Testimony by LegalHealth of the New York Legal Assistance Group (NYLAG) on the Impact of New Immigration Enforcement Priorities on Access to Health and Legal Services

November 28, 2017

Thank you and good morning to Chairman Menchaca, Chairman Corey Johnson, Council Members, and staff for the opportunity to testify before you today on immigrant access to health care in this new immigration environment that is challenging us all.  My name is Norma Tinubu, and I am the Senior Supervising Attorney at LegalHealth, a division of the New York Legal Assistance Group (NYLAG).  NYLAG serves immigrants, seniors, veterans, the homebound, families facing foreclosure, renters facing eviction, low-income consumers, those in need of government assistance, children in need of special education, domestic violence victims, people with disabilities, patients with chronic illness or disease, low-wage workers, low-income members of the LGBTQ community, Holocaust survivors, as well as others in need of free legal services.

LegalHealth is the nation’s largest medical-legal partnership, providing general legal assistance in the healthcare setting to patients of hospitals and community health centers.   A large number of our clients are immigrants in need of medical treatment and care for severe and/or life-threatening illnesses. Last year alone, we represented 2,500 immigrants at our legal clinics situated in 29 hospitals throughout New York City, most of them public.

We are proud of our collaboration with New York City government partners to increase access to care for New York City’s immigrant community through the Council’s Immigrant Health Initiative (IHI) and through ActionNYC, facilitated by the Mayor’s Office of Immigrant Affairs.  Through these partnerships, LegalHealth has increased targeted immigration legal services that lead to life saving care and treatment for immigrants and their families, including obtaining insurance to receive heart, liver, and kidney transplants.  It is important to recognize the nexus between immigration and healthcare; assisting an immigrant in regularizing his or her immigration status often directly leads to that person having the ability to access health insurance and healthcare they would not have been able to receive while undocumented.

We are grateful that both the City Council and the Mayor’s Office have embraced LegalHealth’s medical-legal partnership model, a service delivery structure that has become increasingly critical to immigrants since the new federal Administration took office.  Providing services to immigrants in places they know and trust, such as hospitals, is an important way to ensure that they can and will access these services.  We have seen firsthand the chilling effect that recent Executive Orders on immigration, and the increased actual and expected immigration enforcement activities, are having on immigrants. More than ever before, New York City’s undocumented immigrant residents are afraid to go about their daily lives, seek legal assistance, seek medical care, and access the various systems available to them for fear of deportation.  Our hospital partners report that patients are afraid to attend medical appointments or follow through on legal services referrals.  We have even seen heartbreaking examples of this, including a client with aggressive leukemia who is currently too fearful to submit her relative petition due to fear of immigration enforcement. Without the Medicaid she would receive by regularizing her immigration status, she will be unable to receive a life-saving stem cell transplant.  Still, we know that a person provided with a “warm” referral and assurance of safety is more likely to access services than someone who is simply given another phone number to call.

Because of LegalHealth’s unique model of on-site legal clinics in the hospital setting, we have direct access to patients through hospital staff referrals of patients for immigration and Medicaid assistance. The City Council’s funding of the IHI has allowed us to expand our reach to patients of H+H’s public hospital system, allowing us to take on more clients and open more clinics.   A simple staff referral is all that is necessary to initiate services to a patient, some of which are at the bedside.  Since 2016, Immigrant Health Initiative funding has allowed us to provide a range of immigration and Medicaid related services to nearly 350 immigrants in H+H facilities including family petitions, applications for adjustment of status, Special Immigrant Juvenile Status, U/T visas for crime victims, and immigration benefits for victims of domestic violence under the Violence Against Women Act. We have also provided trainings for H+H medical personnel and staff, ensuring that they understand when patients are in need of immigration legal services and know how to refer them to LegalHealth. We have also recently offered targeted trainings, forums/information sessions, and webinars for our hospital and community partners to help them navigate the new immigration environment and deal with the fear and reluctance of patients to keep necessary medical and legal appointments and seek other services in the City.  This outreach conveyed the legal information necessary for making informed decisions for better responses to new and hostile immigration policies.

LegalHealth’s ActionNYC program is also modeled on legal services to patients in the health-care setting.  Through six onsite legal clinics, patients of long-term acute-care facilities are given access to attorneys who screen them for immigration benefits, which often lead to health insurance and immigration benefits.  Since its inception, 168 patients have been screened from Coler, Carter, Kings County, Sea View, McKinney, and Coney Island facilities.   We continue to work on the cases of 62 patients from these facilities.  In addition, Action/NYC allowed us to house our legal services in the public hospitals to serve community members who are not patients of the hospital and call 311 when they want to schedule an appointment to speak to an immigration lawyer. This initiative allowed us to open additional clinic days to serve the broader community in a setting the immigrant community would feel comfortable going to.

Without continued funding of these important initiatives, many immigrants will go without the legal assistance needed for not only health care, but for long-term or permanent solutions to their immigration status. For example, NYLAG provided services under the Immigrant Health Initiative to a client who has been living in the U.S. for the past 25 years with a deportation order that made her vulnerable to deportation at any time. She was referred by her psychiatrist and therapist at Elmhurst Hospital for help with obtaining status and Medicaid for treatment of bipolar disorder.  Without regular Medicaid she could not continue regular therapy and treatment for her condition. We represented her in reopening and terminating her deportation order and successfully handled her adjustment to lawful permanent residence.  Once her deportation order was terminated, we assisted her in obtaining Medicaid for her mental health therapies.  She is now a lawful immigrant and a working New York City taxpayer whose health and welfare changed for the better because of legal interventions funded by City Council dollars.

As legal services advocates, we need the continued commitment of the City Council and the Mayor’s Office to provide funding to allow providers to continue providing robust and immediate responses in our current immigration climate.  Continued funding allows advocates to provide critical legal services to immigrants for a healthier and safer New York City for all of us.

Thank you for your time this morning and I am happy to answer any questions you have.

 

Respectfully submitted,

New York Legal Assistance Group