IMMIGRATION ISSUES & AND CONSIDERATIONS FOR HEALTHCARE PROFESSIONALS. An Affiliate of the Justice For Our Neighbors Network

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2 IMMIGRATION ISSUES & AND CONSIDERATIONS FOR HEALTHCARE PROFESSIONALS An Affiliate of the Justice For Our Neighbors Network

3 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

4 About the Immigration Legal Center

5 Immigrant Legal Center The Immigrant Legal Center (ILC) is a non-profit organization providing highquality legal services, education and advocacy ILC recently moved offices and changed our name South Omaha (24 th & E) Central Omaha (42 nd & Center) Justice For Our Neighbors-NE (JFON-NE) Immigrant Legal Center (ILC)

6 ILC Programs: Immigrant-Focused Medical Legal Partnership Attorney of the Day / Child and Family Team Rural Community Inclusion Domestic Violence Iowa Services Immigrant Worker Legal Partnership

7 About You?

8 U.S. Immigration Legal System

9 U.S. Immigration System Executive Legislative Judicial (enforces laws) (makes laws) (interprets law) DHS- Secretary of DHS DOJ- Attorney General DOS- Secretary of State HHS- Secretary of HHS U.S. Supreme Court ICE Immigration & Customs Enforcement EOIR Executive Office of Immigration Review U.S. Consulates ORR Office of Refugee Resettlement U.S. Courts of Appeals CBP Customs & Border Protection BIA Board of Immigration Appeals U.S. District Courts USCIS U.S. Citizenship & Immigration Services IJ Immigration Judge

10 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

11 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. Words Matter!

12 Four Categories of Immigration Options ( Paths to Citizenship ): Family-Based Immigration* Humanitarian Relief* Employment-Based Immigration Diversity Program *ILC focuses on providing assistance with family reunification and humanitarian options

13 Family-Based Immigration Options

14 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)

15 Lisa, a U.S. citizen, would like to be reunited with her brother, Joseph, who is a Mexican citizen. How long will they have to wait? Wait Times?

16 Visa Bulletin May 2018 Family- Sponsored All Chargeability Areas Except Those Listed CHINA-mainland born 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

17 Wait Time Estimates Family - spons ored All other countri es Mexico F1 7.5 yrs. 49 yrs. F2A 3.39 yrs. 3.8 yrs. F2B yrs. 119 yrs. F yrs. 106 yrs. F yrs. 162 yrs.

18 Humanitarian Options

19 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

20 Relief from Persecution (Asylee/ Refugee Status)

21 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

22 Options for Victims of Crime in U.S. (U/T Visa, VAWA Self- Petition)

23 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.

24 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.

25 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.

26 Special Immigrant Juvenile Status (SIJS)

27 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

28 Cancelation of Removal

29 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 hardship to a U.S. citizen or LPR spouse, parent or child Must be in removal proceedings!

30 What If There Are No Immigration Options Available Right Now?

31 Deferred Action for Childhood Arrivals (DACA)

32 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 professional licenses

33 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, 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).

34 Intersection of Immigration & Healthcare

35 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

36 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

37 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.

38 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

39 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

40 How You Can Help!

41 Foster a Welcoming and Safe Environment for Undocumented Community Members 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 Know Your Rights and Safety Planning Guide:

42 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.

43 Access To Immigration Legal Services Anyone can apply for low-income immigration legal services by calling the Nebraska Immigration Legal Assistance Hotline (NILAH) Call:

44 Interested in Learning More? Websites: immigrantlc.org nilah.org

45 4223 Center St Omaha, NE immigrantlc.org