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Thursday, April 18, 2024

Alachua County immigrants fear new SB 1718’s impact on health care

Individuals aren’t required to answer the documentation status question asked at hospitals

Project Continuity with UF Health educating the public about Pap tests and cervical cancer on Sept. 30, 2023.
Project Continuity with UF Health educating the public about Pap tests and cervical cancer on Sept. 30, 2023.

With a community plagued by doubt, Guatemalan immigrant Adriana Menendez is buried by countless calls from Hispanic immigrants to the Project SALUD referral line about a new immigration law.

The referral line, managed by Menendez, is part of an initiative from the nonprofit Rural Women’s Health Project. Callers can receive medical advice, legal assistance and other lifesaving resources. 

The growing number of calls stems from Gov. Ron DeSantis’ signing of Senate Bill 1718 in May, Menendez said.

“[At] that time there was so much fear,” Menendez said. “That’s when I really saw the fear, when I received call after call about the same subject and the same questions.”

The law took effect July 1 and is among the strictest immigration laws in the country. The legislation restricts the transportation of illegal immigrants across states, creates rigorous verification of citizenship for employers and requires hospitals to ask about patients’ immigration status. 

One of the controversial aspects of the law is the provision requiring any hospital that accepts Medicaid to ask patients whether they are U.S. citizens, lawfully present in the U.S. or not lawfully present in the U.S.

Immigrants constituted 24.4% of the population growth in Gainesville from 2014-2019, increasing the number of immigrants in the city to around 14,800, according to city data.

Menendez, along with a host of local advocacy organizations, health care workers and community members worry about the impacts the law could have on immigrant households across Alachua County.

Advocacy groups’ initiatives

Project SALUD has seven comunicadoras — communicators — who share information about services with the community. Recently, Menendez said the organization is focused on informing immigrants they don’t need to share their citizenship status with hospital staff.

Although there are no consequences for not answering the question, Menendez said, immigrants are choosing to avoid hospitals due to fears and safety concerns about the law. 

One undocumented woman who spoke with her decided to have her baby at home with a midwife because she was nervous about the risks of a hospital visit. In more severe cases, families fled the state, Menendez said.

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“They were so afraid of what could happen and they said specifically… ‘I might not know the area, I might not know anybody there, but I know I’m going to be safer than in the state of Florida,’” Menendez said. 

Health care services

UF Health hospitals do ask patients for their citizenship status, although outpatient facilities aren’t required to ask patients the question, UF Health spokesperson Gary Mans said.

“The inquiry must be followed with a statement that the response will not affect patient care or result in a report of the patient’s immigration status to immigration authorities,” Mans said.

The Emergency Medical Treatment and Labor Act ensures all patients regardless of citizenship or immigration status have access to emergency medical treatment. 

An internal medicine resident from HCA North Florida, who asked to remain anonymous due to concerns about losing employment, said they do not ask about the immigration status of a patient during admissions.

Immigration status may bias the care patients receive at health facilities, they added.

However, the resident said they must consider questions about documentation status during the discharge process.

“Can they receive proper follow-up [care]?” they asked. “Can they go to an outpatient [rehabilitation] facility?” 

Gainesville has two local clinics funded through grants and donations and they aren’t required to ask about immigration status. Two of those clinics are UF’s Equal Access Clinic and Mobile Outreach Clinic.

In addition to language interpreters on-site, EAC offers a Spanish night when all clinic services are in Spanish. This event is held every Monday from 5:30 p.m. to 9 p.m. at 7th Day Adventist Church.

The MOC and the EAC are both present at the free health fairs organized with community partners like Children Beyond Our Borders.

Young-Rock Hong, UF assistant professor in the health services research, management and policy department, said there is a current lack of evidence on this policy’s impact on hospital utilization.

It would take some time for data to accumulate before we would be able to do so, Hong said.

However, Hong said he believes there has already been some impact on the immigrant community in Florida as access to health care has been a long-standing issue.

“Many immigrants may fear that seeking health care would reveal their immigration status, making hospitals immigration screening centers instead of safe and lifesaving places,” Hong said.

Community concerns

Another part of SB 1718 causing unease among local immigrant communities is the provision specifying certain driver's licenses issued by other states exclusively to unauthorized immigrants are not valid in Florida.

To combat concerns, Veronica Robleto, the Human Rights Coalition of Alachua County program director and legal navigator, said the organization instituted a community ID program.

The HRC community ID program provides a reliable form of identification to local immigrants who may have limited access to a government-issued ID card that has been officially recognized by the County Commission and County Sheriff’s Office.

The community ID is also accepted by UF Shands, the Mobile Outreach Clinic and Equal Access Clinics.

Yet, the community ID program faces funding concerns due to the new law. The first provision of SB 1718 prohibits local cities and counties from providing funds to community ID programs. 

“The way it's written in the law is it prohibits from providing funds to any entity that issues IDs without confirming lawful presence or someone's immigration status,” Robleto said.

The organization recently launched a fundraising campaign to keep the program afloat, Robleto said.

Tabora, a 27-year-old Honduran immigrant, attended the free health fair with her husband who works at UF. She lives in Texas but visits Gainesville often and said she was pleasantly surprised by the resources available at the event. 

As an international student, Tabora said she worries about the effects of SB 1718 on the medical decisions other students make. Medical services are costly for international students, she said, and with the new law, they will only feel more discouraged to seek that help.

The law feels like a loss and an injustice to the community, Tabora said. 

“In some part, it feels unfair,” Tabora said. “With all the effort immigrating entails for people, they are just looking for better opportunities and then are denied those opportunities.”

Contact Valentina and Jinelle at vsandoval@alligator.org and jvazquez@alligator.org. Follow them on Twitter @valesrc and @vazquezjinelle.

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Valentina Sandoval

Valentina Sandoval is a third-year journalism major and the Spring 2024 Enterprise Editor. Whenever she's not writing, she's expanding her Animal Crossing island, making Spotify playlists or convincing someone to follow her dog on Instagram.


Jinelle Vazquez

Jinelle Vazquez is a senior at UF pursuing a major in Public Health with a minor in Indigenous Studies. They currently report for the enterprise desk covering health. In their free time, they enjoy hiking, photography and making art.


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