ACCMA has worked in collaboration with the California Academy of Family Physicians and CAFP Foundation, San Francisco Marin Medical Society, American Academy of Pediatrics-California, Osteopathic Physicians and Surgeons of California, and Sonoma County Medical Society to increase awareness within the health care community of ongoing issues created by the current immigration policies in our country.
Some of the issues being raised by immigration actions at the Federal level, such as the separation of families, ICE activities, changes to the Public Charge policies for Medicaid, and CHIP, will have repercussions for all members of the community, including physicians, their clinical practice teams, and their patients. The ACCMA believes that increasing physician and practitioner awareness about immigration issues will create a more stable and responsive community, if and when these immigration actions are implemented.
Each of the six partners involved in this project have implemented a multi-pronged information strategy that includes a series of position papers, which can be referenced below.
In September 2018, the Trump Administration issued a proposed regulation that changes long-standing rules governing how and whether immigrants can be determined to be a "public charge;" widens the scope of programs considered by the government in making such a determination; and dramatically lowers the bar for refusing admission or denying individuals green cards or US visas on this basis. The concept underpinning this proposed rule may be replicated in other future proposed rules.
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Children in families in which a parent has been detained and deported exhibit significant changes in behavior that can include "changes in eating and sleeping, frequent crying, increased fear and anxiety, and/or withdrawal or anger." Some children experience "speech and developmental difficulties, including regression and reversal of developmental milestones."
Family separation and detention can complicate and exacerbate existing trauma among vulnerable populations. As noted by the American Academy of Pediatrics, separating children from their parents exposes them to "toxic stress" that can disrupt healthy development and lead to lifelong negative impacts on their mental and physical wellbeing.
The primary effect of the threat of an ICE raid on a health care facility is a reticence among patients to seek medical care. Three steps should be taken by family and primary care physicians:
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