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NALBOH Discusses Immigration Policy

Tuesday, December 18, 2018  
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A proposed new immigration policy change by the Trump administration may pose a threat to the U.S. public health in the near future.   A proposed “public charge” is alarming immigrant populations to withdraw from benefits such as public health services.  Local health departments are seeing individuals and family members requesting their names be removed from recipient lists.  They are also refusing any future care or follow-up.  The threat to the public health comes from those individuals who are currently being treated and /or followed for contagious diseases, such as TB.  Also the refusal of immunization, either adult or child, could lead to local, or large scale epidemics in the future.  Measles could return as a wide spread, very contagious disease.  Preventable epidemics could further tax our thinly stretched public health dollars.

The concept of “public charge” has been around since colonial times.  In simple terms it requires the person immigrating to the United States to be self-sufficient and not requiring significant government; i.e., public assistance.  The current ruling, from the President Clinton era, for “public charge” is an individual that receives more that 50% of their income from public sources. This aid could be form of Supplemental Security Income, Needy Family Assistance, government prolonged medical care.  Funds from state and local governments may now be considered toward Public Charge.   Under the proposed rule changes, benefits from non-cash sources such as Medicare, non-emergency Medicaid, food stamps, public housing assistance, homeless aid, and /or rental concessions would now be part of the considered amount.    Immigration officials will have more discretion to determine if the applicant might become a public charge in the future.  The new ruling would restrict even more amount of aid the individual could possibly receive and be approved for permanent immigration status, such as green cards.  Receiving public assistance now could be a larger negative factor in the immigration consideration.  The amount and types of public assistance that will be allowed is causing great confusion and fear among those seeking permanent U.S. status.  Family admission may be impacted even harder.

The time to be proactive may be now on the federal level.   Assistance for public health care could be removed from the list of items to be considered in the “public charge” evaluation for immigration status.  Education of the immigrant community about any public health changes made would greatly reduce fears (whether real or perceived); thereby, reducing the changes of epidemics and threats to the Public Health.   Letter and calls to Homeland Security, Immigration officials, and your Federal and State representative may eliminate prolonged, and expensive battles against disease and public health threats we have worked so hard to win. 

            NALBOH is discussing this proposed Trump administration issue to determine the next steps for public health and what we as board of health members can do.