By BETSY TAYLOR and JULIE MINDA
For the time being, young undocumented immigrants protected under the Deferred Action for Childhood Arrivals are able to renew their legal protection under the program, but their future is far from certain.
Cesar Montelongo Hernandez
President Trump set a March 5 deadline to prompt Congress to develop a more permanent solution for this group — a deadline it was not expected to meet as Catholic Health World went to press March 2. However, orders had been issued in two U.S. District Courts to provide a temporary extension to enable DACA beneficiaries to renew their status.
In the five years it has been in effect, DACA has given approximately 800,000 undocumented immigrants, who were brought to the U.S. as children, temporary relief from the threat of deportation and permission to legally work here.
According to the Pew Research Center, more than nine-in-10 of current DACA beneficiaries were born in Latin America. The New York Times cited surveys of DACA beneficiaries to estimate that 140,000 of them work in health care and education.
It's difficult to get a good count on the undocumented population known as the "Dreamers," after the Dream Act. This is legislation first introduced in 2001 that would provide the opportunity to obtain conditional legal permanent residence and an eventual pathway to citizenship for an estimated 1.8 million immigrants brought to the U.S. as children. It has been reintroduced in the current Congress, and CHA continues to support it.
'On the front line'
CHRISTUS Health's Gabriela Saenz and Presence Health's Will Snyder spoke to Catholic Health World in late February about their concern for the many DACA beneficiaries working in their systems and Dreamers living in the communities they serve. Saenz is vice president of advocacy and public policy for Irving, Texas-based CHRISTUS Health. Snyder is vice president for external affairs for Chicago-based Presence Health.
Both systems serve communities with very large Hispanic populations; and the Dreamers and other undocumented immigrants are an essential part of their communities.
"Dreamers are in our workforce — they are on the front line, and as patients they are coming in and seeking care from us," said Saenz. According to the Centers for Disease Control and Prevention, Mexicans are nearly twice as likely to die from diabetes as whites. Saenz said people with protected immigration status do not hesitate to seek preventive care, while those who are undocumented tend to allow dangerous health conditions to fester rather than seek care.
"Being in South Texas, we see people who are undocumented end up in the emergency department for conditions that could have been prevented, but they were avoiding the hospital for fear of deportation. Many only come in when they are on their deathbed. It's a public health concern to ensure people get proper care — if they have the surety they will not be deported, they get the care they need," Saenz said.
Snyder said in many Presence Health facilities most patients are Hispanic. It is important to have immigrants who are protected under DACA and other immigrants who are legally able to work, employed in those facilities — as well as at the system level. Snyder said, "we want patients to feel like they're coming home, and that we are reflective of our patient population."
Unsettling times
Among the many immigrants watching the looming deadline with trepidation was 25-year-old Eymy Rosales Sandoval, a unit tech with CHRISTUS Mother Frances Hospital of Jacksonville, Texas. Protected under DACA, she said in late February, "I am afraid for myself and for all of the Dreamers out there."
Eymy Rosales Sandoval was to start her nursing education this year, but if her DACA protections are dismantled, she'll have significant setbacks in her education and career plans. She is a unit tech at CHRISTUS Mother Frances Hospital of Jacksonville, Texas.
Rosales Sandoval said she's hoping to start school in the fall to fulfill her lifelong dream of being a nurse, but if she loses her protected status, "I will have to start all over. I will be deported to (my native) Mexico and will have to restart my career. It would be a nightmare."
DACA status is renewable every two years. Ultimately, depending on the outcome of legal and congressional actions, protections could expire. Those expirations likely would occur on a staggered basis rather than in a single stroke for all Dreamers with DACA status.
CHA and its member organizations long have advocated for permanent protection for Dreamers, and during the recent Senate debates over legislation establishing a path to citizenship, the association asked Senators to forge bipartisan legislation that would keep Dreamers safely and legally in the U.S.
"It is our moral obligation to address the questions surrounding Dreamers," Saenz said. "Recently the Dreamers have been used as a political bargaining chip, and that is disheartening because that takes away from the importance of this issue."
An issue of life
Saenz and Snyder said their systems will continue to defend Dreamers' pursuit of legal immigration status and employment opportunities in the U.S., and health care access for immigrants irrespective of their immigration status and what transpires at the federal level in the coming weeks. "This is a priority for us, we have an obligation to take care of these vulnerable populations," said Saenz.
"This is an issue of life," said Snyder. "Being pro-life is why we do what we do, and this is just another important chapter. Immigrants are human beings who deserve dignity and respect, and it is the responsibility of our leaders to find equitable solutions so people can flourish.
"People's lives are hanging in the balance," he said.
'A better life'
Rosales Sandoval came to the U.S. with her mother and sisters in 1999, when she was 6 years old to join her father who had been working in the U.S. for several years. "My parents brought us here for a better life," Rosales Sandoval said. In her current job, she takes patients' vital signs, and helps them eat and bathe. It was to be her entry into the acute care field and a nursing career.
In Rogers, Ark., 27-year-old Yuri Osornio has DACA status and works at the Mercy Clinic–Family Medicine and Obstetrics. Born in Mexico, she is the mother of three. She started in health care checking in and assisting patients at the clinic's front desk. She took night classes to become a medical interpreter. Bilingual in English and Spanish, she exchanges information between patients and medical providers at the clinic.
She hopes to continue her schooling to become a licensed practical nurse and work in pediatrics. "My dream inside is to become a nurse," she said, though that dream is on hold, while she waits to see if a legislative path allows her to remain in the U.S.
Osornio's parents moved to California when she was a toddler, and then to Arkansas when she was in elementary school. They'd been living in the north-central Mexican state of Guanajuato, in a rustic home open to the elements. Osornio said her father told her they came to the U.S. because "he wanted a better future for me."
Now, she doesn't know what to tell her sons, who are U.S. citizens. They fear having to move to Mexico if their mother loses her temporary immigration protections. "I've been praying every day. I pray with my kids that hopefully something does pass and we can stay here," Osornio said.
Cesar Montelongo Hernandez, 27, a student in the M.D./Ph.D program at Loyola University Chicago, has DACA status. By virtue of his acceptance into the highly competitive program, Hernandez receives a full tuition scholarship. Only two to three students are accepted into the program annually. He wants a career in personalized, or precision medicine, in part because his father was sometimes bedridden due to improperly managed diabetes.
Hernandez said that before coming to the U.S., his family lived in Ciudad Juárez, a city infamous for violence, in a home without electricity or running water. His parents worked in fields and factories after they moved to New Mexico, and when Hernandez's father's health allowed him to work. (His father's health has since improved.) "I wish I could be the kind of person who could keep my dad, or really anyone, from getting sick and having to go through that," Hernandez said.
Loyola University Chicago Stritch School of Medicine has 32 medical students with DACA status. Administrators say the Dreamers, bicultural and often bilingual, diversify the education of all their medical students. Many of the students with DACA status come from medically underserved communities and say they want to work with underserved populations.
All want to make contributions in health care. Mark Kuczewski, chair of the department of medical education and director of the medical school's Neiswanger Institute for Bioethics, said: "These are hard-working young people who could be your doctor."
To find CHA advocacy on behalf of Dreamers visit: chausa.org/advocacy/issues/immigration/immigration-reform
Copyright © 2018 by the Catholic Health Association
of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3490.