Publish Date:   May 29, 2024 Type:  Testimony and Comments, Comment Letter Topics:  Data Disaggregation, Health Care Access, Public Health, Medicare Ethnicity: Language:  English State: APIAHF comment letter to the CMS requesting for improvements on the collection and usage of comprehensive race, ethnicity, language, and other demographic data on Medicare Advantage (Part C) beneficiaries and providers. Currently, Medicare Advantage data is not in compliance with OMB standards for federal race and ethnicity data.

Publish Date:   July 2024 Type:  Testimony and Comments, Comment Letter Topics:  Data Disaggregation, Health Care Access, Public Health Ethnicity: Language:  English State: Comment letter submitted by APIAHF to the Office of Minority Health supporting the development of public health vaccine and prevention campaigns involving community health workers (CHWs).

Publish Date: June 2022 Type: Fact Sheet, FAQ, Infographics Topics: Alzheimer's, Brain Awareness, Dementia Ethnicity: Language: English State: Dementia is a brain condition that affects the brain’s functions to control thought, memory, and language. Alzheimer’s is the most common form of dementia, accounting for 60-80% of dementia cases.

WHAT WE DO APIAHF works to ensure that all Americans have access to health coverage and quality care that they can afford and rely on, no matter where they come from or what language they speak. ​ HEALTH EQUITY AND ACCOUNTABLILITY ACT (HEAA) ABOUT HEAA The Health Equity and Accountability Act (HEAA) is a comprehensive and strategic legislative blueprint that aims to eliminate racial and ethnic health inequities. HEAA is the only legislation that directly addresses the intersection of health inequities with race and ethnicity, as well as immigration status, age, disability, sex, gender, sexual orientation, gender identity and expression, language, and socio-economic status. Since 2003, HEAA has been introduced by the Congressional Tri-Caucus, comprised of the Congressional Asian Pacific American Caucus (CAPAC), the Congressional Black Caucus (CBC), and the Congressional Hispanic Caucus (CHC). CAPAC is leading the introduction of HEAA for the 118th Congress, and Congresswoman Barbara Lee (CAPAC Health Task Force Co-Chair) and Senator Mazie K. Hirono are the lead sponsors. This Congress will be the first time HEAA will have a bicameral introduction. Over 300 racial and health equity organizations, researchers, provider groups, and community-based organizations have contributed to the development of HEAA since its inception. Additionally, over 150 Members of Congress have co-sponsored HEAA over the past decade. HEAA builds on the gains made under the Affordable Care Act (ACA) and lays out a vision of additional investments and policy reforms Congress should make to enhance the health and well-being of communities that are underserved and marginalized, address systemic health inequities, and ensure access to high quality and affordable health care for all. LEARN MORE ABOUT THE 118TH CONGRESS INTRODUCTION OF HEAA FULL BILL TEXT ONE-PAGER ENDORSING ORGANIZATIONS POLICY HEALTH EQUITY AND ACCOUNTABILITY ACT (HEAA) — ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ MEDIA “Everyone deserves access to high-quality, affordable health care, but health disparities prevent many marginalized and underserved communities from accessing these essential resources and services. The Health Equity and Accountability Act will help to dismantle these barriers by implementing comprehensive provisions to address inequities, including strengthening data collection, increasing access to health services and resources, and diversifying the health care workforce. I am proud to lead this effort and will continue working to ensure that communities across Hawaii and throughout the country have access to the affordable and equitable health care they deserve.” Senator Mazie K. Hirono ​ “Higher uninsured rates, language and cultural barriers to care, social determinants, and greater exposure to pollution are just a few of the factors that threaten and hurt the health of Americans of color. The Health Equity and Accountability Act would create a healthcare system that works for all Americans – no matter their race, ethnicity, gender, or language ability – by advancing culturally and linguistically appropriate health care, improving data reporting, addressing diseases that disproportionately harm certain communities, and so much more. This legislation is a necessary step to take for health equity to be a reality for all, and I am honored to once again join Congressmember Lee and Senator Hirono to lead the introduction of this bold, legislative vision on behalf of the Tri-Caucus this Congress.” CAPAC Chair Rep. Judy Chu ​ “As Chair of the Congressional Hispanic Caucus, I’m proud to join the Tri-Caucus Chairs and leading Congressional Members in introducing the Health Equity and Accountability Act (HEAA) of 2024. HEAA is a bold, comprehensive vision to address persistent ethnic and racial health disparities to improve health outcomes for people of color, including millions of Latino families. Data shows Latinos, like many minority populations and underserved communities, face uphill challenges in accessing affordable and high-quality healthcare. This legislation is a critical step toward a fairer healthcare system that prioritizes health equity for all.” CHC Chair Rep. Nanette Barragán ​ “As a Co-Chair of the Congressional Asian Pacific American Caucus Healthcare Taskforce, and a member of the Congressional Black Caucus, I am proud to lead the re-introduction of the Health Equity and Accountability Act (HEAA). HEAA is a bold, comprehensive vision for addressing racial health disparities and improving health outcomes in communities of color and the underserved. It’s the only legislation that directly addresses the intersections of health inequities and race and ethnicity. We need to pass HEAA to address the underlying challenges that prevent communities of color and underserved communities from gaining coverage and accessing high-quality, affordable health care. With the help of our advocates and partners, I know Congress can act to create a truly just health care system for all.” Congresswoman Barbara Lee ​ “For generations, Black Americans have faced persistent disparities in health outcomes and access to quality, affordable health care in our nation. The Tri-Caucus is committed to removing barriers and expanding access to healthcare in our communities. The CBC is proud to join our Tri-Caucus partners in cosponsoring the Health Equity and Accountability Act which will take significant steps towards removing systemic barriers, improving outcomes, and making our communities healthier.” CBC Chairman Rep. Steven Horsford ​ “Every person should have high quality and affordable health care regardless of where they live, language they speak, or ability to pay. HEAA is visionary legislation to address the vast inequities facing Asian American, Native Hawaiian, Pacific Islander, and all communities who are underserved in every sector of our health care system, including vulnerable populations getting care at community health centers. AAPCHO is proud to join Senator Hirono, Congresswoman Lee, Congresswoman Chu, and the Congressional Tri Caucus in introducing HEAA in the 118th Congress. We appreciate our partnership with APIAHF and the broad coalition of patient, provider, disease, and civil rights groups who contributed to this bill. We look forward to Congress advancing HEAA’s vision of a health care system that truly meets the needs of our nation’s diverse communities.” Jeffrey B. Caballero, MPH, executive director of the Association of Asian Pacific Community Health Organizations ​ ​ “As our nation's demographics change, so do our health needs. Underserved and underrepresented communities face substantial barriers to obtaining quality health care and equitable health outcomes. APIAHF is proud to lead the 118th Congress's reintroduction of HEAA, with AAPCHO, to tackle these health disparities head on. HEAA invests in culturally and linguistically appropriate health care and health services, creates a pipeline for an inclusive workforce, and deploys innovative strategies to reach communities regardless of region, immigration status, gender, ethnicity, age, or disability. Achieving health equity requires a multi-faceted approach, and HEAA provides a blueprint to do exactly that.” Juliet K. Choi, President & CEO of the Asian & Pacific Islander American Health Forum ​ IN THE NEWS CONGRESSIONAL PRESS RELEASE APIAHF PRESS RELEASE PRESS EVENT FOR INTRODUCTION TO HEAA OVERVIEW OF HEAA'S TITLES Title I focuses on the collection and reporting of data related to disparities associated with the demographic factors of race, ethnicity, sex, primary written and spoken language, disability status, sexual orientation, gender identity, age and socioeconomic status. It creates a commission and a task force to explore data collection practices to achieve health equity and best practices to integrate artificial intelligence and algorithmic bias, respectively. It also expands the scope of impact for programs that understand and address minority health concerns and health disparities. ​ Title II focuses on improving access to and the quality of care that is culturally and linguistically appropriate through pilot programs that test interpreting services, federal reimbursement of language access services in Medicaid, CHIP and Medicare, and accountability of federal programs providing Federal financial assistance. ​ Title III recognizes the need to improve the diversity and quality of the nation’s whole health care workforce. It provides grant and loan repayment programs to promote inclusion in a number of different health professions. It focuses on directing funding to underrepresented students who may not otherwise be able to achieve the education needed to participate in the workforce. Title III also provides resources to medical institutions to allow them to better provide growth opportunities for their staff. ​ Title IV addresses systemic barriers to quality care for disparities-impacted populations through expanding coverage, improving access, innovating in delivery, and creating health empowerment zones. It brings down barriers to coverage for immigrants, people living in U.S. territories, Native Americans, Medicare beneficiaries, and at-risk youth. It improves community health, funding for providers of care, addresses rural health needs, and ensures those enrolled in health insurance can access the providers and benefits they need. It recognizes the ongoing efforts in delivery and payment system reforms and the need to include the impact on health disparities in those efforts. ​ Title V addresses a range of sexual and reproductive health needs, including pregnancy-related care, as well as infant and child health needs for historically and currently excluded and underserved individuals and communities. It seeks to dismantle barriers to and inequities in access to health and health-related services and coverage, information and education, and other vital resources. It also focuses on the research, tools, data-based models, workforce capacity-building, programs, and other resources necessary to promote the health and wellbeing of Black, Indigenous, Latinx, Asian American, Pacific Islander, and other people of color; women; lesbian, gay, bisexual, transgender, queer or questioning, gender non conforming, and nonbinary (LGBTQ+) people; immigrants; infants; children; and families. ​ Title VI focuses on strengthening protective factors and resources that bolster mental health, and on eliminating structural barriers that contribute to mental health and substance use disorder inequities. The title addresses the interplay between structural factors and traumas including systemic racism and discrimination, violence, adverse weather events, and COVID-19 and the resulting mental health impacts for the communities of focus under this act. Provisions provide for expanding coverage and access to necessary supports and services across community settings; promising interventions through demonstration projects; research to enhance knowledge and understanding of mental health and substance use inequities; strengthening the mental health workforce; and strategies to address unmet needs in underserved populations ​ Title VII addresses high-impact minority diseases through expansion of research, funding, screenings, testing, access, and treatment and prevention including: cancer, hepatitis, cardiovascular diseases, HIV/AIDS, kidney disease, diabetes and obesity, and other chronic diseases. The title specifically focuses on diversity in clinical trials, Medicare coverage gaps, improvements and outreach in Alzheimer’s disease research, and patient-centered approaches. ​ Title VIII updates the definition of certified electronic health information technology, requires assessments of and provides funding opportunities for adoption of health information technology in racial and ethnic minority communities, and extends Medicaid electronic health record incentive payments to community health centers, rehabilitation facilities, long-term care, home health agencies, and physician assistants. ​ Title IX ensures the federal government is responsive to, and responsible and held accountable for, efforts to reduce health inequities and disparities. It expands civil rights protections for anyone operating with Federal financial assistance, ensures populations in correctional facilities receive care, and ensures that there is transparency in how protections are enforced. Requires a number of reports on how the government is addressing health inequities and disparities. ​ Title X defines social determinants of health, and the role they play in creating health inequities. The title also describes the relationship between built environments and health, and how health income assessments and the implementation of evidence-based programs can remediate environmental hazards in communities. Sec. 1005 specifically calls for the creation of a CDC grant program to address these root causes. Title X also includes language on environmental justice, specifically in regard to clean air rules, lead and radon exposure, gun violence research and the impact of the Deepwater Horizon oil rig explosion in the Gulf Coast. ​ PAST ITERATIONS OF HEAA — 117th Congress: HR 7585 , S 4486 116th Congress: HR 6637 , S 4819 115th Congress: HR 5942 , S 3660 114th Congress: HR 5475 113th Congress: HR 5294 112th Congress: HR 3954 111th Congress: HR 3090 110th Congress: HR 3014 109th Congress: HR 3561 108th Congress: HR 3459 ​ APIAHF'S HISTORY WITH HEAA APIAHF has been a community working group lead of HEAA in 2005, 2011, and 2018, and a co-lead with AAPCHO in 2024. As a community working group lead, APIAHF works with the Congressional Asian Pacific American Caucus (CAPAC) on bill revisions and introduction; and organizes and directs the working group to provide feedback on the current iteration of HEAA. ​ ​ POLICY — HEALTH EQUITY AND ACCOUNTABILITY ACT POLICY — EXPANDING ACCESS TO HEALTHCARE DATA DISAGGREGATION MEDICARE & MEDICAID HUMAN EQUITY & HUMAN RIGHTS HEAA ​ LEARN MORE ABOUT OUR POLICY WORK Expanding Access To Healthcare Data Disaggregation Medicare and Medicaid Human Equity and Human Rights LEARN MORE ABOUT OUR POLICY WORK Expanding Access to Healthcare Data Disaggregation Medicare and Medicaid Human Equity and Human Rights Expanding Access To Healthcare

LEARN MORE ABOUT OUR POLICY WORK Expanding Access to Healthcare Data Disaggregation Medicare and Medicaid Human Equity and Human Rights HEAA POLICY EXPANDING ACCESS TO HEALTHCARE — WHAT WE DO APIAHF works to ensure that all Americans have access to health coverage and quality care that they can afford and rely on, no matter where they come from or what language they speak. ​ POLICY — EXPANDING ACCESS TO HEALTHCARE DATA DISAGGREGATION MEDICARE & MEDICAID HUMAN EQUITY & HUMAN RIGHTS HEAA EXPANDING ACCESS TO HEALTHCARE WHAT WE DO APIAHF works to ensure that all Americans have access to health coverage and quality care that they can afford and rely on, no matter where they come from or what language they speak. ​ Health coverage is a strong predictor of access to health care in the U.S. Health coverage rates vary widely among Asian Americans, Native Hawaiians, and Pacific Islanders. As a group, Asian Americans, Native Hawaiians, and Pacific Islanders are more likely to be uninsured than non-Hispanic whites. Specific ethnic groups face extremely high rates of uninsurance: In 2016, 14% of Nepalese Americans, 12% of Micronesians and 9% of Laotians were uninsured. REMAINING UNINSURED Despite improvements through the Affordable Care Act, Medicaid and CHIP, disparities within AA and NHPI communities remain due to varying degrees of poverty, immigration-based barriers, lack of cultural competency in the health care system, and language access barriers. ​ Immigration status is a major social determinant of health, impacting the type of coverage a person is eligible for and whether that person can access routine and preventive care. As a result, many Asian Americans and Pacific Islanders are locked out of public programs due to federal and state immigration restrictions. Nationally, 35% of noncitizens are uninsured, compared to 8% of naturalized citizens and 7% of native-born citizens. ​ In addition, many Asian Americans, Native Hawaiians, and Pacific Islanders that qualify for public programs remain uninsured because of language and cultural barriers in the enrollment process, misinformation about eligibility, and other family hardships such as food and housing insecurity. LEARN MORE ABOUT OUR POLICY WORK HEAA Data Disaggregation Medicare and Medicaid Human Equity and Human Rights WHAT WE DO APIAHF works to ensure that all Americans have access to health coverage and quality care that they can afford and rely on, no matter where they come from or what language they speak. EXPANDING ACCESS TO HEALTHCARE

DATA DISAGGREGATION WHAT WE DO APIAHF advances the collection, reporting and analysis of detailed data to make sure Asian American, Native Hawaiian and Pacific Islander communities are visible and heard. ​ LEARN MORE ABOUT OUR POLICY WORK Expanding Access to Healthcare HEAA Medicare and Medicaid Human Equity and Human Rights OUR POSITION APIAHF believes that detailed and accurate data collection, analysis, reporting, and dissemination at the federal, state and local levels is essential to having diverse communities be visible and represented. ​ Asian Americans, Native Hawaiians and Pacific Islanders trace their heritage to more than 50 different countries and speak more than 100 different languages. Yet, when diverse communities are considered as one, the resulting data leads to inaccurate policy assumptions and poorly targeted investments that undermine equity for all. ​ APIAHF works to ensure that the distinct social, health, educational and economic di­fferences within Asian American, Native Hawaiian and Pacific Islander communities are represented in policy, research and advocacy. APIAHF advocates for comprehensive data collection and analysis that is scientifically robust and refined in its results, through strategies that include combining multiple years of data for analyses of smaller populations, proper sampling methodologies including oversampling, and ensuring that surveys are administered in a culturally and linguistically appropriate manner. ​ 30 YEARS ADVANCING DATA EQUITY Since our founding 1986, APIAHF has been a leader in advocating for health data equity, serving as a national convener and working with state and local community-based organizations to advance the issue. This focus, and the major impetus for the creation of APIAHF, originated with the 1985 Report of the Secretary’s Task Force on Black and Minority Health (“Heckler Report”). This foundational report, by then U.S. Department of Health and Human Services Secretary Margaret Heckler, was one of the first comprehensive government reviews of minority health disparities, but incorrectly concluded that Asian Americans, Native Hawaiians and Pacific Islanders (AA and NHPI) were healthier than other minorities, despite only analyzing aggregated data. Since then, APIAHF has successfully led advocacy for the collection, analysis, and reporting of AA and NHPI data through successful legislative and administrative strategies, nationally funded partnerships, and as a thought leader on data equity. ​ OUR STRATEGIES APIAHF works to increase data and research on Asian American, Native Hawaiian, and Pacific Islander communities by supporting: Standardized collection of data on race, ethnicity, primary language and sociodemographic factors. Efforts to collect data in health surveys, hospitals and health care organizations and plans. Increased data collection and reporting by federal agencies. Adequate resources to support efforts to collect Asian American, Native Hawaiian and Pacific Islander health data. Partnerships with funders and state and local health advocates to advance data equity at the local level. Policy Recommendations: Health Equity Cannot Be Achieved Without Complete and Transparent Data Collection and the Disaggregation of Data FEBRUARY 2021 - HEALTH BRIEF READ MORE Advocating for Data Disaggregation by Race and Ethnicity MAY 2021 READ MORE POLICY DATA AGGREGATION — LEARN MORE ABOUT OUR POLICY WORK Expanding Access to Healthcare Expanding Access to Healthcare Medicare and Medicaid Human Equity and Human Rights HEAA POLICY — EXPANDING ACCESS TO HEALTHCARE DATA DISAGGREGATION MEDICARE & MEDICAID HUMAN EQUITY & HUMAN RIGHTS HEAA