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Authors note: The disability community is rapidly evolving to use identity-first language in place of person-first language. This is because it views disability as being a core component of identity, much like race and gender. Some members of the community, such as people with intellectual and developmental disabilities, prefer person-first language. In this report, the terms are used interchangeably.

Introduction and summary

Disabled people face unique challenges when seeking asylum in the United States, and their needs are often overlooked. From a disabled Honduran man1 facing physical accessibility barriers on his way to the United States, to an undocumented child2 with cerebral palsy detained by U.S. Customs and Border Protection (CBP) after surgery, the denial of disabled peoples rights both before and during the asylum process requires increased attention and action. Asylum-seekers also face major legal challenges when making claims for protection based on their disabilities.3

Thirty-two years ago, the Americans with Disabilities Act of 1990 (ADA) was signed into law. It was subsequently amended in 2008 to state that disabled peoplewhether their disability is congenital (being born with a disability), acquired (getting a disability later in life), or perceivedshould be provided the same rights and opportunities as nondisabled people. Yet there has been little attention paid to how the ADA and other disability civil rights protections can be combined with other areas of law to protect multimarginalized populations such as disabled asylum-seekers.4

The ADA makes it clear that disabled people are a protected class of individuals who face various forms of discrimination, including outright exclusion and that the United States goals are to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for such individuals.5 The ADA builds off of an earlier disability nondiscrimination law, Section 504 of the Rehabilitation Act of 1973, which applies to all entities that receive federal funding6 and has been used in class action lawsuits7 filed on behalf of disabled asylum-seekers. While the ADA does not apply to the substantive matters of asylum proceedingsmeaning that an asylum-seeker cannot invoke it to justify their claim for statusit may provide additional resources for disabled individuals throughout the asylum process.

This report provides an overview of the impacts of the U.S. asylum system on disabled children and adults; explores legal issues at the intersection of immigration and disability; and offers recommendations for applying existing disability civil rights protections, such as the ADA, to assist disabled asylum-seekers through the process of gaining permanent legal status.

The immigration system is rooted in a history of ableism and eugenics

Disabled noncitizens have faced targeted discrimination since this nations founding. Eugenics, racism, and ableism have long played a pivotal role in informing immigration policies.8 Eugenics is the theory that humans can be improved through selective breeding and euthanasia.9 It has influenced leaders across the world, including in the United States, and wasand still isthe basis for many racist, ableist, and xenophobic attitudes and policies.10

Poor, disabled immigrants have historically experienced heightened scrutiny in U.S. immigration law and policy. The Immigration Act of 1891,11 which transferred immigration enforcement to the federal government, founded the Office of the Superintendent of Immigration, renamed the Bureau of Immigration in 1895. The office set about creating specific policies that targeted poor, nonwhite, and disabled immigrants, utilizing eugenic beliefs by requiring physical, medical, and mental intelligence inspections12 that penalized disabled bodies. These policies were implemented as individuals entered the United States through Ellis Island and Angel Island. Howard Knox, the assistant surgeon at the U.S. Public Health Service at Ellis Island, described why the service utilized puzzles to measure intelligence in a 1915 article:13 The purpose of our mental measuring scale at Ellis Island is the sorting out of those immigrants who may, because of their mental make-up, become a burden to the State or who may produce offspring that will require care in prisons, asylums, or other institutions.

Although this more explicitly exclusionary legislation from the early 1900s has been amended, discriminatory practices continue to negatively affect disabled immigrants. For example, although the scope and definition of public charge has evolved since the 1970s,14 noncitizens can still be considered public charges.15 This means that the likelihood that an individual will become (or already is) primarily reliant on public cash benefits or will require funding for long-term institutionalization,16 which is disproportionately true for many disabled people, is factored into determinations of inadmissibility and deportability.17

The public charge rule was expanded under the Trump administration and effectively prompted immigration officers to equate health with lack of disability,18 which had a disproportionate impact19 on disabled immigrants of color. This regulation has had the chilling effect of discouraging immigrants and their families from accessing critical services.20 Even before former President Donald Trumps new public charge rule went into effect, 11.4 percent of immigrant families reported avoiding nutrition programs such as the Supplemental Nutritional Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) due to fears around public charge.21

In March 2021, the Biden administration stopped the implementation of the Trump administrations expansion of the public charge regulation.22 However, there is the possibility that it could be invoked again in the future. Even though public charge is very rarely used as a ground for deportation, its usage could increase if it is expanded again.23

An estimated 12 million people24 with disabilities were forcibly displaced25 worldwide in 2020 alone. The actual number is likely even higher, but because data collection instruments tend to ignore disabled status or are not accessible to all disabled people,26 there are no inclusive, reliable data about this particularly vulnerable population.

The right to seek asylum is protected by U.S. law.27 While not every asylum-seekers claim for protection will be successful, the law generally permits individuals who have applied for asylum to remain in the United States until their eligibility for protection is determined.

It is important to emphasize that the difference between an asylum-seeker and a refugee is procedural, since the legal standard for protection is the same in U.S. law. Asylum can be granted to individuals who meet the statutory definition of refugee but who are already in the United States or seeking admission at a border.28

By contrast, people who arrive in the United States with the formal legal classification of refugee have their claims for U.S. immigration status processed while they are still overseas, often in refugee camps. When they arrive, they are resettled through the Office of Refugee Resettlement.

An asylum-seeker29 is someone who presents themselves at or between a U.S. port of entry, such as a land border, or has entered the United States, and is seeking protection from persecution or other serious human rights violations. The U.N. 1951 Refugee Convention30 and its 1967 Protocol (to which the United States is a party) define a refugee as someone who is unable or unwilling to return to their country of origin owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion.31 This definition was adopted into U.S. law32 in 1980 and is the legal standard applicable to refugee and asylum protection claims in this country.

Barriers to accessing asylum

The ability to safely escape violent situations to reach U.S. territory is key to accessing asylum. This presents challenges for adults and children with disabilities who are not physically mobile and may be dependent on caretakers.

Many disabled people cannot access critical assistance available during humanitarian evacuations and are left behind. For example, a recent Disability Rights International report33 examined the conditions of two Ukrainian childrens orphanages after the Russian invasion and found that many disabled children with the greatest support needs were abandoned by major relief agencies. These children were left in increasingly overcrowded, understaffed, and unsafe facilities that led to the deterioration of their physical and mental health,34 while less disabled and nondisabled children from peer institutions were safely evacuated to neighboring countries.

During conflicts, overstretched and under-resourced humanitarian aid groups are often forced to abandon disabled people in chaotic evacuation operations. For example, during the Syrian civil war, nearby fighting trapped 148 mostly disabled and elderly civilians for days in a nursing home with only five caretakers.35 Eleven people died from gunfire or a lack of medication before relief agencies could reach them.36 As the Russian war against Ukraine continues, smaller organizations such as Fight for Right37 are largely alone in their efforts to support disabled people on the ground, including facilitating evacuations38 for people trapped in their homes.

Disabled people who can escape violent situations in their countries of origin and seek asylum face hurdles beyond those facing other refugees in accessing protection.

Moreover, without safe migration pathways, many asylum-seekers endure perilous journeys to reach the United States and face abuse, which can cause them to become disabled. Importantly, disability is a protected status that can be acquired at any time during a persons life.

A report39 by the Mexican Coalition for the Rights of Persons with Disabilities documented how asylum-seekers transiting through Mexico to reach the U.S. border may become disabled during their journey. Asylum-seekers interviewed for the report experienced direct attacks from not only gangs but also federal police officers. One Honduran man was left paralyzed after being shot in the back by a Mexican federal agent. Others became disabled while trying to embark or disembark la Bestiathe Beast, a fast-moving freight train that connects Mexico to the United Statesor due to road accidents exacerbated by overcrowding. Beyond physical disabilities, migration can also exacerbate or cause new mental disabilities such as post-traumatic stress disorder.40

Many asylum-seekers are forced to take perilous journeys in their search for protection, and those risks are often exacerbated for disabled asylum-seekers. For example, asylum-seekers may rely on the aid of predatory smugglers in order to reach the United States. In 2019, Border Patrol officers rescued41 two physically disabled Honduran men who were thrown into the Rio Grande River by their smugglers.

Disability as the basis for asylum

Asylum-seekers flee persecution stemming from war, violence, or conflict. In addition to being able to seek protection on the grounds of race, religion, nationality, and political opinion, disabled asylum-seekers may seek protection based on persecution stemming from their disability. To do this, they must show that they meet the legal standards for having a well-founded fear42 of persecution43 that is connected to their membership of a particular social group.44

The ADA provides the foundation to understanding disability within a nondiscrimination civil rights framework. It defines45 an individual with a disability as a person who has a physical or mental impairment that substantially limits major life activities; has a record of such an impairment; or is regarded as having such an impairment. This means that both people with impairments and people perceived as such are considered disabled and are protected by the ADA, even without a formal diagnosis.

The ADA specifically names people with disabilities as a class of individuals46 who experience discrimination and thus require civil rights protections. At the same time, the Immigration and Nationality Act (INA) notes that members of a particular social group47 can seek asylum in the United States due to persecution in their home countries. Disability itself is not explicitly listed as a protected group in the INAs definition of a refugee; thus, disability would need to fall under membership of a particular social group to provide the basis for an asylum claim.

In the 1985 decision in Matter of Acosta, the Board of Immigration Appeals (BIA), the appellate body of the U.S immigration court system, explained that what ties particular social groups together are common immutable characteristics that are unchangeable and fundamental to an individuals identity or conscience.48 According to the U.S. Citizenship and Immigration Services (USCIS) handbook for refugee and asylum adjudications,49 a valid group must be both socially distinct and particular at the same time.

U.S. courts and immigration judges have begun to consider disability as satisfying the criteria to constitute a particular social group50 that can experience torture or inhuman or degrading treatment. In the matter of Ricardo de Santiago-Carillo,51 a man with schizophrenia claimed he would face disability-based persecution if he was deported back to Mexico and placed in an institution.52 With this case, the BIA established for the first time in 2000 that disabilityspecifically people with serious mental illnesscan constitute membership of a particular social group for the purpose of receiving asylum. However, the BIA has not taken a uniform approach to determining what constitutes a particular social group for disability-based asylum claims. For example, in Raffington v. Immigration and Naturalization Service (INS), the BIA denied a motion to reopen an asylum claim because mentally ill female Jamaican women are too large and diverse a group to qualify.53 Similarly, in Mendoza-Alvarez v. Holder, the BIA rejected the proposed particular social group of all insulin-dependent diabetics who suffer from mental illness because it lacked sufficient particularity.54 However, in Tchoukhrova v. Gonzales, the BIA and a federal appellate court took a broader approach, and ruled that Russian disabled children and their parents constitute a particular social group for the purpose of asylum.55

One unexplored avenue for overcoming this challenge of consistently defining a particular social group potentially rests in the ADAs naming of people with disabilities as a class of individuals who experience specific discrimination, thus requiring civil rights protections.

However, as the case law shows, many disabled asylum-seekers have struggled to prove to immigration courts that they belong to a class of individualsa particular social groupeligible for protection. In these instances, the courts have ruled that the particular social groups claimants identify with are not particular enough and overly broad, even if their membership to that group is precisely the reason for their persecution.

In the absence of a consistent approach to this challenge, a question emerges about why the courts cannot interpret asylum law in the spirit of the broad, protective, and class-based approach of the ADA. If courts took this approach, asylum-seekers would still have to prove their well-founded fear of persecution and its connection to their membership in a particular social group, but they would already be recognized as belonging to a protected group that requires protection as a result of specific discrimination.

Even when disabled asylum-seekers can substantiate that they belong to a particular social group due to their disability, they must also prove that the treatment they face amounts to persecution. Despite persecution being central to the definition of a refugee, there is no single definition of persecution in U.S. asylum law.56 Thus, asylum officers, immigration judges, the BIA, and federal courts draw from past decisions, international human rights law, and the United Nations High Commissioner for Refugees (UNHCR) when evaluating whether someone has experienced persecution.57

Each evaluation of whether an asylum-seeker has a well-founded fear of persecution occurs on a case-by-case basis, and the threshold for a harm amounting to persecution is extremely high.58 Current guidance from USCIS states that to meet the standard for persecution, asylum-seekers must prove that the harm they experienced was inflicted by the government or an entity the government was unable or unwilling to control, as well as that the level and type of harm experienced is sufficiently serious.59

The ADA and U.S. asylum law protect disabled people and asylum-seekers from different levels of harm. Not only do ADA protections safeguard against discrimination, but the courts have ruled that they can also protect people from disability-based harassment.60 Persecution is a much more severe harm than either discrimination or harassment, as articulated by a federal appellate court in Stanojkova v. Holder.61 The court defined discrimination as unequal treatment, and harassment as the targeting of a specific group for adverse treatment. However, for the court, the difference between persecution and these types of harm is that persecution necessarily involves the use of significant physical force or the credible threat of it.62

Importantly, for the purposes of receiving asylum, experiences of discrimination and harassment that by themselves do not amount to persecution may qualify as such when considered cumulatively.63

This strict standard to demonstrate persecution explains how a court could recognize that a disabled asylum-seeker faces harm due to their membership in a particular social group on the basis of disability but still deny them protection. For example, in Ricardo de Santiago-Carillo, despite upholding that Santiago-Carillo belonged to a particular social group of people with serious mental illness, the BIA did not grant him asylum and ordered his removal. The BIA noted that institutionalization itself did not reach the threshold of persecution required by U.S. asylum law.64 However, abusive practices and treatment within these institutions could amount to persecution, especially given the recognition by the U.N. Committee on the Rights of Persons with Disabilities and others that institutionalization often leads to isolation and higher risk of violence, especially for multimarginalized groups such as women with disabilities.65

Some disability-based abuses clearly rise to the level of persecution and torture, justifying asylum claims.66 Such human rights violations67 could range from forced sterilization to involuntary commitment in institutions, where abusive practices and treatment68 such as forced sterilization and psychosurgery can occur without consent. Some have argued that these practices could even be considered crimes against humanity.69

However, meeting the legal standard in asylum law can be very challenging, even when the evidence appears to support granting disability-based protection claims. For disabled asylum-seekers returned to Mexico without family or community support, Disability Rights International70 found an immediate risk of detention in facilities where the death rate is very high. This risk is compounded for disabled children who end up in abusive orphanages. Additionally, according to Human Rights Watch,71 Mexico is still a virtually inaccessible country where there are minimal policies for support and services that allow disabled people to live in their communities. Put simply, disabled people in Mexico face unsafe and dangerous environments in institutions and risk abuse on the basis of their disability, which could factor into their asylum claims.

Even if persecution has been documented and substantiated, disabled asylum-seekers must also establish the direct nexus between their treatment and their membership in a particular group. In 2018, an immigration judge reversed on remand the decision of the BIA in Perez-Rodriguez v. INS to deny the claimant, who had a mental health disability, withholding of removal and asylum.72 The judge found that Perez-Rodriguez would be subject to persecutory harm upon returning to Mexicowhich was corroborated by Eric Rosenthals expert testimony derived from73 Disability Rights Internationals investigations into institutions such as mental health facilities. Still, the BIA overruled74 the immigration judge, arguing that the subpar conditions of the institutions could also be attributed to economic and political factors, instead of persecution alone. In other words, the BIA stated that the persecution Perez-Rodriguez faced was a function of countrywide conditions not specifically targeted at disabled individuals. The Eighth Circuit concurred with the BIAs decision in 2020.75

Disabled asylum-seekers may also seek limited immigration relief through the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT),76 which prevents the United States from deporting people to a country where they are more likely than not to face torture or cruel and degrading treatment. The CAT defines torture as any intentional infliction of severe physical or mental pain or suffering, with the involvement of a public official, for the purposes of obtaining information or a confession, punishment, coercion, or discrimination.77

However, the legal threshold78 for substantiating a CAT claim is higher than that for an asylum claim. A claimant must show that they could face torture, which is a more severe harm79 than persecution. Protection under the CAT only allows for withholding or deferral of removal, neither of which provide a pathway to permanent legal status, and leaves open the possibility that the claimant could be ordered to be removed to a third country. As with asylum claims regarding disability, some courts have granted80 CAT protections to disabled asylum-seekers, and others have not.

Navigating an asylum claim

Asylum-seekers have their eligibility for protection determined after they are already in the country. There are two pathways81 for claiming asylum in the United States: defensive and affirmative. In affirmative cases, the asylum-seeker comes forward to request protection after already being present in the United States. In defensive cases, the government is seeking to deport the individual, and the asylum-seeker is raising asylum as a defense to deportation. Those pursuing defensive asylum have presented themselves to an official at or between a port of entry, or have entered the country without legal documentation, before making their claim.82

In 1996, the Illegal Immigration Reform and Immigrant Responsibility Act established a process of expedited removal83 for noncitizens deemed to lack a legal basis to remain in the United States. Those removed through this process do not have the right to contest the removal determination. By law, expedited removal should not84 be used against asylum-seekers, whose protection claims must first be assessed and adjudicated. Once immigrants reach or cross the border, U.S. Customs and Border Protection can initiate expedited removal proceedings against certain individuals who are removable, mandating their detention. From detention, these people can begin the process of claiming defensive asylum.85 Once they express their experiences or fear of persecution in their home country, an asylum officer is supposed to conduct a credible fear interview.86

If an asylum officer determines that an asylum-seeker meets the threshold for credible fear meaning that there is a significant possibility that they could establish a case for asylumtheir case will be referred to an immigration judge with the U.S. Department of Justices Executive Office for Immigration Review (EOIR), who will determine whether or not to grant asylum or other forms of relief.87 Asylum-seekers who receive a denial can appeal their cases. Those who have exhausted their appeals are ordered to be removed and returned to their country of origin.

The credible fear interview, which lays the bedrock for an asylum claim, presents immense challenges to all asylum-seekerschallenges that are exacerbated by disability. Since these interviews are often conducted while an asylum-seeker is detained, their mental or physical disabilities may be exacerbated by traumatizing detention conditions,88 making it even more difficult to meaningfully participate in their interviews. As Human Rights First recently found,89 asylum-seekers often spend months in detention before receiving a credible fear interview, prolonging this harm.

Most asylum-seekers and immigrants in removal proceedings do not90 have the right to government-appointed counsel. Lack of access to counsel is one of the biggest challenges faced by detained asylum-seekers and immigrants, despite being a strong determinant91 of their case outcomes. Detained asylum-seekers and immigrants with lawyers are more than twice as likely92 to be granted immigration relief than those without counsel. And for immigrants and asylum-seekers able to access counsel independently, those lawyers have a positive obligation under the ADA to provide reasonable accommodations.

In the 2015 landmark case Franco-Gonzalez v. Holder, a federal district court ruled that detained immigrants and asylum-seekers with severe mental disabilities have the right to federally appointed counsel.93 This is the first group of noncitizens to win a right to legal representation. The case also resulted in the development of a national plan94 to identify and protect those with serious mental health conditions in immigrant detention centers in Arizona, California, and Washington. However, while this ruling was an important milestone, the courts, in evaluating the requirements for counsel, should expand the rulings scope to include other vulnerable groups such as children and other immigrants and asylum-seekers with developmental disabilities.

Unaccompanied children with disabilities

Unaccompanied children with disabilities are a particularly vulnerable population. Traveling without a parent or guardian, they move through the asylum system under the care of federal agencies; many are released to families for the duration of their immigration case, but some may spend months or even years in custody. In 2021, U.S. Customs and Border Protection reported 144,83495 encounters with unaccompanied children at the border, but neither CBP nor the agency that takes custody of unaccompanied children, the U.S. Office of Refugee Resettlement (ORR), releases public data on the number of unaccompanied children who disclose they have, are perceived to have, or are determined to have disabilities.

Similar to adults, children are detained upon arrival at the border after encountering CBP. However, under the Flores settlement agreement96a core set of requirements for the detention, release, and treatment of children in immigration custodyand the Trafficking Victims Protection Reauthorization Act (TVPRA),97 children must be transferred from CBP detention to the custody of the ORR within 72 hours.

Once a child is released from CBP custody, the ORR is required to place children in the least restrictive setting in their best interests, which is usually reunification with their parents or other family members. Before that release, the ORR places children in a variety of different settings. Examples98 of levels of ORR placement include:

Although the ORR is legally obligated100 to place children in facilities with the least restrictive setting in the best interests of the child, a Disability Rights California report101 found that children with disabilities are disproportionately placed in ORRs most restrictive placement settings. One operational secure facility, the Shenandoah Valley Juvenile Center, is the subject of ongoing litigation regarding whether unaccompanied children under its care have been provided adequate, trauma-informed mental health care.102 While priority for foster care placements is given to disabled children as a matter of ORR policy, the policy also calls for children who exhibit self-harming behaviorwhich may stem from a history of trauma or psychiatric disabilityto be moved from shelter care facilities to staff secure or secure care facilities.

The Olmstead v. L.C.103 Supreme Court decision, which held that the integration mandate of the ADA upholds the right of disabled individuals to live in less restrictive settings, could be applicable in placement decisions and arguments for release. This principle of integration is reflected in the ORRs internal regulations104 for children to be placed in the least restrictive settings and its priority for children with special needs to be placed in transitional foster care settings.

In 2018, the National Center for Youth Law filed Lucas R. v. Azar,105 alleging that the ORRs placement policies and practices violate Section 504, the Constitution, and the Flores settlement because unaccompanied children who have or are perceived to have disabilities are not being placed in the least restrictive setting and are instead being segregated on the basis of their disability. The lawsuit challenged the ORRs rejections of parent or sponsor placements and alleged that the consequences of these restrictive placements prolong the time children spend in ORR custody and create administrative barriers to their release. As the case undergoes litigation, a recent March 2022 decision required the ORR to provide clear and convincing data to support the placement of a child in a more restrictive setting, in addition to strengthening due process for children who are at risk of being elevated into restrictive placements.106 This means that there are increased opportunities for advocates to challenge restrictive placements.

As children in detention approach their 18th birthday, U.S. Immigration and Customs Enforcement (ICE) determines if the young person, who cannot remain in ORR custody after they turn 18 years old, will be released or placed in adult detention. In the Garcia Ramirez v. ICE107 class action lawsuit, a federal district court determined that ICE failed to consider less restrictive settings for unaccompanied youth aging out of the system. While Garcia-Ramirez was not about disability, the ruling is especially relevant for young people with disabilities aging out of custody who require support services to live in their communities in the least restrictive settings. After the ruling and amended ICE training and directives, the majority of youth108 have been released instead of being forced into adult detention.

After fleeing Honduran gangs at age 17 and entering the United States, Kevin Euceda109 experienced the negative effects of restrictive settings firsthand. Once placed in ORR custody, he was moved to a secure facility based on disclosures he made to a clinician, which he thought were confidential. When he aged out of ORR custody, his therapy notes were shared with ICE,110 whose lawyers cited them to appeal both his grant of asylum and his grant of protection under the CAT, for which he had proved he had a well-founded fear of persecution and was more likely than not to be tortured upon return to Honduras. After spending more than three years in detention fighting for release, he decided to self-deport as COVID-19 ravaged detention centers. A month after he returned to Central America, he was found dead.111

Since Eucedas experience in detention in 2021, the Biden administration revoked the Trump-era information sharing policy112 under which his information was transferred. This policy also allowed ICE to use ORR information to arrest 170 potential sponsors suspected of unlawful presence in the United States,113 deterring others from coming forward as sponsors and leading to prolonged periods of family separation and time in ORR care for unaccompanied children.114 Such detention could cause isolation that can contribute to health deterioration and lack of access to necessary disability services and supports.

A new memorandum of agreement was established in efforts to limit information sharing between the ORR, ICE, and CBP on matters relating to unaccompanied children and their sponsors.115 Additionally, the ORR has instituted a new policy that bans the sharing of non-essential case file information, including medical, mental, and behavioral health information, for the purposes of immigration proceedings or enforcement.116 However, administrations also can create new agreements to resume and potentially expand information sharing policies, which could create further barriers and discrimination against disabled asylum-seekers.

Disability and detention

Asylum-seekers have the right to remain in the United States while their claims are being processed, but they do not117 have the right to be free from immigration detention during that time. This has serious implications for disabled asylum-seekers who may face discriminatory treatment in detention.

To protect their clients from discriminatory treatment, many immigration and disability rights lawyers rely on Section 504118 of the Rehabilitation Act, which covers a majority of immigrant detention centers that are privately owned or operated.119 Section 504 has been used as a basis to support the right to reasonable accommodations in detention, as well as to prevent the placement of disabled people, including children, in solitary confinement120 or higher-security121 detention facilities instead of in integrated settings.

While detainees with disabilities in federally owned, operated, or funded detention centers can make Section 504 claims, Title II of the ADA122 applies to private entities that provide public accommodations, as well as state and local governments themselves (but not the federal government). This includes detention centers that are privately run and carrying out programs, services, or activities on behalf of state or local governments, such as contracts to provide detention services. It remains unclear whether Title III of the ADA covers privately run detention facilities.123 Thus, further probing of the ADAs applicability by immigration and disability rights lawyers and organizations, in addition to federal agencies such as the Department of Justice, could be helpful for detained asylum-seekers, especially if they are detained in private or state-run detention facilities.

Although the U.S. Department of Homeland Security (DHS) is mandated to comply with Section 504 and the ADA (depending on the type of detention facility), by creating disability access plans124 for each of its agencies, the implementation of such plans is still a major concern. There is a lack of well-funded, proactive enforcement mechanisms for both the ADA and Section 504, meaning that disabled asylum-seekers experiencing discrimination and ableism must undertake costly litigation to access accommodations and legal protections.

One investigation125 by Disability Rights California into the Otay Mesa Detention Center found that ICE lacked protocols for disabled asylum-seekers and immigrants to request accommodations. In another instance, an investigation by the American Civil Liberties Union (ACLU) found that ICE outright ignored accommodation requests. According to the investigation, Fabian Vazquez,126 an immigrant with a hearing disability detained at the Aurora Contract Detention Facility, had to wait months before ICE provided him with a set of hearing aids despite requesting them as soon as he entered detention. During this time, he was reportedly not able to communicate with his attorney. In addition, the ACLU found that ICE officers forced Vazquez to take visits in a loud room, effectively preventing him from communicating with his friends and family.

At the Winn Correctional Center in Louisiana, a Human Rights Watch investigation found that Manuel Amaya Portillo,127 a Honduran asylum-seeker, was denied access to a wheelchair for his physical disability and had to rely on other detainees to access the shower, toilet, and sink. According to the report, on the day that inspectors toured the facilities and interviewed detainees, Portillo was segregated in a small room and given sedatives without his consent.

Asylum-seekers with mental disabilities have also suffered discrimination and mistreatment. Human Rights First found128 that mental health care is limited in ICE detention centers. Detained immigrants and asylum-seekers have been denied medication for mental illness, verbally abused for requesting mental health care, and denied care outright.

In 2019, disability and immigrant advocates initiated a class action lawsuit, Fraihat v. U.S. Immigration Customs Enforcement,129 arguing that the conditions of immigrant detention centers and their lack of monitoring and oversight amount to discrimination against detainees, specifically for those with disabilities. The outcome of the case has the potential to mandate better detention conditions and to reshape who may be detained, based on possible accommodations.

In recognition of these failings, in April 2022, ICE released a new directive130 regarding the detention, monitoring, identification, transfer, and release of immigrants and asylum-seekers with serious mental disabilities. While this effort does not provide for the release of all disabled detainees, mechanisms including communication between ICE and legal representatives and the creation of safe release plans represent an important step toward addressing the disproportionate ways that detention negatively affects disabled immigrants and asylum-seekers.

Conclusion

Many disability and immigrant rights organizations are fighting to raise awareness and increase protections for disabled people in immigration detention who wish to seek asylum in the United States. The ADA recognizes disabled people as a protected group and affirms their right to be free from discrimination because of their disabilities. There is a large opportunity for disability and immigration advocates to work together and learn from each other, including by exploring the applicability of the ADA, along with other legal protections, for disabled asylum-seekers. The U.S. Department of Justice, the U.S. Department of Homeland Security, and federal policymakers should also take note of the evidence of discrimination and the unique challenges disabled asylum-seekers face as their protection claims are considered.

Combined with the group-based protections enshrined in asylum and refugee law, the ADA could contribute to the potential for building an immigration system that affords disabled asylum-seekers both dignity and due process as they seek humanitarian protection.

The authors would like to thank Kyle Ross, Suzanne Harms, and Anona Neal for fact-checking, and Professor Arlene Kanter, Anne Kelsey, Debu Gandhi, Elisa Massimino, Nicole Lee Ndumele, Nicole Svajlenka, Rachael Eisenberg, and Mario Bruzzone for their reviews and input.

More here:
Crossing the Border: How Disability Civil Rights Protections Can Include Disabled Asylum-Seekers - Center For American Progress

Democratic incumbent Gov. Gavin Newsom is being challenged on the Nov. 8 ballot by State Sen. Brian Dahle to be Californias governor for the next four years. The San Diego Union-Tribune Editorial Board sent each a 17-question written survey. Here are Newsoms responses.

Q: What would be your main goal as governor for the next four years and how would you demonstrate to Californians that it is being accomplished?

A: I dont think any of us could have predicted four years ago what the future would hold. A global pandemic and economic recovery, successive years of climate change fueled record wildfires, a historic drought and countless other crises. No one can predict what the next four years will bring California. As your governor, I promise you: Whatever challenges come our way, I will always lead the California Way based on compassion, common sense, telling the truth, following science, treasuring our diversity, defending our democracy, protecting our planet and always planting seeds for the future.

Q: A recent Public Policy Institute of California poll showed 68 percent of Californians dont feel that government is doing enough to combat the drought. What will you do as governor to improve the states water supply and reliability?

A: To match the pace of climate change, California must move smarter and faster to update our water systems. During my first months in office, I called for a comprehensive water resilience portfolio. The portfolio prioritized 10 key actions to secure Californias water future. Over the last two years, weve made serious progress, including balancing our groundwater basins, updating infrastructure, restoring river systems including the nations largest dam removal effort on the Klamath River, and improving water management through technological advancements and voluntary agreements.

California is investing over $8 billion in these actions to secure the future of Californias water supply.

The most recent, historic $5.2 billion investment in California water systems has enabled emergency drought response, improved conservation and allowed for local water suppliers to become more resilient to drought. This year, my administration has doubled down on those efforts, with an additional $2.8 billion for drought relief to hard-hit communities, water conservation, protection for fish and wildlife, and long-term infrastructure to permanently strengthen drought resilience.

We have invested billions in securing the future of Californias water supply. Just last week, we announced a new, focused water supply strategy that updates state priorities based on new data and accelerating climate change.

This strategy includes creating storage space for up to 4 million acre-feet of water, recycling and reusing at least 800,000 acre-feet of water per year by 2030. Another strategy includes freeing up 500,000 acre-feet of water for new purposes each year by permanently eliminating water, waste and using water more efficiently, making new water available for use by capturing stormwater and desalinating ocean water and salty water in groundwater basins, diversifying supplies and making the most of high flows during storm events.

Q: As the drought worsens, how would you balance potential water restrictions with the sustainability of Californias agricultural industry for those who depend on it for work and food?

A: Weve seen our farmers and ranchers make significant progress in conserving water and deploying smarter irrigation strategies since the last drought. The Central Valley produces a fourth of the nations food. It is not easy to grow that much food, let alone while trying to reduce water, but our farmers have figured how to do it and improved their yield to water ratio, while theyre at it. Between 1980 and 2015, Californias agricultural sector produced 38 percent more food with 14 percent less water.

Additionally, in May, the California Department of Conservation announced the award of more than $40 million to regional organizations working to reduce groundwater reliance and create local environmental and economic opportunities through land-use changes. The grants explore whether some agricultural lands might be put into alternative uses to reduce water demand and the burden on local aquifers.

To manage through this dry period and ensure our long-term water supply reliability in the face of climate change, we all have to do our part to conserve and invest in creating new water supplies and stretching those that we have.

Thats why my administration launched a new strategy document called Californias Water Supply Strategy, Adapting to a Hotter, Drier Future, which calls for investing in new sources of water supply, accelerating projects and modernizing how the state manages water through new technology.

To help make up for the water supplies California could lose over the next two decades due to hotter, drier weather, the strategy prioritizes actions to capture, recycle, de-salt and conserve more water. These actions include creating storage space for up to 4 million acre-feet of water, which will allow us to capitalize on big storms when they do occur and store water for dry periods; recycling and reusing at least 800,000 acre-feet of water per year by 2030, enabling better and safer use of wastewater currently discharged to the ocean; freeing up 500,000 acre-feet of water through more efficient water use and conservation, helping make up for water lost due to climate change; and making new water available for use by capturing stormwater and desalinating ocean water and salty water in groundwater basins, diversifying supplies and making the most of high flows during storm events.

These actions are identified broadly in our water resilience portfolio the states master plan for water released in 2020 but they will be expedited given the urgency of climate-driven changes.

Over the last three years, California has earmarked more than $8 billion to modernize water infrastructure and management. The historic three-year, $5.2 billion investment in California water systems enacted in 2021-22 has enabled emergency drought response, improved water conservation to stretch water supplies, and enabled scores of local drought resilience projects. The 2022-23 budget includes an additional $2.8 billion for drought relief to hard-hit communities, water conservation, environmental protection for fish and wildlife and long-term drought resilience projects.

Q: Gun Violence Archive data show California had an average of 44 mass shootings per year between 2013 and 2021, nearly one a week. How would you balance gun safety with the constitutional rights of gun owners?

A: California has led the way when it comes to common-sense gun safety. By enacting gun violence prevention laws such as universal background checks, red flag laws and a ban on assault weapons, California has cut its gun death rate in half. In fact, Californias gun death rate is now 58 percent lower than the national average, and ranks the 44th lowest in the nation.

Just this year, I continued that charge by fast-tracking vital gun safety policies, including a bill modeled after a perverse Texas abortion law upheld by the U.S. Supreme Court, making California the first state to allow individuals to sue those making, selling, transporting or distributing illegal weapons for damages.

California will continue to show the nation what smart gun policies do: Save lives.

Q: Californians are increasingly concerned with rising crime after it fell to historic lows in 2020. What would you do to reduce crime and ensure the safety of Californians?

A: Every Californian deserves to feel safe whether thats at home, at the park or at work. While long-term crime trends in California are down in almost every category, states across America have seen a recent uptick in organized retail theft and other violent crimes, particularly those involving a firearm.

I believe we must invest in public safety while also tackling the root causes of crime. This last year, I released my Real Public Safety Plan that focuses on three main areas to keep our streets safe:

1. Bolstering local law enforcement response to stop and apprehend criminals by providing new grants to local law enforcement and prosecutors so they have the resources they need to apprehend and prosecute criminals, and creating a permanent Smash and Grab Enforcement Unit, operated by the California Highway Patrol, to crack down on organized retail and auto theft across the state.

2. Ensuring prosecutors are holding perpetrators accountable.

3. Getting guns and drugs off our streets.

Q: California has nearly 700 prisoners on death row, and the state hasnt executed anyone since 2006. How will your administration approach the death penalty over the next four years?

A: Im a strong opponent of the death penalty. I believe the intentional killing of another human being is wrong full stop.

I know that many Californians believe the death penalty is an appropriate punishment for heinous crimes. Even so, the implementation of the death penalty has been a catastrophe. Its wasted billions of dollars without deterring crime or providing any benefit to public safety. Its discriminatory unevenly and disproportionately applied against people of color, people with mental disabilities and people in poverty and completely irreparable when the system makes a mistake.

I couldnt, in good conscience, allow this system to go on. In my first few months as governor, I signed an executive order placing a moratorium on the death penalty, withdrawing Californias legal injection protocols, and immediately closing the execution chamber at San Quentin State Prison. I stand by this approach.

Q: Six years after the passage of Proposition 64 to legalize recreational marijuana, concerns about the health of the cannabis industry and public health are growing. What would you do differently to oversee the industry in the next four years? What, if anything, should change?

A: The task of creating a well-regulated commercial cannabis market in California the oldest and largest market in the nation has matched the scale of the market. Its an enormous challenge, however; even before Proposition 64 landed on the ballot, the Blue Ribbon Commission smartly warned that legalization would not be an event. It is a process that takes time and a commitment to constantly assess and adjust.

My administration has done this, taking significant and swift steps to modify the framework that was put in place in 2016 with the passage of Proposition 64.

In just two years, we created one department to license and regulate the industry, greatly simplifying and streamlining local government and business engagement with Californias cannabis regulators enhanced resources to strengthen our enforcement efforts and better support local law enforcement, increasing state capacity to support local law enforcement and make a larger dent in the illegal market. A proof point of this is the Department of Cannabis Controls recent announcement that it just exceeded $1 billion in illegal product seizures, meaning less product that could harm consumers and less unfair competition to our legal operators. I also just reformed statewide cannabis taxation, reducing costs to participate in the legal market, and increasing the states ability to hold bad actors accountable.

These efforts represent the tip of the iceberg, and we have a lot of work to do before California can be held up as a model for the nation. While our cannabis regulatory framework seeks to uphold a number of important California values environmental stewardship, reinvestment in overpoliced communities and strong local engagement, to name a few many of the policies incorporated into the Medical and Adult Use Cannabis and Regulation Safety Act leave us wanting when put into practice.

More local participation, safe retail access, lower barriers to licensing compliance and capital resources that meet the needs of the diversity of our market are all necessary to foster a truly safe, sustainable and equitable market. Alongside this, enforcement against egregious illegal actors criminal enterprises that traffic workers, harm our drought-stricken waterways, threaten violence against our communities and threaten the viability of our market must also increase.

Q: California has 2 million undocumented immigrants. What would you say to them and what would you say to others who dont want undocumented people in the state?

A: Californias strength comes from our diversity.

The Trump handbook of a closed-door immigration policy is both ineffective and cruel. It does not stop people from seeking protection or opportunity at the border. Instead, it has caused a massive backlog in our asylum system and forced migrants to take dangerous routes, including relying on human smugglers.

In California, weve advanced a national model that keeps people safe, both border communities and migrants, while spending billions less than states like Texas.

Our nations economic growth has been stifled by Republicans refusal to enact comprehensive immigration reform. Inflation is increasing and supply chains are breaking down in part because we do not have enough workers to fill essential jobs. That is a direct result of our national failure on immigration policy.

California has relied on immigration to regenerate and reinvent our economy and support local communities. Immigrants are the embodiment of Californias entrepreneurial spirit and are the key to our states success.

Twenty-five California companies that are on the Fortune 500 list were founded by immigrants or children of immigrants. Nationwide, a quarter of all new companies are created by immigrants. That number jumps to 42 percent in California.

From Silicon Valley to the Central Valley, California depends on immigrants.

Simply locking our doors and closing our borders hurts our economy, is contrary to our values and jeopardizes future growth. We can and must create an immigration system that respects borders, keeps our economy competitive and reflects our values.

Q: Californias economy relies heavily on income taxes tied to capital gains and can fluctuate wildly. How would you ensure that it is prepared for a potential reversal of fortune with the economy?

A: Its true. Californias revenues can skyrocket one year and plummet the next, and its my responsibility as governor to budget with this in mind.

There are a few things weve done to prepare:

First, weve saved more than $37 billion in budgetary reserves. In tough times, these reserves will help us protect our most important programs and services.

Second, weve put well over $10 billion to reduce pension liabilities. Well be putting in more in the coming years if revenues allow. This isnt flashy, but its critical to the fiscal health of our state in the long term.

Third, weve used the vast majority of our surplus funds for one-time purposes including transformative investments in climate, infrastructure, education and more. This year, 93 percent of our discretionary surplus was allocated for one-time purposes. In other words, we dont assume that we can put these surplus dollars to use year after year, because we cant.

Q: What will you do in Sacramento to combat climate change?

A: From day one, my administration has been laser focused on the issue of climate change enacting nation-leading policies that will not only lead to a brighter future for the state, but the entire world.

California is standing up to Big Oil, eliminating all new gas cars by 2035 and pushing for stronger setback laws to keep our communities safe from the harms of oil drilling.

Just this last year, California invested in a record $54 billion climate commitment and world-leading efforts to cut carbon pollution and move toward an oil-free future. Now, I am pushing to codify our statewide carbon neutrality goal to dramatically reduce climate pollution by 2045; adopt a more aggressive 2030 greenhouse gas emissions reduction target going from 40 percent to 55 percent below the 1990 level; establish a setback distance of 3,200 feet between any new oil well and homes, schools or parks; create new clean electricity targets, and advance natural and engineered technologies to remove carbon pollution by establishing a clear regulatory framework for carbon removal and carbon capture, utilization and sequestration.

So long as I am governor, California will continue to lead the way for America and the rest of the world on the meaningful actions necessary to combat the climate crisis we all face.

Q: What do you see as the biggest hurdles to California overcoming greener transportation models and how would you overcome them?

A: Transportation is our biggest source of carbon emissions, so one of my top priorities is to make greener transportation options available for as many Californians as possible.

Lets start with zero-emission vehicles. It wasnt that long ago when people laughed at the idea of an electric car. Now, thanks in large part to Californias nation-leading vehicle standards and powerhouse economy, zero-emission vehicles are more accessible than ever. Through the state budget, weve put in billions of dollars into across-the-board zero-emission vehicle adoption, including $6.1 billion this year alone.

We are also expanding and improving other transportation options for Californians. Again, were investing billions of dollars into improving our transportation system, including $14.8 billion this year. This includes making sure we finish up the Central Valley segment of the high-speed rail.

Finally, were making it easier for Californians to live where they work. High housing costs have pushed Californians further and further away from job centers making commute miserable and filling up our air with pollutants. I will discuss our housing initiatives in more detail later on, but Ill note here that were investing nearly $1 billion this year for the kinds of downtown-oriented housing projects that make life easier for Californians and help us meet our climate goals.

Q: What reforms or changes are needed in Californias schools to ensure student success?

A: Californias 2022 education budget is $170 billion larger than the entire budgets of 48 states. Were doing so much to strengthen our public education system that its hard to put into words.

Our first goal is to make sure that education reflects the lived realities of our students. Californians are extraordinarily diverse, and we will see better outcomes when our education systems are built around that.

Thats why weve invested tens of billions of dollars into childcare slots, universal transitional kindergarten for all 4-year-olds, universal meals, expanded before- and after-school programs, and more. This is the kind of comprehensive support that helps students and families not just succeed but thrive. (Contrast this to red states, where theyre banning books and demonizing students, families and teachers for who they are and calling it reform.)

Our second goal is to help our people power our future. We want Californians to be able to choose meaningful careers that allow them to support their families, contribute to their communities, and help our state tackle its greatest challenges.

To do this, were reinvesting billions of dollars back into our higher education system. We even struck agreements with the University of California, California State University and California Community College systems that make these investments contingent on student success and job outcomes.

Im hopeful that more and more Californians will see the tangible results of these investments in the coming years and that, taken altogether, they will truly transform our public education system.

Q: The Employment Development Department has been plagued by scandal because of backlogged unemployment claims and massive fraud. How will you improve this agency?

A: Lets be clear: What happened at the Employment Development Department was inexcusable, and Ive directed my staff to do everything it can to right the ship.

So far, weve made a lot of progress. We established an Employment Development Department strike team, which has helped make its services much more user-friendly. We now have easy-to-access dashboards as well as chat bot and text messaging systems. We didnt have these basic tools in place before the pandemic. We also hired thousands of temporary employees and redirected staff to assist the Unemployment Insurance branch and extend call center hours.

Were also cracking down on fraud. I created a Task Force on Pandemic Unemployment Insurance Fraud, which has led to hundreds of arrests and convictions and thousands of active investigations stopping fraudsters and holding them accountable for ripping off the state. The Employment Development Department has since recovered over $1 billion in Unemployment Insurance funds.

But the root cause is antiquated, legacy government systems that dont serve Californians well in the 21st century. Weve done a lot on this too, from creating an Office of Data and Innovation to investing millions into government innovation and technology modernization. This isnt flashy work, but its the kind of thing that prevents another EDD scandal from happening years or decades into the future.

Q: Reducing homelessness has been a focus for all levels of government, especially state government, in recent years. What would you do differently over the next four years?

A: Our homelessness crisis is a challenge that was long in the making the tragic product of insufficient affordable housing supply and the hollowing-out of our mental and behavioral health system since the 1970s and 1980s.

We are doing everything we can to turn the tide. Since I took office, weve invested over $17 billion to combat homelessness. These dollars dwarf anything the state had done before. We pioneered Homekey which delivers shelter beds faster and cheaper by converting existing buildings and were holding local governments accountable by making them demonstrate that theyre putting our dollars to good use.

Mental and behavioral health are a large part of this crisis. If we cant provide comprehensive treatment, we wont be able to help a lot of people. A big chunk of our $17 billion-plus homelessness investment includes funding to create housing and treatment options for people with behavioral health challenges. Were also leveraging Medi-Cal to provide timely behavioral health care to people experiencing homelessness, in times of crisis.

This is also why my administration worked with the Legislature to develop CARE Court a framework for providing care and services to Californians experiencing mental health and substance use crises. I look forward to working with the Legislature to get CARE Court done this year, and its my hope that this will support the thousands of Californians living on our streets who have been the hardest to reach.

Q: What can and should the state government do to address the high cost of housing?

A: Housing, too, is an issue long in the making. For decades, local governments didnt build anywhere near enough housing. The state wasnt doing much to force their hands, even though state law requires local governments to accommodate housing growth.

Under my administration, were changing this. Within my first month in office, we sued Huntington Beach for its failure to build enough homes putting the four dozen other cities not following state law on notice. We established the Housing Accountability Unit within the Department of Housing and Community Development, which has the tools to enforce state housing law. And we empowered the California Department of Housing and Community to force cities to rewrite bad housing plans and to review practices in cities with too many barriers.

Were backing up these significant policy changes with significant state investments about $13 billion for housing between last year and this years budgets. These dollars will accelerate the development of affordable housing, particularly in downtown-oriented areas with shorter commutes, and support homeownership opportunities.

Ive also worked with the Legislature to sign dozens of bills to address the high cost of housing, including Assembly Bill 1482, which caps rent increases at no more than 10 percent in a 12-month period.

Q: Californias population has declined for the past two years. What does that fact say about the state? Would you try to reverse this trend, and how?

A: The last two years have been challenging, to say the least, so I dont want to make any conclusions about trends. But I do know that Californians are increasingly concerned that the high cost of living is putting the California dream out of reach.

I want to reassure Californians that we hear you and we are going to do everything we can. Ive outlined many of our key priorities, from climate change to education to housing and homelessness. Theres even more I could talk about from the affordable insulin were going to manufacture to the billions of dollars in tax rebates were putting back in Californians pockets.

California punches above its weight because leaders before us were ambitious enough, and audacious enough, to build this state up from the ground. Now, our task is to stay on top amid new and unprecedented challenges. That is not easy. But we have made incredible progress during my first term, and Im excited to do even more in my second term.

Q: Why should voters elect you over your opponent?

A: In recent years, Californians have faced some of our toughest challenges. And I have been inspired by the courage and resilience of our residents, from firefighters to health workers to teachers, parents and kids. Through it all, California is still standing tall and stronger than ever. We have all been humbled by the past few years. All of us had our resolve tested, and we have overcome unthinkable trials. I would be honored to continue charting Californias path forward for the next four years and tackle whatever challenges lay ahead.

See the article here:
Nov. 2022 Election: Q&A with Gov. Gavin Newsom, candidate for California governor - The San Diego Union-Tribune

Current immigration policies are straining hospices ability to grow and retain their workforce amid widespread shortages.

Immigrant workers help to fill some of the biggest areas of need in the hospice and palliative care labor supply. But national policies are contributing to a diminishing pool of these workers, putting pressure on providers capacity to accept patients, according to OpusCare President and CEO Dr. Ismael Roque-Velasco.

Whats happening in our country during the last few years in immigration has really impacted the health care labor force, Roque-Velasco told Hospice News. What weve seen is that immigration policies arent helping, they are jeopardizing health care access without enough workers to provide care.

OpusCare offers hospice and palliative care in Florida, Texas and Georgia. Two of those states Florida and Texas along with California, are home to nearly half (45%) of the countrys overall immigrant population, according to Pew Research Center data.

National immigration policies are limiting the scope of hospice workforce growth in these states, as well as many others nationwide, said Roque-Velasco.

Foreign-born workers represent 38% of hospice and home health aides, a quarter of personal care aides and 28% of all highly-skilled health care professionals such as physicians and nurse practitioners, according to the National Immigration Forum.

Additionally, immigrant workers make up 22% of the nations nursing assistants and 17% of the entire health care and social services industry, reported the Migration Policy Institute.

With fewer immigrants available to take those jobs, hospices may be particularly vulnerable.

Immigration policies disproportionately impact hospice employees in comparison to other health care settings, according to Mollie Gurian, vice president of home based and home- and community-based services policy at LeadingAge.

Theres an extra step and levels to having qualified people, and immigration is a big part of that, Gurian told Hospice News. Weve heard from hospices that utilize immigration-specific programs to help with the soup to nuts process of obtaining worker visas that it can be harder to hire and train somebody whos just arrived in the country to provide the care needed at the end of life.

U.S. immigration laws are a complex web of rules. Generally, the federal government bases these on principles that include admitting workers with skills that are valuable to the U.S. economy and promote diversity, among others, according to the American Immigration Council.

Duration and eligibility requirements for visa classifications vary, but some allow employers to hire foreign-born workers on either a permanent or temporary basis.

The Immigration and Nationality Act (INA) requires annual caps for the number of working visa recipients across various business categories. The law stipulates that the president must consult with Congress each year on setting those thresholds. The annual limit for permanent employment-based immigrants is 140,000, including eligible family members.

Prospective employers can sponsor an individual for a visa, but the U.S. Department of Labor in some cases requires them to first prove a need in the labor market before even filing a petition.

Immigration processes can take considerable time and effort to complete. This, along with varying levels of eligibility requirements, can hinder hospices ability to recruit and retain this workforce, according to Ben Marcantonio, interim president and CEO, and COO of the National Hospice and Palliative Care Organization.

It can take years, even decades, to navigate your way through the system to get to the United States with a work permit, Marcantonio told Hospice News in an email. While there hasnt been significant immigration reform in decades, policies by the Trump administration, set during the COVID-19 pandemic, increased the backlog of individuals waiting to come to the United States for work. Our aging population and workforce has only exacerbated this worker shortage.

The Trump Administration tightened restrictions on immigration and stepped up deportations. Among other policies, the administration placed firmer limits on incoming workers from certain countries such as Mexico and India, among others.

All told, the White House implemented more than 470 administrative changes during Trumps presidency, an unprecedented pace compared to previous executive actions, reported the Migration Policy Institute.

The fluctuations in immigration policies are creating a self-perpetuating cycle of labor and patient access pressures, said Gurian.

Its important to have a domestic and international pipeline of workers, Gurian told Hospice News. We need all the people we can get specifically for aging services in our demographic reality and make it easier to come to the country by providing wrap-around funding and support when they get here.

Congress and the Biden Administration during the past two years have made attempts to expedite processes for bringing in immigrant workers, including some specific to health care.

In early 2021, the U.S. Citizenship Act died in committee. The bill would have raised the green card limit, eliminated per-country caps, and excluded dependents from the annual maximum on employment-related immigration.

Report language associated with the 2023 State Department appropriations bill, recently approved by the U.S. House of Representatives, urged the agency to streamline the visa process overall, as well as take action to improve processing of immigration applications from medical professionals.

Through report language, Congress makes recommendations to federal agencies on how to use their resources. However, agencies are not required to implement those recommendations.

The U.S. Department of Homeland Security 2023 appropriations bill contains similar language pertaining to the U.S. Citizenship and Immigration Services (USCIS) processing of backlogged and delayed applications. It also increased the USCIS budget by $273 million above 2022 levels, but falls below the agencys funding request by $230.0 million.

The current immigration environment is creating dangerous and detrimental situations for those who want to work in U.S health care, according to Roque-Velasco. Organized and controlled immigration is needed to help create pathways of staffing change in serious illness and end-of-life care, he added.

The only thing were doing is making a lot of criminals very rich, said Roque-Velasco. Some of these immigrants pay thousands just to get across the border and are risking their lives in some areas. If we had a way of bringing people into training and education programs with some kind of controlled immigration, to create some incentives for an immigration policy that will give legal pathways to licenses in different areas, then we might find a great solution to the problems were facing now.

In the absence of reform, hospices can take steps in their own training and education programs to include immigrant pathways to clinical, caregiving and other supportive roles, said Roque-Velasco.

For instance, they can offer sponsorship programs for hospice or home health aides to receive nursing or other clinical education in hopes of advancing their careers into those professions, he stated. The education process could begin remotely before they enter the United States, he added.

Advocates in the hospice space have said that training and education pathways need to be built into immigration policy.

If the current immigration system isnt fixed, then the nation could see more eligible patients die waiting for hospice care without enough workers to provide it, according to Marcantonio.

We need to renew a pathway specifically for those with a health background and training to come and work, said Marcantonio. The need for more health workers is more urgent.

See the original post here:
How Immigration Policy Impacts the Hospice Workforce - Hospice News

Immigration or Invasion?

A report published in an article by the Federation for American Immigration Reform had staggering statistics. During the first year of Bidens Administration, the illegal alien population increased by 1 million, adding $9.4 billion in cost to American taxpayers! Currently, a total of 15.5 million illegal aliens reside in the USA, and the costs of providing taxpayer funded services and benefits to these and their US-born children now is at a whopping $143.1 billion per year! Bidens policies such as terminating the construction of the border wall, cancelling of the Mexico Agreement, and the purposeful defiance of Federal Laws has accelerated this illegal invasion.

This is unfair to American Citizens and to those immigrants who came legally. It creates a humanitarian crisis where illegal aliens are being victimized by drug cartels and sex traffickers for profit. Security issues are compromised where vetting for terrorists ties has been practically impossible because of the sheer numbers invading our country!

Bidens favoritism for the illegal immigrants over American citizens have been obvious. For example, DHS made sure that ample baby formula was available to illegal immigrants and their infants, while American Moms faced empty shelves!

President Biden took an oath to protect and defend our Constitution, our Laws, and our citizens. But he has failed miserably on all counts! We are a welcoming Nation. But immigration must be controlled with common sense. Without a strong, secure and cohesive America, we cannot give security or help to anyone else.

Lucia Hunter

Regarding the Win Waste Proposal

Dear Editor,

As a former longtime City Councillor in Revere, I feel compelled to offer my thoughts on the WIN Waste proposal for a Host Community Agreement in Saugus.

First and foremost, it is important to acknowledge that this is a Saugus issue that should be decided by Saugus officials as well as the state when the time comes. In my two decades on the Revere City Council, I cant recall a situation in which an elected official from another community tried to influence a matter that was before us in Revere.

That does not mean Revere should be without a voice in this discussion. But it should be a voice supported by science and facts, not opinion and emotion.

Revere residents should be aware that the trash that is collected curbside in our city is brought to WIN Waste for disposal and, ultimately, is converted into electricity. The landfill at the WIN Waste facility is used only for the ash that is generated as part of the waste-to-energy process.

Unlike some who are vocal opponents of WIN Waste, I have taken the time to tour the plant and landfill on several occasions, in order to get a first-hand look at the operation and ask any questions or state any concerns I may have had. Through those opportunities, as well as research I have done on my own, I came to the conclusion that any fair-minded person would reach: WIN Waste operates in compliance with all permits and poses no risk to public health or the environment.

One of the first questions I asked when I went there concerned the unlined landfill that we have heard so much about. As it turns out, the landfill is surrounded by a barrier wall that provides as much or even more protection than a traditional plastic liner. That is not an opinion, but rather a conclusion reached by MassDEP in endorsing the use of that type of groundwater protection system.

The City of Revere and Town of Saugus have enjoyed a productive working relationship. I think it is fair to say we each want what is best for the other community. Perhaps we would be better served by allowing our counterparts in Saugus to determine what that is.

Anthony T. Zambuto

Read the original:
Letters to the Editor - Revere Journal

(Photo by Erik McGregor/LightRocket/Getty Images.)

The past few years have made clear that most of American politicsnot just progressive politicshas become centered around identity and not governance. A recent New York Times piece by Stephanie Muravchik and Jon A. Shields documenting Rep. Liz Cheneys primary loss drives this point home, noting that Republicans are succumbing to the same impulses they associate with their liberal opponents: a shrill hostility to different viewpoints, an obsession with virtue signaling and a willingness to purge their own ranks. So too with the increasing contempt that Republicans and Democrats feel for one another. As Jonathan Rauch memorably put it in National Affairs: We are not seeing a hardening of coherent ideological difference. We are seeing a hardening of incoherent ideological difference. What if, to some significant extent, the increase in partisanship is not really about anything?

This uniquely abstract form of politics likely cannot go on forever, as the Times authors note, because any party that elevates symbolism over governing risks stirring mass revolt down the road. Results matter even in the age of identity politics. But an awful lot of damage can be done in the interim before reality comes crashing down.

Localizing more issues might help concretize our politicsto make it more about real policies than symbols, resentments, and identities. But even if our nationalized status quo doesnt budge an inch, there are reforms to be had at the federal levelparticularly in Congressthat could help make politics more about something again.

One step that could work is to transform the Senate filibuster. Calls from the left to abolish the filibuster outright have become louder and more frequent, and are the result of frustration among progressives that they cant easily push their agenda through Congress. Ending the filibuster altogether has its problems, but if done properly, reforming the filibuster could make it a tool for fostering a politics that is grounded more in issues and less in identities.

Congressional dysfunction breeds popular dysfunction. Although we dont like to admit it, our leaders (particularly those of our own party) shape our perceptions of politics. When they cant work together and do anything meaningful with those on the other side of the aisle, many of us internalize the message: The other side is hopelessly misguided or hateful, and the only path forward is to win at all costs and go it alone.

But a Senate governed by simple majorities could further heighten the stakes of national elections and enhance partisans threat perceptions and fears of one another. Scrapping the filibuster could further divide us.

Maintaining the status quo has considerable drawbacks: If normal legislation can pass the Senate only with a 60-vote supermajority and neither party is willing to compromise when its in the minority, not much gets done except in the event of a crisis or through reconciliation. Politicians make promises, nothing happens, and the people grow frustrated. Most of us sit on the sidelines, leaving only the most zealous left on the political playing field. Its a nasty, self-perpetuating cycle.

Moreover, the actual concrete stakes of politics become rather low. This incentivizes uscitizens and politicians aliketo act like the most irresponsible versions of ourselves in the political realm. Words no longer have consequences. We double down on our identities, symbolism, and vague and overblown rhetoric, raising the temperature of a politics where partisan fights arent exactly about anything concrete anymore.

So, if were concerned about division, scrapping the filibuster doesnt seem like the best idea, but neither does maintaining the status quo. Maybe there is a way out of this morass.

Perhaps clearing the filibusters de facto 60-vote hurdle to pass legislation should be just one of two ways to pass normal legislation through the Senate rather than the only way.

By revising the rules of the filibuster, a piece of legislation could pass through the Senate in either of two ways:

First, legislation could immediately pass with a 60-vote filibuster-proof supermajorityas is the case today. Plenty of legislation, particularly time-sensitive legislation with a broad basis of bipartisan support like the COVID relief bills of 2020 and 2021, already passes under this framework.

Second, if legislation cant attain the 60 votes required to invoke cloture and end debate, it should be able to go through the Senate with a bare majority (50 votes plus a vice presidential tiebreaker, or 51 votes), with a crucial caveat: It would have to pass again the next Congressbefore being sent to the presidents desk.

Under this proposal, the Senate rules would be changed so that a bill destined to fail the 60-vote cloture threshold could instead be put up for a vote to the entire Senate sitting as a committee of the whole. Thus, its passage would not trigger the presentment requirement of Article I Section 7 (if the House has already passed the bill). Then, bills that have passed the Senates committee of the whole via simple majority in the prior Congress would be taken up at the beginning of the new Congress, with a filibuster carveout in effect (i.e., these bills passed by the committee of the whole would be able to make it to a floor vote with just a simple majority). If a bill makes its way through the Senate on round two, it would have to pass through the House again since its a new Congress.

What would this look like in action?

Say the Senate was able to muster 55 votes for a comprehensive immigration reform package. Fifty-five doesnt equal 60, but instead of letting the immigration reform legislation die at the hands of the filibuster, this second option would allow the bill to stay alive within the Senate sitting as a committee of the whole. Then, it would sit in the Senatenot yet triggering the presentment requirement of Article I Section 7until the start of the next Congress. Next, for the bill to become law, the Senate would have to repass the legislation with a bare majority during that next Congress following the election cycle. The bill would then have to pass through the House again and be signed by the president.

The key value-add of this reformed filibuster would be its effect on our political discourse: It would help clarify the stakes of campaigns, thereby nudging us (and our elected leaders) to focus a bit more on the actual pending bill and the policy questions it encompasses.

Making available this second, simple majoritarian but slow-moving route to passing legislation could help make our elections revolve around tangible issuesindeed, actual legislation!once again. Senators and their challengers would campaign on whether they support X bill, which had passed through the Senate committee of the whole. That, in turn, could help turn down the temperature as we inch back toward a more concrete and less symbolic politics. We would be debatingand candidates would be forced to run onactual legislation rather than vague, often unattainable promises or fear-driven, overhyped accusations regarding the other side of the aisle. Then, the American people would have the chance to indirectly voice their opinion on the most relevant pieces of legislation, as they could choose to elect a pending bills supporters or its opponents.

Having this second option available for passing legislation in the Senate could also save us from rash legislation that could fundamentally alter American life with a bare majority because, by design, it would build in a cooling off period. The legislation would have time to percolate through the public square before gaining the force of law. Americans could have time to formulate informed opinions regarding itand frankly, so too could our politicians for a change. In fact, it might even bring more Americans into the political process. While appearing on The Remnant podcast with Jonah Goldberg, Sen. Ben Sasse once stressed how so many centrists have washed their hands of politics; they have ceded the political playing field to the politically addicted extremists. They see a politics full of fringe policy proposals and heated, bad-faith arguments, and they conclude that their time is better spent on alternative pursuits. This amended filibuster proposal stands the chance of pulling some of those centrist types back into the political fray, because it will make the stakes of politics clearer. It will make the (as of now) fairly rational calculation to sit on the political sidelines a bit less rational.

In sum, this revised filibuster rule could advance both democracy (the most legitimate, nonpartisan call to arms of the filibusters detractors) and deliberation (the most legitimate, nonpartisan rallying cry of the filibusters defenders). In addition, it might even help foster a less extremist politics.

The net result of this would be a more democratic, yes, but also a more reasonable legal regime. As founders like James Madison well understood, time and reason go hand-in-hand in day-to-day life as well as in politics. Legislation that takes longer to pass is more likely to be the product of reason than passion. At the same time, Madison was a majoritarian through and through; the minority ought not be empowered to indefinitely block the majoritys (constitutional) will.

By championing this additional option as an alternative to the standard filibuster-proof supermajoritarian path of passing legislation through the Senate, our senators can advance democratic values and lay the groundwork for a more reasonable, less vitriolic, less divisive, and more concrete politics.

This might help bring a much-needed dose of reality back to American politicsbefore its too late.

Thomas Koenig is a student at Harvard Law School, and the author of the Toms Takes newsletter. Follow him on Twitter @thomaskoenig98.

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ReformingNot Abolishingthe Filibuster Could Improve Our Politics - The Dispatch