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Beck, Nyah E. | Winter 2023 EiJ Annotations

nebeck

“The OCEJ comprises a general body, staff members, and an advisory board.” The staff members are responsible for the day-to-day tasks and operations of the organization, leading various projects and campaigns for the organization within the local community. The advisory board shapes the direction the organization will go towards in the future. This organization has a unique role for members as they play a significant role and hold the power to make collective decisions. Members are initiated through an orientation process and pay dues (a $25 donation)  to support the organization's collective power, or members can commit to two hours of volunteer service.

Beck, Nyah E. | Winter 2023 EiJ Annotations

nebeck

Data produced by the OCEJ has had a significant impact on the organization's evolution as they revealed through their studies that there were high levels of air pollution in some regions of the county, contaminated water sources, and the impacts of climate change, including increased temperatures and more frequent wildfires. Historically, Orange County has placed many toxic waste sites and other hazardous facilities in low-income minority communities.

Beck, Nyah E. | Winter 2023 EiJ Annotations

nebeck

The OCEJ is committed to developing grassroots leadership to advance a larger environmental justice agenda within the ancestral homelands of Acjachemen and Tongva Nations, now known as Orange County, California.

Beck, Nyah E. | Winter 2023 EiJ Annotations

nebeck

The Orange County Environmental Justice (OCEJ) was founded in 2016; they initially launched a countywide needs assessment for disadvantaged communities. The early organizational structure was around the OCEJ, contributing to reports in collaboration with UC Irvine Community Resilence Projects. They also worked with other EiJ organizations to host collaborative efforts to study various data, including; toxic lead exposures in Santa Ana, soil samples from homes, community gardens, and significant roads and parks in Santa Ana. The early structure consisted of volunteers and advocates who were passionate and concerned about disadvantaged communities in the Orange County region.

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Sara_Nesheiwat

The Emergency Medical Treatment and Labor Act is a law requiring that anyone coming into the emergency department will be stabilized and treated no matter what their insurance situation is. In terms of women's health, it is important to note that this means for active labors, medical treatment is necessary and required, no matter the health insurance of the patient. The purpose of this law to prevent certain patients from being turned away in an emergency situation or refused medical treatments if they are unable to pay, putting their health at risk.

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Sara_Nesheiwat

EMTALA was enacted by Congress in 1986 and was part of the Consolidated Omnibus Budget Reconciliation Acts of 1985. Congress saw different cases around America where doctors were refusing medical care to patients who could not make a deposit at the time of their admittance to the ER. An example of this is a patient Eugene Barnes, who in 1985 suffered a stab wound and ultimately ended up dying because 6+ doctors refused to help him without payment or some form of compensation. This made national news and other cases began to come to light, such as at Baptist Hospital in Miami and many other areas. News outlets began to follow these cases and this caught attention of government officials. Shortly after, EMTALA was enacted.

http://www.pitt.edu/~kconover/ftp/emtala-draft.pdf

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Sara_Nesheiwat

This was touched upon a little in a previous question. Many cases of patient dumping were popping up around America. Patients in need  of emergency medical care were being cast aside, ignored and delayed due to their inability to pay. In addition to the stab patient, Eugene Barnes that sparked this law, there were dozens of other cases where patients needed to be transferred to larger hospitals but the hospital refused to take patients without insurance, so the patients died. There were cases of people being asked right before surgery for a deposit, and being unable to pay were discharged with no surgery. There was also a very high rate of dead babies that were arising due to the fact that mothers in labor were being turned away because the patient was uninsured. It was then realized by the government that there were no legal duties for a hospital to treat people who are in emergency situations but cannot pay, only ethical and moral duties, which apparently weren't enough in some cases. This led to the birth of the EMTALA, requiring medical attention to all ED patients as well as transfers if needed to stabilize, including mothers in labor.

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Sara_Nesheiwat

This policy greatly helped sculpt emergency medicine and public health. By giving the right to the patient to have emergency medical treatment required without proof of insurance or payment, astronomically influenced the amount of patients being turned away and their possibilty of developing worse illnesses or dying. In a paper I read, a young doctor in the late 70s and early 80s remembers watching a woman in labor give birth in the doorway of the hospital and proceed to borht her child in the parking lot after being turned away for not having insurance. By requiring hospitals and doctors to see that all ED patients get care, no patient was at risk of dying or complicating their baby's health and birth due to a lack of insurance, ultimately increasing public health efforts. Not all hospitals turned away their patients, but enough did to make it a public health concern and get Congress involved. EMTALA changed emergency medicine protocols but also public health expectations and actions.

http://www.hhnmag.com/articles/5010-the-law-that-changed-everything-and…