Denny Chan: Hello, everybody. Welcome to as we speak’s webinar on a Chicken’s Eye View: Points Impacting Older Immigrants in 2025. Thanks a lot for becoming a member of us as we speak. I do know individuals are nonetheless trickling into the digital Zoom room, however we’re going to go forward and get began. So by the use of introduction, my identify is Denny Chan. I’m the Managing Director for Fairness Advocacy right here at Justice in Growing old, and I exploit he/him/his pronouns, based mostly out of California. And I’d adore it for my colleagues, Tiffany and Sahar to introduce themselves as nicely.
Tiffany Huyenh-Cho: Hello, all people, my identify is Tiffany Huyenh-Cho, I exploit she/her pronouns. I’m additionally based mostly in California and I’m the Director of our California Medicare and Medicaid Advocacy.
Sahar Takshi: Hello, everybody. My identify is Sahar Takshi, she/her pronouns, and I’m based mostly out of Washington DC. And I’m a Senior Legal professional at Justice in Growing old, engaged on fairness advocacy.
Denny Chan: All proper, thanks Tiffany and Sahar, they’re going to go off digicam till they communicate, however you’re with me no less than for the start. So once more, welcome to as we speak’s webinar on points impacting older immigrants. Subsequent slide, please.
In case you don’t know who we’re, we’re Justice in Growing old. We’re a nationwide authorized advocacy group devoted to utilizing the facility of legislation to struggle senior poverty, and we deal with the social security internet packages that basically safe a dignified future for older individuals, together with healthcare, financial safety, elder justice, and work round housing and entry to the courts. We’ve been round since 1972, and we focus our efforts totally on these older adults who’ve been marginalized and excluded from justice, together with older girls, older individuals of coloration, LGBTQ older adults, and older adults with restricted English proficiency. You’ll be able to learn extra about us at our web site, justiceinaging.org. Subsequent slide.
So for these of you becoming a member of us on the webinar listening dwell, you’ll observe that each one of you might be on mute. It’s best to be at liberty to make use of the questions operate all through the webinar to ask substantive questions. And for any tech points that you just would possibly run into, we’re going to have time on the finish to get to as many questions as we will, and we’ll work exhausting afterward if we don’t reply all these inquiries to observe up with of us afterward by way of e mail. In the event you’re having issues getting onto the webinar, you too can ship an e mail to trainings@justiceinaging.org. This is without doubt one of the hottest questions for every of our webinars, however we’ve a devoted useful resource library out there on-line, after which a recording to this coaching in addition to previous trainings is obtainable at our Vimeo web page and on the conclusion of the presentation, it’ll be uploaded to that web page. For people who would like to make use of it, you may allow shut captioning by deciding on CC from the Zoom management panel. Subsequent slide.
If you would like extra free trainings and supplies, you may be at liberty to hitch our community. We attempt to be intentional concerning the quantity of e mail that we ship out. I do know of us are getting quite a lot of emails, so we attempt to be intentional about that. You’ll be able to go to justiceandaging.org and click on enroll or ship an e mail individually to data@justiceinaging.org, and we will get you signed up that approach. Subsequent slide.
So important to our mission is actually our dedication to justice for all older adults. We consider that with a view to advance justice in growing old, we’ve to make sure that everybody, irrespective of who they’re, are capable of entry what they want as they age with out discrimination and no matter their racial id, their gender, gender id, sexual orientation, means, their language that they communicate, or the nation that they arrive from. And we’re dedicated to that half as bread and butter in our mission. That additionally signifies that in our advocacy work, we push for insurance policies that may guarantee these experiencing the best boundaries to all these packages that we advocate on can train their rights and totally entry the providers and packages that they want. That is the long run that we’re working towards right here at Justice in Growing old, and we’re excited that you just all are becoming a member of us for that. All proper, subsequent slide.
So when it comes to our agenda as we speak within the remaining 55 minutes that we’ve collectively, we’ve three chunks for our agenda. The primary is we’re going to get to know a bit of bit extra about you, the 728 of us who’re on listening dwell. So, we’ll try this by means of a few ballot questions. Then we’ll get to type of the meat and potatoes of our time collectively. So that you’re going to listen to from Tiffany and Sahar about, who’re older immigrants, points round Medicaid information sharing, and situation round understanding the legislation behind protected areas and the way that’s modified this 12 months. We’ll do a high-level overview of different threats that older immigrants are experiencing, after which we’re going to get to some Q&A.
I do need to flag for you all earlier than we get to these ballot questions, that this is a matter of important significance to us at Justice in Growing old and actually, to the nation at massive. We all know that due to the change in administration, there was a dramatic shift in how our nation treats immigrants and the insurance policies underlying these communities. And so, we acknowledge that this can be a fast-moving, ever-changing space of legislation and coverage. So what we’re telling you is actually present as of August twenty fifth. I’ve been based mostly in California, in order of 11:07 AM. And would encourage you in case you are listening at dwelling later to be sure that issues haven’t modified since we final did this webinar. We’ll in fact maintain you updated by means of the Justice in Growing old Listserv as a lot as doable, however we actually wished to acknowledge that this space is altering quickly, even simply developments yesterday that I’ll share a bit of bit extra later.
We additionally know that that is an space the place many individuals require particular person help, and would encourage you all to get in contact with immigration attorneys and different specialists who might help people who want help on the bottom. We’re discussing this as a subject each of nationwide significance and as a group that we care about at Justice in Growing old, as a result of we’re dedicated to justice for everybody. And that features older immigrants, you’ll hear extra about that from Sahar in only a minute. But additionally that immigration and problems with care are additionally intricately related on this nation and in our system. We aren’t eligibility specialists, however we’re specialists within the packages that, as I’ve mentioned earlier than, older adults will depend on, together with older immigrants as they age on this nation. So, we’re going to essentially be targeted on these points. There are quite a lot of actually wonky eligibility questions that we’re most likely not going to get into, however in case you ought to be at liberty to lift them within the chat and we will additionally get you in contact with the suitable individuals if it’s one thing that we don’t have inner experience on.
So once more, thanks for becoming a member of us on this actually, actually vital webinar. We all know this can be a important time for our nation and the older immigrants and immigrant communities who reside right here. All proper, so we’re going to dive into our first ballot query if I can get that launched.
So the query right here is, what class finest describes your work? Are you coming at us from a AAA or agent providers supplier space company on growing old, authorized help supplier? Are you a policymaker or work for a policymaker, or different advocate/stakeholder? And I’m going to offer only a couple, possibly another minute because the votes proceed to return in, individuals to make their choice. Appears just like the votes are slowing down, until that’s a lag on my finish. So we’re going to shut the panel. And the outcomes at closing are at about 25%, one in 4 of you might be coming from a AAA. A little bit below 20% are with a authorized help supplier. About 5%, lower than 5% policymaker, and plenty of of you falling into that final bucket, different stakeholder or advocate.
After which the following and last ballot query. So, what are you most concerned about getting out of this webinar? An outline of rising matters in immigration and notably the problems dealing with older immigrants. Second, higher understanding the connections between immigration and growing old providers. Assets for particular points. And the catch-all when you may’t resolve amongst one, the entire above. We’ll simply give a bit of bit extra time for individuals as they proceed to vote. All proper, I’m going to ask the ballot to shut now. So, it seems like we’re sort of within the low single digits or excessive, or I’m sorry, low double digits for prime single digits for the primary three classes, after which a bunch of you, 67% who’re right here for all of it.
So with that in thoughts, I’m going to ask Sahar to return again on and take us by means of older immigrants.
Sahar Takshi: Hello, everybody. Thanks a lot, and thanks Denny for getting us began. Earlier than we dive into the overview of all the pieces that’s occurring on the planet of immigration, I’d like to take a second to contextualize this dialog by starting to reply the query, who’re older immigrants? So, there are 8.5 million older immigrants, immigrants which are age 60 or older, residing within the US. And this makes up shut to fifteen% of our total older grownup inhabitants on this nation. So clearly, we’re speaking a couple of very vital fraction of our shoppers within the growing old providers area.
And as you may see on this graph, which is predicated on information from 2012 by means of 2016, the inhabitants of older immigrants within the US has been steadily on the rise and is anticipated to proceed. What I like about this graph is that it actually illustrates the connection between growing old and immigration, each of that are growing populations within the US. So, a lot of , particularly in case you come from an growing old providers background, that the older grownup inhabitants within the US, each non-immigrants and immigrants, are anticipated to achieve over 80 million by the 12 months 2050. And as you may see on this graph, that the variety of… sorry, the variety of older adults is anticipated to achieve 80 million by the 12 months 2050. And as you may see on this graph, 20 million of these shall be older immigrants. I.e., that’s about 25% of your entire older grownup inhabitants within the 12 months 2050.
So this actually simply exhibits us how vital it’s for growing old providers and growing old advocates to be fascinated by older immigrants, to be up-to-date on immigration points, and vice versa, for immigration advocates to be fascinated by older adults of their work as nicely.
I additionally need to take a second to speak concerning the range of older immigrants in our nation. The inhabitants of older adults, of immigrants and older immigrants are actually not a monolith. And whereas it’s not on this slide, we will all recognize that there’s nice range when it comes to international locations of origin, of languages and cultures of which older immigrants within the US have. However what I additionally need to discuss is the variety of immigration statuses. So there are a lot of pathways that foreign-born individuals find yourself within the US. These can embrace issues like H-1B work visas, training visas, asylee and refugee standing for those who are dealing with persecution of their dwelling international locations or fleeing a warfare. It may additionally embrace lawful everlasting standing, often known as Inexperienced Card holders. And all of those pathways include their very own burdens, each administrative, authorized, and monetary. And that may in fact contribute to undocumented immigration statuses as nicely. These totally different statuses additionally matter within the context of entry to federal advantages, which we’ll contact on a bit of bit later within the webinar.
After which for older immigrants particularly, we need to be fascinated by when that particular person got here to our nation. So, did they arrive right here in youthful age and age as an immigrant within the US, or did they immigrate in older age? That distinction issues a bit of bit within the context of immigration standing, nevertheless it additionally issues so much within the context of the kind of help the person would possibly want and the best way they work together with the providers which are out there and the assets which are of their group.
It’s additionally vital for us to be fascinated by the significance of older immigrants in all of our communities. So, immigrant communities as a complete contribute to the wealthy range of our nation when it comes to concepts, abilities and tradition. However older immigrants particularly are sometimes those that go down cultural and linguistic data to youthful generations, and that permits for that wealthy range to proceed and to develop and turn into enmeshed in our neighborhoods. Older immigrants are additionally an vital a part of household items and that may be a possibility for household unification.
So for instance, an older immigrant coming to the US to hitch their youngsters and grandchildren who’re already dwelling right here. That is actually useful for the older adults who by being with their family members can fight isolation and have simply higher general well being outcomes. However it additionally advantages households and our society as a complete, as a result of older immigrants are sometimes those that may present each paid and unpaid caregiving help. So for instance, little one care for his or her household unit or offering paid caregiving help to different older adults or disabled people of their communities. And all of this helps the flexibility for individuals to have the ability to age in place and to have a strong community of help as they age.
Sadly although, older immigrants do face vital inequities in growing old within the US. So, a few of these systemic boundaries embrace issues just like the five-year bar, which prevents sure teams of immigrants from receiving advantages equivalent to Medicaid or Social Safety earnings, SSI, Supplemental Safety earnings, SSI, till they’ve reached 5 years of residency. There are additionally quite a lot of different boundaries equivalent to lack of or inadequate language entry, discrimination in accessing providers, hostile habits. And these boundaries, these inequities contribute to well being and wealth disparities. So, one instance is that first bullet on the slide, which is that older immigrants expertise poverty at twice the charges of non-immigrants, and that is a fair increased statistic for older girls immigrants and older immigrants of coloration.
So, along with these present boundaries and inequities, we’re at a time the place we’re seeing quite a lot of new hostilities and threats for older immigrants. So, one is the general anti-immigrant rhetoric that’s so prevalent in our nation. We see it by means of statements made by policymakers and our authorities officers, we see it by means of headlines, and even typically by means of members of our personal group. We’ve seen a number of govt orders over the past six months particularly speaking about immigrant communities and threatening the protection and entry to assets for a lot of of these immigrant communities. We’ve in fact all seen the numerous enhance in ICE raids and enforcement all all through the nation however concentrated in areas with vital immigrant populations. After which we’re starting to see legislation and coverage modifications as nicely. So, type of taking this rhetoric and these conversations and making an attempt to solidify them into our legal guidelines. We’ll be relating all of those matters all through the webinar, however in fact there’s a lot to debate. So in case you have questions, I do encourage you to achieve out to us and we’ll even be sharing some assets on the finish that is likely to be of curiosity.
We shall be speaking concerning the particular impacts of some of the rising threats to older immigrants, however there are a number of general themes of impacts that I want to contact on now. The primary one is what we name the chilling impact. And that’s in response to this general anti-immigrant rhetoric that’s on the market, proposed modifications in legislation and coverage, the best way data is offered by means of the federal government companies or within the information. All of this contributes to a hesitancy of older immigrants enrolling in crucial providers that they may really be eligible for however are nervous about, for instance, if their data is shared or if ICE goes to return after them. So we name {that a} chilling impact, and that’s type of throughout the board occurs throughout… We’re seeing that occur in these occasions.
One other barrier is growing difficulties navigating authorized processes and understanding particular person rights. That is tied intently to each the erosion of those particular person rights, in addition to decreased emphasis on issues like language entry and concentrating on, which might in any other case assist communities, immigrant communities or non-English talking communities, entry providers.
After which in fact, we’re seeing quite a lot of pushbacks from advocates each by means of the courts but additionally by means of the executive course of, equivalent to submitting feedback to proposed rule-makings.
And I’m going to go it now to Tiffany to speak about Medicaid information sharing.
Tiffany Huyenh-Cho: All proper, thanks, Sahar. Subsequent we’ll talk about the latest sharing of personal Medicaid data that occurred this summer season. So this previous summer season, we realized that the Heart for Medicare and Medicaid Providers, or CMS, shared the private information of Medicaid enrollees with the Division of Homeland Safety. In order a reminder, Medicaid is the medical insurance program for individuals in households with low incomes. There are thousands and thousands of immigrants and older immigrants that depend on Medicaid. Medicaid is run by each states and the federal authorities, and CMS is the federal company overseeing the Medicaid program. In order background, all states do routinely share Medicaid enrollee information with CMS. This has been ongoing for years and it’s a part of the state’s obligation to manage the Medicaid program and confirm eligibility for federal funding.
What’s new, nonetheless, is that this information was despatched to a separate company. It was despatched to the Division of Homeland Safety, or DHS, and the Division of Homeland Safety additionally consists of Immigration and Customs Enforcement, or ice. So we realized that CMS first despatched this Medicaid information in June 2025, and later in July it was reported that DHS, the Division of Homeland Safety might entry a database day by day to straight view the private data of all individuals enrolled in Medicaid. This entry lasts for 2 months. It began July ninth and it goes till September ninth. And the sharing of this information with the Division of Homeland Safety goes in opposition to long-standing coverage. And in response to its violation, 20 states sued to cease the sharing of this information. And why was this information shared? It was carried out below the pretense of rooting out fraud and guaranteeing that undocumented immigrants should not accessing Medicaid. Nevertheless, undocumented immigrants don’t qualify for federally funded Medicaid and by no means have. This group can entry emergency Medicaid providers, and that has been allowed for years. Subsequent slide.
So the info that the Division of Homeland Safety can see consists of data like names, addresses, citizenship and immigration data, in addition to social safety numbers. And the Division of Homeland Safety is allowed to make use of this data for immigration enforcement. And the sharing of such delicate data like your handle or your social safety quantity with immigration officers violates privateness legal guidelines and instills worry in immigrant communities. Communities that we all know are already dealing with discrimination and anti-immigrant assaults below the present administration. States and group organizations have spent a long time to construct belief with immigrant communities to enroll in Medicaid, and these latest occasions erodes or utterly erases that belief. Subsequent slide, please.
So, who’s impacted? All 79 million individuals enrolled in Medicaid are impacted. That features US residents, Inexperienced Card holders, different lawfully current immigrants, in addition to people who find themselves undocumented and enrolled in emergency Medicaid. So, these are all individuals which are allowed to be on Medicaid both as lawfully current immigrants or individuals which are undocumented after which entry Medicaid for emergency lifesaving providers. Lawfully current immigrants have lengthy certified for full Medicaid advantages, and these embrace individuals like refugees, asylees, or trafficking victims. So, Medicaid has lengthy been a security internet medical insurance program for low-income immigrants.
And with the sharing of this private data, Medicaid use has been weaponized and it’ll create a chilling impact for all immigrants and others who use the Medicaid program. Older immigrants who want healthcare might hesitate to enroll in Medicaid due to the worry of what is going to be carried out with their private data. Folks at present enrolled in Medicaid might select to dis-enroll, figuring out that their private data is being shared. Or older immigrants might restrict the medical providers that they want for worry of their data being shared. So all of this, all it does is result in poor well being incomes and hurt public well being, general. Subsequent slide, please.
And what can individuals do? What we all know is that dis-enrolling or canceling Medicaid protection is not going to erase the info that’s already been shared. The Division of Homeland Safety does have entry to this data and dis-enrolling is not going to delete that information. All it is going to do is lead somebody to lose well being protection, nevertheless it is not going to erase any information that’s already been shared. Advocates also needs to know that candidates don’t have to share extra data than crucial. So sharing the immigration standing of a family member who is just not making use of for Medicaid advantages on behalf of themselves is just not crucial.
And I simply need to acknowledge how horrible the sharing of such non-public, private information is. And the worry and uncertainty that’s being wrought on immigrant communities, individuals are being put in a really troublesome place to resolve whether or not to forgo healthcare once they want it or to proceed on regardless of of it. And to be put on this place as each appalling and punishing.
The excellent news is that the lawsuit that was filed by states did win a preliminary injunction of their favor final week on August 12. And what meaning is that CMS is prohibited from sharing information from the plaintiff states, the states which are concerned within the lawsuit. And the Division of Homeland Safety is prohibited from utilizing the info already acquired from the plaintiff states concerned within the lawsuit. The difficult half is, is that this preliminary injunction, this pause on the usage of the info and the pause on the sharing of Medicaid information solely applies to the states which are a part of the lawsuit. So states that aren’t a part of the lawsuit, this preliminary injunction doesn’t apply. And so the info of Medicaid recipients in these states will proceed to be shared and considered by the Division of Homeland Safety.
So, the 20 states the place the preliminary injunctions do apply are listed on the slide. This short-term reduction is just not a choice on the deserves itself over the legality of the sharing of this non-public information, however it is going to stay in impact till the lawsuit ends, or 14 days after the federal authorities creates a reasoned decision-making course of to clarify their change in coverage about sharing this very non-public Medicaid data with the Division of Homeland Safety. So with that, I’ll flip it again to Sahar.
Sahar Takshi: Thanks, Tiffany. Subsequent, I’m going to speak about protected areas. And this pertains to what I discussed earlier as an rising menace that are elevated immigration enforcement actions, ICE presence, and ICE raids all through the nation.
So first, what are protected areas? Nicely, protected areas are areas which have traditionally been free from immigration enforcement by means of understandings with, by means of steerage from the federal authorities. Traditionally, areas equivalent to healthcare amenities, spiritual areas, social providers companies, and colleges had been areas during which immigration enforcement couldn’t simply readily enter. Nevertheless, as of January of this 12 months, the Division of Homeland Safety has carried out away with this longstanding steerage and has terminated the protected areas insurance policies. And because of this these areas that I discussed, healthcare areas, spiritual areas, social providers areas, and colleges, don’t obtain these particular protections from immigration enforcement presence. Nevertheless, it’s vital to acknowledge that though the protected areas insurance policies is gone, constitutional rights and different authorized protections do nonetheless apply to those areas. So over the following few slides, I shall be speaking a bit of extra concerning the constitutional protections and a few of the different protections and the way you would possibly need to change a few of your insurance policies to make sure that you’re taking full benefit of those protections.
So, we’ll start with an outline of Fourth Modification protections. The Fourth Modification protects in opposition to unreasonable searches and seizures. So, because of this areas which are thought of non-public, an space during which an individual would have an affordable expectation of privateness, can’t simply be readily entered by an immigration enforcement agent. So what meaning is that if ICE brokers intend to look a personal space, a personal space, they need to accomplish that in accordance with the Fourth Modification. Nevertheless, if that area is a public area, then they can enter and search.
So, what makes an area non-public versus public? Nicely, an space is likely to be thought of public whether it is in plain view. So an instance of this is likely to be a space during which like a ready room or a foyer to a hospital during which anyone can enter. It might probably embrace areas equivalent to a congregate meal corridor, an exercise room, an grownup day middle, the primary area at your native rec middle in your neighborhood. Nevertheless, whereas these areas would possibly usually fall below plain view and is likely to be thought of public, they are often thought of non-public in case you basically make them so. For instance, by means of marking them as being non-public, limiting entry and simply including extra boundaries that may point out the area is a personal area.
Equally, data could be thought of public whether it is in plain listening to. Proper? So if it’s one thing that may be seen or heard in a public area. So for instance, in case you’re ready in a foyer and also you hear somebody talking, possibly they’re sharing some details about their medical historical past however they’re doing so within the foyer, that is likely to be thought of plain listening to and that’s due to this fact public. However the identical thought applies that that may very well be made non-public by placing it behind closed doorways and including extra restrictions in how that data is accessed.
So, there are a number of exceptions to this distinction between non-public and public. So, though a personal area usually can’t be accessed by immigration brokers, it may be accessed below three circumstances. That’s one, if the ICE brokers have a sound warrant. This should be a judicial warrant signed by a federal court docket that specifies the realm to be searched. That is totally different than an administrative warrant that comes from an immigration court docket. So if an ICE agent involves, for instance, a grownup day middle and presents a warrant, you need to be sure you’re reviewing it to make sure that it’s coming from the suitable court docket, that it’s signed by a federal choose, and that it features a description of the particular area that’s to be searched.
One other exception is that if the proprietor or a certified consultant of that personal area consents to a search. So, you is likely to be in a, let’s say grownup day middle the place there’s a room that’s marked non-public, but when the proprietor of the middle says, “Really, it’s okay for ICE agent middle right here,” then that may be consent to that search.
After which the third exception is in conditions during which the ICE brokers, immigration enforcement, or different legislation enforcement consider that there’s an emergency. That is decided on a case-by-case foundation by that enforcement official. So in these conditions, what is likely to be finest is for individuals within the space to soundly doc what is occurring. That is likely to be writing it down, in case you really feel snug, that is likely to be recording what’s happening, after which that data can later be used to fight no matter motion was taken.
So, I’m going to share only a few ideas relating to bolstering your Fourth Modification Rights, notably in case you are able the place you’re employed with older immigrants and you’ve got some degree of management over how the area is marked and the insurance policies surrounding that area.
So one tip as I discussed could be clarifying which areas are public versus non-public. So if you want to extend a few of your protections for the older immigrant shoppers that are available in by means of your doorways, you would possibly contemplate labeling an space equivalent to a ready room or a foyer that may sometimes be public, you would possibly need to label it as non-public. You additionally would possibly contemplate extra entrance necessities. So for instance, if an area has sometimes been walk-in, you may institute appointment-only processes or possibly a call-in earlier than you are available in, sort of course of. After which you may take extra steps for areas which are non-public, particularly areas the place data is being held. Proper? When you have information on people, in case you have images of individuals, you need to be sure that these doorways are locked, they’re shut, cupboard doorways are locked, issues of that nature, issues which are finest practices.
I do need to acknowledge that a few of these actions, whereas they do enhance, they may assist enhance these Fourth Modification protections and that feeling of security, they do additionally create extra boundaries for individuals, proper? So in case you’re sometimes a walk-in kind of workplace or a walk-in kind of grownup day middle, this positively does create an extra barrier for these shoppers, and that may be one thing the place it’s a must to suppose creatively about tips on how to handle that.
The second tip are simply basic finest practices that I believe most people do interact in regardless, nevertheless it’s value reminding that these finest practices additionally might help shield older immigrants within the occasion of immigration motion. So, issues like guaranteeing that paperwork which have personally figuring out data should not disregarded in public areas, they’re put away in folders in a cupboard, lock the cupboard. When you have, for instance, a foyer with any individual that has a pc that’s taking down data, guaranteeing that that laptop display screen is just not dealing with the general public, that any individual that’s wanting and gained’t be capable to see the pc display screen. Equally, in case you’re leaving the realm, turning off the monitor, placing the information away, in order that it may possibly’t simply be seen from out in public. After which additionally, in case you’re discussing data, for instance, about an older immigrant consumer the place you’re discussing their identify, their immigration standing, their handle, you need to be sure you’re doing that in a personal space behind closed doorways the place different individuals can’t hear you.
And the third tip could be employees coaching. I believe that is turning into more and more vital for areas the place older immigrants frequent, whether or not that’s grownup day facilities, nursing amenities, PACE facilities, others the place employees ought to pay attention to how they will act within the occasion of immigration enforcement. So, part of that employees coaching would possibly contain designating which employees shall be speaking with legislation enforcement or ICE brokers within the occasion of immigration motion. You additionally need to be sure that these designated employees are educated up on tips on how to evaluation a warrant, tips on how to reply questions, how they will safely doc ICE’s actions. After which for all employees, even when they’re not the designated of us, coaching them on tips on how to maintain shoppers, older immigrants, and the entire employees even, calm and secure within the occasion of enforcement motion. So for instance, it is likely to be somebody’s job because the designated employees to speak with the ICE agent if they arrive knocking in your door, and the opposite employees can quietly have older immigrants go to a different room the place they are often calm and secure in the meanwhile.
So, I’ll discuss by means of a hypothetical situation. So within the situation, after ICE raids within the space, an grownup day middle creates new insurance policies to guard immigrant shoppers. This consists of limiting the foyer to registered shoppers and inserting indicators that say non-public on the doorways to the exercise room and to the clinic. The grownup day middle additionally designates a locked room to carry the entire consumer information, and so they determined that they’re not going to gather immigration statuses until it’s required by legislation. The middle’s managers all obtain coaching on how they’d evaluation warrants and the way they’d reply questions from immigration brokers in the event that they had been to return. So, that’s one situation. That’s one hypothetical of the way you would possibly need to implement a few of these ideas.
Along with Fourth Modification protections, there are different protections which may apply. One in all these is HIPAA, which is the Well being Insurance coverage Privateness Act. That is the federal legislation that units the usual for safeguarding delicate affected person well being data. So affected person data can’t be shared with anybody, until that affected person consents or that there’s a legitimate warrant or a subpoena. So within the occasion of immigration enforcement, for instance at a well being clinic or a well being middle, if these brokers are asking to see a consumer’s or a affected person’s medical file, HIPAA protects them from doing that until these brokers have a warrant or that affected person has mentioned, “It’s okay, share it.”
There are additionally state legal guidelines that may add extra privateness protections. Typically they mirror the federal HIPAA legislation, however there may also be extra ones. So I encourage you to search for your particular state’s privateness legal guidelines and see what different protections would possibly apply.
I additionally do need to emphasize that what we’re sharing as we speak is an outline of the Fourth Modification and of those protections, however it’s actually vital in case you have questions on tips on how to implement new insurance policies to guard older immigrants, particularly in case you’re a corporation that receives federal funding. I do encourage you to talk with a lawyer in your state to speak by means of what you are able to do and what your choices are particular to your states. And with that, I’m going to go it again to Denny to current on different threats to older immigrants. Oh no, I’m sorry, passing it to Tiffany. My dangerous.
Tiffany Huyenh-Cho: No worries. Thanks, Sahar. So subsequent up, we’ll talk about another latest developments that affect older immigrants. Subsequent slide, please.
You could have heard of H.R.1. It’s the federal finances invoice that makes sweeping and drastic modifications to Medicare and Medicaid, the medical insurance packages that thousands and thousands of older immigrants depend on for care. H.R.1 was handed this summer season by the Republican-led Congress and signed into legislation on July 4th. This invoice can also be known as the One Large Stunning Act, however that identify was stripped simply earlier than it handed. So we seek advice from it as H.R.1 for brief. So H.R.1 makes sweeping modifications to Medicaid and Medicare, and over 15 million individuals are estimated to turn into uninsured. For immigrants particularly, H.R.1 straight terminates eligibility for Medicaid, Medicare, and Inexpensive Care Act tax credit for a lot of teams of people who find themselves right here as lawfully current immigrants.
And as a reminder, Medicaid is the medical insurance program for individuals with restricted incomes, and Medicare is the federal medical insurance program for those who are over 65 or individuals youthful than 65 with a incapacity. And Medicaid is especially essential for older adults as a result of it supplies the wraparound providers that Medicare doesn’t cowl, like long-term care, transportation to and from medical appointments, in addition to private care providers that many older adults depend on to stay dwelling at dwelling and as an alternative of establishments. Subsequent slide, please.
So previous to H.R.1, many lawfully current immigrants certified for Medicare or Medicaid, in the event that they in any other case met different program necessities like age or earnings. Lawfully current immigrants is an umbrella time period for all kinds of immigrants who’ve been granted residency and standing to dwell within the US. So some examples are refugees, or individuals who have fled persecution and have been granted asylum in the US, or individuals with short-term protected standing.
So below H.R.1, lawfully current immigrants not qualify for Medicare or Medicaid, until they fall below three particular classes. And people are lawful everlasting residents or Inexperienced Card holders, sure Cuban and Haitians that entered below a household reunification program, and folks residing below the Compacts of Free Affiliation. So these are individuals from choose international locations within the Pacific Ocean like Palau or Micronesia. And outdoors of these three classes, all different lawfully current immigrants will not qualify for Medicare or Medicaid.
And the timelines for these modifications range. For Medicare, these modifications are already in impact and for Medicaid, it is going to begin in October 2026. So, what this implies is that healthcare shall be stripped from many older grownup immigrants within the subsequent few years. Individuals who have lived and labored within the US for many years. And for older immigrants on Medicare or quickly turning 65, that is notably punishing. Immigrants pay into Medicare by means of federal payroll taxes. And with H.R.1, they’ll lose entry to Medicare regardless of paying into this system for years. Subsequent slide, please.
The stripping of immigrant eligibility for Medicare and Medicaid is dangerous for a lot of causes, for many, just because immigrants are being focused and barred from accessing reasonably priced well being protection. One other provision of H.R.1 additionally individually limits immigrant eligibility for the Inexpensive Care Act tax credit that offset the price of non-public medical insurance that’s purchased by means of {the marketplace} exchanges. So the fruits of all of those modifications signifies that older immigrants, quite a lot of them shall be left uninsured. There shall be few to little choices in case you can’t afford the total value of personal medical insurance, otherwise you don’t have protection by means of an employer. An immigrant is already considerably extra prone to be low earnings in comparison with US residents, and even when employed usually tend to work in low wage jobs that don’t present well being protection. So H.R.1 dismantles entry to reasonably priced healthcare and undermines the immigrant communities that dwell and work in the US.
And whereas in a roundabout way focused, older grownup US residents who use private caregivers are additionally impacted. Caregivers within the US are sometimes immigrants and make up 32% of the house care workforce. So, immigrant caregivers both paid or unpaid, who lose well being protection by means of Medicaid may have to search out different employment that may supply them medical insurance. And this can depart many older adults in jeopardy if the direct care workforce shrinks.
And to be taught extra concerning the particular provisions of H.R.1, in addition to timelines and ideas for advocates, please go to our web site. We not too long ago had a webinar overlaying these modifications. And later when the PowerPoint is shared, you’ll see a hyperlink to the assets slide and our webinar supplies. And with that, I’ll flip it to Denny.
Denny Chan: Thanks, Tiffany and Sahar, I’m going to shut this out with a few different points that we’re watching and wished to flag for you all. Though earlier than I dig into that, I simply wished to flag on the protected areas coverage. One factor simply to ensure everybody’s clear on, we all know that there’s a rise in ICE enforcement actions throughout the nation. We have now not but heard of enforcement in these forms of amenities in locations the place older adults both obtain or reside, obtain providers or reside. Nevertheless, we wished to spend a while speaking about it as we speak partially as a result of we’ve gotten quite a lot of inquiries and we don’t fairly know what future immigration enforcement will appear like. So we thought it was actually vital to flag for you all and for individuals to grasp what rights, what constitutional legislation applies in that particular context. However we’ve not but fairly seen huge scale enforcement in these settings. So, it’s an FYI.
By way of different points that we’re watching and simply to again up a bit of bit, we needed to actually choose and select how a lot we had been going to suit into the 60 minutes. However one factor that we wished to flag for you all outdoors of a few of these different points, is that final month the Division of Well being and Human Providers issued a change, a discover of reinterpretation relating to the Private Duty and Work Alternative Reconciliation Act of 1996. This was adopted or got here at a time final month the place different companies additionally issued comparable notices and a few you might need heard known as this the Head Begin memo. However what this memo set forth was actually a change in how HHS was deciphering the Private Duty and Work Alternative Reconciliation Act from 1996. It was a shift in a long time of coverage. And what it did was it added 13 providers the place the federal authorities would contemplate somebody’s immigration standing with a view to obtain these providers. A kind of being Head Begin.
Head Begin was the one that basically bought quite a lot of consideration within the press, however there have been numerous different providers that additionally had been to be included below the HHS discover, together with different providers the place older adults obtain. So for instance, group well being facilities, group providers block grants, and so forth.
As with many issues below this administration, states sued state attorneys basic sued. And no less than within the 20 states plus DC who’re plaintiffs within the present lawsuit, there’s a keep from enforcement of this memo till subsequent month, after which litigation will proceed no less than on the deserves. Necessary to notice that this memo was efficient instantly and is at present in impact in these states that aren’t plaintiffs to the lawsuit. However HHS did supply a 30-day remark window, and you may go to Justice in Growing old’s web site to search out our feedback on how this reinterpretation impacts older individuals, together with older immigrants but additionally older adults who should not immigrants.
There are additionally simply to flag for you all, some govt actions pertaining to language entry. So this actually issues to these immigrants who’re restricted English proficient or might not communicate English as their first language. There was an govt order issued earlier this 12 months declaring English because the official language. That very same EO additionally undid a long time value of coverage laid forth by the Clinton Administration round significant entry for people with restricted English proficiency. Simply final month, we noticed a brand new steerage from the DOJ Legal professional Common Bondi that additional clarified what this could appear like for federal companies and departments. And simply yesterday, we noticed Housing and City Improvement point out that they had been going to take down supplies provided in different languages, in addition to restrict entry to interpretation providers. Necessary to know that Title VI nonetheless applies, that Lau v. Nichols and a few of the case legislation about this nonetheless applies. However proper now, are seeing that try and restrict entry for people with restricted English proficiency.
After which what I flagged earlier initially was that simply yesterday, Well being and Human Providers indicated that they’d start sharing with states, people who they consider have unsatisfactory immigration statuses for Medicaid functions. We’re nonetheless studying extra about what that may entail, however they’ve indicated that they’re going to do month-to-month sharing. That is my level earlier that these things is altering actually shortly, and in order we be taught extra, we’ll ensure that to maintain our community updated on that as nicely. Okay, subsequent slide.
We wished to get to some assets. A pair from Justice in Growing old, together with one which connects immigration and older adults. One other about immigration enforcement in settings, actually speaking by means of the protected areas coverage that Sahar walked by means of. A hyperlink to the webinar that Tiffany talked about about H.R.1. And another assets from companions, all associated to a few of the issues that we’ve mentioned as we speak.
Okay, so I do know I promised that we might have a while for questions. You also needs to be at liberty to achieve out to us on-line and by way of e mail. Our e mail addresses are right here on this slide. However I’m going to first begin, I’m going to ask each Sahar and Tiffany to return again on digicam. And I do know that no less than there’s the problems round Medicaid information sharing, Tiffany, there have been some questions across the timeline, in addition to the type of timeline particular for the injunction that was issued. So, in case you can stroll us by means of that half once more simply to be sure that of us are clear concerning the timeline and the timing of it, that may nice.
Tiffany Huyenh-Cho: Yeah. So, the database that was created that permits DHS, Division of Homeland Safety to view the info of Medicaid enrollees, they got entry to this database for 2 months, from July ninth to September ninth. What occurs after that? We don’t know, however that’s the timeline for this entry. After which there’s the preliminary injunction that stops each CMS from sharing information and DHS from viewing information on this database, that’s in place for these 20 states which are a part of the lawsuit solely. And that preliminary injunction will final till both the lawsuit ends or 14 days after the federal authorities has provide you with a reasoned decision-making course of to clarify this alteration of their coverage about sharing this sort of private information. So, there’s two totally different timelines occurring.
Denny Chan: Nice, thanks for that. I’m going to Sahar, we bought numerous questions on protected areas and I puzzled in case you might discuss a bit of bit extra concerning the totally different concerns, what’s non-public, what’s public, notably in nursing properties?
Sahar Takshi: Sure, in fact. And I hope that you just all can hear me. I believe having a pair web points. However as I mentioned, private and non-private do have implications when it comes to whether or not immigration enforcement and legislation enforcement is ready to are available in and search. And the distinction between the 2 largely comes down to only the information of the scenario, and whether or not there’s sufficient proof that the area that we’re speaking about could be thought of non-public by all affordable requirements. Proper?
So within the context of a nursing facility, in case you contemplate the structure, proper? You might need the parking zone that’s outdoors. Typically, that may be thought of a public area. One thing just like the foyer or the ready space would usually be thought of a public area. Nevertheless, like I discussed, the nursing facility might take steps to point that these areas are non-public. So for the foyer particularly, relatively than having it’s open door coverage, you would possibly institute one thing like call-ahead necessities or register on-line necessities earlier than you’re capable of enter. You would possibly put indicators on the door. You would possibly even have the door’s locked and any individual has to return open it for you in case you’re coming into that area.
Considering additional right into a context like a nursing facility, you might need issues like exercise rooms, areas the place usually it’s principally the shoppers however possibly different individuals can are available in once in a while. You may also need to contemplate clearly marking these areas as once more being non-public or for nursing facility residents solely. No matter verbiage you need to use to make sure that these areas proceed to be one thing that you just wouldn’t usually contemplate to be public.
After which additional into that, you would possibly contemplate the person individual’s rooms if there’s a clinic on website. These usually could be thought of non-public, however once more, it doesn’t damage to emphasise that. Once more, with these signage, with these efforts like closing the door, extra necessities earlier than you’re even capable of get to that a part of the power. All of those steps work in direction of bolstering these protections. And within the occasion that there’s an immigration enforcement, as Denny mentioned, we’ve not heard of that taking place, however in fact we all know that immigration enforcement is occurring in our communities and it creates quite a lot of uncertainty. So, it doesn’t damage to consider what insurance policies you would possibly need to pursue in areas the place older immigrants are current. Simply in order that they will really feel secure and which you can additionally really feel such as you’re doing the very best which you can.
Denny Chan: All proper, thanks, Sahar. I do know we’ve a bunch of different questions within the Q&A, and we’ll observe up with of us offline to the extent that we will and have solutions. I need to thank Sahar and Tiffany for co-presenting with me as we speak. Thanks all for coming, and we’ll maintain you all posted as developments proceed. Thanks.
