By Jon Lurie
Systematic Alien Verification comes to Minnesota; Basic health care for immigrants in peril		Norma Atusta surveys the busy lobby at West Side Community Health Services in St. Paul. As nurse manager of the clinic, it’s her job to see that every one of these patients, many of whom are Hispanic immigrants, receive quality health care. While the task can be daunting, Atusta, a native of Colombia, says she and her co-workers are passionate about helping the people they serve. Lately, however, she says she’s been anxious about her future and the future of the families who use the clinic. A new Minnesota law, due to be implemented next summer, is expected to have a drastic impact on federally funded clinics like West Side. Starting July first, patients will be required to provide proof of their immigration status when applying for federally funded health care. Atusta says she fears clinics that serve large immigrant populations will be forced to close or transform to serve other communities. “We are going to go against our mission, because the mission of this clinic is to provide services to communities that are under served, communities that are struggling with access to health care, regardless of the barriers: economics, religion, language, immigration. I see this new law as a huge barrier to supporting the communities that we’ve been [supporting] in the past.” The law, known as the Systematic Alien Verification for Entitlements Program, or SAVE, was enacted by Congress in 1986. Minnesota was one of five states exempt from the program by a state-requested waiver. But last year, Republican lawmakers in the legislature shepherded a provision that will eliminate Minnesota’s waiver from the program. The intent of SAVE is, ostensibly, to prevent undocumented immigrants from receiving federal services. Those who work with immigrants see the effects as having dire consequences. Executive director of the Immigrant Law Center of Minnesota, Karen Ellingson, says children of undocumented immigrants will suffer most under SAVE. Although American-born children are automatically eligible for federal services, Ellingson believes undocumented parents may not bring their ill children to the clinics because they’re scared of being discovered and deported. “Our fears are that people won’t report domestic violence, people won’t report child abuse, because somebody in the configuration isn’t legal and they’re going to get into trouble. People aren’t going take advantage of rights and offices that could protect them just out of this fear that they’re going to be reported to immigration.” Ellingson says the acronym SAVE is ironic. She expects it will harm many and while saving nothing, but perhaps a few dollars. Stephanie Hayes, Office Manager at West Seventh Community Dental Clinic near downtown St. Paul, says she anticipates the SAVE program could actually end up taking lives. “When you’re in a lot of pain, you’re in a lot of pain. I’ve seen many people sitting in this waiting room during urgent care hours who are out here crying, in excruciating pain. People have killed themselves to stop the pain of a toothache. If these people can’t come here, there’s no where else to go. I don’t know what they’ll do.” Hayes says she’d “feel bad” if she had to turn a patient in to the INS, but she thinks she and her co-workers will follow the law when the time comes. The Immigration and Naturalization Service, which lobbied the legislator last year to make reporting undocumented patients mandatory, says SAVE is a good program that will benefit Minnesota’s working families. Chuck Midby, INS supervisory special agent and a lifelong Minnesotan, said he understands and appreciates the reputation Minnesota has as a caring place. Midby contends the state will continue to be a caring place. He said under SAVE the children of undocumented immigrants will be eligible for medical treatment. “Unfortunately some parents might have the perception there’s a danger there, but in reality there shouldn’t be. There’s a provision in our regulations which prohibits INS from using information on applicants for enforcement purposes when people are going in and making a good faith application.” Midby said the only information that can be used for enforcement purposes would come from “a fraudulent application. They’re assuming somebody else’s identity or they’re using a counterfeit document or in some way they’re trying to defeat the system. That’s the only time that we could potentially use information gained from this program to arrest people.” Midby said that, because of a shortage of personnel, arrests are a low INS priority. Its number one concern is what he calls “criminal aliens.” While the INS won’t be tracking people down in their homes, it will be referring the names received from health care workers to county prosecutors. There, Midby said, those on the lists will be charged with illegally receiving federal benefits, or welfare fraud, a deportable charge. “If somebody’s an undocumented alien in the first place they’re going to be deportable with or without that charge. It just makes it more serious,” he said. Despite INS assurances, many undocumented parents in the Twin Cities are worried about what will happen next year if their children become ill. Louis, an undocumented 26-year-old Venezuelan, is helping his sister rear her child in Minneapolis, where they have lived for seven years. Upon meeting for this interview on Lake Street, Louis insisted on changing locations. He finally settled on a bench in a remote corner of the Calhoun Square shopping mall. Louis said under SAVE, undocumented immigrants will avoid medical care for themselves and their children at all costs. “There’s going to be a lot of people who would rather remain anonymous, and would rather actually die [than show up at a clinic and declare their status]. There’s a lot of people who would rather let their kids go sick instead of go to the doctor because they don’t know they can get help. They think they are going to be reported, so they’d rather let their children suffer at home. If it’s a little pneumonia or it’s a little cold, they’ll just pray it’s going to pass.” Louis said he and his sister want nothing more than to work hard, pay their taxes and provide a quiet, stabile life in the Twin Cities for his niece. “We don’t dream of anything fancy. We just dream of the possibility of being able to give her what she needs, to provide her with protection. She’s just a little girl, and she’s just come into this world. She’s only four years old. We’re trying to do our best to try and keep her safe. Our dream is to see her grow, go to school, prepare herself, and go on.” Whatever the eventual effect SAVE will have on his niece, Louis, who is HIV-positive, has immediate health concerns. He said SAVE will keep him from going to the clinics to receive treatments that hold his illness at bay. Better to die in the United States, he said, than to go back to desperation and unemployment in a country that now seems foreign to him. “If I have to go back to my country, which is something I don’t want to do, I will not be able to get health insurance. Only rich people in my country can afford health insurance. There’s no possibility that I could get into an AIDS treatment program, because there’s nothing like that there. I don’t think I’d be able to get help anywhere. The only hope that I have is to somehow get legal residence in this country.” Immigration experts say people like Louis stand a slim-to-none chance of obtaining legal residence in the United States. His HIV status, his country of origin, and his illegal status are factors that bode poorly for his chances. Louis complained that had he been from Cuba he would have been eligible for residency upon touching U.S. soil. “It’s not fair that people from one country should receive better treatment than people from another.” He’s also angry about the service he’s received from a long line of immigration attorneys. “None of them will ever talk to me on the phone. They make an appointment and take my $250 so they can tell me there’s nothing they can do.” Louis said people in the United States should understand that immigrants, whether working legally or illegally, have taxes taken from their paychecks like everyone else. The only difference is that most undocumented workers never receive refunds for which they are eligible because they’re afraid that filing a tax return will get them into trouble. State Representative Lynda Boudreau of Faribault sponsored the Minnesota SAVE legislation. In recent years Faribault has become home to hundreds of recent immigrants searching for work in the agricultural economy. Boudreau says she’s been hearing constituents complain that up to half of their co-workers in the factories and fields are working illegally. “People don’t take kindly to folks coming here doing things that aren’t legal, doing things that are taking the dollars that they worked hard to earn. These are hard working people, many of whom are reluctant to take benefits themselves, because of pride. They don’t think kindly of others who would do that, and would do that illegally.” Boudreau said she believes SAVE will satisfy her constituents’ concerns. Boudreau and INS officials say other states haven’t kept statistics on how SAVE has affected them so they can’t anticipate the impact on Minnesota. “I would hope that one of the effects would be that people are not coming here to obtain benefits illegally. That the word would get out that you have to be a legal citizens or qualify, at least, not be an illegal alien,” Boudreau said. “I know that term sounds kind of strange but that is the term that’s used. I hope the word gets out. Other states don’t allow it. Why should we?” Back at West Side clinic, Norma Atusta said she took an oath to do no harm. She’s distressed that starting next July, with the implementation of SAVE, her job will entail doing harm when she is forced to turn over names of undocumented patients to the INS. Atuesta believes the effects of SAVE will ripple far beyond the immigrant community. When an entire segment of society is afraid to seek health care, she said, diseases will go untreated increasing the probability that they will spread throughout the general population. “I think that health care, regardless, is part of your human rights, like education or housing,” she said. “I don’t see how we can discriminate against people who are not from this country. I think that one of the responsibilities of this government or any other kind of government in the world is to provide health care, and make sure that the citizens who are living in this country are healthy.”l