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Brian Lehrer: It's the Brian Lehrer Show on WNYC. Good morning again, everyone. This Thursday afternoon in The Greene Space, a public event on health and health politics in New York City. We call it the annual WNYC Health Convening. This year we'll focus on three main topics, protecting abortion access in New York, the health needs of the asylum seekers, and the impact of vehicle emissions and idling on New Yorkers.

The event is free to the public, but RSVPs are required. Just go to our website, thegreenespace.org. That's green, with an E at the end, by the way, thegreenespace.org. You can RSVP if you want to attend on Thursday afternoon. With us now to preview and discuss some of these issues, WNYC's Jaclyn Jeffrey-Wilensky, data reporter of and on health issues for WNYC and Gothamist, and Desiree Frias, community organizer for South Bronx Mutual Aid, which did a lot to help feed people at the height of the pandemic and is now working to assist the new asylum seekers with health needs among other things. Hi, Jaclyn and Desiree, welcome to WNYC.

Jaclyn Jeffrey-Wilensky: Hi. Thanks for having us.

Desiree Frias: Hey. Thanks for having me.

Brian Lehrer: Jaclyn, you want to give a little overview beyond what I did of the event Thursday afternoon at 2:00 and what we hope to accomplish?

Jaclyn Jeffrey-Wilensky: Oh, sure. Myself and my colleagues on the health desk at WNYC will be speaking to some of the preeminent experts in these areas, abortion access, emissions, and migrants healthcare needs. We'll also be taking questions from the audience. It's a great opportunity to get some FaceTime with folks who are really on the front lines of these issues.

Brian Lehrer: I see you are moderating the health needs of asylum seeker session. Where do you even begin with 70,000 newcomers in the last year and basically none of them with health insurance when they get here?

Jaclyn Jeffrey-Wilensky: I find it helpful to think chronologically, so beginning from where folks are arriving from through their migration, and now in New York City, their health needs are evolving all the time. You have whatever situation was happening in their home country, they may have fallen behind on basic primary care, vaccines, medication management, chronic illness management through the physical and mental trauma of migration all the way through to the trauma of adjusting to a new culture, close living quarters, different food. There's a lot of health needs there.

Brian Lehrer: Desiree, you want to introduce people to Bronx Mutual Aid, when and why it began and what you've done to date before the current wave of asylum seekers?

Desiree Frias: Yes, absolutely. My name's Desiree Frias, so she and her pronouns. I've been organizing with South Bronx Mutual Aid, which is my hometown. I'm born and raised here. Since right around the start of the pandemic when I gave birth to my son, a lot of organizers in our community really wanted to focus our efforts on ensuring that our neighbors needs were met. We felt that throughout the pandemic we were often forgotten, low-income families, families of color and migrants.

We've been organizing for that whole time period, almost three years now. We've moved probably around nine tons of food directly into people's hands. No questions asked. I think that's really the model of South Bronx Mutual Aid, is that we meet people's needs exactly where they are without a lot of the barriers that they may face when trying to access city services.

Brian Lehrer: How are you helping asylum seekers today with healthcare? Where would you begin on that?

Desiree Frias: It's a complex issue. Like Jaclyn pointed out, some people are coming with preexisting conditions, some people are picking up conditions along the very long and arduous journey here, whether it's physical trauma, breaks and scars, or it's psychological trauma. In fact, some ER doctors are reporting a special kind of seizures that people are having here, psychogenic, non-epileptic seizures. They have no history of seizures, but the trauma is so severe that they're having these very drug-resistance epileptic seizures.

In order to address these needs, we're not only plugging people into the New York public health system, which they have full access to, but a lot of them don't know that and are afraid to access services for fear of being deported. We're also providing our own health clinics in partnership with hospitals like Columbia Presbyterian so that they feel more comfortable coming to us and getting plugged into services over time.

Brian Lehrer: That's really interesting. There's a South Bronx Mutual Aid health clinic that has a relationship with New York Presbyterians Hospital system?

Desiree Frias: Yes. We had a one-off Saturday clinic, but we had probably a couple of hundred families come because we have WhatsApp chat with every hotel and with migrants in those locations. People are really willing in that peer-to-peer relationship to come through for an event, but those one-off events obviously are not permanent healthcare. People need their own primary care physicians to manage long-care health needs. I think that that needs to be the priority moving forward.

Brian Lehrer: Listeners with any connection to the new immigrant population or any questions about providing them with healthcare, we welcome your calls at 212-433-WNYC, 212-433-9692 for Desiree Frias from South Bronx Mutual Aid, and our reporter Jaclyn Jeffrey-Wilensky, who's going to be moderating a session at the annual WNYC Health Convening on Thursday afternoon at The Greene Space with Desiree and others on the health needs of the asylum seekers. 212-433-WNYC.

I wonder if any health professionals listening right now have had contact with asylum seekers and want to just help us report this story, either talk about the most common needs that you're seeing, the most daunting obstacles to them getting the care that they need, maybe some of the finances since there's probably no or not much health insurance reimbursement involved here.

Any healthcare providers want to jump in on this who are on the front-line tier in any way, or asylum seekers yourselves, or anybody in the community that comes in contact, or the many communities, I should say, that come in contact with asylum seekers recently arrived? 212-433-WNYC, 212-433-9692. Give us a call. You can also send a text to that number. Jaclyn, how is the city set up for this? Is the public hospital system and our community clinics officially open to newcomers regardless of immigration status or health insurance status?

Jaclyn Jeffrey-Wilensky: Yes. One thing that's really interesting about how the city is handling asylum seekers is that New York City Health and Hospitals, the city's public hospital system, has actually run point in many cases on setting up these gigantic, the larger-scale hotel shelters, like the Row and the Stewart, and organizing onsite healthcare as well as connecting asylum seekers in other shelters, so like community health centers. It's pretty unusual in that regard. Normally, you'd expect homeless services or maybe some other agency, but it's pretty unique. It does give health an opportunity to come front and center.

It's worth flagging, though, that we've done some reporting on issues at these onsite health clinics. There was an issue a few months back with vaccines with the vaccine clinics. The practitioners brought on there weren't able to decode or understand the international vaccine records and the international vaccine formulations that were brought by some asylum seekers. That led to people missing vaccines or getting doubles of vaccines, which, of course, isn't the end of the world, but these vaccines are important. It's even gotten to the point where we've seen some outbreaks of chickenpox in shelters because people are living in such close quarters.

Brian Lehrer: Interesting. Here's a text that I'll give to you, Jaclyn. I think this is probably beyond the scope of what Desiree is doing at South Bronx Mutual Aid. Listener texts, "I'm a city employee, who is paying for this?" Who is paying for this is one part of the question. How much is healthcare for 70,000 migrants costing the city is the implication there.

Jaclyn Jeffrey-Wilensky: I have some stats collated, but I'm not an expert on the financial side of things. What I do know is that the city's independent budget office put out a report in November of 2022 and they estimated the cost of asylum seeker healthcare at about $1,500 for each person. That's for basic medical care. It doesn't include some of the specialized medical services that folks might need depending on their individual situations.

It's a little hard to know exactly where that money is going because of the mayor's emergency declaration. It just makes it very, very hard to track and count. I will say, though, that the city has estimated that caring for asylum seekers in general, not just healthcare, will cost about $4 billion by the end of June 2024.

Brian Lehrer: Mayor Adams keeps asking the federal government for more help, but we usually hear about it with respect to housing in particular. Sounds like from what you just said, healthcare is also a very big financial burden on the city right now. I don't feel like we hear it from the mayor in as explicit terms, which is one of the reasons it's good that you're bringing attention to it in the health convening on Thursday. Have you heard the mayor talk about this?

Jaclyn Jeffrey-Wilensky: Sort of. There was a report put out called The Road Forward by the Adams administration, I think a couple months ago at this point, and they did make a few specific asks when it came to healthcare. Specifically, they're asking for expanded coverage of community health centers, which are really a lifeline for asylum seekers arriving. They're also calling on the state to expand state-funded healthcare coverage for undocumented adults. They're also calling on the federal government to give more vaccines at the border to make it a little bit easier once folks arrive in New York to be up to date on their vaccines.

Brian Lehrer: Let's take a call. Carol-- Oh, go ahead. Desiree, go ahead.

Desiree Frias: If I can just chime in, Brian, for one second. Who pays for this? We have a city budget of $106.7 billion, and with public health, we all pay. The children that have the chickenpox outbreak from one of the hotels are going to public school in New York City. We ride subways together. I really think that public health is one of those spaces where every dollar invested is going to come back tenfold. The healthier your populace is, the better the city is for everyone. I just think that it should be a main priority for healthcare for everyone that lives in New York City when all eight million of us live right next door to each other.

Brian Lehrer: How do you get the funding at South Bronx Mutual Aid to do the work that you do not being a government agency?

Desiree Frias: Mutual Aid projects are all funded in different ways. What's really incredible about them is that we do have transparent funding. We have an open collective website, where you can see every dollar coming in and out. Places like [unintelligible 00:12:21] which cooks hot indigenous meals, culturally sensitive meals for migrants every day they have a line down the block, and I know for a fact that they're spending their own money, like $40,000 a year, maybe even more.

When you look at 40,000 a year compared to the $106.7 billion, I really feel that community organizations and mutual aid groups can take a dollar way further because organizers like me grew up poor. [chuckles] I know how to cook meals and make it stretch, so I think the city should really lean on that lived experience.

Brian Lehrer: Carol in Queens, you're on WNYC. Hi, Carol. Thanks for calling in.

Carol: Hi, Brian. I heard you wanted some perspective from healthcare providers that are providing care for the newly arrived migrants. I've been working with a city fund and initiative through an agency for the last nine months in the hotels. I've been at the Port Authority processing, I've also been at Randall's Island, and I've been most recently at one of the larger hotels that are focused on families.

Overall, it's been just a wonderful experience to see how well the city is really rolling out the welcome mat and providing them with plenty of services, but in terms of medical, it could sometimes take an hour or two hours, sometimes even three, to get a family that's just arrived in the shelter settled, especially if they have several children, they're often ill with anything from sprains and strains, infections. They're most often not vaccinated at all for anything, or if they are vaccinated, we have no records, so we have to just start from scratch. It's a very time-consuming, but very rewarding thing to do.

In terms of supplies, routinely, we're running out of antibiotics, which were hard to get anyway. Sending people to emergency rooms which facilitate transport to the city hospital emergency rooms for urgent matters because they were prepared to also process the migrants so that they could get a care provider so that some of the needs they need could get met within the city hospital system. It was really a very well-coordinated effort, but it does take a lot of ingenuity to figure out how to get all these things done.

Brian Lehrer: Do you sometimes become the primary care provider for some of the migrant individuals or families? I know nurse practitioners, which you said you are, are taking primary care duties in lots of contexts these days, not just MDs.

Carol: In the shelters, we are not supposed to act as a primary provider. We are to refer them to the clinic, and the clinics in the city hospitals do provide us with the ability to make appointments. In situations where kids needed to go to school, we had to shift to a whole vaccine program that went on for months to get these kids vaccinated, and we had to do their school physicals so that they could take it to the principals and get into the school. We did shift back and forth a lot.

Brian Lehrer: Carol, thank you.

Carol: It's a huge effort.

Brian Lehrer: Thank you very much for that report from the healthcare frontlines. It's so interesting. In a way, Desiree, it breaks our hearts, and in a way, it can really inspire us because look what they're doing.

Desiree Frias: Absolutely. I think the biggest pushback for us as organizers is Mayor Adams' characterization of this as a crisis. Since 1892 to 1954, Ellis Island Hospital had 12 million people pass through. For the first seven years, they just had six doctors on staff. The fact that we have built up our city through welcoming migrants, I think by characterizing it as a crisis, it's really pitting New Yorkers that were born here or people that moved here against people that are moving here.

I think that regardless of where you were born, if you're coming to New York, you should be welcomed. 18% of Americans were foreign-born in 1910, and right now New York City is only 22% foreign-born. I really don't see it as a crisis. I think that switching the narrative on that is really important to unite New Yorkers as we move forward and continue to live with COVID and the effects of it.

Brian Lehrer: Terryanne in Bergen County, you're on WNYC. Hi, Terryanne.

Terryanne: Hi Brian. I work or volunteer as a Spanish interpreter for a place called the Bergen Volunteer Medical Initiative. It's in Hackensack, New Jersey, Bergen County, and our clients are working people without insurance, so not specifically asylum seekers, but certainly-- I'm going to assume we have some. I've been here for two years and it's just so inspiring because we have volunteer doctors, specialists, nurse practitioners, nutritionists, and they're all here to help people and keep them from having to go to the emergency room for healthcare. I'm so grateful I can help. That's my comment. [chuckles]

Brian Lehrer: A lot of people are so grateful that you are helping, Terryanne, thank you very much. Estella in Brooklyn, you're on WNYC. Hi ,Estella.

Estella: Hi, Brian. Thanks for the segment. My wife and I are going through the process of becoming custodians for a young man who migrated. He's unusual within the asylum case in that he has special immigrant juvenile status. He's seeking special immigrant juvenile status, and so we're trying to navigate the healthcare part for him since he's not yet our custodian.

We had concerns about having him access Medicaid with the fear that if the state in the future were to become more conservative, that there would be a public charge law that would ultimately hurt his case. I was curious if the speaker could comment on that.

Brian Lehrer: Right. Hopefully, we're not going down that road in New York State anytime soon. Jaclyn, anything from your work as a health reporter that can help Estella as she and her wife adopt an unaccompanied migrant child?

Jaclyn Jeffrey-Wilensky: I'm sad to say that I don't know too much about that specific situation, although I'd be happy to look into it and research it more. What I do know and what I've learned from chatting with Desiree and others is that that fear does keep many, many people in that situation, from seeking out much-needed healthcare. Right now in New York City, at least, no one will ask about your immigration status when you're seeking care. I think it merits more exploration.

Brian Lehrer: Desiree, I wonder at South Bronx Mutual Aid, besides helping to provide direct services and referrals, if you're helping people apply for Medicaid, if you think that's even a route that is open to either unaccompanied migrant children like Estella is in the process of taking in or any of the migrants?

Desiree Frias: Benefit application is not something that most of us do. We do more on-the-ground work. Our line to everyone is that New York City Health & Hospitals, the public hospitals, so it has to say NYC Health and Hospitals in front of the name. Those are open to all New Yorkers regardless of migration status or ability to pay.

What benefits they'll sign you up for once you're there, whether it's the New York City migrant healthcare program, which was released last year, or if it would be a federal program like Medicaid, I'm not sure. That's really where we're recommending people to go to, to hospitals like Metropolitan Hospital on First Avenue or Belvis Gotham Health on 142nd Street.

Brian Lehrer: As we wrap up, Desiree, you want to make a little pitch for people who might want to volunteer with South Bronx Mutual Aid? I know you're volunteer-based, or donations, you can ask for that too, or just how can people help?

Desiree Frias: We're sbxma.com. We're also on Instagram at South Bronx Mutual Aid. We have a link to our Open collective there where you can see all the money we bring in and very quickly put back out. I think that the main thing that I want people to do is to shift this narrative of seeing migrants as a crisis or someone that we have to be pitted against when really as New Yorkers, from the beginning of the founding of this city, we have come together to work through so many problems. Recovering from COVID is going to be one of those things that we're only going to get through if we work together.

Brian Lehrer: That's Desiree Frias, community organizer for South Bronx Mutual Aid. I'll say one more time that this conversation has been a preview of a WNYC Greene Space Event this Thursday. It's going to be two o'clock Thursday afternoon in The Greene Space, a public event on health and health politics in New York City. We call it the annual WNYC Health Convening. This year it is focusing on three main topics, The Health Needs of Asylum Seekers, which we've been discussing in this segment, but also two other things, protecting abortion access in New York and the impact of vehicle emissions and idling on New Yorkers. The event is free to the public.

We just ask that you RSVP in advance. You can do that at The Greene Space's website. That's greenespace.org. Remember green is spelt with an E at the end, so the greenespace.org, and WNYC's Jaclyn Jeffrey-Wilensky will be one of the three moderators on Thursday afternoon, and in particular on this asylum seekers issue. Jaclyn, you want to say one last quick word about what people can expect or what you're preparing for that conversation that we didn't touch on here today?

Jaclyn Jeffrey-Wilensky: We'll get into lots more detail with Desiree and possibly another panelist who we're working on locking down both the on-the-ground experiences of organizers like Desiree and the latest standards of care for people who are newly arrived because it's like an emerging area of medicine, caring for asylum seekers, refugees, and migrants.

Brian Lehrer: Jaclyn and Desiree. Thanks. Good luck Thursday.

Jaclyn Jeffrey-Wilensky: Thanks.

Desiree Frias: Thank you.

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