Supporting Immigrant Families

John I. Takayama, MD, MPH

Governor Brown signed SB54 into law on Oct 5, 2017; this largely prohibits local law enforcement from sharing information with federal immigration authorities; and assures schools, hospitals, libraries and courthouses as safe and accessible spaces for everyone in California. The bill goes into effect on Jan 1, 2018.

Two days later, on October 7, 2017, “All Are Welcome: Supporting the Health of Immigrant Families” was held in Oakland to inform health professionals about the negative impact of current federal policies and ways to protect children and families. California has 10 million immigrants (27% of the state population); 25% are undocumented. Viannay [JG1] Sanchez, protected under the Deferred Action for Childhood Arrivals program and a graduate of UC Santa Cruz, opened the discussion by describing the devastation and hopelessness she felt when her parents (her mother was an oncology nurse at Highland Hospital) were deported; and she was left to care for her younger siblings. Through panel lectures and intimate workshops, experts delineated past and current federal policies, their psychological impact on children and families, and practical information for professionals to use.

In one workshop, Know Your Rights, Mark Silverman, senior attorney at the Immigrant Legal Resource Center, reassured but urged participants to be prepared. ICE (US Immigration and Customs Enforcement) policy dictates that immigration enforcement be avoided at sensitive locations such as clinics, hospitals, schools and churches, but the possibility of investigation and enforcement does exist. If ICE were to try to enter a clinic, clinic staff can deny their entry to “private” (patient care) areas without appropriate judicial warrant. Clinicians can also help families prepare by providing legal information such as those available through the National Immigrant Law Center ( Zenaida Aguilera at La Clinica De La Raza described one model “policies and procedures” that her clinic has developed to prepare staff to respond and inform ( Jason Thompson from the UCSF Osher Center for Integrative Medicine reminded participants that inhumane policies, aggressive law enforcement and even well meaning attempts by health professionals may remind children and families of past traumatic events. Jed Rodriguez, from YouthSpeaks, captured the emotional toll and urged resistance in his poetry slam.

As pediatricians, the most important first step is to understand what patients and their families are experiencing. We can employ welcoming signage in our clinics and secure safe spaces; we must prepare our staff to support families and prevent unlawful and disruptive intrusions. Most importantly, this is the time to work with experts, especially in the legal and mental health disciplines, to advocate on behalf of children and families affected by divisive governmental policies.

The full-day conference was sponsored by Kaiser Permanente, The San Francisco Foundation, Alameda County Public Health, the Child Health Equity Institute at UCSF, UCSF Office of Diversity and Outreach and STEP UP at Zuckerberg San Francisco General.

Key Links:

• symposium support materials

• toolkit

• NILC (National Immigrant Law Center) resources for health care providers seeking to create a safe space within their facility for immigrant patients (after registering, it may take a day or so to obtain access to the resources)