Health in­dus­try frets about DACA’s fate

Young im­mi­grants make up a no­table por­tion of home aides, med­i­cal stu­dents

The Arizona Republic - - TRENDING - Car­men Here­dia Ro­driguez

The Latino clients of­ten ap­proach her for help, Jen­nifer Ro­driguez said, rec­og­niz­ing a friendly face and ask­ing in bits of bro­ken English whether their na­tive Span­ish is fa­mil­iar to her.

Ro­driguez, 28, works at a psy­chi­atric care fa­cil­ity in Elkhart, Ind., as an ad­min­is­tra­tive as­sis­tant, help­ing clin­i­cians care for chil­dren and ado­les­cents with men­tal ill­ness. In­ter­pret­ing for clients doesn’t fall un­der her job de­scrip­tion, and her boss some­times tells her to say no when she’s over­whelmed.

“But I would never do that to my peo­ple,” Ro­driguez said.

She ar­rived in Goshen, Ind., from Mex­ico when she was 3, with no rec­ol­lec­tion of her birth­place and no doc­u­ments to prove she be­longed in the na­tion she now calls home. In 2012, Pres­i­dent Obama es­tab­lished a pol­icy called De­ferred Ac­tion for Child­hood Ar­rivals (DACA), which granted Ro­driguez — and nearly 800,000 oth­ers who came to the coun­try as chil­dren and do not have doc­u­men­ta­tion to stay — free­dom from con­cerns about be­ing de­ported and the op­por­tu­nity to earn a liv­ing.

Now the Trump ad­min­is­tra­tion is mov­ing to end DACA.

“It’s hurt­ful that I con­sider this my home, yet to other peo­ple I am an il­le­gal,” she said.

This month, At­tor­ney Gen­eral Jeff Ses­sions an­nounced Pres­i­dent Trump would can­cel Obama’s ex­ec­u­tive or­der that set up DACA. The ad­min­is­tra­tion is pro­vid­ing a six-month grace pe­riod un­til the pro­tec­tions end, giv­ing Congress time to pass leg­is­la­tion to ad­dress the le­gal sta­tus of th­ese im­mi­grants, known as “DREAMers.” Trump and Demo­cratic law- mak­ers have agreed to work on a plan to al­low them to stay in the coun­try, but there are few details, and some con­ser­va­tives have raised con­cerns.

No firm sta­tis­tics ex­ist show­ing how many DREAMers work in the health care sec­tor, but in­dus­try lead­ers sug­gest DACA’s end could have an im­pact, es­pe­cially among med­i­cal stu­dents and home health aides.

Mul­ti­ple health care groups de­nounced the Trump ad­min­is­tra­tion’s move.

A state­ment re­leased by the As­so­ci­a­tion of Amer­i­can Med­i­cal Col­leges (AAMC) said its mem­bers are “ex­tremely dis­mayed” by the de­ci­sion.

The Amer­i­can Med­i­cal As­so­ci­a­tion said the ad­min­is­tra­tion’s an­nounce­ment “could have se­vere con­se­quences for many in the health care work­force, im­pact­ing pa­tients and our na- tion’s health care sys­tem.” It urged Congress to pass a per­ma­nent so­lu­tion.

“The more the ad­min­is­tra­tion threat­ens im­mi­grants and their fam­i­lies and their com­mu­ni­ties,” said Robert Espinoza, vice pres­i­dent of pol­icy at PHI, a long-term care ad­vo­cacy group, “the more we threaten that work­force sup­ply.”

The move could force med­i­cal stu­dents and res­i­dents to cut their train­ing short, the AAMC said.

For­eign-born and in­ter­na­tional med­i­cal grad­u­ates also tend to work in un­der­served ar­eas, said Matthew Shick, di­rec­tor of gov­ern­ment re­la­tions and reg­u­la­tory af­fairs at AAMC. Phas­ing out DACA could also sever a life­line con­nec­tion be­tween doc­tors and pop­u­la­tions in sore need of health care.

Sixty-five DREAMers were en­rolled in med­i­cal schools across the na­tion dur­ing the last aca­demic year, Shick said.

“It sounds like a small num­ber,” he said, “but they’re treat­ing any­where be­tween 1,000 and 2,000 pa­tients in their clin­i­cal panel.”

DACA’s end also could have a large im­pact on the coun­try’s abil­ity to care for pa­tients in a cul­tur­ally sen­si­tive man­ner, said Kurt Mosley, vice pres­i­dent of strate­gic al­liances for Mer­ritt Hawkins, a physi­cian re­cruit­ment com­pany.

And sta­tis­tics point to the need: Ac­cord­ing to the U.S. Cen­sus Bureau, His­pan­ics — who make up the bulk of DREAMers — are ex­pected to ac­count for nearly 29% of the U.S. pop­u­la­tion by 2060.

“You know, we’re a na­tion of di­ver­sity, and our work­force should re­flect that,” Mosley said. “And (dis­solv­ing DACA) is a step back­wards.”

Health care al­ready re­lies on im­mi­grants to fill the ranks. More than a fifth of DREAMers work in the health care or ed­u­ca­tion in­dus­tries, ac­cord­ing to a 2016 sur­vey by groups in­clud­ing the Na­tional Im­mi­gra­tion Law Cen­ter and the Cen­ter for Amer­i­can Progress.

One sec­tor of the work­force that heav­ily re­lies on for­eign-born em­ploy­ees is di­rect care, which in­cludes nurse aides, home health aides and per­sonal care as­sis­tants. Ac­cord­ing to Espinoza, one-quar­ter of all such em­ploy­ees are im­mi­grants.

As the pop­u­la­tion ages, those jobs will con­tinue to be in high de­mand.

“What our sec­tor needs most is care,” Espinoza said. “And th­ese kinds of fed­eral de­ci­sions im­pede that — it im­pedes our abil­ity to pro­vide care.”

“We’re a na­tion of di­ver­sity, and our work­force should re­flect that. And (dis­solv­ing DACA) is a step back­wards.”

Kurt Mosley, of Mer­ritt Hawkins, a physi­cian re­cruit­ment com­pany

ED­UARDO MUNOZ AL­VAREZ, GETTY IMAGES

Im­mi­gra­tion ac­tivists in Newark protest the Trump ad­min­is­tra­tion’s de­ci­sion to end the De­ferred Ac­tion for Child­hood Ar­rivals pro­gram.

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