IMMIGRATION ISSUES & AND CONSIDERATIONS FOR

HEALTHCARE PROFESSIONALS

An Affiliate of theJustice For Our Neighbors Network

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

About the Immigration Legal Center

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)

• 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:

About You?

U.S. Immigration Legal System

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

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

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.

• 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”):

Family-Based Immigration

Options

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)

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?

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

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.

Humanitarian Options

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

Relief from Persecution

(Asylee/Refugee Status)

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

Options for Victims of

Crime in U.S. (U/T Visa,

VAWA Self-Petition)

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.

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.

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.

Special Immigrant

Juvenile Status (SIJS)

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

Cancelation of Removal

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!

What If There Are No Immigration Options Available Right Now?

Deferred Action for Childhood

Arrivals (DACA)

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

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).

Intersection of Immigration & Healthcare

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

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

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.

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

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

How You Can Help!

▪ 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/

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.

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

Interested in Learning More?

• Websites:• immigrantlc.org• nilah.org

• Email:• mindy@immigrantlc.org• josh@immigrantlc.org

4223 Center St | Omaha, NE 68105 | 402.502.4604 | immigrantlc.org