Sunday, April 05, 2020

Don't Be Stupid- Don't Deport DACA Health Care Workers

Don’t Deport DACA Health Care Workers 
If the Supreme Court affirms the administration’s termination of DACA, thousands of vital health care workers could be deported.
By Bill AseltyneBeth EssigDebra L. Zumwalt and Abbe R. Gluck
Mr. Aseltyne, Ms. Essig and Ms. Zumwalt are general counsels for health care systems. Ms. Gluck is a professor at Yale Law School and Yale School of Medicine.
·       April 2, 2020
The Covid-19 pandemic is stretching our public health system to its limits and challenging our ability to meet the urgent and critical medical needs of the country as never before. As executives responsible for the legal affairs of major hospitals and lawyers working in Covid-19 hot spots, we know how crucial it is to have every available front-line medical worker fighting this pandemic.
But 29,000 of those workers are being threatened with deportation by the Trump administration. They have been protected by the Deferred Action for Childhood Arrivals program, under which undocumented immigrants who came to the United States as children can obtain protection against deportation and authorization to work in the United States. The Trump administration terminated that program, the Supreme Court is currently considering the lawfulness of that determination, and the court’s decision could come at any time.
New data from the Center for American Progress reveals that the DACA-recipient health care work force includes more than 6,000 diagnosing and treating practitioners, including respiratory therapists, physicians assistants and nurses; some 8,000 health aides, including nursing assistants and orderlies; more than 7,000 other health care support workers; and some 5,500 health technologists and technicians.
The Association of American Medical Colleges told the Supreme Court that nearly 200 physicians, medical students and residents depend on DACA for their ability to practice medicine and serve their communities. Those 200 trainees and physicians alone would care for hundreds of thousands of patients per year in normal times — the association estimates as many as 4,600 patients per year, per person. Under the demands of the Covid-19 pandemic, those numbers will be much higher.
The Center for Migration Studies found that 43,500 DACA recipients work in the health care and social-assistance industries, including more than 10,000 in hospitals.
If the Supreme Court upholds the decision to terminate DACA, nearly 700,000 people — including those health care workers — will lose their ability to work and live in the United States. The administration is preparing to deport DACA recipients and has repeatedly stated that it will do so if the Supreme Court gives it the green light, something that could happen as soon this coming Monday, April 6. There are many reasons for the Supreme Court to hold the administration’s decision invalid, and the pandemic confirms those flaws.
Even before the crisis, primary-care doctors, nurses and other health professionals were in short supply. The Association of American Medical Colleges and over 30 other groups told the Supreme Court last fall that our health care system relied on DACA health care providers.
That need is even more acute now. For example, as of last week, more than 300 workers in four of Boston’s biggest hospitals had tested positive for the coronavirus. As Covid-19 hospitalizations increase, health care professionals are increasingly likely to become ill. This is especially true because of the current national shortage of personal protective equipment in some health systems that puts health care workers at an even higher risk of infection.
Each health care worker who tests positive must self-quarantine for at least two weeks, further intensifying the current worker shortages. We have already seen the disastrous impact of provider shortages in Europe, particularly in hardest-hit Italy and Spain. Their experiences demonstrate that expanding provider capacity will be key to reducing Covid-19’s death toll.

Allowing DACA’s termination would undermine the extraordinary measures being applied by states, universities, hospitals and private institutions across the nation to address the critical shortage of health care workers. New YorkConnecticut and California, for example, have issued orders allowing the authorization of professionals with out-of-state licenses to practice; California and New York have asked retirees to return to service; and New York has authorizedgraduates of foreign medical schools with at least one year of graduate medical education to provide patient care in hospitals.
Medical schools in New York and Massachusetts are accelerating the graduation of medical students to speed more doctors to the front lines of the pandemic. Field hospitals have been set up in Central Park and the Javits Center in New York and in the Yale University gymnasium, among other sites. Naval ships have arrived in New York, the pandemic’s epicenter, and Los Angeles to further increase health care capacity. All of those places need to be staffed. At the federal level, the administration is actively seeking medical professionals from abroad to help with Covid-19 treatment.
But hospitals and communities have already invested in the training and education of DACA health care workers — investments that would be lost if the Supreme Court eliminates their ability to work in the United States. These providers cannot be quickly replaced upon the announcement of an affirmative Supreme Court decision — it takes over a decade to fully train a new physician and years to train nurses and other critically needed health care workers.
Moreover, it is not just the DACA health care workers who are contributing to our fight against the coronavirus. More than 150,000 other DACA recipients work in other industries that we depend on right now, including grocery stores, drugstores, transportation and warehousing, manufacturing, and custodial and food service. Our doctors and nurses rely on scientists and pharmacists to develop and administer testing and treatment for Covid-19. Many of those essential workers are DACA recipients, too.
brief recently filed with the Supreme Court by lawyers representing DACA recipients asks the court to take account of the current crisis as it weighs their fate. The brief correctly asserts the enormity of the need for health care professionals in this crisis and that the Trump administration did not adequately consider the interests of “employers, civil society, state and local governments, and communities across the country,” among many others, when it made the decision to end the program.
Nor would a temporary fix be acceptable. Our workers cannot be asked to serve in this crisis for now, only to be deported later. That would be inhumane and shortsighted. Just as we rely on these essential workers today, we will rely on them and be grateful for them tomorrow.
If the Supreme Court allows the termination of DACA during this pandemic, the work of our hospitals will suffer a critical blow at exactly the moment when we can least afford it. At a time when the importance — and scarcity — of our medical resources has never been clearer, neither our institutions nor the nation can afford a disruption to the health care work force. We desperately need all hands on deck for this fight.
Bill Aseltyne is senior vice president and general counsel of Yale New Haven Hospital and Yale New Haven Health System. Beth Essig is executive vice president and general counsel, Mount Sinai Health System. Debra L. Zumwalt is general counsel of Stanford University, including Stanford Medicine. Abbe R. Gluck is a professor of law and faculty director of the Solomon Center for Health Law and Policy at Yale Law School.
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