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IMMIGRATION ISSUES & AND CONSIDERATIONS FOR
HEALTHCARE PROFESSIONALS
An Affiliate of theJustice For Our Neighbors Network
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AGENDA:• About the Immigrant Legal Center (ILC)
• Basic familiarity the U.S. immigration legal system
• Brief overview of the intersection between immigration legal assistance and healthcare
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About the Immigration Legal Center
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Immigrant Legal Center
• The Immigrant Legal Center (ILC) is a non-profit organization providing high-quality legal services, education and advocacy
• ILC recently moved offices and changed our name
• South Omaha (24th & E) →Central Omaha (42nd & Center)
• Justice For Our Neighbors-NE (JFON-NE) →Immigrant Legal Center (ILC)
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• Immigrant-Focused Medical Legal Partnership
• Attorney of the Day / Child and Family Team
• Rural Community Inclusion• Domestic Violence• Iowa Services• Immigrant Worker Legal
Partnership
ILC Programs:
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About You?
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U.S. Immigration Legal System
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U.S. Immigration System
Executive
(enforces laws)
Legislative
(makes laws)
Judicial
(interprets law)
DHS-Secretary of DHS
DOJ-Attorney General
DOS-Secretary of State
U.S.Supreme Court
U.S.Courts of Appeals
ICEImmigration &
Customs Enforcement
CBPCustoms &
Border Protection
USCISU.S. Citizenship &
Immigration Services
EOIRExecutive Office of
Immigration Review
BIABoard of Immigration
Appeals
IJImmigration Judge
U.S. Consulates
U.S.District Courts
HHS-Secretary of HHS
ORROffice of Refugee
Resettlement
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Members of Our Community:
U.S. Citizens• By birth in the U.S.• By acquisition• By naturalization• By derivation
Non-U.S. Citizens• Immigrants /
Lawful Permanent Resident (LPR)
• Fleeing persecution
• Temp. permission• Non-immigrants• Undocumented
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Words Matter!
• NO human is “illegal”
• Being present in the U.S. without permission is not a crime
• Over 11 million undocumented individuals in the U.S.
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• Family-Based Immigration*• Humanitarian Relief*• Employment-Based
Immigration• Diversity Program
*ILC focuses on providing assistance with family reunification and humanitarian options
Four Categories of Immigration Options(“Paths to Citizenship”):
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Family-Based Immigration
Options
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Who Is Family?
• Immediate relatives include the spouse, children (unmarried & under 21), and parents of a US citizen child (under 21)
• Preference Category relatives must wait for a visa to become available to them
1st Preference: Unmarried adult children of a US citizen
2d Preference: 2A- Spouse and children (under 21) of LPR 2B- Unmarried children of LPR
3d Preference: Married children of USC (regardless of age)
4th Preference: Siblings of USC (regardless of age)
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Wait Times?
Lisa, a U.S. citizen, would like to be reunited with her brother, Joseph, who is a Mexican citizen. How long will theyhave to wait?
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Visa Bulletin May 2018
Family-Sponsored
All ChargeabilityAreas ExceptThose Listed
CHINA-mainlandborn INDIA MEXICO PHILIPPINES
F1 08APR11 08APR11 08APR11 15NOV96 22JAN06
F2A 01JUN16 01JUN16 01JUN16 22APR16 01JUN16
F2B 15MAY11 08MAY11 08MAY11 01DEC96 15DEC06
F3 01FEB06 01FEB06 01FEB06 01SEP95 01APR95
F4 01OCT04 01OCT04 01MAR04 08JAN98 01FEB95
https://travel.state.gov/content/travel/en/legal/visa-law0/visa-bulletin/2018/visa-bulletin-for-may-2018.html
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Wait Time Estimates
Family-sponsored
All other countries
Mexico
F1 7.5 yrs. 49 yrs.
F2A 3.39 yrs. 3.8 yrs.
F2B 10.49 yrs. 119 yrs.
F3 21.81 yrs. 106 yrs.
F4 22.7 yrs. 162 yrs.
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Humanitarian Options
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Humanitarian Forms of Immigration Relief
• Refugees, Asylees, individuals granted Withholding or Convention Against Torture
• Relief for Victims of Crime (VAWA, U-Visa, T-Visa)
• Special Immigrant Juvenile Status (SIJ)
• Cancellation of Removal
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Relief from Persecution
(Asylee/Refugee Status)
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Refugee/Asylee Status• A “refugee”:
– Unable or unwilling to return to or avail him or herself of the protection of his or her home country
– Because of a well-founded fear of persecution
– On account of race, religion, nationality, political opinion, or membership in a particular social group
• Asylee: An individual who meets the refugee definition within the United States, and applies within one year of arrival in the U.S., or meets an exception to the one-year deadline
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Options for Victims of
Crime in U.S. (U/T Visa,
VAWA Self-Petition)
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U Visa Requirements
• Be a victim of a qualifying criminal activity; AND
• Suffer substantial physical or mental abuse; AND
• Possess information concerning that qualifying criminal activity; AND
• Have been helpful, be currently helpful, or be likely to be helpful to a federal, state, or local law enforcement agency investigating or prosecuting one of the qualifying criminal activities; AND
• The criminal activity violated the laws of the United States and could be prosecuted in the United States.
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T Visa Requirements
• A victim of a severe form of trafficking in persons; AND
• Have physical presence in the United States,, or a point of entry on account of such trafficking; AND
• Comply with reasonable request for assistance in the investigation or prosecution of acts of trafficking (unless victim is under 18 or unable to cooperate due to physical or psychological trauma); AND
• Would suffer extreme hardship involving unusual and severe harm upon removal.
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Violence Against Women Act (VAWA) Self-Petition
• Allows certain spouses, children, and parents of U.S. citizens and certain spouses and children of permanent residents to file an immigrant visa petition for themselves, without the abuser's knowledge.
• This allows victims to seek both safety and independence from their abuser, who is not notified about the filing.
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Special Immigrant
Juvenile Status (SIJS)
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SIJS Eligibility• Under 21 years old• Unmarried• Present in the United States• Subject of a state “juvenile” Court Order
finding the following before the child reaches the age of majority:• Have been abused, abandoned and/or
neglected by one or both parents• Reunification with one or both parents not viable• Return to country of last habitual residence not
in best interest
NOTE: A parent whose child becomes an LPR via an approved SIJS Petition can never receive any immigration benefits from their child
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Cancelation of Removal
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Cancellation of Removal Eligiblity
• At least 10 years of continuous presence in the U.S.
• Must establish good moral character
• No disqualifying criminal convictions
• Prove that removal would result in exceptional and extremely unusual hardshipto a U.S. citizen or LPR spouse, parentor child
• Must be in removal proceedings!
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What If There Are No Immigration Options Available Right Now?
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Deferred Action for Childhood
Arrivals (DACA)
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DACA Basics
• Arrived in U.S. before 16 years old
• Under 31 in 2012
• Continuance presence since 2007
• Studied in the U.S.
• Good moral character: Background check
• DACA does NOT provide a pathway to LPR status or citizenship; it provides temporary protection from deportation, work authorization, and the ability to apply for a SSN, as well as driver’s and professionallicenses
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Update on DACA
• On September 5, 2017, the DACA program was rescinded by the Trump Administration.
• On January 9, 2018, a Federal District Court in California issued an order mandating that USCIS resume accepting DACA applications for most individuals who have previously been granted DACA. A Federal District Court in New York issued a similar order on February 13, 2018.
• On April 24, 2018, a Federal District Court Judge in D.C. held the government’s rescission of DACA to be illegal and ordered the government to accept new DACA applications. However, the Court stayed its decision for 90 days (until July 23, 2018) to allow for the government to prove that its decision to end DACA was made properly.
***As of today, only DACA RENEWAL applications are being accepted (no initial DACA applications).
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Intersection of Immigration & Healthcare
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Immigration Status → Health Care → Health
• Over 60% of a person’s health is determined by social factors, including whether or not they have current immigration status in the U.S.
• When community members are forced to live in fear because of their immigration status, their health and the health of our community suffers
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Barriers to Immigrant Access to Healthcare
• Legal and policy barriers to public benefits
• Refugees and asylees become ineligible for benefits after 7 years
• Social, linguistic, economic and cultural barriers
• Fear, mistrust, and lack of knowledge• High cost of healthcare• Consequences to accessing benefits for
self or family members
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ABCs of IMLPs
Immigrant-Focused Medical Legal Partnerships (IMLPs)bring together medical professional and immigration legal service providers to address social causes of health disparities, including access to immigration status, work authorization, safety planning and access to benefits.
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Health Harming Legal Needs
• A study at Lancaster General Health in Pennsylvania showed that 95% of the highest-utilizing patients had 2-3 civil legal problems
• When those legal problems were addressed, health improved and overall health care costs decreased by 45%
• Federal funding restrictions often inhibit Legal Aid Organizations from providing legal services to many undocumented immigrants
• Thus, many traditional MLPs are not able to provide services to immigrants facing barriers to accessing healthcare
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Benefits of Immigrant-Focused MLPs
• As immigrants gain access to legal status, barriers created by high out-of-pocket costs are reduced
• As immigrant families gain knowledge about their immigration strategies and learn of their rights under law, we reduce barriers created by fear, mistrust, and a lack of knowledge
• As immigrants gain increased access to public benefits or insurance, providers realize decreased uncompensated care costs
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How You Can Help!
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▪ Encourage patients to obtain immigration consultations with reputable immigration legal service providers
▪ Provide information to patients on rights / how to create a safety plan
▪ Organize / participate in community preparedness and response plans to an immigration enforcement action▪ Have a clear set of directives for staff▪ Connections made with local civic and non-profit
groups in this area
Foster a Welcoming and “Safe” Environment for Undocumented Community Members
Know Your Rights and Safety Planning Guide: http://www.nilah.org/
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Where are Safe (“Sensitive”) Locations?
Immigration & Customs Enforcement (ICE) Policy includes certain “sensitive locations,” including:• Schools, including preschools, colleges, universities
and other institutions of learning;• Medical treatment and health care facilities, such as
hospitals, doctors’ offices, accredited heath clinics, and emergent or urgent care facilities;
• Churches, synagogues, mosques, and other institutions of worship;
• Site of a funeral, wedding, or other public religious ceremony; and
• Public demonstration sites, such as marches, rallies or parades.
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Access To Immigration Legal Services
Anyone can apply for low-income immigration legal services by
calling the Nebraska Immigration Legal
Assistance Hotline (NILAH)
Call: 855-307-6730
www.nilah.org
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Interested in Learning More?
• Websites:• immigrantlc.org• nilah.org
• Email:• [email protected]• [email protected]
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4223 Center St | Omaha, NE 68105 | 402.502.4604 | immigrantlc.org