1/14
Meet Hilda. I was one of her doctors. When she died, she left 2 sons behind. My grief about her situation brought anger and then determination.
A
#tweetorial
on outcomes, advocacy, and policy in dialysis access for undocumented immigrants.
#medtwitter
#nephtwitter
#NSMC
WOOHOO! We are funded! So humbled! Just received our NOA for our U01 !!! Excited to work with a consortium to address structural racism to reduce kidney health disparities!
#healthdisparities
#KidneyDisease
My journey to research & healthcare policy change has been one with
It is with happy tears that I share some incredible news! As of 9-1-18, non-citizen patients will have access to standard outpatient dialysis! ESRD will be included in the definition of "emergency medical condition" in Co!
@medicalaxioms
@Peralta_KHRC
@DrDeidraCrews
@allisontong1
๐ฉทToday, I ran a half marathon under beautiful fall colors in Denver. I will miss running for the next few weeks.
As healthcare providers it's often hard to find time for self-care, myself included. I am having a surgery this week to prevent breast cancer, a choice I put off
I never imaginedโฆthis girl who grew up in poverty from ๐ฒ๐ฝ & w/English as a second language. Never EVER imaginedโฆin a Super Bowl commercial.
Thank you
@CUAnschutz
for highlighting our awesome campus!
Deeply grateful for the thoughtful award (painted by Denver artist Arlette Lucero) & beautiful reception from
@COHealthFDN
&
@KeriAnnJo
I received the Dr. Virgilio Licona Community Health Leadership Award for our work to improve access to care for undocumented immigrants ๐
Thanks to everyone who joined us in celebrating
@Cervantes_Lily1
, recipient of the 2021 Dr. Virgilio Licona Community Health Leadership Award, earlier this week!
@KarenMsquared
#COHealth
Hilda inspired me to use research to change the way dialysis is done in Colorado for undocumented immigrants.
Dialysis in the Undocumented: Driving Policy Change with Data
โThis is the reality of being young in America: sitting through a shooting and waiting for information just hours before youโre scheduled to testify in support of gun safety bills.โ - Gracie Taub, co-lead for Denver East High School Students Demand Action
So much joy! HB22-1289 was signed today!!!
#CoverAllColoradans
!
โExpanding health-care coverage to all children, pregnant & postpartum people, regardless of immigration status, is fundamental to correcting the root causes of health inequitiesโ
@SerenaForCO
#SiSePuede
14/14
We are only as healthy as the most vulnerable among us.
Today, despite the COVID-19 pandemic, undocumented immigrants continue to receive emergency dialysis in many states. This increases unnecessary exposure + use valuable ED resources.
Dr. Bernard Lown said โHow can I be a doctor and close my eyes to this overwhelming reality.โ
Itโs time to defy the status quo. Itโs time to demand and to create change. All people, regardless of immigration status, should have sustainable, high quality, access to healthcare.
Congratulations to Dr.
@Cervantes_Lily1
on being awarded the 2024 Bernard Lown Award for Social Responsibility! Your dedication to medicine and social justice is an inspiration to all! ๐๐
#medicine
#socialjustice
#DEIJ
This is devastating. As a parent of an East HS student we must ALL engage in advocacy and change this.
Our students are courageously engaging legislators at the capital, talking to media, and raising awareness on the streets.
@MomsDemand
@StudentsDemand
@abbeywinter1
In the aftermath of the shooting that injured two administrators at Denver's East High School, students from East and West high schools, along with parents, faculty and staff walked to the state Capitol building to demand lawmakers take action to make schools safer.
1/Three years ago today, our state Medicaid agency expanded access to dialysis for undocumented immigrants and...
๐ฐsaved the state millions
โญ๏ธreduced mortality
๐๏ธimprove quality of life
If undocumented immigrants continue to rely on emergency dialysis in your state, read on..
Excited to share a special study that inspired camaraderie, community organizing, and changed healthcare policy in Colorado
@JAMANetwork
My dear friend and patient Hilda died in 2014. A few years later, we developed a peer support group for undocumented immigrants with kidney
Sure, Trump thinks immigrants are a problem, but as a physician and researcher with immigrant parents, I know the real problems are access to healthcare, social justice issues, & โconcepts of plans.โ
#WeAreImmigrants
Incredible persistence from
@StudentsDemand
& teachers at East High School.
Today, they celebrate 4 Colorado bills signed into law yesterday and meet at the capitol to demand contโd action & accountability.
โwe are not doneโ
#GunLawsSaveLives
@MomsDemand
@abbeywinter1
Wow! Inspired beyond words! Standing room only after
@gradydoctor
โs brilliant presentation
@CUMedicalSchool
In awe of you. Thank you for everything you do!
Excited to share our Kidney International manuscript w/
@Neil_R_Powe
and
@allisontong1
looking at patient reported outcomes (QOL & symptoms) & experiences of undocumented immigrants who transition from emergency to standard dialysis.
@ASNAdvocacy
Muchas gracias a mi familia y amigos!!! So excited to be inducted into
@the_asci
!!! Grateful to everyone that has walked this journey with me!
@CUDeptMedicine
@CUDivHospMed
Grateful to all the people who worked tirelessly behind the scenes, from concept to delivery of
#CovidVaccine
Vaccinated today for my community
#SiSePuede
#Familia
Trust science. We are all in this together.
#righttobarearms
Feliz Aรฑo Nuevo.
Gratefulโone year ago today, I survived a crazy car accident & decided I would always live in the moment. Sharing some photos that capture 2 of my favorite moments this week in Iceland.
๐ Feeling incredibly honored to receive the
@LownInstitute
Bernard Lown Award for Social Responsibility. This recognition belongs to all of usโ to every patient, mentor, and colleague who's been part of my journey. Here's to continuing our work to advance
#HealthJustice
for
Announcing the winner of the 2024 Bernard Lown Award for Social Responsibility:
@Cervantes_Lily1
Dr. Cervantes was selected for her exceptional work advancing health equity and expanding access to care for undocumented immigrants.
12/14
States can define what constitutes an emergency medical condition.
On Feb 1, 2019, guided by our research, Colorado Medicaid opted to include kidney failure in the definition of an โemergency medical conditionโ expanding access to scheduled dialysis to the uninsured.
โญ๏ธNew pubโญ๏ธ
Undocumented people are restricted from federal insurance options, which make quality care difficult to access for those with kidney failure, including transplantation. 1/11
@JAMANetworkOpen
@Cervantes_Lily1
@gatoclau71
Within 38 hours of going live, OmniSalud, a program that provides undocumented Coloradans with private health insurance, filled all 11,000 spots! INCREDIBLE โค๏ธ ! Deep gratitude to
@C4HCO
, the amazing people and organizations that advocated for this program, as well as the trusted
Really excited to share my Big Idea Talkโa Ted style talk about how I faced moral distress from a cruel and unjust law/policy and how I partnered with others to change a law thatย was killing myย patients.
@RWJF
@CSPfellows
#MedTwitter
Graduated from the transformative Clinical Scholars RWJF Program this week!
Deeply grateful for 3 years of leadership development, friendships with community-partnered and equity-focused peers, and support
@CSPfellows
@UNC
@RWJF
@SallieG22
Appreciative of my mentors who encouraged me to create a fun title/logo for our study. Really happy with the result. Shout out to
@Nephro_Sparks
for guidance on creating it.
Providing standard dialysis over emergency dialysis saves the state millions of dollars--In Colorado, the cost of emergency dialysis was 8-fold greater.
From NOLA--โWe are poor people,โ said Deras...holding signs that pled for continued treatments. โBut we are human beings.โ
UMC will close a program for undocumented dialysis patients. After initially saying it would end in a month, the hospital said this afternoon, after protests, petitions and inquiries, that they would continue treatment until they come up with a plan.
4/
Patient: "I didn't think this was real. My family told me this wasn't real."
**I hold her hand. More tears***
Misinformation & disinformation is real.
While burnout & exhaustion from this long road is real for us as clinicians, we must dig deep and have compassion.
Honored to participate on a panel with United States Secretary of Health and Human Service,
@SecBecerra
and Governor
@jaredpolis
to discuss healthcare policy and health equity. It was an insightful event hosted by
@Tepeyac_Health
. Feeling inspired and excited to catalyze health
So proudโQualitative study from Drs. Ram, Simpson, Manisha & Katya: โExperiences of undocumented immigrants w/hematologic cancer who cannot access hematopoietic stem cell transplantโ
โIf I had money, I would live. Itโs hard when you see human life reduced to thisโ
@SocietyGIM
Determined to give kidney failure patients across Colorado equal access to standard dialysis,
@Cervantes_Lily1
and her research team led a major change in the stateโs health policy.
Now sheโs taking her work nationwide.
#WorldKidneyDay
|
@RWJF
I feel angry and scared.
Every day, Bella goes to school and I donโt know if she will come home. An East HS student was shot in front of school & died.
Students are leaning inโprotesting, talking to legislators & reporters, posting on social media
#GunControlNow
So honored to receive the annual Dr. Virgilio Licona Community Health Leadership Award! Excited to continue my passion in the light of Dr. Licona's legacy!
Thank you
@COHealthFDN
and all of my patient and partner stakeholders for being part of this journey!
๐ Join us in celebration of Dr. Lilia Cervantesโ as the 2021 Dr. Virgilio Licona Community Health Leadership Award recipient! ๐ Thank you for your tireless fight to advance health and health equity,
@Cervantes_Lily1
.
#COHealth
8/14
We found that emergency dialysis is hard on clinicians too:
Led to burnout due to:
- witnessing needless suffering & high mortality
- moral distress because care is reflective of immigration status
Woohoo! Presented my final to my committee for my Master of Science in Clinical Science this morning! Thank you to amazing mentors,
@gatoclau71
, peers, and mentees for this incredible social and health justice research journey!
@michelchonchol
@katierizzolo
@Neil_R_Powe
@HAMFDP
6/14
We began research...
Compared to undocumented immigrants that received scheduled 3x/wk dialysis, those receiving emergency dialysis have a:
Mortality that is 5-fold worse at 1 yr:
Mortality that is 14-fold worse at 5 yrs:
New publication โญ๏ธ
Undocumented immigrants face many transplant barriers.
In
@AJKDonline
,
@katierizzolo
, Dr. Klassen, & I review & provide clarity around OPTN guidelines/policies as they relate to undocumented immigrants & transplant equity
#NephTwitter
Inspired by
@DrDeidraCrews
visit to Colorado for Collins lectureship! โค๏ธ Powerful presentations on
#kidney
#disparities
for nephrology & medicine grand rounds.
Such a joy to be in-person for this awesome visit.
Grateful to be featured in
@acphospitalist
today
The inequities experienced by
#undocumented
#immigrants
with
#kidney
disease who rely on emergency dialysis are enormous -- greater mortality, symptom burden, and poor quality of life. We must do better.
3/14
An estimated 6000-8000 undocumented immigrants with kidney failure have limited access to care due to exclusion from Medicare, provisions of ACA & some Medicaid programs.
This U.S. map shows where dialysis is covered by Medicaid (green).
10/14
Comparing utilization/costs between undocumented immigrants that receive emergency dialysis vs 3x/week scheduled dialysis:
- 5 fewer ED visits per month
- 1.6 fewer hospital days per 6 month
- savings of $6000 per person per month
@OanhKieuNguyen
Congratulations on completing nephrology fellowship
@katierizzolo
It has been such an honor to witness your passion for health justice work and advocacy! You are a brilliant rockstar & I love your energy! Feel incredibly honored to have worked w/you so closely these last 3
Looking forward to grand rounds this week!
@Cervantes_Lily1
from
@CUMedicalSchool
joins us to discuss "Dialyzing the Undocumented Community: Research and Policy".
๐๏ธ Wednesday, February 24
โฐ 12:10 - 1:15 pm ET
Learn more โก๏ธ:
โค๏ธCelebrated Hildaโs 5 year kidney transplant anniversary!
โญ๏ธ Her pictures illustrate her journey from emergency to regular dialysis-->transplant-->creating โGuerreras Latinasโ & our NIH community research to reduce kidney disparities in Latino/a/x.
@katierizzolo
@mattysincs
13/14
Step by step guidance to change access state by state:
-Gather a coalition who can develop case for change & influence decision-makers
-Engage media
-Gather the data
-Provide policy analysis
-Monitor outcomes
To reduce the burden of CKD among Latinx individuals, we must create culturally tailored interventions that build trust and cultivate community-clinic partnerships. Excited to share our narrative in
@CJASN
@nkf
@FlorAlvaradoMD
@katierizzolo
@tessa_novick
Love our tradition celebrating Dia de los Muertos, an annual remembrance of friends and family. Decorating sugar skulls and celebrating with delicious food.
9/14
And emergency dialysis is also difficult for family because they experienced
- death anxiety
- physical and emotional exhaustion
Also, children acting as caregivers dropped out or missed school and faced psychosocial distress.
Celebrated a life changing health policy win! It has been a 4-year journey that culminated in policy change last month! Inspired by
@apoorva_ram
, Haley Simpson, Manisha, & Katyaโs grit and persistent advocacy!
Canโt stop smiling after a breathtaking 1/2 marathon trail race ๐๐ฝโโ๏ธthrough the redwoods & across rivers! 3rd place. San Lorenzo River Trail Run. โค๏ธ
โค๏ธ is full. Celebrated the holidays with our Latina research team and our Colorado patient & community partners. Feel so blessed to work on
#kidney
#HealthEquity
research in partnership with our beautiful community.
Community Health Workers unite to improve outcomes in
#kidney
disease! โญ๏ธ Inspired at
#nkfclinicals
โI had to interpret to patients that they couldnโt receive care because of their immigration statusโ
1/
On COVID-19 ward -- LatinX Spanish-speaking pt
Me: "We may need to transfer you to the ICU"
Patient: "I'd rather go home. I have supplements that will make me better."
Me: "I'm worried. You're very sick."
Patient: "I don't feel sick."
Excited for Day 2 of the Hispanic/Latina Women in Medicine conference! Loving the inspiring conversations, new friendships, and talks on empowerment, finding meaning, personal journeys, and conquering burnout.
#HLWIM2024
My journey to research and advocacy was inspired by Hilda โค๏ธ
Appreciate
@CUAnschutz
investment in sharing this story through video and including Hilda, friends, & family.
Appreciate all my partners including patients, families,
@chprogress
@aubreykhill
2/14
Hilda suffered along with the other 80 undocumented immigrants with kidney failure, who in Colorado could only receive dialysis every 6 to 7 days when at the brink of death (=โemergency dialysisโ).
Illustration
@NathanAGray
Hildaโs story shows how one patient can change & inspire us to begin a path of advocacy. The privilege we have of caring for people comes w/a duty to take concrete action when we see suffering. We cannot accept unjust/unsustainable systems that cause harm. Thank you
@drlessing
Honored to have won the
@AOA_society
Robert H Moser Essay Award to help amplify
@Cervantes_Lily1
& Hildaโs message & share why her powerful eg is such an inspiration for me & to us all. Brick By Brick: The Advocacy Journey of Dr Lilia Cervantes
#MedTwitter
11/14
Whatโs the solution?
EMTALA- A federal law allowing Emergency Medicaid that specifies that hospitals provide emergency services to anyone w/an emergency medical condition.
As of now, CMS provides no subregulatory guidance on the definition of emergency medical condition
Attended Latina 1st foundation luncheon with our Latina med students & Latina kidney navigator team โhonored trailblazer Sonia Flores from
@CUDeptMedicine
& Latinas in high school received scholarships!
@NHMAmd
@LatinasInMed
@CUSOMODI
Girls can be what they can see!
#Latinas
@UNCKidney
Our nephrologist of the day is Dr. Deidra Crews from
@hopkinsneph
. Dr. Crews is a nephrologist, researcher, and Associate Vice Chair for Diversity and Inclusion.
#BlackHistoryMonth
๐จ Call to action! We will build a coalition to promote
#InternationalMedicalGraduates
! ๐โค๏ธ
#IMGs
bring diverse perspectives and invaluable skills. We will advocate for policies that remove barriers to their clinical practice in the U.S. It's time to disrupt outdated systems!
Anyone who has the privilege of listening to one of
@Cervantes_Lily1
talks immediately understands the power of her work and the innumerable lives she has saved through her work. Important takeaways:
- Advocacy saves lives
- Advocacy takes little to get started & is attainable
Celebrating life๐งกon this beautiful
@nkf
walk in Denver with โGuerreras y Guerreros, Salud de los Riรฑonesโ on behalf of people with
#kidney
disease who have no health insurance.
#undocumented
#healthjustice
7/14
Our qualitative study of patients found physical & psychosocial distress due to:
- symptom accumulation
- being turned away from treatment (despite being ill) due to triage by lab values
- the perceived imminence of death
- no access to transplant
Published today
@JAMANetworkOpen
Qualitative study-perspectives of 30 dialysis center clinicians on the social challenges faced by
#LatinX
with
#KidneyDisease
on dialysis.
***We need community-based interventions that improve patient activation & support
Never has the need for physician advocacy been greater!
This webinar is designed to help you re-frame the challenges you see as opportunities for advocacy and action.
@SGIM
Equity COVID-19 Webinar Series!
@renutip
9/17at 7p.m. E.T.
Excited to be at the inaugural Hispanic/Latina Women in Medicine conference this morning! Phoenix Mayor Kate Gallego is here, speaking and showing her support โwe want our physician workforce to mirror our communitiesโฆwe are working to expand access to medical pathways.โ ๐
Dr. Lilia Cervantes, recently named the 2021 Dr. Virgilio Licona Community Health Leadership Award Recipient, is featured in
@ColoradoSun
.
Thank you for all you do to bring Latino voices and leaders to the forefront,
@Cervantes_Lily1
.
#COHealth