#community access care
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Community Access Care Programs
Community access care programs provide low-cost health screenings and education to people with complex needs. Often, these programs are able to help individuals navigate the health care system and find affordable health insurance.
Argus community access care is one of the largest NYS Department of Health approved ACCESS (formerly case management) providers in NYC. Our caring staff is available 24 hours a day to assist participants in finding and obtaining health, housing & support services.
Community health centers (CHCs)
Community health centers (CHC) are non-profit, community-driven organizations that provide a range of healthcare services. They are primarily focused on helping underserved populations access primary care and health promotion programs. These organizations are governed by a community-elected board of directors.
They remove barriers to care that include financial, cultural, language, and geographic limitations. They also work with other agencies in the community to address other social determinants of health, such as housing and food.
While CHCs are not free clinics, they offer affordable medical and dental care, and discounted prescription medications. They are open to anyone, including uninsured and underinsured patients. They can even help patients find the best Medicare plans on GoodRx. Additionally, they have been early adopters of care coordination and integration. This is especially true for those states that have expanded Medicaid, according to KFF. These states have 60% more community health center Medicaid revenues than those that have not. This money allows CHCs to expand their outreach and hire more primary care physicians.
Program directors
Whether they work for non-profit or corporate companies, program directors are responsible for overseeing the company’s programs. They ensure that these programs are in line with the company’s goals and budgets. They also create strategies for the success of the programs. To succeed as a program director, you must have strong management skills and extensive business knowledge.
The job description of a program manager can vary from company to company, but many of the duties are the same across industries. These responsibilities include planning, scheduling, and strategizing for program goals. They also help develop budgets and other business-related documents. They also serve as a liaison and spokesperson for the program.
Often, these positions require long hours. They may have to arrive at the office early or stay late to make sure everything is ready for the next day. In addition, they must be able to work well with multiple teams and people. These jobs are usually demanding, but they can be rewarding when you have the right skills.
Social determinants of health
The social determinants of health are the non-medical factors that influence a person’s quality of life and health. These factors are determined by a person’s environment, including where they live and work. They affect a person’s ability to eat well, get an education, and live in a safe and healthy community access. They also determine a person’s access to healthcare and their ability to afford medical treatment.
Social determinants are the root causes of health disparities. They can be seen in the wide differences in outcomes among individuals and groups, as well as in the inequities within the healthcare system itself. To improve the health of our nation, these factors need to be addressed by government agencies, private companies, philanthropy, and community- and faith-based organizations. This can be done through new partnerships, creative initiatives, and innovative delivery models. This approach can help ensure that all patients receive the care they need to stay healthy. These efforts can also prevent discrimination by ensuring that all people are treated fairly.
Federally funded CHCs
Community health centers, also known as Federally Qualified Health Centers (FQHC), are not-for-profit organizations that provide comprehensive medical care, low-cost dental and vision care, and pharmacy care. They are primarily located in medically underserved communities and serve both insured and uninsured patients, and reduce the need for expensive hospital-based and specialty care.
CHCs are largely funded by grants from the federal government and receive additional revenue from patient fees, third-party payer reimbursements, and Medicaid. The majority of CHCs are non-profit organizations and have boards of directors made up of local volunteers.
During the COVID-19 pandemic, many CHCs used telehealth to reach patients who couldn’t make it to their office. Some even gave away products like N95 masks and at-home rapid tests. KFF found that implementing ACA Medicaid expansion improved the ability of rural CHCs to meet patient demand and boost quality of care. However, reversing or phasing out expansion could significantly undermine these gains.
Moreover, it would be detrimental to the health of many low-income patients.
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What is Community Access NDIS?
Community access ndis provides a wide range of services to people with disabilities. These services can include everything from running errands to attending personal development courses. They also provide disability support for people in remote communities.
Ultimately, community access ndis empowers individuals to lead full lives with selfdetermination and inclusion. Through these supports, individuals can cultivate friendships and pursue activities that enrich their soul.
Benefits
If you have a disability and would like to participate in community activities, the National Disability Insurance Scheme (NDIS) can help you find a suitable provider. The NDIS supports people to engage with their local community through social and community participation programs, which promote inclusion and provide opportunities for personal growth.
Some community access services can help you run errands or attend appointments. These services can also help you take part in your chosen recreational activities. Some community access services offer specialised support for activities such as music sessions, numeracy programs, and group outings.
The benefits of these activities can be significant, and many participants experience improvements in their independence. Some participants may even achieve a sense of belonging in their community. These activities can be a great way to get out of the house and meet new people. If you’re thinking of signing up for these services, make sure to talk to your NDIS planner or a specialist disability service provider.
Eligibility
The eligibility requirements for community access ndis include having a permanent impairment that significantly reduces your ability to participate in daily activities. It can be caused by disease or injury, and the condition must have been diagnosed by a doctor. If you are unsure whether you meet the eligibility requirements, contact your GP for an assessment.
You may also be eligible for the NDIS if you are receiving support from a DHHS program that is transitioning to the NDIS. These programs include Disability Support Register, Respite and Early Choices. You can contact your local office to find out more about this process.
If you are a younger person at risk of entering residential aged care, SensesWA will work with the NDIA and other mainstream agencies to explore all options. This includes testing NDIS eligibility and exploring appropriate services, such as state/territory palliative, health, and housing services. In addition, a short notice cancellation policy is in place to allow you to change or cancel your service.
Accessibility
When it comes to community access care support under the NDIS, there are many different ways that you can use your funding. You can choose to try new activities or continue with existing hobbies, or you can use the funding to travel to medical, school or work appointments.
It is important to communicate your accessibility requirements to the activity organisers or group leaders. This will ensure that you are able to attend and participate in the activities that interest you. This will also reduce your dependence on family and friends for transport and help you achieve greater independence in the community.
The NDIS MH Transition Support Project (TSP) partnered with the NDIA to develop resources and training for Primary Health Networks and community MH providers to assist participants in their applications for community access. These resources include fact sheets, a consent form to act on behalf of the applicant, and an Evidence of Psychosocial Disability (EPD) form.
Costs
Price limits set out in the NDIS Price Guide (previously known as the Support Catalogue) limit how much registered providers can charge participants for specific supports. These include community and social activity costs, and access community transport participation activity costs. These are a series of supports that enable participants to pursue recreational activities and engage in broader community participation.
These supports are typically delivered through group-based activities and may require additional charges for transport to these activities. These costs are capped at 0.85c per km. If you do not have transport funding in your plan, Senses WA can utilise the Core Support budget to provide transport services.
While average NDIS plan utilisation rates have increased slightly in remote areas, these figures mask the severity of market gaps, which can be especially high in very remote areas. These market-based arrangements can drive poor outcomes and long term pressures for participants. NDIS needs to find a better model for providing high quality supports for participants in remote communities.
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do you ever think about how we have phannies in every field? like we have doctors and baristas and mental health therapists and geologists and audiologists and engineers and neuroscientists and authors and social media consultants and activists and child care workers and museum managers and teachers and biologists and emts and linguists and accessibility coaches and sign language interpreters and artists and musicians and editors and actors and chefs and fucking EVERYTHING. not to mention the specific knowledge bases and hobbies we have outside of our professions—coding, linguistic and cultural diversity, artistic creativity, political/social awareness, passion for justice, research, make up and hair and fashion design, media literacy, philosophy, all of our special interests/hyperfixations, etc. we could run a successful commune no problem at all. we’re so smart and talented and resourceful and powerful.
the phandom is rooted in a past of being infamously shitty, and i do see yall slipping back into old habits sometimes (mostly on twitter but sometimes here and you know it <3) but it’s pretty fucking cool how capable this community is and our ability to unify. anyway phanmune when.
(if you want, leave your knowledge base/skills in the tags or replies. can be profession, hobby, major/program of study, what you study in your free time, what you want to learn about, what you’re interested, all of the above, anything)
#this is me having a commie fantasy about liberation#i want this so bad i want COMMUNITY#I WANNA LIVE IN A COMMUNE IN THE WOODS#anyway here’s my resume:#i have a psych bachelors degree and am in a mental health counseling program#i have been a crisis worker for two years and working in mental health in general for longer than that#i also have extensive knowledge of philosophy and politics#and i kick fucking ass at languages#can converse in 6 language and have a level of understanding and/or knowledge in 8 languages#i’m experienced and knowledgable in accessibility and#activism and i’m a writer and musician#and have been taking care of animals professionally for 8 years#i do NOT have proficiency in microsoft word or excel or powerpoint i am completely lying about that on my resume#dnp#dan and phil#phan#dan howell#daniel howell#amazingphil#phil lester#d&p#dip and pip#danisnotonfire#danandphilgames#yeet my deet#yeet my deenp
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download this distribuatable flyer from clean air club
#palestine#disability justice#anti imperialism#masking is community care#disabled people deserve access to public spaces too
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I don't usually don't like to make broad and sweeping statements like this (let alone publicly) but if it helps to get more people involved then i'm gonna put my two cents in.
Covid cases are rising globally right now (Covid itself has never gone away) and if you wholeheartedly believe yourself to be a leftist, then you should still be masking. Accessibility is community care and one of many important parts of intersectionality. That should be something you are incorporating into your politics.
There are genuine exceptions to wearing a mask. But if you can, please do.
My general advice is to wear an kn95, n95 or better (something that creates a seal) in all public spaces. Listen and support those you know who are high risk and remember that your chances of being disabled by covid become higher the more times you contract it. Please be safe and help to keep others safe.
If you haven't been masking and feel bad about not having been or were misinformed, it is never too late to start again.
#mypost#covid 19#covid#covid isn't over#masking#mask#pandemic#leftist#politics#community care#accessibility#disability#long covid
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Aquarium/Fishy Symbols
Aquarium
Fish Food
Gold Inca Snail
Betta Fish
Hope you like them :3
#aac emoji#aac symbol#aac user#high tech aac#vixyaac🐙#aac device#discord emoji#custom emoji#emoji blog#bettafish#betta#inca snail#gold inca snail#aquarium#fish food#fish care#accessibility#communication
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"Just ignore how every minority man is treated, because talking about it is basically like saying some women don't experience misogyny"
Never the point of this convo. In fact, you're literally making up a guy to be mad at. Why is it that a different minority talking about their own issues in their own space makes you feel this way? Why is it a minority making their own words to explain something they experience now an attack on you? Is it, perhaps, that you don't understand the experience and therefore project your own understanding of it onto everyone who speaks about it regardless of THEIR actual experiences?
I'll be the first to admit I don't know every fucking experience out there. I gotta trust my trans sisters when they talk about their experiences- same with any other identity I don't understand. Why are trans men not afforded this? We are literally an oppressed minority. Our bodies are constantly regulated and cracked down on and treated as freakshows. I feel like on some level, as trans people, others have to feel it and see it. Right?
Or are we just supposed to stay invisible?
#transandrophobia#like i love the logic leaps made by these people who are SO mad about this...#its just more and more clear you just want us to shut up and stop talking and taking up space. we get it. you dont care about our issues.#at least give us space to talk about it????#like man id like to talk about my reproductive rights and my bodily autonomy and how im affected by shit but thats kinda hard to do when#everyone just wants you to shut up#like im sorry ???? im not a cis man. i have like. actual issues im dealing with? even though i am a man myself? that doesnt negate my#experiences LITERALLY FUCKING BEING HATECRIMED ????????#i would like to control the language i use to explain my experiences. im not gonna tell you how to tell your story. why the fuck would you#try to do that to me???#also like even cis men suffer under the patriarchy this shit sucks for everyone. theres very few people who actually thrive under this shit#it hurts a lot more people than it props up#some people have access to privledges. doesnt mean that. EVERYONE has access to those privledges.#quit being nasty. quit trying to divide the community. you arent helping anyone by projecting your trauma on EVERYONE.#“just ignore peoples talking about their issues because (strawman pulled out of ass)” maybe talk about shit you understand#and go get a breath of fresh air or something. look at something pretty. do literally anything productive and/or relaxing. because this isnt#doing shit for you or anyone else
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why do all my dads play guitar
#do i have a type???#[fakeman redacted]. ricky. lyle. is a pattern forming here?#theres probably more but im dumb#i dont know just a thought#sometimes i wonder if i should go full on chaser like kitty used to#like im being serious im already such a bad person would it really kill me to start searching for if [redacted] has a kin community#surely not but maybe because in a video [redacted] mentioned it mockingly? like because hes old hehe so its gotta exist#maybe they got chased off the internet... maybe i should ask my papa to build me one...#too forward? too cringe? i always thought it was before but desperate times call for desperate measures#i act like this is a personal journal and nota place other people can access#who even cares. im the king of sunk cost fallacy#anyways maybe someday ill get the courage to be that much of a degen to my own padres face but for now ill just vaguepost it in tumblr tags#and wish i wasnt the worlds most shame filled failure because being so shameful takes the fun out of the indulgence#lulah yaps
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Community Access Services
Community access services explore community resources available to all people, natural supports, and develop methods to access additional services, support and activities needed by the individual.
C-level services usually address symptoms of community problems – for example, food for the hungry or shelters for the homeless. They are usually short-term and narrowly focused.
Housing
Housing is a basic need that helps people feel safe and secure. Community access services programs can help individuals find housing options that fit their needs and budgets. These programs can provide subsidized rental units, permanent supportive housing and transitional housing. They can also offer home modifications that make living at home easier, such as installing ramps, widening doorways, modifying kitchen and bathroom work areas and adding lever handles on doors.
In addition to housing, community access programs can also assist people with finding transportation and other basic needs. These programs can provide assistance with getting to doctors' appointments, health screenings and other services. They can also help navigate the health care system and find affordable insurance and medical, dental and mental health care. Some programs even provide food, clothing and furniture. They may also be able to help people with finding employment. The programs can also connect people with community resources that can assist them in keeping their homes and communities healthy and safe.
Employment
Community Access Programs provide vocational training and work-readiness assistance. They also teach life skills such as budgeting, public transportation and safety. Some programs, like Goodwill's Community Access Foundational Track, are designed to be experiential in nature, with people working in the community about half the time.
Intensive Support Services focus on improving the person served's self-care, task completion, communication, sensory/motor skills, socialization and problem-solving abilities. These services can be provided individually or in a group setting.
Day Support Services enable persons served to connect with their communities by providing activities based on the Individual's strengths, needs and preferences. These activities may include recreational, cultural, educational and community association programs. The services can be provided in a group setting up to 10 individuals or one-to-one with a staff to participant ratio. The service cannot be delivered in the person's home, family home, personal care home or other residential arrangement. The service may also include programming to reduce maladaptive behaviors.
Education
Community Access provides training and support to help individuals acquire, retain or improve the self-help, socialization and adaptive skills necessary for active participation in and independent functioning outside their family home. These services may be provided in a day program setting or in the community with a 1:6 staff to participant ratio.
Providing a wide range of activities, the CAT program equips persons served with fundamental enrichment skills and a more positive perspective on daily life.
Activities may include trips to the mall, zoo, or movies, and are individualized to the strengths and needs of each person served.
CAT also assists people to stay in their homes and communities rather than in institutions by making their homes affordable, safe and accessible. This is done by leveraging resources such as the Medicaid Home Modification benefit and state income tax credits.
Health
Argus Community Access provides a range of services, including care management. Its individualized programs are tailored to each participant’s strengths, needs and goals. Programs include linkage to healthcare and supportive services, one-on-one solution based counseling, and support groups. They also provide free rapid 20 minute HIV and Hep C testing, STI testing on site, sexual health education to both individuals and groups and long term prevention counseling for those living with HIV or at risk of infection.
Day programs can help participants with basic enrichment and community integration, focusing on their strengths and skills to achieve their personal goals. A typical schedule for these programs can include daily activities, training in areas of community access, coping strategies for daily challenges, and socialization and adaptive skills. Typically, these programs have a 1:6 staff-to-participant ratio. They may take place in a day program building or community settings. This service is available for all ages. Changing Minds Young Filmmaker Festival and NYC Mental Health Support Services are examples of this type of organization.
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I still mask because I want to be on the right side of history.
Masking is uncomfortable and inconvenient, but I know it's the right choice for me bc it aligns with my morals and values. I believe in protecting others as much as I believe in protecting myself. I don't want to get anyone sick! And I believe, many years from now when they teach the history of the Covid pandemic, history will smile on the helpers and the doers and the ones who continued to mask.
I often feel so depressed at the current state of the Covid pandemic, but I feel hopeful and confident in my choice to respond by continuing to mask and avoid high-risk events or situations. And I sincerely love and appreciate everyone who is doing the same.
❤️
😷
#‼️‼️‼️‼️‼️#THE PART ABOUT HISTORY LESSONS IN THE FUTURE#EXACTLY THAT.#I ABSOLUTELY want to be on the right side of history#like i just KNOW down the line generations from now people are going to want things to be sustainable#and are going to turn back to history to learn from those that ACTUALLY TRIED TO TAKE CARE OF THEIR COMMUNITY#and anon i 100000% feel you. shit's been depressing as hell and i try to keep dreaming for a better reality to keep myself going#i see little things here and there that inspire me and knowing there's so many ppl out there that are committed to masking#and making a more accessible and covid safer spaces - i feel hope#thank you for sharing 😷💛#i still mask because#covid isn't over#covid is airborne#covid awareness#covid pandemic#covid#ask queue
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Headline 14h ago - Meta announces removal of fact checking
Headline 10h ago - Rump hints at economic war to annex Canada
Headline 9h ago - women can now be referred to as 'household objects' under new Meta guidelines
Headline 8h ago - Rump hints at military force to annex Greenland, Panama Canal
Headline 7h ago - Biden bans medical debt from affecting credit score
Headline 6h ago - Rump again alludes to WW3 if Israel isn't chilled out by Jan 20
Headline 5h ago - Rump says Gulf of Mexico to be renamed Gulf of America
Headline 4h ago - Rump team admits Jack Smith found evidence of vast criminal conspiracy
Headline 3h ago - Rump judge temporarily delays release of Jack Smith's Special Council Report
Ah, it begins again with gusto.
If y'all also memory-holed 2016-2021 like the rest of us, be prepared for the face-melting speed at which Shit Starts Happening in the coming weeks now that the election has been certified, and yes even before he's sworn in, whether or not he's allowed to do whatever it is.
No, it will not slow down, stop, or get better. It will keep getting faster, more, and worse.
It will be A Lot, just to even keep track of it all. Just like last time.
I do not have the energy for it, but if no one has already, there should be a good handful of blogs + mods prepared and dedicated just to covering as many headlines/stories as possible. It would be Important and possibly Dangerous Work. And even though I recognize it needs doing, I also recognize it is far outside my ability to reliably provide.
#us politics#rambleramble bullshit time#i am pouring myself two shots tonight. one to clown on le pen#and one to brace for This#tw alcohol#so to the void this goes#i wish all of us the very best of luck#take care of each other. prioritize your struggles#stay fuckin hydrated#and reach out to local orgs even if you're homebound or need accessibility services#please please please. find your communities#do not rely solely on digital networking that may or may not continue to be available#yes it is valid and valuable. use it while we can. have other options for if we can't#i know it's hard to tolerate a diverse irl community which might include centrists and conservatives#but you can do it i believe in you#dont bring proshipping to the soup kitchen etc etc
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"Missouri Attorney General Andrew Bailey terminated his emergency rule on gender-affirming care Tuesday — less than a week after the state legislature sent a ban on minors starting treatment to the governor’s desk.
The ACLU of Missouri filed a lawsuit in late April seeking to block Bailey’s emergency rule, alleging the attorney general didn’t have the authority to use the state’s consumer protection law to block access to puberty blockers, hormone therapy and gender-affirming surgery. A judge put the rules on hold until July, when a hearing is scheduled...
The now-terminated emergency order would’ve affected adults, a step that caused fear in the LGBTQ+ community, advocates told The Independent. Some began preparing to move out of state when they heard about the emergency order...
A spokesperson for the Missouri Secretary of State’s office said he received the termination paperwork around 4 p.m. Tuesday [May 16, 2023].
If Bailey wishes to enact his order, which would set barriers to accessing gender-affirming care, he must restart the process...
The ACLU of Missouri released a statement Tuesday evening, calling the termination a “victory for Missourians’ right to bodily autonomy.”
“After weeks of embarrassing Missouri on the national stage, the Attorney General has finally joined everyone else in recognizing that his hasty attempt to usurp other branches of government cannot withstand scrutiny,” the statement says.
House Minority Leader Crystal Quade, D-Springfield, said in a statement that Bailey “grossly overstepped his legal authority, and everyone knows it.
“So, it isn’t surprising he withdrew his unconstitutional rule knowing another embarrassing court defeat was inevitable,” she said. “Missourians deserve an attorney general worthy of the office, not one who persecutes innocent Missourians for political gain.”
Fischer said, despite uncertain circumstances, the removal of barriers to care is a “win” for transgender Missourians.
“From the conversations we’ve already had with community members and trans leadership, people are thrilled to see the attorney general terminate his rule especially since it targeted the entire trans community: children and adults. In our eyes, this is a win,” he said."
-via Missouri Independent, 5/16/23
Note:
It's nowhere near enough, but it's still so important, especially for all the trans adults in Missouri who were being forcibly detransitioned and starting to be denied access to gender-affirming care, including hormones, which they'd often been on for years.
At this point, I will celebrate every bit of respite we can get.
Missouri would've been the first and only state to ban access to transgender care for adults. It's inexcusable that trans kids are still going to be denied care. But if this rule hadn't been withdrawn, there would've been a lengthy court battle over it lasting years, and in the meantime, every red state that could get away with it would be using Missouri as a blueprint and successful precedent to pass their own bans on gender affirming care for adults.
The fact that Republicans have been denied that successful precedent is VITAL.
#transgender#transphobia#trans rights#gender affirming care#united states#us politics#missouri#attorney general#lgbtq#lgbtq rights#queer community#trans rights are human rights#healthcare access#healthcare#gender affirming care is healthcare#good news#hope
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honestly something thats really frustrating about autism is that it feels like i have to force people into engaging with stuff that i like in order for them to care about me. because so much of my sense of self is tied to the things that i do/care about, interacting with people (especially irl friends and family) that 'care' about me is really isolating when it feels like they couldn't give less of a shit about what im excited about. they "tolerate" my existence and thats enough for them i guess but im so alone with all these thoughts i have abuot why this thing i like is actually cool and well made and interesting and its not just the fact that i already like it. i feel it when i share these feelings and all i get are empty responses or blank stares like im just that offputting for being a little strange about something i find fascinating
#mandy#its a vent kinda day huh#i wish i lived somehwere that felt like community was accessible for disabled people#its nice that a lot of people like me for being cute and pretty and silly and stuff but also i wanna talk about the intricacies of game#design and the technical aspects of art and the ways in which spaces can be made better for people to live in them#without feeling like they just dismiss what im saying like 'oh thats neat'#I JUST WANT PEOPLE TO CARE ABOUT ME grahhhhhhhhhhhhhhhhhhhhhhhhhhhhhh#and not just the me that exists in their mind the actual me in the world#i want people to actually interact with my existence as if i was real and affected the space around me
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#tbh i think it's definitely both these things#cognitive impairment as well as a neurobiological response to trauma#anyway not wearing a mask is fascist regardless of what YOU assess the risk level to be. more than 7 million dead; thousands disabled by LC#disabled people deserve access to healthcare and all public spaces#wearing a mask is harm reduction#wearing a mask is community care
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.-.
#I think I’m done hearing about the TikTok ban now#I know that it’s a community#I know that it’s the result of shitty out of touch government overreach#but it’s going to create a generation of jackbooted fascist Trump acolytes#Who care more about their stupid app than democracy#and will gladly be OK letting vulnerable communities get burned to the ground#if they can get back access to the fucking app#which they are acting like it is dead#which is the most American – centric bullshit I’ve ever heard#it is still business as usual in the vast majority of the world#it’s just banned in America#and I feel like there are a lot of people that will be fine throwing away the LGBTQ plus community if they can get back their fucking app.#lgbt#lgbtqia+#tiktok ban#tiktok
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This isn't surprising not one bit, Texas has archaic abortion laws and will real what they've showed much to suffering and death of many women. This will obviously affect the health sector in Texas and strain health services for women who may need to leave the state to receive medical treatment or even a simple gynecology exam. Republicans never cared about women nor the fetus as it was always about control, this patriarchy 101 and anyone with a working brain and empathy can understand that. Men never have to fear having our bodily autonomy from being taken away, well until Republicans start mandating men and women breed resulting in the LGBTQIA+ community being seen as 'unproductive' but hey that's later on the Republican agenda. For now we can still fix this mess, we will not and must not settle for anything less than abortion being enshrined in our constitution.
#politics#the left#leftism#progressive#culture#eat the rich#tax the rich#us politics#communism#corporate greed#abortion access#abortion debate#abortion rights#abortion is healthcare#abortion bans#bodily autonomy#pro choice#healthcare for all#healthcare industry#healthcare services#health#medicine#doctors#medical care#treatment#texas#texas news#gynecologist#gynecological health#obstetrics and gynecology
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