Many medical providers who work in safety-net hospital systems do so to provide care for any and all patients, regardless of their immigration status or ability to pay. Every day, we witness how social determinants of health such as poverty, lack of access to housing or nutrition affect our patients. That is why, as physicians working at the Denver Health Human Rights Clinic, supported House Bill 1194, to create an Immigrant Legal Defense Fund. The bill passed the Colorado General Assembly this week, and will provide legal representation to immigrants and asylum seekers so that they can better access legal status, and in turn, health care.
When we provide medical treatment for patients, we consider the whole person in front of us and what has led them to seek care. As physicians, we have the duty to safeguard, improve, and promote the health and well-being of our patients. It is heartbreaking to see the many barriers to quality health care that our undocumented patients face. In addition to limited access and the inability to afford it, many are simply afraid to seek medical treatment even when desperately need it. Many fear that if they seek help, they will be deported or separated from their family. We frequently see the negative physical and mental health effects on our undocumented patients because of this fear. No one should have to hesitate to call 911 when they are dying.
Many medical providers, as well as the undocumented patients for whom they provide care, are unaware that they may qualify for legal status. Legal status affords access to better health care and improved general health. However, even when appropriately identified, asylum-seeking immigrants, including unaccompanied children, have no right to court-appointed legal representation in deportation proceedings. As a result, the majority of children and adults appearing before an immigration judge in Colorado go unrepresented. Currently, the national rate of granting asylum to those seeking protection is about 24%.
However, immigrants claiming asylum with both legal representation and medical and/or mental health forensic examinations to document their trauma are significantly more likely to gain legal status. With appropriate legal and medical support, as many as 85-89% of asylum cases are granted. Once legal status is gained, immigrants can come out of the shadows to access primary care, preventive medical screening, and treatment for underlying medical issues. Accessing this care ultimately leads to cost savings for hospital systems (and taxpayers), by decreasing use of ERs as the main source of care and in many cases decreasing late presentation for complex, preventable illnesses.
That is why the Denver Health Human Rights Clinic works with non-profit immigration legal service organizations like the Rocky Mountain Immigrant Advocacy Network (RMIAN). Within this legal-medical partnership, asylum-seekers are given legal services, medical care, and medical and mental health forensic evaluations. The Denver Health Human Rights Clinic alone has over 68 clinical volunteers and the capacity to perform 15-20 forensic evaluations per month.
As physicians with firsthand experience supporting effective partnerships between legal and medical providers to combat disparities in care, we feel compelled to support a legal fund for immigrants in the U.S. without legal status. By passing this bill, organizations like RMIAN will be able to increase access to legal representation for immigrants. This will also allow the Denver Health Human Rights Clinic to support the creation of a robust system to connect patients with resources for legal aid, options to apply for legal status, and ongoing medical and mental health care services. This will improve the lives of our patients, our medical providers, and our community.
Janine Young is an associate professor of pediatrics with the University of Colorado School of Medicine and the medical co-director of the Denver Health Human Rights Clinic. Jennifer Whitfield is an associate professor of emergency medicine with the University of Colorado School of Medicine and an emergency physician at Denver Health. Evangelia Murray is a third-year resident physician in emergency medicine at Denver Health.