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Advocating for Your HIV Positive Noncitizen Client
National Advocacy
Keep abreast of Congressional developments.
Educate yourself on legislation that may affect benefits for noncitizens, and become a part of collaborative efforts to change the current restrictive laws. Connect with the noncitizens and public benefits network of the National Immigration Law Center. See resources.
State and Local Advocacy
Join local efforts.
By eliminating, reducing, and placing conditions on public benefits for all poor people, Congress has pitted different groups of impoverished residents against each other. You can ensure that the interests of noncitizens with HIV/AIDS are not left out of decisions on how to distribute scarce state and local resources. Identify non-profit organizations or coalitions in your state that advocate for noncitizen access to benefits. Share the information and advocacy strategies you learn with other networks.
Get involved in local and state decision-making bodies.
HIV/AIDS service providers and advocates for immigrants must get involved in the local and state process for determining how to use federal money targeted for people living with HIV/AIDS. You or your colleagues should serve on planning councils for Title I funding, consortia for Title II funding, AIDS Drug Assistance Program (ADAP) advisory councils and those determining how RyanWhite/CARE Act money will be spent. Work with local planning councils, state consortia and community prevention planning bodies to ensure that immigrants' needs are included in priority setting for money for people living with HIV/AIDS.
Educate your state and local decision-makers.
Make them aware of the ongoing devastating effects of previous welfare and immigration reform. Urge your state legislators to reject limiting benefits. Educate and mobilize others in your area to do so as well. Legislatures should use federal money for all "qualified" noncitizens and create, maintain or restore alternative state and local programs to help noncitizens who are not "qualified." Similarly, they should reject applying sponsor deeming to state and local funds, and instead provide a safety net for immigrants hurt by the federal first-five-years disqualification and sponsor deeming requirements. If your state is contemplating cost-cutting measures such as "freezing enrollment," educate your state legislators about the costs of hunger, homelessness, spread of disease, and unnecessary and costly emergency room visits that will result.
Insist on funding for interpreters and translation.
Federal civil rights laws entitle people with Limited English Proficiency (LEP) to meaningful access to services funded by the federal government. For more information on agencies' responsibilities toward people with Limited English Proficiency, go to www.lep.gov.
Individual Advocacy
Explore and secure health care access.
Use this manual and the other resources mentioned within it to decide for which benefits your client currently qualifies. Consider the range of options, including federal programs and block grants administered by the states that are accessible to noncitizens. It may be that the best advocacy is to help your client obtain an immigration status that qualifies her or him for more benefits. Be aware that the use of public benefits may, in some cases, have implications for obtaining immigration status. For more ideas on advocacy strategies to ensure immigrant-friendly health care access, consult resources on the back cover.
Partner with local immigration attorneys.
You can help each other. Immigration attorneys have legal expertise, but may know not have much knowledge about treatment and health insurance options for HIV positive individuals, which is a key factor in an immigration case. For instance, it is unlikely that an immigration lawyer could explain "ADAP" or name the medical research programs in your area offering free HIV/AIDS treatment. In turn, the immigration attorney may be able to answer your and your client's questions or address misconceptions about "public charge" and "sponsor liability." If you know an immigration attorney who is not familiar with HIV/AIDS issues, but is willing to learn, please refer her or him to our resources (see resources.) The National Immigration Project of the National Lawyers Guild offers technical assistance and training materials on HIV/AIDS issues for immigration attorneys.
Challenge inappropriate screening by benefits' administrators.
Accompany your client when he or she applies for benefits, and review the application form. Encourage your client not to give any unnecessary information or any false information, such as a false social security number. Urge agencies to eliminate unnecessary questions regarding immigration status and social security numbers from their forms and intake process. In particular, question a state or individual policy of checking the immigration status of other family members besides the recipient of Medicaid, SCHIP, or TANF benefits. Refer to HHS guidance that forbids them to do so. Argue that the only people who an agency could "know" are here "unlawfully" are people who have a final determination on a claim for SSI, TANF, or housing and have a final order of removal from an immigration judge and are not appealing that decision. Alert a local immigrants' rights or legal services organization to practices you think go beyond the law.
Train your own managers and coworkers to promote internal policies that are friendly to noncitizens.
Adopt clear policies regarding noncitizens to ensure that your HIV/AIDS organization is open and accessible to anyone living with HIV/AIDS. Do not use social security numbers as case numbers and for CDC reporting purposes.
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Advocacy Tips and Example
Service providers can help noncitizens gain access to public benefits in several ways:
- Urge state and local governments to restore, maintain, and expand benefits to a broad array of noncitizens.
- Urge those who administer public benefits programs to interpret the law flexibly and generously.
- Join local, state, and national coalitions to educate state and local governments about benefits and health care and to resist restrictive laws.
- Educate your own community of HIV/AIDS service providers, including your coworkers and managers.
Example
If your state is considering capping enrollment in the AIDS Drug Assistance Program (ADAP), which provides HIV treatment to low-income, uninsured, and underinsured HIV positive individuals, educate decision-makers on why this is bad health care policy. Write up your most sympathetic client stories and encourage your colleagues to do the same. Make sure the noncitizen voice is heard among your own community of HIV/AIDS service providers, because there may be anti-immigrant sentiment there, too.
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Conclusion
Congress has made it very difficult for noncitizens to receive the assistance they need. You can help ensure that state and local governments meet the needs of noncitizens who can't receive federal benefits. You also can advocate with benefits' administrators to interpret the law flexibly, in a way that will help the most people. Most importantly, you can help your clients understand their options so they can make intelligent, informed choices.
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Why Does Congress Bar Noncitizens with HIV?
The Politics of Immigration and AIDS
Many people in this country do not understand HIV/AIDS or how it is spread. They hate and fear people living with HIV/AIDS. At the same time, attacks against noncitizens on the federal and state level have intensified dramatically in recent years. The post September 11, 2001, environment has contributed to anti-immigrant animosity and misconceptions. Study after study shows that noncitizens contribute more to our society than they take, but some politicians and the media play to people's fears by blaming all noncitizens for society's problems, from terrorism to lost jobs, from health care costs and crime to public benefits fraud. Some governors, state legislators and members of Congress believe they get votes by passing laws that harm noncitizens. This is doubly true for those living with HIV/AIDS. Congress will not
remove the policies that harm noncitizens living with HIV/AIDS until public attitudes toward noncitizens and HIV/AIDS improve. Noncitizens living with HIV/AIDS and those who work with them must help change the hostile political climate. Speak out against these policies! Work on the state and local level to preserve rights and benefits for all noncitizens. Write to your senators and representatives. Contact a local immigrants' rights or AIDS service organization to find out how you can help.
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