco as newcomers, you know, it's very small, so we're not getting many refugees and asylees, but for folks who may have been here for a couple years and are still receiving public assistance, they could see their CalFresh benefits cut. The way that would typically occur, by the way, is that it would typically be a cut that would not happen automatically, but that would instead go into place at the time of the client's recertification. So, you know, there's a lot of, you know, there's a lot more to this, but I think I want to keep it kind of short and simple today. And you can check the website for more information and hopefully you can find whatever you need there. But I think the thing I wanted to focus on in terms of the The ability of us to assist folks who might be losing their is that we're going to start a program called the short term food assistance program. And so this short term food assistance program will be again utilizing this funding that comes from the refugee programs bureau. And what we'll be doing then is we'll be providing eligible folks who lose their CalFresh with the same level of assistance as that CalFresh was. The catch or the only negative thing there is that it will be short term. It's only going to be for three months in a year. So we're rolling that program out. And if you or clients you're working with are affected by this, what I would recommend they do is we're targeting the CalWORKs population. And so I'd recommend that CalWORKs clients who are affected by this reach out to their employment specialist. And their employment specialist would be the one typically to connect them to this new source of funding that would supplement their CalFresh. So I know that's a lot of information. If you want more details, you can check out our website. I'll also put my, you know, my contact information in the chat so you can reach out to me personally. But I wanted to give a heads up to everyone out there. So you heard about that. So that's it for me for today. And I'll pass it along to my colleague, Christy.

Hi, thanks. Christy Dietrich here. I'm from the San Francisco Department of Public Health. And I'm very happy to have our DPH partners, Healthy San Francisco and the San Francisco Health Plan here today to share details on how anyone can access healthcare at our DPH clinics throughout the city, regardless of immigration status. And then to also share that for anyone in San Francisco who has applied for or plans to apply for asylum status and arrived in San Francisco in the past two years, Our newcomers health program, Asylum Seeker Health Services, provides one-on-one support with healthcare coverage, gaining access, making medical appointments, and as well as many other support connections. So our multi-lingual referral form asks for very minimal information and Jamie will put it in the chat and I'll pass my time to our presenters next. Thanks.

Thanks, Kristy. Really helpful updates. I know we got some questions in the chat that we're working on, but I just wanted to drop those links from DPH and our Newcomer Health Program. All right. So thanks again to our partners for the updates. I am going to now transition to our first presenter. So we are going to have a Healthy San Francisco program overview, and I'd like to pass it over to Jessica Burley and Isabel Sandoval from Healthy San Francisco to talk more about their program. Take it away, Jessica.

Thanks so much. Hi, everybody. We're happy to be here with you all today to share some information about Healthy San Francisco. Let me go ahead and share my screen. Okay, so my name is Jessica Burley. I am the supervisor for the Healthy San Francisco program. I'll be presenting part of the information today, and you'll hear from my colleague, Isabel, as well.

Oh, thanks, everyone. Hi, Jessica. Thanks. Yeah, I'm a program specialist with Healthy San Francisco, and I'll be taking the second part of this program as well. Thank you.

Thanks, Isabel. Okay, so today we'll be going over an overview of the Healthy San Francisco program, what services are covered under the program, who is eligible for the program, what some participant costs might be if they do enroll in the program, the enrollment process, a resource that we have available to folks on our website, the participant portal, and we'll have some time for Q&A as well. So first, just to situate the program in the health care landscape of the city, the program is meant to be the safety net health care access program. So many people potentially access care through their employer, through employer sponsored insurance, or purchase care through Covered California. Other folks are eligible for Medi-Cal or Medicare. And then Healthy San Francisco is meant to be a health care access program for folks who are not able to access it. in one of these other ways. So with recent changes to Medi-Cal that some of you might be aware of and which I'll touch on briefly, Healthy San Francisco is going to be an especially important resource for some folks that you all work with. So Healthy San Francisco is a Department of Public Health healthcare access program created in 2006 by the Healthcare Security Ordinance. It was designed as San Francisco's healthcare safety net, along with our sister program, San Francisco City Option. And Healthy San Francisco provides access to care for those who are not eligible for public insurance or who are unable to purchase private insurance. Certified application assisters at 32 sites across San Francisco screen applicants for all health insurance options, and then they assess for Healthy San Francisco eligibility. Because Healthy San Francisco is the safety net program, it is the program of last resort, and enrollers are trained to screen out of other options first. Every medical home, so every clinic that's part of our network, has certified application assisters and serves as an enrollment site, as do the health plan service center, which you'll hear about today, and the enrollment and eligibility unit at Zuckerberg San Francisco General Hospital. And once enrolled participants can access care immediately, so the sisters, who are completing applications are actually making eligibility determinations as part of the application process and someone is enrolled in the Program. As soon as the application process is complete, they can go see a doctor or pick up prescriptions right away there's no waiting period for the Program. So Healthy San Francisco is a Department of Public Health program. It's administered by the San Francisco Health Plans. We are the third party administrator for the program. We manage all program operations. And the program offers access to care regardless of employment status, immigration status, or any pre-existing health conditions. It offers comprehensive services and a choice of providers within San Francisco and sliding scale fees for participants that are based on income. And one thing that we always try to make sure to convey whenever providing information about the program is that Healthy San Francisco is not health insurance, it's healthcare access program. And that distinction is important for a number of reasons. It can't be considered insurance because there are limited services. So Healthy San Francisco does not meet minimum essential benefits as established in the Affordable Care Act. And there is a limited network of providers. So Healthy San Francisco participants sign up with a specific medical home, a specific clinic in our network, and their care will only be covered when they see a doctor at that clinic or receive services at the hospital or pharmacies that are linked to that clinic within Healthy San Francisco. It's also not considered insurance because it's not portable. So that means that only care received in San Francisco is covered by the program. And there aren't rights to appeal claims in the same way that there are with insurance. The program doesn't pay claims. We pay a flat monthly amount to clinics in our network for each participant. So there's no appeal process or robust grievance process the way there is for insurance claims. There is, however, a complaint process for Healthy San Francisco participants to report any issues that they might be having with the program or with the network. So Healthy San Francisco participants are considered uninsured and because Healthy San Francisco is not considered health insurance, participants might need to pay the California individual mandate penalty if and when they file taxes. And this often takes participants by surprise, because even though Healthy San Francisco is not insurance, it looks and feels a lot like it when you access care. So Healthy San Francisco is not health insurance, but it is a healthcare access program. So participants enroll for 12 month coverage terms. They can renew for additional coverage terms as long as they remain eligible. They choose a medical home when they enroll. This is the clinic where they will receive their primary care services. You can see a map here on the screen. There are sites all over the city for folks to choose from. And then services are only covered when received at that selected medical home. And each of those medical homes is partnered with a hospital for emergency care and with pharmacies for prescription medication access. And this is what the network looks like. So you can see that there are SFDPH, so San Francisco Health Network clinics. There are 13 clinics in that network that are part of the Healthy San Francisco network. There are nine clinics within the San Francisco Community Clinic Consortium that are part of the Healthy San Francisco network. There are six NEM sites within San Francisco that are part of our network, as well as Sister Mary Philippa, which is now part of UCSF, and Kaiser. is one of our medical homes as well. And you can see here in this grid which hospital is associated with those clinics for hospital care and then pharmacies as well. And all of our participants access behavioral health services through Community Behavioral Health Services at San Francisco Department of Public Health Behavioral Health Program. and most folks can enroll at any enrollment site so any of our medical homes typically will have staff who are trained to perform enrollments and then the majority of the enrollments do happen at the san francisco health plan service center and the eligibility and enrollment unit at zuckerberg general hospital kaiser is the only medical home that can only enroll at the san francisco health plan service center And these are the services that Healthy San Francisco provides. So there's preventative and routine care, excuse me, laboratory services and tests, durable medical equipment, alcohol and substance use disorder treatment, family planning, specialty care, mental health care, ambulance services for emergencies, urgent care from the medical home, and emergency care and hospital care and prescription medicine. And again, these need to be received at the participant's selected medical home or at the hospital or pharmacy associated with the medical home in order to be covered by the program. So you can see that the services offered are pretty comprehensive, but there are some that are not offered. Services that are not covered are listed here, most notably dental and vision services. Any services received outside of the participant's medical home and a few others listed here. Gender affirming surgery is highlighted because, while the program doesn't directly cover these procedures, we do have a strong referral relationship for our program participants with Gender Health SF through the San Francisco Department of Public Health and participants are able to get those procedures covered that way. There are five eligibility criteria for healthy San Francisco so someone must be an adult age 18 or older, they need to live in San Francisco and they must be uninsured. And they must not be eligible for full scope medical or medicare if people are eligible for one of these programs that's probably going to be the better option for them, and then the household has to be below 500% of the federal poverty level. Excuse me, I'm getting over a cold. My throat's a little bit scratchy. So when it comes to the Medi-Cal and Medicare eligibility for Healthy San Francisco, people who are eligible for full scope pre-Medical or any part of Medicare, regardless of whether or not they're actually enrolled, are not gonna be eligible for Healthy San Francisco. Individuals can be enrolled into restricted Medi-Cal and still be eligible for Healthy San Francisco. So if someone is eligible for both, being dually enrolled will give them the most comprehensive coverage. And this is especially important with the recent state policy changes that froze enrollment for the expansion population and brought restricted Medi-Cal back into existence for these populations. And I'll go over a little bit of information on that as well. So back in, over the course of the last six years, there were several Medi-Cal expansions that allowed folks who were not previously able to enroll into Medi-Cal to enroll. So those were folks without SIA or without satisfactory immigration status. On January 1 of this year, the state froze new enrollments for folks who are in those expansion populations, so for anybody without satisfactory immigration status. For those folks, if they're currently enrolled in Full Scope Medi-Cal, they can maintain their coverage as long as they complete their annual renewal on time. So for people who are enrolled in Medi-Cal, Full Scope Medi-Cal, it's really important that they be encouraged to complete their renewal process If they lose their coverage now that the freeze has gone into effect, they'll have a grace period to re-enroll and after that they only become eligible for restricted Medi-Cal. there's a couple other changes that are upcoming which I won't go into too much detail about. There is a change on July 1 related to dental coverage for folks who are enrolled in full scope medical without satisfactory immigration status. And then October 1, 2026, there are going to be some additional changes related to immigration statuses, such as refugees, asylees, parolees. Those folks may no longer qualify for full-scope Medi-Cal under the new federal rules. And there are some links on the slides here. I understand you're going to be getting the slides, so there is some more information at those links. And I do want to note, you know we're not medical experts are here necessarily to focus on medical updates, but the expansion freeze especially does have an impact on healthy San Francisco. And who is eligible for the Program. So for the folks who are losing medical because they did not renew their coverage, they have a three month grace period to re enroll. When this grace period ends for somebody without satisfactory immigration status, they will be eligible for restricted scope or emergency medical and healthy San Francisco if the other criteria are met. While they're within that three month period, because they can still re enroll and continue receiving full scope services, which means they continue to be eligible for full scope medical those folks would not be considered eligible for healthy San Francisco. And then for individuals without SIS who have not yet applied for Medi-Cal, they're only eligible for Restricted Scope or Emergency Medi-Cal and then might be eligible for Healthy San Francisco if they meet the other program criteria. And people eligible for financial assistance through covered California are still eligible to enroll in healthy San Francisco covered California is private insurance, even with subsidies. Private health insurance might not be affordable for some people so healthy San Francisco program rules do allow people to enroll even if they're eligible for subsidies through covered California. And participants pay fees to the program four times a year, every quarter, which are based on income and range from $0 to $450. So people who are under 100% of the federal poverty level are not going to pay a quarterly fee to the program. And you can see the range of FPLs and fees for folks here on the screen. Participants also pay point of service fees directly to their medical home, so this is somewhat like a copay when people access services, and this varies by clinic, services, and usually the income of the participant.

And we'll pass to Isabel. Thanks, Jessica. Okay, so we'll go into a little bit more detail as to how someone can enroll. So applicants should schedule an appointment with a certified application assister. These appointments are offered over the phone. It depends on the location. There are some locations that only do phone appointments. Some do both, phone it in person or some some locations just do in person. So to schedule an appointment, the applicant can contact a medical home. It could be their same medical home that they already attend, and they can ask to see if they have a certified application assister, or they can call Healthy San Francisco Customer Service Line, which we're open Monday through Friday, 8 to 5 You'll see the number on your screen. There's also the ability to make an appointment online. So you can schedule an enrollment appointment through our website. If you get on our website and you scroll towards the middle, towards the end of the page, you'll see schedule an online appointment and it'll ask you details and it would be directly with our service center. Next page, please. Thank you. So how to prepare for an enrollment appointment. So we do ask folks to bring in three documents. The first one being a proof of identification. Just one of the following is needed. There's no need to bring all four of these things. Only one of these things is needed. So it must contain a photograph and date of birth. It could be a driver's license or state ID, a San Francisco ID. It could be a foreign passport. It could be expired. That's okay for proof of identification. And then also the option also could be a consulate ID as well. A second document that we do ask folks to bring in is a proof of San Francisco residency because Healthy San Francisco is solely for San Francisco residents. We do ask for proof of San Francisco residency and we would need one of the following documents. It should have the applicant's name and it needs to be within 45 days of the application date. So we need to see that it's dated within the 45 days of application. It could be the driver's license. That's fine. That would be good for both things. So like driver's license can be used for proof of identification. As long as it's not expired, it can also be used for proof of residency. The same with the San Francisco ID. A utility bill can be used as long as it's within 45 days of the application date, as well as lease, as long as it's within the time range of the application. Or if, for example, someone subleases an apartment or the applicant's name is not on the lease, they can use an affidavit of third-party support. And that's a form that can be found within our website as well. Next page, please, Jessica. So preparing for an enrollment appointment continuation, the third piece of document that we do ask is a proof of household income. So it's going to be the most recent copy of maybe the following documents for each member of the household. And when we say household, we mean the person applying, plus if they have someone that they live with, either they're married or they have a domestic partner, then we would need also proof of income. Even if the partner is not actually applying for HSF, their income is also counted as household income. So it would be the most recent copy of the following documents, and they must be within 45 dates of the application, dated within 45 days of the application date. So we would need two to three pay stubs, depending on the cycle of when they're paid. but two to three pay stubs within 45 days or the most recent tax return or a benefits letter if they are receiving unemployment or social security benefits or workers' compensation, et cetera. For self-employed applicants, if the person is self-employed, we would just need the tax return from the previous year or to fill out a profit and loss statement that would include the last three months of income. There's also a template online as well inside of our website. In our website, you would find that. And there's also a declaration of cash income. So we understand that folks, they're not paid via check or direct deposit or anything like that. They are just paid cash income. So we do have a declaration of cash income form that's also within our website that can be downloaded as well for folks who need to use that. Next page, please. So we spoke a little bit about household members. Healthy San Francisco determines household size differently for Medi-Cal. A household member for Healthy San Francisco includes a spouse or a self-declared partner. It also includes biological or adoptive children, 20 years old and under. And we also include unborn children. So if someone is pregnant, it would be counted as two, a household of two. Next page, please. Participant Portal, so this is a public-facing tool that can be used by participants with the program or the general public. And basically, you're screening yourself for basic preliminary eligibility for the program. You put in your information. It's totally anonymous, so you can just put in an alias name. and put down your information to see maybe what you qualify for. So you find out more about how to schedule an appointment also with a certified application assister and you can prepare for the process. So if you do see that you may be eligible for Healthy San Francisco, if you by putting in some of these this information like income, it asks just basic information, income and household size and A few other questions, but it's very basic. And like I said, it's totally anonymous, but it would give you a better idea of whether you qualify for the program or maybe you qualify for Medi-Cal and you don't know it. So it gives you more information. And by this, you can plan to schedule an appointment with a certified application assister. and you can prepare for the application process. You can also upload necessary verification documents into the HSF enrollment and eligibility system before the enrollment appointment. So it's possible that you may need to upload documents if you, actually do a phone appointment. If there is a participant who would rather do a phone appointment rather than an in-person appointment, then there is the way to upload these documents, like taking a picture of your ID or your income information. You take a picture of these documents and you upload it to the SafeSite. And you can also download blank forms, the ones that we spoke about, like the cash income form, or there was also the affidavit of support form. Those types of forms are also found on our website that could be downloaded. And the participant portal, as we mentioned here, it's linked. So you will get these slides and you can click on this link. which would take you to the participant portal, but it's also embedded within various places within our website as well. Next page, please. And our HSF customer service line, folks tend to use this to schedule an enrollment appointment for the general public, or if they want more information about Healthy San Francisco, or if they're a participant and they lost their car, they need a replacement ID card, they would certainly call our phone number. request a participant handbook to learn more about the program and coverage services. Phone number or address change if they do need to update their mailing address or phone number, please give us a call. Medical home changes if they If they need to change their medical home for any reason, they would give us a call to request a change. And then healthy San Francisco billing questions. If they have a question about the quarterly bill or if they didn't receive their quarterly bill, they want to give us a call about it. We can certainly resend that to them. This is also the the line where you would call to file a complaint or a grievance. We totally, we take those very seriously and we look into all complaints that are made. So we do encourage participants to give us a call at our customer service line. And also if a person is requesting disenrollment from the program, we mentioned this here because let's say someone applies for Medi-Cal during the time they are in healthy San Francisco and they do get enrolled into Medi-Cal, the systems don't speak to one another. So we won't know that the person is now enrolled in Medi-Cal. They would need to give us a call to let us know so that we can disenroll them. And if they have, paid into the Healthy San Francisco quarterly fee part of the program, then they would be receiving a reimbursement for that or a partial refund for what they've paid as well. So that's important to always let us know when it is that they need to be disenrolled from the program. And within customer service, there's various languages that are spoken. There's Spanish, English, Cantonese, Mandarin, Russian, and we also have access to the language line. And as you see on your screen, that's the phone number for customer service, Monday through Friday, 8 to 5 p.m. Next page, please. That's it. So now is the time for questions. If anyone has questions for me or Jessica, for both of us, happy to take any questions.

Thank you so much. This is really helpful and in-depth. Because we do have a second presentation, I just want to do two quick questions for you. The first one is, does the quarterly fee need to be paid each quarter or can it be paid at the end of the year?

So the quarterly fees are paid basically when someone enrolls, they will receive their first quarterly invoice sent to them by mail within seven to 10 days after they enroll. So yeah, every quarterly bill is due at the time of when they receive the invoice. So every three months they do need to pay that quarterly bill.

Yes. Thank you. And for proof of income, if an individual has no income, are they required to provide documentation of this?

So we generally ask, like, get a better idea from the participant, like if they're being supported by someone, if maybe family is providing support, we have them fill out the affidavit of support form. So that's a form that's online. It just depends by person. But yeah, there's other documentations that they would fill out just stating maybe making a general declaration of how they support themselves or what income they are receiving. There's also the cash income form as well. So, you know, we're happy to work with folks to see what sort of documentation they may have, but we don't want that to deter the person from applying.

Thank you. Awesome. Thank you. And the last question I'll ask before we move on to our next presenter. And again, the last slide, you know, was the outreach email for folks to follow up with more questions if we're not able to get to your question today. But I wanted to ask this really quickly. If someone is kicked off Medi-Cal or unable to re-enroll, will the Human Services Agency, you know, let them know about Healthy San Francisco? I guess what is kind of the communication for someone that may be losing access to benefits? Or is it kind of our job to do that outreach and let people know that this program exists? You could respond generally to that. Thank you.

Yeah, I mean, I can't speak in too much detail about the practices of the Human Services Agency necessarily. I know that the folks at the Human Services Agency do know about Healthy San Francisco and have received training on the program and do often refer folks to Healthy San Francisco on a sort of individual case-by-case basis if it's something that they think they might be eligible for and they're losing. Medi-Cal, but there's not sort of like an organized structured outreach effort for those folks who are losing Medi-Cal. So that's one of the reasons why it's really important to communicate this information to all of our community partners who are working directly with folks who can convey this information, let people know about Healthy San Francisco as a resource if they're losing Medi-Cal.

Absolutely. Thank you, Jessica and Isabel, for the presentation. Very thorough, lots of information. We'll drop that email for folks to follow up with more questions. And yeah, thank you again. With that, we're going to transition into our second presentation from the enrollment support at the San Francisco Health Plan Service Center. And so I'm going to pass it over to Erica Wan to share screen and provide a presentation over to you, Erica.

Just make sure.

Okay, just making sure that you guys are able to see it right. Let's go for it. Okay, perfect. Thank you. Hello my name is Erica Nguyen and I'm the senior enrollment specialist at the San Francisco Health Plan Service Center. So today I'm going to give an overview of our SFHP service center as well as provide some updates on upcoming Medi-Cal changes. So our service center value and vision is to be trusted, empathetic, as well as value source for clients looking to apply for or enrolled in San Francisco health care programs. So our SFHP Service Center connects people to San Francisco health care programs so that they can get health care services that they needed and they're entitled to. So the SFHP Service Center staff, you know, we serve clients with respect, empathy and listen to all their concerns. So we actually welcome immigrants and we actually want to create a safe space. that we were able to provide support that values their culture as well as our staff that speak different languages and in their own language like Spanish, Cantonese, Mandarin, as well as we do provide interpretation services with the language line. So there are business hours for the service center is open 3 days a week on Tuesday, Wednesday and Thursday for in person appointments as well as we offered phone and video appointments Monday for Fridays as well as Saturday mornings. So phone and video appointments on Saturdays are from 830 to noon to meet our clients needs and all services are by appointments only. So the SFHP Service Center is available for all San Francisco residents to apply for health care options such as Medi-Cal, Cover California, Healthy San Francisco, CalFresh, as well as the SF City Option Program. And our enrollment services provides application assistance on Medi-Cal application. However, we do not make the final eligibility determination. The final eligibility determination is still made by the county. And we do offer enrollment assistance for Covered California as well as Healthy San Francisco and also other community services and customer service that refer Longxiu Huang, Like clients or to agencies like and we also do outreach to and basically our goal is to promote universal coverage and medical enrollment to help our Members, you know be enrolled and state and row. Longxiu Huang, And why it is important, because we want our participants, you know. to be enrolled in coverage as well as we are a one-stop shop that we manage complex eligibility and enrollment situations through partnership with the human services agency so basically we act as a health advocate you know for members or families as well as we provide application and enrollment assistance for various like health coverage options program You know, we also do CalFresh enrollments, you know, for submitting the application as well as we provide high quality services in multiple languages, you know, then much, you know, for clients to feel comfortable if we were able to speak their language and a better understanding as well as we do also outreach and community referrals. So by promoting medical enrollment we are you know we Trump wanted to help and more people to learn more about medical as well as to sign up for free or low cost health coverage. So we share information about our service Center at Community events, as well as with our Community partners. We help clients to understand how to apply or renew their medical coverage and for all medical applications that we submitted. We also track those status of their applications, whether if it is approved or denied as well as we do case management. to do follow-ups after we submit the application and provide clients with the next step. And also we encourage members to keep their coverage and make sure that they were to renew on time, as well as also we share information on, for example, if maybe during their renewal, they no longer qualify for Medi-Cal, then what other the health coverage options that they may potentially be eligible for, like Covered California or Healthy San Francisco. And the goal is to make sure everyone in San Francisco has health insurance and health coverage. So, as Jessica earlier mentioned that one of the, like, medical changes due to hr1 you know is the enrollment freeze so starting january 1st of 2026 some adults will no longer be able to enroll in full scope medical based on their immigration status and this includes individuals with no satisfied without satisfying immigration status or even some lawfully present immigrants with temporary status like student or visitor's visa. So these individuals can only get restricted Medi-Cal. However, you know, if you already have Medi-Cal and, you know, you just need to make sure that you complete your renewal on time so you will not lose your coverage because this enrollment freeze is only affecting new applicants trying to enroll with the Medi-Cal program, but not necessarily for individuals who are already enrolled. And as long as you still meet the Medi-Cal income eligibility criteria, despite your immigration status, as long as you complete your renewal on time. And pregnancy services remain covered under all forms of Medi-Cal. regardless of your immigration status. This includes prenatal care, labor, delivery, and from the time the member has discovered that they are pregnant to one full year of postpartum care. And this coverage is protected as well as available even if other benefits change, as well as individuals who are in a former or foster care youth program You know they're also excluded from this enrollment freeze until they turn age 26 and SFHP service center can also offer support to those who need extra assistance. So. Like I've mentioned earlier that if you already have Medi-Cal, you can keep your Medi-Cal coverage as long as you're renewal on time. And the easiest and fastest way is to create your account online through benefitscal.com. And it is actually good, you know, to make sure that you know your renewal date, you know, write it down. So, you know, you don't missed it as well as, you know, you want to make sure that your county has your most updated contact info. So you would not lose, you know, you would not like miss any important notices from the county. And still the Medi-Cal income rules and California residency is still, you know, the eligibility criteria. And for example, if you did miss your renewal, like enrollment, like, you know, your renewal month, you know, to renew your benefits, you have up to 90 days to fix it. because if you do not fix it within the 90 days grace period, as Jessica mentioned earlier, you could lose your full scope coverage. And despite if you still meet the other eligibility criteria and you will only be granted restricted Medi-Cal. And restricted Medi-Cal only covers emergency care, prenatal pregnancy related services, as well as nursing home care. So this next slide, you will see the timeline of Medi-Cal changes happening between this year in 2026 to 2028. So beside the enrollment freeze that we just covered, starting January 1st of 2026 is the return of assets limit for certain groups, meaning Medi-Cal will check what you own during your renewal or when you apply. And this rule applies to adults age 65 or older or individuals with disability. So you can have up to $130,000 as your assets, meaning money in your bank account or if you have a car or if you have a You know, a property, but other than the one that you're living in or driving. Okay. Because these are all considered as assets and the limit could be up to 130,000 for a single person and. 65 000 for each additional household member up to a maximum of 10 household size and in january i'm sorry in july of this year you know as jessica also mentioned earlier that there will also be changes with your dental coverage so some adults may have medical without dental coverage because of their immigration status however you will still be able to get urgent dental care such as you know serious tooth pain infections or tooth extraction and in July next year some adults um you know will actually need to um actually I'm sorry about that so and by January 1st of 2027 some adults ages 19 to 64 We need to meet the work requirement and have eligibility checks every six months and by work requirement, meaning that you must prove to medical that you work go to school volunteer or you know, to be on a job training. So you can either work at least 80 hours per month or earn an income of at least $580 per month. Or you could be attending school at least half time, meaning taking at least six to eight units. Or it could be also a combination of, you know, the activities, you know, meet the eligibility requirement, you know, which could be like a combination of going to school and working, you know, as long as it is 80 hours per month. And this rules actually applies to everyone, no matter your immigration status. As well as now you'll be required, you know, starting January 1st of 2027. So, you are some adults will actually be required to renew their medical coverage every 6 months and instead of a year. So, meaning 2 times a year. Um. And renewals happen on an individual level. So meaning that if a person in your household, they might be not required to do a renewal because of their age, like it's a mixed household with a child, right? But if the child is already renewed, but that doesn't mean that you not have to meet that renewal requirement. And later in the year of July of 2027, some members must pay a $30 fee as a monthly premium. And this may affect adults ages 19 to 59 who are undocumented or without satisfying immigration status, or even though if they do have certain lawful present immigrants. And this premium applies, and if this premium applies to those individuals, and if they don't pay, they could actually lose their full scope Medi-Cal and be moved to restricted benefits only. And the same concept applies that if you did not pay your monthly premium for what you own, you also have up to 90 days to pay for it. if you um then or else you will only get restricted medical and then lastly as of 2028 of october some adults are now required to pay a small fee which is what we call co-payment and this co-payment is decided the amount of the copayment should not exceed more than $35 per services, and you will not be required to pay for more than 5% of your family income. And this will affect adults that are age 19 to 64 and earn an annual household income of $15,560. But it will not apply to individuals if they are pregnant or on Medicare. And the big takeaway is that these changes are happening in phases. So they are not all happen at all at once. So as the Human Services Agency, which is Medi-Cal, when they receive more guidance from the state, they will publish any updates on their website. So please visit their website for more of the latest information. So this is the flyer that we have for San Francisco Health Plan that there's actually a QR code that individuals can scan that will link them to the benefitscal.com where members or individuals can either apply directly through Benefits Cal or update their contact information, as well as to submit any verification documents that the county needed, as well as they can also visit, you know, by calling our service center or visit online to schedule an appointment with us or get support, you know, to renew their Medi-Cal benefits directly with the Human Services Agency. So our service Center also you know do Community engagement, as well as outreach we you know go to. And also, like outreach events to promo like awareness of our service Center like this year, we were at the on chinatown like Luna new year festival and also that we. promote the DSNAP, our Medicare Care Plus program, which is for due eligible special needs plan. It is a specific plan for Medicare Advantage, you know, for individuals who qualify for Medicare and Medi-Cal. So that's why we call it the Medi-Medi plan, as well as we are present at, you know, community events and the resource fairs, as well as, you know, Healthy San Francisco referrals. And this is our flyer for our service center that we're at 550 Kearney Street. And since our appointments are by phone or in person, but need to make sure that you contact us to schedule an appointment since currently right now we're not taking any walk-ins. That's it.

Thank you, Erica really appreciate the information very thorough as well. Um, just, um. For the sake of time, I just wanted to ask a question that came through is. A folks call your referral site is available in multiple languages. Or for folks calling or accessing the service site that you mentioned towards the end there.

Uh, I believe we are, we do have like English, Spanish, uh, I believe English, Spanish and Chinese. So like, yeah, I thought they were able to schedule the appointment and I believe it just because it's the same as, you know, for healthy San Francisco, right. And Tagalog.

to yeah well all the program materials are available in um spanish chinese tagalog and vietnamese um in preparation for vietnamese being a threshold language in the city um i think in terms of the service center which i believe the question was about the appointment there are enrollers at the service center who speak um spanish and and chinese right uh and then there's um language line like translation available for other folks correct yeah so our um

Basically, our enroller still speaks Spanish, Mandarin, as well as Cantonese.

Excellent. Thank you. I think this was a wealth of information and Just to summarize, if folks have follow-up questions, I know there's a lot of individualized questions. You know, everyone has a different situation, immigration status. If you're curious about you or your clients' specific cases, reach out to the Service Center and Healthy San Francisco's, you know, information line if you have any follow-up questions that are a little bit more tailored to specific circumstances. But Erica, thank you so much for your presentation. We're going to wrap now and I just want to thank Jessica and Isabel as well for the wealth of information that was provided. I think this is a very meaty presentation and I hope folks know how to follow up and ask questions about this very essential service that is accessing health services in San Francisco. We're very lucky to have this program within the city. So just really encourage folks to continue to share the word as folks look for help and access to these services. As we wrap, I just wanted to remind folks, I didn't drop the link earlier, but I wanted to share the link for our Immigrant Leadership Awards to RSVP in the chat for everyone to attend. We hope you can make it on June 8th at City Hall. And lastly, I want to put in the chat an opportunity to provide feedback about these forums. We really want to continue to provide useful information to our immigrant service providers. And so I have a link to an anonymous feedback survey that I've put in the chat. for anyone to share their feedback about this webinar if they attended a previous one and want to share information and feedback about one that we've done in the past or what you want to see in the future we'd love to hear from you so that link is in the chat and that concludes today's sf immigrant forum webinar we hope to see you at the next one in july And we'll be sharing information on that. And if you haven't joined our listserv, please do. We'll be sharing out the slides and information within the next week for today. And I see a lot of claps and hearts in the reaction. So I just want to thank everyone for your continued participation and to have a good day. Thank you so much.