Head of community health center pledges to hold fast

By TOMO HIRAI

Nichi Bei News

Lance Toma felt inspired visiting the National Japanese American Memorial in Washington, D.C.

“I was walking to the Capitol and I made sure I visited the memorial, which is right next to the Capitol, and the cherry blossoms were in full bloom last week, and it was just glorious,” Toma told the Nichi Bei News in early April. “You know, it was like, ‘We can do this.’”

Toma is chief executive officer of the San Francisco Community Health Center, a federally-funded LGBTQ and people of color health organization. Since the inauguration of Donald Trump, the health center’s future funding has come under attack as day-one executive orders targeting “gender ideology” and “diversity, equity and inclusion” programs put the organization in the administration’s crosshairs.

“We received directives from the federal government to ‘immediately terminate, to the maximum extent, all programs, personnel, activities, or contracts’ related to the executive orders on DEI and gender ideology. This threw us — and all of our partners across the country — into a state of confusion,” Toma said in a Feb. 7 statement.

Since then, the health center, alongside multiple LGBTQ, health and HIV organizations throughout the United States, sued the Trump administration Feb. 20 in the U.S. District Court for the Northern District of California through Lambda Legal. The suit argues nearly half of the center’s 180 employees and a quarter of its 5,000 clientele are transgender or gender non-conforming, meaning adhering to the executive orders would run counter to the organization’s fundamental work.

Since filing the suit, funding for the health center remains in place, but Toma is bracing for any potential cuts that could impact his organization.

“Yeah, we’re in contingency planning mode right now, and doing as much as we can to advocate for cuts not to happen. But I think, if that happens, we’re going to do everything we can to work with our funders, work with the city, work with the state, to ensure that we can hold on for as long as we can, because so much of what we’re doing is lifesaving for the clients and patients that we’re serving, and so we really are going to do everything in our power,” Toma said in a phone interview.

The San Francisco Community Health Center, originally founded as the Asian and Pacific Islander Wellness Center, was founded in the 1980s in response to the HIV epidemic in the Asian and Pacific Islander community. It continued and expanded its mission and celebrated becoming a federally qualified health center in 2015.

Today, Toma said the organization serves some eight to 10 times the number of people the organization once served when he first joined in 1999.

“(Becoming) a community health center was one path for sustainability, and to ensure that, actually, we could take care of the entirety of a person’s health and wellness needs. And why I feel like it was so critical is, there hadn’t been a new federally qualified health center in San Francisco for over 40 years,” Toma said. “So, us achieving that designation was pretty remarkable for the city itself. And what it does is that it brings in resources in us being able to be a Medi-Cal and Medicare provider … which then is supporting the city’s health care safety net.”

The API Wellness Center rebranded to the San Francisco Community Health Center in 2018 to denote its federally funded services are accessible to all who walk in through their doors. Toma said his organization continues to focus on serving vulnerable populations. Being located in the Tenderloin, he said the organization is helping with the fentanyl overdose crisis, dispatching medical teams that provide care on the streets. Additionally he said he has chosen to “double down” on serving and partnering with the transgender community to open a stand-alone drop-in space and resource center for transgender people, as well as the Taimon Booton Navigation Center, a 70-bed shelter for the trans community.

As some say Trump’s policies and implementation of anti-diversity policies have emboldened racist rhetoric more than ever, Toma said it is important to fight against its normalization.

we will never let this be normal,” he said. “The normalization, that’s what we have to resist actively and vehemently. I just feel like, we can’t let that be normalized.” The gay Yonsei Okinawan American from Hawai‘i joined the organization in 1999 and became its head in 2006. Toma said it was natural for him to move to San Francisco and work on HIV care and combat stigma against it within the API community.

“As a queer person, HIV was always on my radar, as a young person and even going to college, but ultimately, I’m a social worker, I’m a licensed clinical social worker, and that’s where I chose to focus my career and my energies,” he said.

Toma holds a master’s degree in social work from the University of Chicago.

He added the recent cuts jeopardize the work done in the 1990s and 2000s to combat HIV in the city.

“San Francisco has been such a leader with respect to driving new HIV infections down, to the point where we really can see the end of the epidemic,” he said. “And so, the concerns are that so much of all of the advances that we’ve done collectively in our city will come undone and take years and years to reestablish, because it’s just taken so long to get here, and to move the community to a place where they’re able to access the care that they need.”

Toma noted that, if a person diagnosed with HIV is given treatment right away and remains on treatment, that individual can “live a long and healthy life,” and lower the burden on the healthcare system as a whole by avoiding other health complications that stem from lack of treatment.

“Community health centers are such a vital resource for everyone. … Our goal is to ensure that no one is without quality health care. And at San Francisco Community Health Center, we provide the health care that is focused on providing the most culturally and linguistically competent care for, really, the most marginalized folks,” Toma said.

He went on to call on people to talk to community and elected leaders to ensure the needs are conveyed to those in charge.

“I also serve on the California Commission on Asian and Pacific Islander American Affairs, and one of our priorities is around storytelling and making sure that we are listening, and gathering, and really amplifying the stories of our communities, because we just know that is how we’re going to attend to the emerging issues that are coming up, and we can’t ignore any of that, especially in these times when folks are feeling like their lives could be impacted because of what’s happening at the federal level,” he said.

Through all this work, Toma said he knows he is not alone. Professionally, he said he met with a health equity coalition of some 70 Asian American, Native Hawaiian, Pacific Islanders in Oakland last month. He noted, while the meeting also worked to advance health policy priorities for the community, the members also took time to care for each other.

“There’s such motivation to fight the good fight, or fight the necessary fight, but also to take care of each other in that process. And so there’s that, and I have a loving and supportive husband, and he is also there to make sure that I’m taking care of myself too,” Toma said.

Beyond, that Toma also reflected on the Japanese American community’s resilience.

“Our elders have gone through internment, which was still in our recent history, and I feel like the learnings and the strength and the resilience is … I feel like that is what helps me sort of ground myself in how we fight back,” Toma said. “I just feel grateful I get to follow in those footsteps.”