HomeMy WebLinkAboutPacket Health Board Oct 1 2019Whatcom County
Council as the Health Board
COUNTY COURTHOUSE
311 Grand Avenue, Ste #105
Bellingham, WA 98225-4038
(360) 778-5010
Meeting Agenda
Tuesday, October 1, 2019
10 AM
Council Chambers
COUNCILMEMBERS
Barbara Brenner
Rud Browne
Barry Buchanan
Tyler Byrd
Todd Donovan
Carol Frazey
Satpal Sidhu
CLERK OF THE COUNCIL
Dana Brown -Davis, C.M.C.
Council as the Health Board Meeting Agenda October 1, 2019
Call To Order
Roll Call
Director/Health Officer Report
Public Health Advisory Board (PHAB) Update
Health Protection for Immigrant Families Presentation
Public Session
Health Board Discussion and Action
Adjournment
Whatcom County Page 2 Printed on 113012024
WHATCOM COUNTY COUNCIL
SPECIAL COUNCIL MEETING
AS THE
HEALTH BOARD
10:00 a.m. Tuesday, October 1, 2019
Council Chambers, 311 Grand Avenue
AGENDA
Meeting Topics
Pages
Time
1.
Director/Health Officer Report
no ppr
10:00-10:20
2.
Public Health Advisory Board (PHAB) Update
no ppr
10:20-10:30
3.
Health Protection for Immigrant Families Presentation
1 - 58
10:30-11:00
4.
Public Session
no ppr
11:00-11:20
5.
Health Board Discussion and Action
no ppr
11:20-noon
Whatcom County
HEALTH
f1L Department
HEALTH BOARD
Discussion Form
October 1, 2019
AGENDA ITEM #3: Health Protection for Immigrant Families Task Force Report
PRESENTER: Sterling Chick and Lindsey Karas, PHAB Members
BOARD ACTION: Q Action Item Discussion FYI - Onl
SIGNIFICANT POINTS OR EXECUTIVE SUMMARY
In December 2018, recognizing the growing health risks to immigrant families, the
Health Board passed Resolution 2018-050 (Attachment 1) to ensure that the health and
social service needs of citizens and immigrants of all statuses are met. The resolution
empowered the Public Health Advisory Board (PHAB) to convene a Task Force in 2019.
A total of 46 people participated in information gathering sessions and Task Force
meetings. Participation included representatives from schools, churches, social and
health services, government agencies, and people who had been directly impacted by
Immigration and Customs Enforcement (ICE) actions.
The results of the Task Force evaluation are included in the attached Health Protection
for Immigrant Families Task Force Evaluation Report (Attachment 2). The report
describes the problem and provides an evaluation of the current system. It also
summarizes key findings and recommends potential action to address the findings.
Based on the Task Force Evaluation Report, the PHAB created a list of policy
recommendations for consideration by the Health Board that are impactful, reasonable
and at the policy level (Attachment 3). The recommendations are intended to reduce
the fear and trauma experienced by immigrant populations and to improve coordination
and community information related to immigration laws, health care and social service
needs.
BOARD ROLE/ACTION REQUESTED
Provide feedback to the PHAB about the recommended policy actions.
Determine which policy actions the Health Board would like to move forward.
ATTACHMENT(S)
Attachment 1: Resolution 2018-050 — Health Protection for Immigrant Families
Attachment 2: Health Protection for Immigrant Families Task Force Evaluation Report
Attachment 3: Recommended Policy Actions — Health Protection for Immigrant Families
Whatcom County
' f HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 1
F-111 I IMIN MLVAI:1.raiI
PROPOSED BY: PUBLIC HEALTH ADVISORY BOARD
SPONSORED BY: HEALTH DEPARTMENT
RESOLUTION NO. 2018-050
HEALTH PROTECTION FOR IMMIGRANT FAMILIES
Whereas: In accordance with RCW 70-05.060 it is the responsibility of the Whatcom County Health
Board to supervise all matters pertaining to the preservation of the life and health of the people within
its jurisdiction and;
Whereas: the Whatcom County Board of Health shall supervise the maintenance of all health and
sanitary measures for the protection of the public health within its jurisdiction and;
Whereas: on October 29, 2013, the Whatcom County Health Board unanimously passed Resolution
2013-038 Call for Compassionate Community Approach to Public Health Related Services and;
Whereas: the Whatcom County Health Board has identified the health of children and families as a
policy focus area for 2018 and;
Whereas: Whatcom County, just like many counties in Washington State, is the home and workplace
of large immigrant communities with citizens and immigrants of all statuses; and
Whereas: Recent Immigration and Customs Enforcement raids and detentions in Whatcom County
have caused immigrant families significant trauma resulting in mental health concerns in adults and
adverse childhood experiences (ACE'S) for young children and;
Whereas: Fear of detention and deportation has caused families to avoid seeking needed medical and
social services and;
Whereas: Changes to federal laws are being proposed that would cut off government health benefits
and housing for immigrants and their families and;
Whereas: Whatcom County may face increased demands for assistance from immigrants and their
families resulting from changes to the "public charge" definition because fewer individuals will be able
to access federal benefits such as Supplemental Nutrition Assistance Program, Section 8 housing
vouchers and healthcare services and;
Whereas: Whatcom County administers federal programs, and changes to federal laws could impose
burdensome new tracking and reporting requirements for local offices that administer these programs
and;
October 1, 2019 Health Board Agenda Packet Page 2
r-11IVMS] MJI :1.1aiI
Whereas: Changes to federal law may discourage immigrants and their families from seeking federal
health benefits, such as Medicaid or the Children's Health Insurance Program (CHIP) resulting in health
impacts to those families, decreased health status of our community and increased costs to county
budgets and;
Whereas: The Health Board has resolved to seek opportunities to increase awareness and promote the
concept of a "compassionate" or "trauma sensitive" approach and to integrate this paradigm into the
broadest possible range of all public health, education, and human services in our county and;
Whereas: The Whatcom County Health Board seeks to stand in support of our immigrant families by
upholding the principles of health equity and ensuring that the health and social service needs of
citizens and immigrants of all statuses are met.
NOW, THEREFORE, BE IT RESOLVED by the Whatcom County Health Board that:
The Health Board will contact our U.S. Senators and Representatives opposing changes to
federal legislation that would reduce health, housing and other social service benefits for
immigrant families and;
The Health Board will further ensure that "compassionate approaches" are built into all public
health related services and contracts including human services programs and;
The Public Health Advisory Board shall convene a task force as provided for in WCC
24.01.051.A.4 to evaluate existing systems and support services for families impacted by the
threat of deportation including access to health care, mental health, housing and other social
services considering cultural, safety and language barriers preventing access.
APPROVED this 4th day of December 1 2018
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WHAT OVI C TY HEALTH BOARD
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Rud Browne, Health Board Chair
October 1, 2019 Health Board Agenda Packet Page 3
/-111IVd101:IJIq►IIN
Health Protection for
Immigrant Families
In Whatcom County
Whatcom County Public Health Advisory Board (PHAB)
Task Force Evaluation Report
Prepared by Crossroads Consulting
CROSSROADS
CONSULTING
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 4
r_1ar_Nl:1•IA011w5l
Table of Contents
ExecutiveSummary................................................................................................................................ 3
Section I: Findings and Recommendations.......................................................................................... 5
Summary of key issues and recommendations for policymakers
Section II: Context and Methodology................................................................................................... 7
Background for this report and reasons for a coordinated response
Introduction....................................................................................................................................................7
Background..................................................................................................................................................... 7
HealthImpacts on Families.............................................................................................................................8
Impacts on the Whole Community.................................................................................................................9
The Response from Whatcom County Leaders.............................................................................................10
Task Force Convened by the Public Health Advisory Board.........................................................................12
Respondingto Rapid Change........................................................................................................................12
Section III: Evaluation of the System................................................................................................. 14
Issues, solutions, and results identified by task force participants
Families.........................................................................................................................................................15
TrustedAllies................................................................................................................................................16
Network of Social/Health Services................................................................................................................17
FinancialSupport/Work................................................................................................................................18
Policies, Training, and Accountability...........................................................................................................18
CommunityAwareness.................................................................................................................................19
SectionIV: Appendices........................................................................................................................ 21
Appendix A: Participants and Process..........................................................................................................21
Appendix B: Tools and Resources.................................................................................................................24
September 2019 - Health Protection of Immigrant Families Task Force Report 2
October 1, 2019 Health Board Agenda Packet Page 5
/G1a/GN7:1AIA011V51
Executive Summary
In accordance with RCW 70.05.060, it is the responsibility of the Whatcom
County Health Board to supervise all matters pertaining to the preservation of
the life and health of the people within its jurisdiction. In Whatcom County,
this includes a large immigrant community.
In the United States, it is estimated that 1 in 4 children are members of
immigrant families. 5.6 million of those are young children under age 6, who
have one or more parents who were born outside of the U.S., and 94% of those
children are U.S. citizens (Center for Law and Social Policy).
In December 2018, recognizing the growing health risks to immigrant families
under the current federal administration, the Health Board approved Resolution
2018-050 to ensure that the health and social service needs of citizens and
immigrants of all statuses are met.
The resolution empowered the Public Health Advisory Board (PHAB) to convene
a task force in 2019. A total of 46 people participated, including representatives
from schools, churches, social and health services, government agencies, and
people who had been directly impacted by Immigration and Customs
Enforcement (ICE) raids. This report reflects the findings of the task force's
evaluation and offers recommendations for action.
Two recent changes in state and federal policies are important to consider. On
May 21, 2019, Governor Jay Inslee signed into law the "Keep Washington
Working" act which prohibits local police, Washington state patrol, sheriffs, jails,
and school resource officers from sharing information with ICE and Customs
Border Patrol (CPB). A summary of this legislation is included in Appendix B.
Another significant policy change occurred on August 14, 2019, when the Trump
administration issued the new "Public Charge" rule. This rule establishes criteria
for denying a green card application (the pathway to legalization) if the
individual is using public benefits such as SNAP and Medicaid. National studies
have already shown that the rule change is causing families to disenroll from
programs or forgo benefits for which they are eligible, even if those services are
not part of the new rule change.
In evaluating the systems and services of Whatcom County, the task force agreed
that there is a critical need for public communications to ensure that immigrant
families, health and safety providers, and the community at large are able to
understand the growing crisis and respond effectively.
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 6
r_1ar_N1:I•IA011V51
Of greatest concern, there is increasing fear and isolation spreading throughout
immigrant communities, affecting both documented and undocumented
families. Children are experiencing high levels of trauma from fear of
abandonment, or actual abandonment. The trauma of immigrant families also
ripples out, causing secondary trauma for teachers, health care providers, social
service workers, and employers.
The Task Force Report is a call to action, founded on a belief that we carry
shared responsibility for community health and safety, with policymakers,
service providers, and community members each playing a role:
Policy Makers
Provide leadership to address
community needs proactively and
transparently. Allocate resources
to support policy direction and
provide the pubic with accurate !
information.
Community Members Service Providers
Contribute to the well-being
of Whatcom County in many
ways and expect that all
members of our community
be protected from
discrimination,
impoverishment, and
violence.
Provide competent, non -
biased, and compassionate
services. Coordinate efforts
and use resources wisely to
protect public safety,
encourage prevention, and
promote health equity.
The task force findings and recommendations indicate that immediate action is
needed to provide relief for immigrant families. With the leadership of Whatcom
County government, our community will work together and be stronger.
Ultimately, we all hope for common-sense immigration reform at the federal
level. In the meantime, local jurisdictions are able to take meaningful action to
address the growing threats to community health and safety.
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 7
/d\IVd[01:IJI:II,II IN
As schools, health and human service providers, churches, local charities, and businesses work to
strengthen the network of information and support, policies and funding are needed to
strengthen the infrastructure and ensure that the efforts on the ground are supported.
The following set of Findings and Recommendations was offered to the Public Health Advisory
Board in September of 2019. The Findings and Recommendations are grouped into three areas.
FINDINGS
Funding/Infrastructure
41 Immigrant families (both documented and
undocumented) are not accessing needed
services and supports due to fear, isolation
and language barriers and because of lack of
transportation for those in rural areas.
41 Detention and deportation have a major
impact on the stability and mental health of
all members of a family and the surrounding
community.
411Resources for mental health services and
housing for immigrant families are
inadequate, both during a crisis and for
extended periods when the family has no
income or support services (Medicaid, SNAP)
that would be available to other low-income
families.
RECOMMENDATIONS
➢ Provide the infrastructure for health
and human services providers to
coordinate their services and create
bridges for immigrant families to access
care before, during, and after a crisis.
➢ Reduce health impacts on children.
Support school districts with funding
and technical support to ensure
services and referrals for immigrant
families are provided year-round.
➢ Prioritize funding for housing and
behavioral health for vulnerable
immigrant families. Ensure that
Whatcom County has a strategy to
address the growing gap in basic health
care needs.
Direction/Communication
Providers lack the accurate information
and tools they need to help immigrant
families access essential information and
services.
➢ Ensure that accurate, up-to-date
information is provided to the
community, through a local, centralized,
authoritative, and trusted source.
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 8
/d\IVd[0I:IJl:II,II IN
411Employers may not know the laws
regarding checking employees'
citizenship status, dealing with ICE
surveillance and raids, and protecting
immigrants' rights and dignity.
�' Immigrant families view local law
enforcement with fear and are unwilling
to call 911. This leads to under -reporting
of crime and emergencies, which risk the
lives of both immigrants and the
community at large.
➢ Help businesses and organizations
establish "safe space policies" so that
staff know what to do in case of ICE
raids.
➢ Ensure that law enforcement and
emergency service providers can
demonstrate transparently and
effectively that they do not collaborate
with ICE and that they can be relied
upon for compassionate care.
Policy Development/ Enforcement
Discrimination, insufficient translation
services, and inadequate training in
trauma -informed care for immigrant
populations still exist, which reduce the
effectiveness and reliability of services.
➢ Ensure that there is adequate training
in anti -discrimination and trauma -
informed care for all county
departments and organizations
receiving county funding that may
interact with immigrant families.
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 9
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Introduction
In December of 2018, the Whatcom County Health Board passed resolution 2018-050 to stand in
support of our community's immigrant families. The resolution empowered the Public Health
Advisory Board to convene a task force to "evaluate existing systems and support services for
families impacted by the threat of deportation considering cultural, safety and language barriers
preventing access."
This report reflects the findings of that
evaluation and offers a set of recommendations
for action.
Background
In Washington State, approximately one in
seven residents is an immigrant, and one in
eight is a native-born US citizen with at least
one immigrant parent (American Immigration
Council, 10/17). As of 2016, approximately
23% of Washington's immigrant population
was undocumented (-240,000 people). During
the same period, approximately 9% of K-12
students in the state were living with at least
one undocumented family member (Pew
Research Center).
A 2015 study (using 2012 data) indicated that
the top occupations for undocumented workers
in Washington state were service jobs (28%),
farming (19%), and construction (11%). This
study also found that 44% of the farmworkers
in Washington state were undocumented (Pew
Research Center). Other studies put this
number considerably higher since
undocumented immigrants try to keep a low
profile. The numbers also have fluctuated
greatly over recent years with changes in
immigration policy, border security, and the H-
2A agricultural -workers visa program to bring
temporary farmworkers into the country.
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 10
rd\I rd101iI Jl:II,II IN
Changes in federal immigration policies have had a significant impact on the health and safety of
immigrant families. In 2017, immigration -related arrests conducted by Immigration and
Customs Enforcement (ICE) increased by 30% compared to 2016 (American Bar Association). In
May of 2017, the Department of Homeland Security (DHS) rescinded the Deferred Action for
Parents of Americans and Lawful Permanent Residents (DAPA) policy, which had extended stays
for undocumented parents of lawful citizens.
With the induction of a "zero -tolerance" federal immigration policy in May 2018, all illegal entry
referrals from the Department of Homeland Security can result in prosecution, including of
immigrants with children born in the United States (DHS, 2018). The zero -tolerance policy has
resulted in over 2,500 children, including infants, being separated from their families (ACLU,
2019). Whatcom County, which has over a hundred thousand acres of agricultural land and a long
tradition of Latinx farmworkers and food workers in the labor force, has seen the effects of these
federal policies.
Health Impacts on Families
For many years, anti -immigration laws and policies have been impacting access to health
services and overall health outcomes of undocumented immigrants in the United States
(Martinez et al., 2015). Studies reveal that immigrant families face significant barriers to
accessing the health system, including discrimination, lack of translation services, and lack of
cultural competency among providers.
Undocumented immigrants often wait until their health issues have reached a critical point prior
to accessing health care because they are afraid of being reported to authorities (Hacker et al.,
2015). Immigrant survivors of domestic violence and sexual assault, even if they are legal
residents, are increasingly unwilling to report crimes, cooperate with law enforcement, or
pursue protection orders and parenting plans. (BWCCADV Annual Data Report, 2019)
The stress on children and the impact on children's health are especially of concern. A recent
study of cohort data involving US -born adolescents, with at least one immigrant parent, showed
that the current US immigration policy is correlated with higher anxiety levels, sleep problems,
and blood pressure changes (Eskenazi et al., 2019). The very real trauma of having a family
member (often the father and breadwinner of the family) detained or deported manifests in
mental and physical health problems and financial strain experienced by the entire family.
Migrant children are less likely to have a primary care physician or clinic, use preventative
services, and use primary care, dental care, and specialist services but have a higher usage of
emergency and hospital services (Markkula et al., 2018). In a recent report from the Center for
Law and Social Policy (CLASP), providers report that immigrant parents are:
• Increasingly reluctant to enroll or maintain enrollment in WIC, SNAP, and Medicaid
• Refusing prenatal care
• Keeping children home from school and childcare.
This fear of utilizing health and social services will likely be exacerbated if the new public charge
rule published on August 14, 2019 should go into effect in October 2019.
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 11
rd\I rd101iI Jl:II,II IN
Impacts on the Whole Community
On August 29, 2018, the ICE targeted Granite Precast in Bellingham, arresting 16 immigrants
while they were on their way to work. This was not the first raid in Whatcom County; previous
ICE raids had occurred in 2007 and 2009, affecting a combined total of approximately 28 families
with about 65 children. The community responded more swiftly and effectively to the 2018
Granite Precast raid, perhaps because of increased public awareness and objection to the federal
changes to immigration policies. After the Granite Precast raid, the Whatcom Community
Foundation was invited to meet with family members to try to help them connect with funding
and resources. The stories shared by these families helped our community understand the
gravity of the situation, and imagine:
o You walk outyour front door afteryour husband has left for work only to find the car
running, door open, and he has vanished.
o Your dad leaves for work the day before you start 1stgrade and he never returns home.
o You have a four -week-old baby, your husband is detained, and you don't know when or if he
will come home.
o Your dad fled violence in your home country and was detained in another state for almost
three months before being released on bond (exhausting the family's savings). He makes it to
Bellingham and hugsyou for the first time in 5years. You are detained the following day.
We are all affected by what happens to our coworkers, employees, schoolmates, neighbors, and
friends. The stresses on immigrant families in Whatcom County are having a ripple effect,
impacting the whole community. For example:
• The sudden disappearance of a community member is traumatic for all who know them,
especially for their close family and friends. Children who experience trauma carry the
adverse consequences with them through life. They frequently experience behavioral and
mental health problems, trouble functioning in school or work, and difficulty in
interpersonal relationships.
• Whatcom County businesses in agriculture, food services, and the construction industry
are major employers of immigrant families. The loss of these employees has direct
economic impacts on the businesses where they work.
• Immigrant families who lose their primary breadwinner are in dire financial straits. They
often need some social supports to meet their basic needs; however, it is becoming
increasingly likely that immigrants who access social and health services may
compromise their applications to stay in the country. The decision to not access essential
health services can have a lasting effect on children, who are usually US citizens.
• Immigrants who are afraid to see a health care provider for physical or mental health
problems often delay care until a situation becomes a health crisis; such crises often
require expensive treatment, which puts a burden on the health care system.
• Children who have a relative or family friend who has been taken away by authorities
become distrustful of law enforcement and emergency responders. It is difficult to explain
to a young child the difference between being in jail for a crime and being in a detention
September 2019 -Health Protection of Immigrant Families Task Force Report
October 1, 2019 Health Board Agenda Packet Page 12
rd\Ird10liIJl:II,II IN
facility. When a child sees a person in a uniform and fears someone will be taken away,
normal family activities like attending the County Fair become traumatic events.
Response from Whatcom County Leaders
The members of the Public Health Advisory Board (PHAB) were asked to consider the increasing
risks to health and safety of Whatcom County immigrant families and the impacts on their
children. PHAB responded by developing and proposing Resolution 2018-050 to the Whatcom
County Health Board, which the Health Board approved in December 2018. The principles
articulated in the Resolution are as follows:
September 2019 -Health Protection of Immigrant Families Task Force Report 10
October 1, 2019 Health Board Agenda Packet Page 13
F-111 I V-1101iIJlq►IIM
RESOLUTION NO. 2019-050
HEALTH PROTECTION FOR IMMIGRANT FAMILIES
Whereas: In accordance with RCW 70.05.060 it is the responsibility of the Whatcom County Health Board to supervise
all matters pertaining to the preservation of the life and health of the people within its jurisdiction and;
Whereas: the Whatcom County Board of Health shall supervise the maintenance of all health and sanitary measures for
the protection of the public health within its jurisdiction and;
Whereas: on October 29, 2013, the Whatcom County Health Board unanimously passed Resolution 2013-038 Call for
Compassionate Community Approach to Public Health Related Services and;
Whereas: the Whatcom County Health Board has identified the health of children and families as a policy focus area for
2018 and;
Whereas: Whatcom County, just like many counties in Washington State, is the home and workplace of
large immigrant communities with citizens and immigrants of all statuses; and
Whereas: Recent Immigration and Customs Enforcement raids and detentions in Whatcom County have
caused immigrant families significant trauma resulting in mental health concerns in adults and adverse
childhood experiences (ACE'S) for young children and;
Whereas: Fear of detention and deportation has caused families to avoid seeking needed medical and
social services and;
Whereas: Changes to federal laws are being proposed that would cut off government health benefits and
housing for immigrants and their families and;
Whereas: Whatcom County may face increased demands for assistance from immigrants and their families
resulting from changes to the " public charge" definition because fewer individuals will be able to access
federal benefits such as Supplemental Nutrition Assistance Program, Section 8 housing vouchers and
healthcare services and;
Whereas: Whatcom County administers federal programs, and changes to federal laws could impose
burdensome new tracking and reporting requirements for local offices that administer these programs and;
Whereas: Changes to federal law may discourage immigrants and their families from seeking federal health
benefits, such as Medicaid or the Children' s Health Insurance Program (CHIP) resulting in health impacts to
those families, decreased health status of our community and increased costs to county budgets and;
Whereas: The Health Board has resolved to seek opportunities to increase awareness and promote the
concept of a" compassionate" or " trauma sensitive" approach and to integrate this paradigm into the
broadest possible range of all public health, education, and human services in our county and;
Whereas: The Whatcom County Health Board seeks to stand in support of our immigrant families by
upholding the principles of health equity and ensuring that the health and social service needs of citizens
and immigrants of all statuses are met.
September 2019 - Health Protection of Immigrant Families Task Force Report 11
October 1, 2019 Health Board Agenda Packet Page 14
rd\Ird10liIJl:II,II IN
Task Force Convened by the Public Health Advisory Board
Whatcom County Health Board Resolution 2019-050 established direction and also empowered
the Public Health Advisory Board to convene a task force to "evaluate existing systems and
support services for families impacted by the threat of deportation, considering cultural, safety
and language barriers preventing access."
With the support of Health Department staff, a subcommittee of the PHAB began the evaluation
process in March 2019 by identifying organizations that were believed to provide services to
immigrant families. Representatives of these organizations were invited to information
gathering sessions. These were hosted at Villa Santa Fe, a Catholic Housing Services apartment
complex for low-income farmworkers in Bellingham. Twenty-seven people attended the first
session in May, and sixteen people attended the second session in June. A translator was
available at both sessions. Participants included representatives from schools, social services,
churches, health services and government agencies as well as people whose families had been
directly impacted by ICE raids. The focus of these sessions was to learn how families are
impacted by the threat of deportation and to identify systems and service gaps.
The task force was formally convened in July, and those who had participated in the information
gathering sessions were invited to attend along with others who had heard about the process
and expressed interest. A total of three task force meetings were held at Villa Santa Fe with
professional facilitation and notetaking. Task force members worked together to clarify the
issues, articulate desired outcomes, and identify potential solutions.
The draft report was reviewed by task force members and other key stakeholders in August and
presented to PHAB in September. A diagram of the process and a list of participating
organizations can be found in Appendix A. Throughout the process, participants shared
information about best practices and training materials, which are referenced in Appendix B.
Responding to Rapid Change
In just the few months that the task force process was underway, several significant policy
changes occurred, and there was a threat of another national ICE surge. As mentioned above, the
new public charge rule published on August 14 is due to be enacted in October unless
successfully challenged in court. As the media spread the news, these quotes from Whatcom
residents reflect the growing confusion and anxiety:
"We try to tell families that they can still get these services [SNAP, Medicaid] but they may be
taking a risk. And we don't know how retroactively the DHS will apply the rule" -Public service
agent
"Igo into families' homes and provide speech therapy for school -aged kids. Some of the funding for
my services is coming from the federal government, and 1 am wondering if that is a problem.
Everyone is confused - but I don't want to stop helping kids that need our help."
-Health care provider
September 2019 -Health Protection of Immigrant Families Task Force Report 12
October 1, 2019 Health Board Agenda Packet Page 15
r-111IrG10I:IJI:I.IIM
"Everyone at work is freaking out because my boss is saying that now we all have to give them our
social security cards and our passports, or they are going to have to paygiantfines."
-Waitress (age 24, Caucasian)
With so much confusion about the laws, and given the rate of change, it is essential that there is
clear, authoritative guidance for employers, service providers, agency staff, and the community
about what the facts are and how to navigate the risks. Guidance such as this publication, offered
by Protecting Immigrant Families could be helpful if there was an effective mechanism for
communication through trusted sources.
F►ARRPROTECTING PUBLIC CHARGE: GETTING THE HELP YOU NEED
IMMIGRANT
MILIFS UPDATED SEPTEMBER 2019
WHAT IS PUBLIC CHARGE?
"Public charge" or the "public charge test" is used by
immigration officials to decide whether a person can
enter the U.S. or get a green card (lawful permanent
resident or "LPR" status). In this test, officials look at
all of a person's circumstances, including income,
employment, health, education or skills, family
situation and whether a sponsor signed a contract
("affidavit of support") promising to support the
person. Officials can also look at whether a person
has used certain benefit programs (in the past, only
cash assistance and long-term care were counted).
CHANGES TO PUBLIC CHARGE
The government is changing how it makes public charge decisions. Immigration officials will
look more closely at factors like health, age, income, skills (including English language skills),
and use of more public programs, including:
• Supplemental Nutrition Assistance Program (SNAP, "EBT" or "Food Stamps")
• Federal Public Housing and Section 8 assistance
• Medicaid (except for emergency services, children under 21 years, pregnant women,
and new mothers)
• Cash assistance programs (like SSI, TANF, General Assistance)
***Services that are not listed above will not be counted in the new public charge test. This
includes WIC, CHIP, school lunches, food banks, shelters, and many more - these programs
are safe to get if you are eligible.
Another significant policy change occurred on May 21, 2019, when Governor Jay Inslee signed
the Engrossed Second Substitute Senate Bill 5497 into Washington state law. Also known as the
"Keep Washington Working Law" or the "Sanctuary State Law," it declares that local police,
Washington state patrol, sheriffs, jails, and school resource officers are prohibited from:
➢ Asking you about or collecting your place of birth, immigration status, or nationality,
unless it is for an ongoing criminal investigation.
➢ Stopping or detaining you to determine immigration status.
➢ Giving ICE/CBP your personal information (for example, a home address).
➢ Holding you on ICE/CBP detainers or ICE administrative warrants.
➢ Allowing ICE/CBP access to interview you in jail. If ICE/CBP is in the jail investigating
a criminal offense, you have the right to remain silent and refuse to speak with ICE.
The jail must get written consent from you before ICE/ CBP can interview you.
➢ Denying you services or benefits if they have an ICE detainer, notification request, or
immigration warrant.
➢ Notifying ICE/CBP when you will be released from custody.
➢ Contracting with ICE and CBP to do immigration enforcement.
Again, there is little awareness and understanding of the new Keep Washington Working Law,
but it provides the opportunity for county and city governments to more clearly direct local law
enforcement in the interest of public health, to build trust in our local public safety systems.
September 2019 -Health Protection of Immigrant Families Task Force Report
13
October 1, 2019 Health Board Agenda Packet Page 16
The purpose of the task force was to evaluate existing systems and support services for families
impacted by the threat of deportation, including access to health care, mental health, housing and
other social services, considering cultural, safety, and language barriers preventing access.
During the preliminary information -gathering sessions, participants were provided with a list of
social and health services available for immigrant families in Whatcom County, and asked to
consider four questions:
• What would support services ideally look like for families?
• What do we have now?
• What do we need?
• Who might be able to help?
From these conversations, a conceptual model emerged of the critical barriers and gaps in
systems and services (diagram below). During the subsequent task force meetings, the analysis
focused on solutions relative to each of these six areas.
In the course of this analysis, there was clear agreement that our community needs both
immediate actions as well as system change. Ultimately, the surge of ICE detentions must stop if
we want immigrant families to be healthy and safe in our community. In the meantime, there are
many things that we can do now to help our community work together and be stronger, with
policymakers, service providers, and the community members each playing a role.
September 2019 -Health Protection of Immigrant Families Task Force Report 14
October 1, 2019 Health Board Agenda Packet Page 17
rd\I rd101iI Jl:II,II IN
The following task force analysis represents the issues, potential solutions, and desired
results relative to six system areas:
• Families
• Trusted Allies
• Network of Social/Health Services
• Financial Support/Work
• Policies, Training, and Accountability
• Community Awareness
Families
Issues Identified
• ICE raids create a culture of fear that impacts both undocumented and documented
adults, their families, and their communities.
• People are regularly under ICE surveillance at their workplaces, which is highly stressful.
• Detention and deportation affect the mental health of all members of a family. Children
experience severe trauma.
• Families are not accessing needed services and supports due to fear, isolation, language
barriers, and lack of transportation for those in rural areas.
Potential Solutions
• Provide training to service providers to ensure families receive trauma -informed care and
also understand how to deal with their own secondary trauma.
• Help families create safety plans to prepare for ICE raids and know what to do if they
occur.
• Help employers understand what the laws are, how to stop surveillance, and how to
respond to raids.
• Expand capacity for schools to serve as a central, safe place for the whole family to access
information, education, and linking to resources.
Desired Results
• Families feel safe and are able to stay together.
• People do not have the continual stress of ICE agents and other authorities surveilling
them at their workplaces.
• Resources are already in place to minimize the stress for families if a crisis occurs. People
understand their legal rights.
• People can safely access social and health services, without re -traumatization, and their
needs will be met.
September 2019 -Health Protection of Immigrant Families Task Force Report 15
October 1, 2019 Health Board Agenda Packet Page 18
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Trusted Allies
When there is a raid, trusted allies are service providers or allies who are first in contact with
the immigrant family and are trying to help. These people play an essential, but sometimes
invisible, role in the system. Trusted allies are often affiliated with "sensitive locations" —
schools, churches, daycares, medical facilities —or other non-profit agencies or businesses
that serve immigrant families. Trusted allies are those who are trying to help people locate
family members, cope with trauma, understand their rights, navigate the legal system, and
access the network of support.
Issues Identified
• There are not enough trained trusted allies.
• Trusted allies are often overwhelmed, frustrated by lack of resources, and experience
burnout.
• Since the established 911 emergency response system is not trusted by immigrant
families, trusted allies are also trying to fill that gap.
• No system exists for helping trusted allies connect with each other, support each other, or
ensure that they have the same reliable information.
Potential Solutions
• Establish a centralized phone number for families in crisis, accessible 24/7, with people
who speak Spanish (possibly reconstitute the old Whatcom County crisis services line
with volunteer support).
• Secure funding from county government that ensures the sustainability of resources for
trusted allies.
• Build support for Raid Relief to Reunite Families, a new organization that has been
formed by Latinx families who have direct experience with ICE raids; they have no paid
staff to sustain the work.
• Establish a system for trusted allies to be trained in how to use the ICE website, connect
to the network of support, and have shared sources of up-to-date information.
Desired Results
• All people are able to use the 911 system without fear.
Our community's emergency response system (police, fire, Red Cross, EMTs, paramedics,
etc.) have adequate training in trauma -informed care and are able to quickly connect with
the system of support for immigrant families.
Organizations and businesses have "safe spaces policies" in place and trained staff, ready
with planned responses to ICE and other authorities.
September 2019 -Health Protection of Immigrant Families Task Force Report 16
October 1, 2019 Health Board Agenda Packet Page 19
r-\IrG1•l:I�a021I IN
Network of Social Health Services
Issues Identified
• Stronger community partnerships in social and health services for immigrant families are
needed.
• Providers need to be able to give families a "warm handoff" to real people within the
system who can ensure good follow-through.
• Services need to be offered in the language families understand; immigrant families speak
a variety of dialects.
• Wide -scale training in trauma -informed care and policies around discrimination within
service agencies are needed.
Potential Solutions
• Build upon the best practices identified by Sea Mar's Migrant & Seasonal Agricultural
Workers Promotores Program including: mobile medical and dental outreach clinics to
serve isolated rural communities, multi-lingual service providers, and educational
programs on critical health topics presented at farms, housing sites, and other gathering
places.
• Secure funding for building the network of support and filling the gap of mental health
M-1lrn�K�l
• Establish year-round mental health support services for children and their families
through the schools.
• Train school staff in how to support children who are experiencing trauma related to
raids.
• Pursue an initiative with organizations like the North Sound Accountable Community of
Health (ACH) to bring together partners to build this system and ensure providers are
trained in trauma -informed care and policies.
• Engage faith -based organizations in the network; they are important allies.
Desired Results
• A strong network of coordinated community partners, including county government, is
established, in which everyone would be in the loop regarding the services each
respective community partner is providing, eliminating unnecessary overlaps.
• Providers are informed of the new state law and related mandates.
• A standardized system for referrals is used for helping immigrant families in crisis: what
to do, where to go, how to get needed resources.
• Trauma -informed care is widely integrated and incorporates best practices for
supporting immigrant families.
• The system has plenty of trusted allies and warm handoffs between community partners.
• Mental health support is available for children and their families through the schools
year-round.
• A solidarity network of immigrant families and allies is empowered and supported.
• Providers have effective strategies for addressing transportation and language barriers.
September 2019 -Health Protection of Immigrant Families Task Force Report 17
October 1, 2019 Health Board Agenda Packet Page 20
rd\I rd101iI Jl:II,II IN
Financial Support/Work
Issues Identified
• Financial hardship is a major issue because the family providers who are detained can't
work for months or years while the legal process unfolds.
• Changes in immigration policy are threatening access to necessary public services for
families with undocumented members in the household (e.g., Medicaid, SNAP).
• Legal fees and bonds are very expensive, and there are long delays to get court hearings
for the asylum process.
• Loss of employment creates poverty and impacts mental health.
• There are not enough attorneys who speak Spanish and the indigenous languages of local
immigrants to help with their cases.
Potential Solutions
• Grow the Whatcom Community Foundation immigrant relief fund to one million dollars to
pay for legal expenses (typically around $25,000), and living expenses while the
breadwinner is unable to work.
• Include advice on safety planning with families about the steps needed to ensure that
when a person is detained, the family can receive their last paycheck (e.g., have a power of
attorney document signed in advance, have both spouses on the same bank account so
either can cash a check).
• Establish free childcare for immigrant parents of young children whose partners have
been detained so that they are able to work and navigate the legal system.
• Explore alternative models for breadwinners to contribute productively and be supported
during the years of waiting for the legalization process.
• Create policies and secure more funding for housing support to ensure that families do not
become homeless while the breadwinner is not able to work.
Desired Results
Families are not evicted from their homes when breadwinners are detained, deported, or
unable to provide income for their family. If they are evicted, temporary supportive
housing is available.
A low -barrier support system would exist in the community for both legal and living costs.
Alternative support systems will exist through community allies, churches, etc., to ensure
families' basic needs are met.
Policies, Training, and Accountability
Issues Identified
• The new Keep Washington Working law passed in May 2019 protects the privacy and civil
rights of Washington residents, and employers, agencies, organizations, and individuals
need to know about the protections it provides.
September 2019 -Health Protection of Immigrant Families Task Force Report 18
October 1, 2019 Health Board Agenda Packet Page 21
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• Agencies, employers, and immigrants may not understand the laws about what kind of
citizenship checks are required when hiring or providing services (e.g., E-Verify, and
paper I-9 forms).
• Policies are needed for ensuring that agencies and organizations provide services to
people regardless of their citizenship status.
• There is a lack of consistent policies, practices, and accountability systems within
agencies and organizations to ensure that services are provided safely and fairly to all.
• Extra training is needed for service providers and employers about best practices for
providing trauma -informed care for immigrant families.
Potential Solutions
• Ensure that the Keep Washington Working law is fully implemented and provide wide -
scale public communication that Whatcom County is in alignment.
• Create systems for accountability and oversight to ensure that law enforcement and
emergency services within Whatcom County are following the law.
• Require training in best practices regarding trauma -informed care for community service
providers.
• Ensure that any service agencies receiving county funding are fully aware of what ICE is
legally allowed to do and establish agency policies and training to ensure that staff do not
provide any assistance or information to ICE above that requirement.
• Create a mandatory requirement that when the County Sherriff is informed of impending
ICE activities, they promptly inform the public.
Desired Results
• County government, businesses, and organizations understand the new state law and
make any changes needed to comply with it as quickly as possible.
• Resources exist to address misinformation among employers about what kind of
citizenship checks are required.
• Businesses, agencies, and organizations have policies and practices in place regarding
protecting and serving all people, and accountability systems for ensuring that these
policies and practices are implemented consistently.
• Employers and service providers have the training they need to provide trauma -informed
care to immigrant families.
Community Awareness
Issues identified
With rapidly changing immigration laws and policies, the threats to immigrants' health
and safety are exacerbated.
There are commonly held misconceptions about immigrants (e.g., their reasons for
immigrating, their roles in the workforce, their paths to citizenship, etc.).
There is a need for broad -scale community education about the issues, the laws, and how
immigrant families need and deserve safety and support.
September 2019 -Health Protection of Immigrant Families Task Force Report 19
October 1, 2019 Health Board Agenda Packet Page 22
rd\I rd101iI Jl:II,II IN
Potential Solutions
• Help our community understand the laws already in place that serve as protections for
immigrants.
• Create and distribute easily accessible and up-to-date resources for immigrant families.
• Conduct a public awareness campaign to shift the perceptions of those who may not
realize that there is a problem. Focus the message on how everyone needs and deserves
health and safety.
• Build the network of community allies who are willing to engage in one-on-one
conversations about how the attack on immigrant families is harming our whole
community.
Desired Results
• People understand the laws related to protecting and serving immigrants.
• Service providers, employers, concerned citizens, and immigrants have knowledge and
resources about how to access needed services.
• Organizations and individuals can effectively advocate for a system of care for our
community so that everyone has the services and supports that they need.
This System Evaluation, which was conducted as part of this process, additionally serves as a
road map for service providers and community members to take action. Through the information
sharing and consensus -building during the Task Force process, some implementation has
already begun, but sustained and effective system change will require the Whatcom County
Health Board and County Council to play their part as policymakers.
September 2019 - Health Protection of Immigrant Families Task Force Report 20
October 1, 2019 Health Board Agenda Packet Page 23
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APPENDIX A: Participants and Process
Health Protection for Immigrant Families - Meeting Participants
Organization
Participated in at Least One Meeting
Agape Service Project/WWU Catholic
Melina Sergent
Newman Center
Kelsey Harrington
Bellingham Pubic Schools
Kathe Koruga
Bellingham Unitarian Fellowship
Mike Betz
Steve Powers
Catholic Community Services
Sterling Chick (also PHAB)
Catholic Housing Services
Kati Ortiz
Chuckanut Health Foundation
Heather Flaherty
Church of the Assumption
Nick Mele
Mary Mele
Lucy Lopez
C2C (Community to Community
Liz Darrow
Development)
Rosalinda Guillen
Australia Cosby
Cooperativa Tierra y Libertad
Modesto Hernandez Leal
Mike Riber
DSHS
Tonja Derr
Abdul Rahman
Food Bank(s)
Suzanne Nevan - Ferndale Food Bank
Goodwill
Norma Suarez
Mercy Housing
Lindsey Karas (also PHAB)
Moonbelly Midwifery
Mary Burgess
North Sound Accountable
Megan Argetsinger
Communities of Health
September 2019 -Health Protection of Immigrant Families Task Force Report 21
October 1, 2019 Health Board Agenda Packet Page 24
rd\Ird101iIJl:II,II IN
Organization
Participated in at Least One Meeting
OIC of Washington
Vidal Gonzales
PeaceHealth
Rachel Lucy (also PHAB)
Jerry Rajcich
Chi-Na Stoane
Public Health Advisory Board
Barry Buchanan (also Health Board)
Ruby Castaneda
Raid Relief to Reunite Families
Marisol Chapina
Redeemer Church
Dane Burgess
Marcela Suarez -Diaz
Sea Mar Community Health Centers
Aaron C. Ignac
Jimena Garcia
United Way
Peter Theisen
Unity Care Northwest
Megan Stephenson
Laura Reardon
WA State Dept. of Labor & Industries
Danny Aguilera
Western Washington University
Ceci Lopez
Astrid Newell
Kelly Molaski
Whatcom County Health Dept.
Brittany Fuentes
Taylor Lewis
Whatcom Human Rights Task Force
Shirley Osterhaus
Sue Webber (also Whatcom Community
Community Members
Foundation)
Von E. Ochoa (also staff at Shuksan Middle School)
Leadership: Regina Delahunt, Director, Whatcom County Health Department
Project Facilitation and Report: Holly O'Neil and Mardi Solomon, Crossroads Consulting
(holly@ crossroads.pro)
September 2019 -Health Protection of Immigrant Families Task Force Report 22
October 1, 2019 Health Board Agenda Packet Page 25
ATTACHMENT
Whatcom County Health Board Resolution 2018-050
Health Protection for Immigrant Families
SUMMARY OF OBJECTIVES:
• Ensure that the health and social service needs of citizens and immigrants of all statuses are met.
• Increase awareness and promote the integration of a "compassionate" or "trauma sensitive"
approach to services.
• Evaluate existing systems and support services for families impacted by the threat of deportation,
and identify cultural, safety and language barriers preventing access.
•November, 2018— In response to community concerns, PHAB (Public Health Advisory Board) proposes
a resolution to the Whatcom County Health Board for the health protection of immigrant families.
•December, 2018— Whatcom County Health Board Passes Resolution 2018-050.
•March/April 2019—A subcommittee of PHAB begins identifying agencies and organizations that
provide health and social service supports to immigrant families and invites representatives from those
organizations and people who have been affected by the threat of deportation to a facilitated
Information Gathering Session.
•May/June 2019 — Information Gathering Sessions to identify needs and gaps.
•July/August 2019 — Convene Task Force to review input from Information Gathering Sessions and
prepare a recommendation to PHAB.
•September 2019 — PHAB reviews recommendation from Task Force and evaluates and presents
findings and recommendation to Health Board in October 2019.
September 2019 — Health Protection of Immigrant Families Task Force Report 23
October 1, 2019 Health Board Agenda Packet Page 26
rd\I rd101iI Jl:II,II IN
APPENDIX B: Tools and Resources
Hotlines
1-888-201-1014 CLEAR - Northwest Justice Project in Bellingham - Legal Aid
1-844-724-3737 HOTLINE - Washington Immigrant Solidarity Network
Links to essential tools and systems
• Immigrant Safety Plan for Youth and Children
c From the Legal Counsel ,for Youth and Children (LCYCI. This tool helps parents plan
for the care of their child(ren) in the event that a parent is detained or deported.
• Guide to Creating Safe Space Policies
o From CLASP, this tool provides samples and guidance for implementing "safe space"
policies, which help staff know what to do if ICE comes to the door. The tool was
created for childcare providers but is easily adapted for other organizations.
• What to Do If Immigration Comes to Your Workplace
o From the National Employment Law Proiect. this guide helps employers understand
their rights and responsibilities, and explains what to do in case of an ICE action.
• Calendar of Community Immigration Events
o From the Northwest Immigrant Rights Project, this on-line calendar enables
organizations to post public events (trainings, etc.)
• Immigration Law Updates
o From the Northwest Immigrant Rights Project, this on-line blog provides up-to-date
information on changes to legislation that affect immigrant families.
Important infographics (attached below)
• Know Your Rights - Cards
• Sensitive Locations Infographic
• Know Your Rights - Keep Washington Working Act
Articles (attached below)
• Building Bridges, Reaching Beyond Walls: Increasing Access to Health Care for Migrant
and Seasonal Agricultural Workers (MSAW)
• Immigrant Health: Anchoring Public Health Practice in a Justice Framework
September 2019 -Health Protection of Immigrant Families Task Force Report 24
October 1, 2019 Health Board Agenda Packet Page 27
rd\I rd101iI Jlq►IIN
WASHIN6TON IMMIGRANT
SOLIDARITY
NETWORK
WWW.WAISN.ORG
KNOW YOUR RIGHTS
W"En 2ps"" M lawMWMEMM & AffligratM Armts
-b You do riot have to open your
door to irnmigrafion agents without
a warrant signed by a judge.
PYou donot have tospeak to
ICE' hand over documents or
consent to a search.
# You can ask for an attorney
before signing any paperwork.
The Network is a oaai*n of Labor, Faith,
Immigrant and Refugee fights organlizatkxls
and individuals that sidve to protect, serve and
sirengftn rommuMies across the stake
by providing support, capurily and resources
to build power and a united vane Gn
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HOTLINE TO REPORT
IMMIGRATION ACTIVITY
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September 2019 -Health Protection of Immigrant Families Task Force Report
25
October 1, 2019 Health Board Agenda Packet Page 28
I-111IVd101:I A A►IIN
The Department of Homeland Security (DHS) has longstanding policies that restrict immigration
enforcement actions in "sensitive locations." This means that, except in limited circumstances, immigration
agents should not conduct arrests, apprehensions, or other enforcement actions in the following locations:
Schools, including known and licensed child care
programs, preschools, pre -kindergarten programs,
Head Start programs, and other early care and
education programs.
K-12 schools, colleges and universities, after -care
programs, vocational or trade schools, and other
education -related activities and events are also included
in the policy.
t
7�
Medical treatment and
health care facilities, such
as hospitals, doctors'offices,
accredited health clinics,
and emergent or urgent
care facilities.
Places of worship, such as
churches, synagogues,
mosques, and temples.
scHoaL BUS
9 1
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School bus stops that are marked
and/or known to the officer (during
periods when children are present
at the stop).
a
Religious or civil
During public
ceremonies or
demonstrations,
observances, such as
such as marches,
funerals and weddings.
rallies, or parades.
What this means for early care and education providers:
• Providers should notify staff and parents that the program is considered a sensitive location.
• Providers do not have to allow immigration officials into your program without a warrant.
• Providers should develop internal procedures in case of potential enforcement actions and share them with staff
and parents.
• Providers should track enforcement actions at or near their property. These can be reported to a local immigration
or legal services organization.
Formore information about the sensitive locations policy, please see CLASP and N1LC's factsheet, The Department of
Homeland Security's "Sensitive Locations" Policies, available at closp.org/sensitivelocations.
For questions about the sensitive 1 ocations pol icy or if you believe the policy has been violated, con tact Rebecca Ulirich
(rullrich@closp.org) atthe Centerfor Lawand Social Policy (CLASP). To learn more about CLASP, visit www.closp.org.
Updatedluly2018 C L A S P
September 2019 - Health Protection of Immigrant Families Task Force Report
26
October 1, 2019 Health Board Agenda Packet Page 29
ATTACHMENT
New Community Rights with Police and
Federal Immigration Authorities in WA
Effective May 21st 2019
KNOW YOUR RIGHTS
Washington State Legislature passed the Keep Washington Working Act to protect the rights of
immigrant communities from unnecessary contact with ICE (Immigration and Customs Enforcement
and CBP (Customs and Border Patrol). The new law requires that police and jails change their
practices and policies to ensure the privacy of all Washingtonians by doing the following:
Asking you about or collecting your place of
birth, immigration status, or nationality, unless
it is for an ongoing criminal investigation.*
Stopping or detaining you to determine
immigration status.
Giving ICE/CBP your personal information (for
example, a home address).*
Holding you on ICE/CBP detainers or ICE
administrative warrants (which are signed by
ICE agents and not a judge).
Allowing ICE/CBP access to interview you in
jail. If ICE/CBP is in the jail investigating a
criminal offense, you have the right to remain
silent and refuse to speak with ICE. The jail
must get written consent from you before ICE/
CBP can interview you.
Denying you services or benefits if they have
an ICE detainer, notification request, or
immigration warrant.
Notifying ICEICBP when you will be released
from custody.*
Contracting with ICE and CBP to do
immigration enforcement. MJ
Detaining immigrants for ICEICBP in local jails
through contracts between jails and Dept. of
Homeland Security (DHS).
Using ICE and CBP as interpreters, translators,
or for language classes.
*DOC is exempted from this specifically
Cannot share your personal information with
ICE or CBP unless required by federal law.
Agencies MUST provide services regardless of
immigration status, unless otherwise required
by law.
If you believe your rights listed above have been
violated, please call Washington Immigrant
Solidarity Network (WAISN):
Rapid Response hotline at:
1-844-RAID-REP (1-844-724-3737).
0 WASHINfiTON IMMIGRANT
SOLIDARITY
NETWORK
.J',WASHINGTON
DEFENDER
ASSOCIATION
Washington
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Warklog for Juseice Since 1967
ONEAMERICA
September 2019 -Health Protection of Immigrant Families Task Force Report
W"rth Justice kw All
IMMI�hw s
l� 5
27
October 1, 2019 Health Board Agenda Packet Page 30
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Building Bridges, Reaching Beyond Walls: Increasing Access to Health Care for Migrant
and Seasonal Agricultural Workers (MSAW)
Colleen Pacheco, MIM, MPH December 2018
As one of the nation's 166 Migrant Health
Centers, Sea Mar Community Health Centers
provides comprehensive primary and
preventive health care to Migrant and Seasonal
Agricultural Workers (MSAW) and their
families. Expanding access to care and
improving health equity for Migrant and
Seasonal Agricultural Workers (MSAW) requires
a multi -faceted approach to overcome
significant barriers and health disparities
worsened by laws, which push them further into
the shadows and discourage them from seeking
services and resources. By tailoring localized
programs and interventions and addressing
administrative
processes and training agency -wide, the Sea Mar Community Health Centers MSAW Promotores
Program increased the number of MSAW we served by 96% in four years. For its efforts, Sea Mar
won the 2018 Increasing Access to Care Promising Practice Award from the National Center for
Farmworkers Health.
MSAW experience more barriers to care, and greater health inequities, than year-round
agricultural workers. Agriculture is one of the most dangerous industries and MSAW face
significant occupational and environmental hazards, such as pesticide exposure, muscoskeletal
injuries, skin disorders, and respiratory problems. They work long hours at a fast pace,
performing physically hard work in all kinds of weather, jeopardizing their health and making
them prone to missing medical appointments and encounter difficulties managing chronic health
conditions. In order to survive, they tend to ignore personal discomfort and usually have no time,
or knowledge, of preventive health practices. Frequent mobility, low literacy, limited language
abilities, transportation options, lack of knowledge regarding services, as well as differing
cultural beliefs and health practices, create significant hurdles to accessing resources and care.
Over 54,000 MSAW and family members reside either year-round or temporarily in the nine
counties in Western Washington where Sea Mar offers clinical operations.
Agency -wide processes and systems were initiated, including training to help staff better identify
and capture a client's special agricultural status. In Skagit and Whatcom Counties, where two-
thirds of the MSAW and families reside, efforts were focused on increased community
engagement, building relationships with both growers and the agricultural workforce, and
September 2019 -Health Protection of Immigrant Families Task Force Report 28
October 1, 2019 Health Board Agenda Packet Page 31
rd\Ird10liIJl:II,II IN
initiating innovative outreach service delivery models to overcome structural barriers to care
such as lack of childcare, transportation and long work hours.
In these two counties, the MSAW Promotores Program has been operating since 2010,
facilitating access to services and improving quality of service delivery. Community Health
Workers, or "Promotores," are the core of this program and are recruited from the local
agricultural community to serve on the front lines of public health, effectively forming a bridge
between the agricultural community and health services. They are especially effective at this role
as they possess deep knowledge of social networks and special health needs and are trusted by
the community. Promotores have strengthened existing relationships with growers and
agricultural communities and helped create new access points, allowing us to reach deeper into
these increasingly hidden agricultural communities. During the high harvest season of berries
over the summer months, Promotores visit farms, migrant camps, housing sites and common
gathering places with mobile medical and dental clinics. During the non -peak season, they lead
health workshops and presentations for farmworkers who reside in the area year-round or who
remain in the camps over winter. Although innovative and special initiatives are undertaken
routinely, our multi -faceted approach focuses on:
1. Relationship building to establish trust with highly ethnically diverse communities and
address social determinants of health
2. Expanding service delivery to outreach sites
3. Increasing health literacy and preventive health knowledge
4. Fostering relations with new farms to expand reach and gain access to difficult -to -reach
communities
Key to building connections and relationships with MSAW was the initiation of the MSAW
Mapping Project. We knew the agricultural workforce had transitioned from primarily Spanish
speaking Latinos but were unsure of the extent of the transition. Through this ongoing project,
we discovered a highly ethnically diverse workforce with unique linguistic and cultural barriers.
We identified more than 16 Mexican and Guatemalan indigenous linguistic communities, with
high monolingualism and varying degrees of literacy and Spanish speaking ability across age,
gender and community. We began forging connections with these communities as well as a large
Punjabi community in Whatcom, with similar English language limitations. The Mapping Project
provided significant insight into the diversity, linguistic complexities, cultural barriers, health
care beliefs and practices, such as lack of understanding of health processes and preventive
health practices. The findings justified the hiring of staff who speak these indigenous languages
and the increased community engagement resulted in leaders reaching out for services and
assistance. The findings provide ongoing insights on health messaging and on clinical tools to
enhance patient -provider communication. As these isolated and shy communities felt more
welcome and understood, they began reaching out asking for assistance or workshops and
information.
To address lack of transportation, childcare, and time, clinical services were expanded beyond
the clinic walls through mobile medical and dental clinics at farms, migrant camps and other
gathering sites. Over the last four years, more than 2,100 MSAW have received medical, dental
and health screen services through 96 mobile clinics facilitated during the summer months.
September 2019 -Health Protection of Immigrant Families Task Force Report 29
October 1, 2019 Health Board Agenda Packet Page 32
rd\Ird10liIJl:II,II IN
Many of these patients are newly diagnosed or with chronic conditions such as diabetes or
hypertension who do not regularly visit clinics. The remainder have usually never seen a medical
doctor for a wellness check-up (especially males). All were able to get relevant health
information and follow-up care often not available due to lack of time, money or a tendency to
ignore pain or illness until it becomes acute. In 2017, we began holding mobile flu clinic events
for seasonal workers during the shoulder season and year-round TB screening workshops due to
the high prevalence of tuberculosis within the agricultural community. In addition to workers
obtaining needed vaccines or information, we take advantage of these access events to compel
them to visit the clinics for additional follow-up appointments, for annual exams and preventive
screens. Most of them do end up asking for follow-up appointments.
Increasing health literacy and preventive health knowledge through outreach clinics and
specific health topic workshops helped expand the culturally appropriate health promotional
workshops and events, which the program has always done through door to door canvassing,
workshops at gathering sites, and public service announcements. However, five years ago, farms
began creating space for the mobile clinics. Each year, more farms open their facilities during the
paid workday so their workers can attend our workshops. Additional projects in the community
and clinics are focused on improving patient experience and health outcomes, including an
Indigenous Prenatal Research Grant to research barriers to care and to create effective health
messaging for early prenatal care.
As communities recede deeper into the shadows, opening new access points for farmworkers
is an unending initiative. Building better connections with the ethnically diverse agricultural
workforce communities and their employers has been critical in our success in expanding access
for MSAW. Over four years, we've partnered with eight new farms, 16 in total, annually
September 2019 -Health Protection of Immigrant Families Task Force Report 30
October 1, 2019 Health Board Agenda Packet Page 33
rd\Ird10liIJl:II,II IN
expanding grower collaborations and strengthening existing farm collaborations. These
relationships have allowed us to work with farm management to help workers with urgent or
chronic conditions schedule clinic appointments by coordinating approval to leave work and find
transport to the clinic. Every team member (from manager to promotores) are involved in
cultivating these relations, which can take years, and may require leveraging connections we
have through existing farms or community partners.
This multi -dimensional approach, supplemented by ongoing research and periodic trainings and
audits has allowed the program to build deeper connections and trust with agricultural workers
and employers while finding new ways to improve access and patient health.
For more information, please contact Jimena Garcia at JimenaGarcia@seamarchc.org or Marcela
Suarez at marcelasuarez@seamarchc.org
September 2019 -Health Protection of Immigrant Families Task Force Report 31
October 1, 2019 Health Board Agenda Packet Page 34
r_1Rr_N111 1aA011W
Immigrant Health: Anchoring Public
Health Practice in a Justice
Framework
Im See also Young and Wallace, p. 1171; Allen, p. 1177;
Rothstein and Coughlin, p. 1179; and Sundwall, p. 1184.
The nexus between policy
actions and immigrant health
is central in this issue of AJPH
in two articles by Young and
Wallace (p. 1171) and Rothstein
and Coughlin (p. 1179), serving
as a reminder of the need for
public health practitioners to
adopt a framework that explicitly
connects the dimensions of social
determinants of health with
population health outcomes.
Such a framework incorporates a
root cause analysis to elucidate
the factors contributing to ob-
served health results, including
the centrality of economic, social,
and environmental conditions.
EFFECTIVE PRACTICES
Young and Wallace show
how policies that marginalize
and criminalize immigrants can
minimize the effect of actions
taken to ensure access to health -
affirming resources. Their essay
provides a critical discussion of
the public health implications
of states' complex, contradictory
contexts in which immigrants
may, for example, simulta-
neously benefit from public
programs while living under
the specter of immigration en-
forcement. Their research points
to the need to account for
1156 Editorial Ferrer
interactions across the broad
dimensions that affect both
individual and community
well-being.
Rothstein and Coughlin
note that for a quarantine to
succeed, there must be a set of
protections in place that mini-
mize the legal, economic, and
social effects on vulnerable
individuals who need to be
quarantined. One strategy for
dealing with the unintended
consequences of public health
actions is to enact as few regu-
lations or practices as possible
that restrict individual liberty.
Rothstein and Coughlin offer
an alternative to this approach
in their notion of "safe harbor
provisions," which can com-
plement actions and regulations
enacted to protect population
health; such provisions make
it both more likely that in-
dividuals will comply with
public health directives and
more likely that compliance will
not cause additional harms. The
concept of safe harbor pro-
visions can be broadened, cre-
ating the strategic imperative to
ensure that community mem-
bers have access to the resources
and opportunities that prevent
transmission of an infectious
disease; this allows policies re-
lated to quarantine to align with
a much deeper set of actions
that ensure economic well-
being, protect from discrimi-
nation, and attend to social
connections. In Los Angeles
County, California, this in-
cludes creating safe and wel-
coming places for immigrants
(regardless of citizenship status)
to access a full range of free
health services (including
vaccinations), establishing a le-
gal assistance fund for immi-
grants, and decriminalizing
economic activities such as
street vending.
MULTIPLE FORMS
OF OPPRESSION
Health -affirming policies are
always limited in their effec-
tiveness by practices and systems
that perpetuate discrimination,
maintain exposure to hazards,
and continue grave injustices.
For immigrants, the inter-
sectionality of race, language,
citizenship status, and economic
position create, for many, ex-
posures to multiple forms of
oppression and marginalization
that can negate the many ben-
efits of inclusionary policies.
Public health success depends
on acknowledging this com-
plexity and addressing the
fundamental need for social,
economic, and racial justice to
ensure optimal health and well-
being. Offering sanctuary poli-
cies at Los Angeles County
health clinics is not sufficient
if the possible change in the
public charge rule can penalize
immigrants who receive gov-
ernment services.
Health departments and
public health practitioners will
need to ensure that local, state,
and federal officials enact laws
and regulations that improve the
conditions that shape immigrant
health. The foundation of ex-
cellent public health practice
recognizes our interconnected-
ness with one another and our
environment. Effective disease
control, prevention of chronic
diseases, and promotion of
health -affirming actions de-
mand approaches that are com-
prehensive and rooted in an
understanding of the social
determinants of health. No-
where is this clearer than in our
obligation to ensure that public
health policies and practices do
not unfairly advantage or di-
sadvantage some community
members based on social hier-
archies including race/ethnicity,
ABOUT THE AUTHOR
Barbara Ferrer is with the Los Angeles County Department of Public Health, Los Angeles,
CA.
Correspondence should be sent to Barbara Ferrer, PhD, MPH, MEd, Director, Los Angeles
County Department of Public Health, 313 N Figueroa St, Suite 806, Los Angeles, CA
90012 (e-mail: bferrer@ph.lacounty.gov). Reprints can be ordered at http://uww.ajph.org
by clicking the `Reprints" link.
This editorial was acceptedJune 13, 2019.
doi: 10.2105/AJPH.2019.305235
September 2019 -Health Protection of Immigrant Families Task Force Report
AJPH September 2019, Vol 109, No. 9
32
October 1, 2019 Health Board Agenda Packet Page 35
r-111IrG10I:IJI02r[d
PHAB Recrmmendaticns fcr Health Bard Actin
Health Pratectic- n ficr Immigrant Families
October 1, 2019
Recr mmenda0a n # 1
Build trust between immigrant families and local law enforcement.
Why this is Important: The community has a heightened level of fear and mistrust due to current federal
immigration policy, recent Immigration and Customs Enforcement (ICE) raids and conflicting information
about local law enforcement cooperation with ICE and federal detention policies. This fear prevents families
from seeking needed health services and supports. The resulting stress impacts physical and mental health
for both adults and their children
Recommended Board Actions:
a. Establish a Whatcom County Trust Ordinance or Resolution that clarifies the role of local law
enforcement in federal immigration enforcement, arrests and detentions. (See attached Lawrence Trust
Ordinance example)
b. Authorize funding for the Sheriff to support outreach and relationship -building with immigrant and non-
English speaking communities
Rec^mmendatkn #2
Strengthen the capacity of local employers, businesses, and service agencies to respond to
immigration related issues.
Why this is Important: Misinformation or lack of information about laws and best practices regarding
checking employee citizenship status, dealing with ICE surveillance, and protecting immigrant rights and
dignity can add to immigrant unemployment and fear/stress in the workplace.
Recommended Board Actions:
a. Expedite local implementation and awareness of new "Keep Washington Working" state law.
b. Widely distribute information about county policy, laws and resources associated with federal and state
immigration laws to businesses, employers, and community -at -large.
Recrmmendati!-n #3
Improve service systems to better meet the needs of families, including immigrant families.
Why this is Important: Support agencies are overwhelmed when trying to find health care and services for
immigrant families, including mental health supports. Immigrant families who do seek services often
experience discrimination, insufficient language supports, lack of cultural understanding, and services that
are not trauma -informed.
Recommended Board Actions:
a. Require mandatory training for county staff and contractors (particularly criminal justice, health and
human services) related to: Anti-discrimination/anti-bias approaches, culturally and linguistically
appropriate services (CLAS), and trauma -informed services.
b. Fund a culturally and linguistically responsive health navigation system for all Whatcom County families,
including centralized point for information, referral, and service coordination among providers.
Whatcom County
JlL H EALTRct 9 Health Board Agenda Packet Page 36
Department I".
r-\IrG10l:I�a02M
Document # 133/2015
Be it ordained by the City Council of the City of Lawrence that the Revised Ordinances
of the City of Lawrence are hereby further amended by adding the following new Chapter 9.20
(Lawrence TRUST Ordinance), to be inserted in the proper numerical order:
LAWRENCE TRUST ORDINANCE
Section 9.20.010 Purpose
The purpose of this LAWRENCE TRUST Policy and Order is to increase public confidence in
Lawrence Law Enforcement by providing guidelines associated with federal immigration
enforcement, arrests, and detentions.
Section 9.20.020 TRUST Policy.
It is not within the purview nor mandate of the City to enforce federal immigration law or
seek the detention, transfer or deportation of Lawrence residents for civil immigration
purposes, nor should City resources be expended toward that end. Under no circumstances
shall a person be contacted, detained, or arrested by City of Lawrence law enforcement
personnel based on immigration status, whether known or unknown.
The City of Lawrence will equally enforce the law and serve the public without
consideration of immigration status. Citizenship, immigration status, lack of immigration
documentation, national origin, race, and ethnicity shall have no bearing on an individual's
treatment by Lawrence law enforcement personnel (including but not limited to
classification status, eligibility for work programs, eligibility for alternative to incarceration
programs, right to release on bail), or on decisions to initiate stops, make arrests, or extend
the length of custody.
Section 9.20.030 Definitions
"Immigration & Customs Enforcement" (or "ICE") is the agency within the US Department of
Homeland Security with primary responsibility to investigate and enforce immigration law.
"Immigration Holds" are requests, often called "ICE holds" or "immigration detainers", by federal
immigration officials, including but not limited to those using federal form I-247 (authorized under
Section 287.7 of Title 8 of the Code of Federal Regulations) to local Law Enforcement to voluntarily
maintain custody of an individual once that individual is released from local custody.
"Administrative warrant" means a warrant, notice to appear, removal order, warrant of
deportation, or other ICE custody document (1-200, I-203, I-205 or another listed in the National
Crime Information Database (NCIC)) issued by a federal immigration official, not a judicial officer,
and not based on a finding of probable cause for an alleged criminal law violation.
"Released from local custody" means an individual may be released from the custody of a law
enforcement agency because any of the following conditions has occurred:
(a) All criminal charges against the individual have been dropped or dismissed;
(b) The individual has been acquitted of all criminal charges filed against him or her, -
October 1, 2019 Health Board Agenda Packet Page 37
r-\IrG10l:I�a:12M
(c) The individual has served the time required for his or her sentence;
(d) The individual has posted a bail or bond, or has been released on his or her own
recognizance;
(e) The individual has been referred to pre-trial diversion services;
(f) The individual has been sentenced to an alternative to incarceration, including a
rehabilitation facility;
(g) The individual is otherwise eligible for release under state or local law.
Section 9.20.040 Regulations
a.) ICE holds or administrative warrants. Unless ICE demonstrates a criminal warrant signed by
a judge and based on probable cause, no officer or employee of a City of Lawrence law enforcement
agency shall arrest or detain an individual solely on the basis of an immigration hold or
administrative warrant. This includes extending length of custody by any amount of time once an
individual is released from local custody.
b.) ICE notification requests. No officer or employee of a City of Lawrence law enforcement
agency shall respond to any ICE notification request seeking information about an individual's
incarceration status, length of detention, home address, work address, personal information,
hearing information, or pending release.
c.) ICE access to records or facilities. Unless ICE demonstrates a criminal warrant signed by a
judge and based on probable cause, no officer or employee of a City of Lawrence law enforcement
agency shall allow ICE agents access to or use of facilities, records/databases, booking lists, or
individuals in custody either in person or via telephone or videoconference.
d.) Individuals subject to ICE interventions. Any individual subject to an immigration hold,
administrative warrant, notification request, or contact with ICE, where Lawrence law enforcement
acquiesces to the ICE request, shall be provided with a copy of the ICE request and any other
documentation pertaining to their case that is presented to the law enforcement agency.
e.) U Visa Certification. In furtherance of the US Victims of Trafficking and Violence Prevention
Act, City of Lawrence law enforcement personnel shall consider and sign a U Visa certification
request if an individual is (i.) the victim of a qualifying crime, and (ii.) has been, is being, or will
likely be helpful in the investigation/prosecution of that crime.
Section 9.20.050 Complaints
Allegations of violations of the present TRUST policy and order shall be filed with the Mayor of the
City of Lawrence.
Section 9.20.060 Reporting
Beginning on September 1, 2015 and on every other month thereafter, the Lawrence Police Chief
shall submit a report, with the information detailed below, to the Clerk of the City of Lawrence, with
a copy sent to the Mayor of the City of Lawrence. The City Clerk shall docket said report, and
include the docket on the agenda of the next -occurring meeting of the Lawrence City Council.
October 1, 2019 Health Board Agenda Packet Page 38
r_Mar_Nl:I•IA.rlc]
(a) The total number ICE hold, administrative warrant, and notification requests lodged with
City Law Enforcement officials, organized by the reason(s) given for the request;
(b) The total number of individuals detained pursuant to Section 9.20.040 (d), if any;
(c) The total number of individuals transferred to ICE custody, if any; and
(d) The total reimbursements received from the federal government pursuant to any granted
hold, administrative warrant, or notification request, organized by case.
To the extent that there exist any ordinances to the contrary, they are hereby repealed in that
respect only.
Office of the City Attorney
June 8, 2015
October 1, 2019 Health Board Agenda Packet Page 39
Health Prr.4tecticn fir
Immigrant Families
Sterling Chick - Public Health Advisory Bcard & Clinical Director,
Cathf-71[c Cammunity Services
Lindsey Karas - Public Health Advisory B!zard & Resident Services
C?^rdinatcr, Mercy H?using Northwest
October 1, 2019
Whatcom County Health Board
� Whatcom County
)ll HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 40
DEFINITIONS
(leaving gut prcevccative labels)
• Immigrants
• Nc n-citizens
• Undocumented
• Aliens
fulL
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 41
F,
w
inj
October 1, 2019 Health Board
is
t
fUIL
Whatcom County
HEALTH
Department
REC-PMMENDATI-PNS
IMPACTFUL
REASONABLE
AT THE PPLICY LEVEL
October 1, 2019 Health Board Agenda Packet Page 43
2019 Joint meeting of the Whatcom County Health Board & the Public Health Advisory Board
Health Board: Preservation of the life and health of the people within its jurisdiction
PHAB's Mandate: focus on the responsibilities of the health departmen --•
fulL
Whatcom County
HEALTH
Department
THREE THINGS HAPPENED
ICE RAIDS
KEEP WASHINGTPN W-PRKING
PUBLIC CHARGE
October 1, 2019 Health Board Agenda Packet Page 45
RESQLUTI-PN NQ. 2019-050
HEALTH PRQTECTIQN FQR IMMIGRANT FAMI
Whereas: In accordance with RCW 70.05.060 it is the responsibility of the Whatcom County Health Board to supervise all matters
pertaining to the preservation of the life and health of the people within its jurisdiction and;
Whereas: the Whatcom County Board of Health shall supervise the maintenance of all health and sanitary measures for the protection
of the public health within its jurisdiction and;
Whereas: on October 29, 2013, the Whatcom County Health Board unanimously passed Resolution 2013-038 Call for Compassionate
Community Approach to Public Health Related Services and;
Whereas: the Whatcom County Health Board has identified the health of children and families as a policy focus area for 2018 and;
Whereas: Whatcom County, just like many counties in Washington State, is the home and workplace of large immigrant communities
with citizens and immigrants of all statuses; and
Whereas: Recent Immigration and Customs Enforcement raids and detentions in Whatcom County have caused immigrant families
significant trauma resulting in mental health concerns in adults and adverse childhood experiences (ACE' S) for young children and;
Whereas: Fear of detention and deportation has caused families to avoid seeking needed medical and social services and;
Whereas: Changes to federal laws are being proposed that would cut off government health benefits and housing for immigrants and
their families and;
Whereas: Whatcom County may face increased demands for assistance from immigrants and their families resulting from changes to
the " public charge" definition because fewer individuals will be able to access federal benefits such as Supplemental Nutrition
Assistance Program, Section 8 housing vouchers and healthcare services and;
Whereas: Whatcom County administers federal programs, and changes to federal laws could impose burdensome new tracking and
reporting requirements for local offices that administer these programs and;
Whereas: Changes to federal law may discourage immigrants and their families from seeking federal health benefits, such as Medicaid
or the Children' s Health Insurance Program (CHIP) resulting in health impacts to those families, decreased health status of our
community and increased costs to county budgets and;
Whereas: The Health Board has resolved to seek opportunities to increase awareness and promote the concept of a" compassionate"
or " trauma sensitive" approach and to integrate this paradigm into the broadest possible range of all public health, education, and
human services in our county and;
Whereas: The Whatcom County Health Board seeks to stand in support of our immigrant families by upholding the principles of health
equity and ensuring that the health and social service needs of citizens and immigrants of all statuses are met Page 46
MAY 3WJ N
L
1
19)
A
,I n
Met three times giver
the summer
46 people attended
Schnnls, snclal service
agencies, health
services, government
agencies, churches,
people directly
affected by Ice RAIDS
u
q -,
L
• IN WASHINGT-ON STATE, APPR-OXIMATELY 1 IN 7 RESIDENTS
IS AN IMMIGRANT
• IN THE UNITED STATES, 1 IN 4 CHILDREN ARE MEMBERS -OF
IMMIGRANT FAMILIES
(ABQUT 1 IN 10 IN WASHINGTQN STATE)
-OVER 95% -OF THEM ARE U.S. CITIZENS
(CQVERED BY THE 14T" AMENDMENT TQ THE CQNSTITUTIQN)
• IMMIGRANTS HAVE SIGNIFICANT REPRESENTATI-ON IN
SERVICE JPBS, FARMING, AND C-ONSTRUCTI-ON.
• IMMIGRANT H-OUSEH-OLDS PAID 2.4 MILLI -ON D-OLLARS IN
WASHINGT-ON STATE TAXES IN 2017
October 1, 2019 Health Board Agenda Packet Page 48
HEALTH IMPACT
PN FAMILIES
STRESS
• Trauma
• ACEs
• Toxic Stress
RESULTS
• Brain development
• Readiness fir sch�n-1
r
October 1, 2019 Health Board Agenda Packet Page 49
October 1, 2019 Health Board Agenda Packet Page 49
School
1, 2019 Health Board Agenda Packet Page 50
2013 Birch Bay Bike/Ped Count Volunteers
Health Pr�tectli�n f?r
Immigrant Familiest
Recrmmendatinns fin r
Health Beard A ctior-- n
� Whatcom County
ill HEALTH
Der) artment
October 1, 2019 Health Board Agenda Packet Page 51
Key F'indi*n
fulL
Is
Whatcom County
HEALTH
Department
• Immigrant families in Whatcnm County are
experiencing high levels nf fear and stress
• Fear prevents families from seeking needed
health services and su ppnrts
• Stress impacts physical and mental health fir
berth adults and their children
• Current services and systems are nest
meeting the needs -f immigrant families
October 1, 2019 Health Board Agenda Packet Page 52
Rec P... m mend atioc n #1
Build trust between It
families and k-4 cal law enfcrcemen4l,
• Community has heightened level of fear and mistrust due
to current federal immigration policy and rhetoric, recent
ICE raids leading to detention and deportation, and
personal experience with local law enforcement.
• There is conflicting information about local law
enforcement cooperation with ICE and federal detention
policies.
i11
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 53
Pr,r.::tp_r.4sed PrflicyActicens
• Establish a Whatcorn County Trust Ordinance or
Resolution
• Authorize funding for the Sheriff to support outreach
and relationship -building with immigrant and non-
English speaking communities
0"
i11
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 54
Recc mmendatice n #2
Strengthen capacity rf k4cal empl^yers,
businesses, and service agencies tc
respond tc Immigratic n related issues
• Current challenges include misinformation or lack of
information about laws and best practices regarding
checking employee citizenship status, dealing with ICE
surveillance, and protecting immigrant rights and dignity
i fL
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 55
Pr,r-::tp-r.4sed PrflicyActicens
11
11
Expedite local implementation and awareness of new
"Keep Washington Working" state law
Widely distribute information about county policy, laws
and resources associated with federal and state
immigration laws to businesses, employers, and
community -at -large
i4o"11
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 56
Recr...�mmendat'i'c�n #3
Impr-r.4ve service systems tc. better meet
the needs ^f families, Including
Immigrant families
• Immigrant families who do seek services often experience
discrimination, insufficient translation or other language
supports, lack of cultural understanding, and services that
are not trauma -informed.
• Support agencies are overwhelmed when trying to find
health care and services for immigrant families, including
mental health supports.
i11
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 57
Prr,tp-r.4sed PrflicyActicens
• Require mandatory training for county staff and contractors
(particularly criminal justice, health and human services)
related to:
— Anti-discrimination/anti-bias approaches
— Culturally and linguistically appropriate services (CLAS)
— Trauma -informed services
• Fund a culturally and linguistically responsive health
navigation system for all Whatcom County families,
including centralized point for information, referral, and
service coordination among providers.
i11
Whatcom County
HEALTH
Department
October 1, 2019 Health Board Agenda Packet Page 58