Understand
- Be aware that patients may be afraid, and avoid asking directly about their immigration status:
– “I say, ‘Things are stressful right now — how are you doing?’” (Sarah L. Kimball, MD)
– “What’s your migratory host country? Where is your family? When did you arrive? What health issues have you had in the past?” (Public Benefits Attorney Andrew P. Cohen)
– Connect patients with support groups and mental health providers (Immigration Attorney Mahsa Khanbabai)
- Be aware of Cohen’s primary messages for immigrants using publicly funded programs:
– Trump’s new public charge rule has been blocked by the courts, so the old rule is still in place for now.
– Immigrants should keep their health care benefits and not hesitate to enroll in MassHealth.
– Anyone who is unsure of what to do should consult an immigration attorney and a public benefits attorney; few lawyers know both areas.
Communicate
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Communicate to patients that health care facilities are safe spaces and ICE has no jurisdiction there (Sociologist Tiffany Joseph, PhD, Northeastern University).
- If you are employed in a hospital or large group, refer patients to the navigators who assist with MassHealth applications. Navigators and others can consult:
– Health Care for All: (800) 272-4232
– Health Law Advocates: (617) 338-5241
- If your hospital or group is developing relevant educational materials, display them in your clinical spaces, allowing patients to take them discreetly. Sharable materials are available at the websites listed at right (Resources).
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Know the pro-bono legal options in your area. Some cities and nonprofit organizations offer immigration clinics with free legal consultations.
Advocate
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Support and collaborate with other stakeholders, including legal organizations.
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Volunteer to provide health care to disadvantaged communities in Massachusetts (see below).
“As physicians we have a valuable opportunity to help patients feel supported. We can create an environment of support in our clinics, connecting patients with legal or social support or just providing information. That in itself can be therapeutic. There are also a lot of advocacy opportunities beyond the exam room. Be clear whether you’re speaking for yourself or your institution. This is certainly within our lane, because we’re seeing firsthand the mental and physical health effects on our patients. But we don’t have legal expertise, so multidisciplinary collaboration is incredibly important.”
— Fiona S. Danaher, MD, co-chair, MGH Immigrant Health Coalition
Resources
Health Care for All (HCFA)
Massachusetts Immigrant and Refugee Advocacy Coalition (MIRA)
Protecting Immigrant Families
Health Law Advocates (HLA)
Immigration Advocates Network
