Environment
What dangerous outcome might a child be at risk for if the parents do not have space for or access to a separate crib for the child to sleep in?
SIDS
What might be some barriers to sufficient sleep, which is key for growth and development?
Noise, crowding
How can asylum seekers get health insurance?
Once their asylum application is received, they are eligible to apply for Medicaid under Permanent Residence Under Color of Law (PRUCOL) status. All pregnant people are eligible for Medicaid regardless of immigration status. All New York children can get Child Health Plus, regardless of immigration status or income.
Families with Medicaid may still experience segregated care and increased wait times to access care, as not all providers accept public insurance
Do health care providers have an obligation to disclose patient information to Immigration and Customs Enforcement?
HIPAA prohibits the disclosure of patient information without consent unless the request for information is pursuant to a warrant issued by a judge.
What environmental exposures can be found in poorly maintained shelters that increase the risk of atopic diseases (eczema, allergy, asthma)?
Mold, cockroaches
What important activities do we recommend to parents to help foster development that might be challenging to do with your child in a shelter environment?
Reading books if it's noisy or there is little privacy, pretend play if there is insufficient space or toys
What transportation options are available to asylum seekers if mobility is a concern?
Medicaid transportation program provides free transportation to and from doctor's appointments.
Rides for refugees is a 501c3 non-profit that provides free vehicles to refugees. https://www.ridesforrefugees.org/contact
Can immigration agents enter health care facilities and conducts searches or interviews of the people present?
Under the Supreme Court’s interpretation of the Fourth Amendment, immigration agents may enter a public area of a health care facility without a warrant or the facility’s consent and may question any person present. Health care facilities are protected areas, meaning that enforcement is only allowed under special circumstances (prior permission from DHS, public safety threat, etc.). ICE cannot enter private areas of a health care facility e.g. patient rooms without consent or a warrant.
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What infectious diseases might you be concerned about for a child living in a shelter with other asylum seekers?
Tuberculosis - Recommend Interferon gamma release assay for pregnant women, PPD for children <5 yo
Viral illnesses - Flu, RSV, COVID
Highly contagious - Measles
How can asylum seekers access day care, which can be a safe environment for children to build skills?
This can be very difficult!
In 2023, the city established an initiative Promise NYC, but it only serves 600 children per year and there is a waitlist. https://www.nmic.org/en/promisenyc/
How long can families stay in one shelter before they are required to reapply for housing?
NYC guarantees a right to shelter. Families with children can stay in one shelter for 60 days before they must reapply, 30 days for single adults. This can lead to missed appointments if they are placed in a shelter far away from their health care provider.
What what can we do to help patients who are afraid to come to the doctor's office in person due to fear of deportation?
Telehealth. Consolidate appointments and tests into a single day when possible. Inform patients they have the right to request that their name not be listed on the hospital registry if they are admitted. Avoid commenting on our patients’ immigration status in our notes in case privacy laws change in the future.
https://www.nytimes.com/2025/01/17/opinion/mass-deportations-undocumented-immigrants-health.html