Caring for Immigrant Patients

Health centers serve underserved communities and vulnerable populations by decreasing barriers to accessing health care services. Patients may include immigrant populations. The following resources may be helpful for health centers and health care providers who care for diverse patient populations.

Status of Public Charge Rule: In Effect as of Monday, February 24, 2020

(Updated 2/3/2020) In August, the Administration released the final version of the “public charge” regulation. This rule will make it likely that legal immigrants will be denied Legal Permanent Residency (aka a Green Card) if they have used, or are considered likely to use, benefits including Medicaid and SNAP.  The final rule was scheduled to go into effect on October 15, but three courts issued temporary injunctions blocking its implementation. These injunctions were appealed to the Supreme Court, which ruled on Jan. 27, 2020 that the rule could go into effect.

On January 30, 2020, the U.S. Customs and Immigration Service announced that they will begin enforcing the new rule on Monday February 24, 2020.  Public benefits used prior to that date will not be considered in public charge determinations.

Resources on Public Charge: The following resources address how the new rule will impact health center patients and their families, and how to talk to patients about public charge:

Status of Presidential Proclamation Requiring New Immigrants to Have Health Insurance: Not in Effect

On November 2, 2019, the U.S. District Court in Portland, Oregon issued a temporary restraining order blocking last month’s presidential proclamation, which was scheduled to go into effect on November 3. The proclamation requires that all new immigrants to the U.S. have health insurance within 30 days of arriving, or else demonstrate that they have the financial resources to cover “foreseeable medical expenses.”

Resources for Establishing Medical-Legal Partnerships

The following materials were prepared by the National Center for Medical-Legal Partnership, using cooperative agreement funds provided by HRSA’s Bureau of Primary Health Care.

Join the National Health Center Immigration Workgroup

To ensure that health centers are appropriately prepared to support their immigrant patients, NACHC has collaborated with the California Primary Care Association (CPCA) and the Asian-American Pacific Islander Community Health Organization (AAPCHO) to form a National Health Center Immigration Workgroup.  This workgroup seeks to:
  • educate health centers, PCAs, and HCCNs about proposed and actual policy changes impacting immigrant patients;
  • develop and share resources to support participants in understanding and responding to actual and potential policy changes; and
  • work to align and coordinate messaging around policies impacting immigrant patients.

All staff and Board members from health centers, PCAs, HCCNs, and NCAs are welcome to join the Workgroup.

Talking About Public Charge with Immigrants and Their Families

The Protecting Immigrant Families Coalition has published an issue brief on this topic.

Updated (February 2018) Sample Policies and Procedures by CaliforniaHealth+ Advocates 

CaliforniaHealth+ Advocates, the advocacy affiliate of the California Primary Care Association (CPCA), recently updated its six (6) sample policies and procedures that will help clinics prepare themselves and patients for on-site inquiries regarding service delivery to immigrant patient populations. CaliforniaHealth+ Advocates worked very closely with legal counsel, Feldesman Tucker Leifer Fidell LLP (FTLF) and immigration partners, like the National Immigration Law Center (NILC), to provide clear, detailed and direct policies and procedures that can be implemented immediately to help immigrant patients while they seek services at a health center.

Also, CPCA, in partnership with the Northwestern PCA, is hosting an immigration webinar series where the sample policies and procedures will be reviewed in detail. If you would like to register for any upcoming webinars regarding immigration or would like to see the recording of any past webinars, please go to CaliforniaHealth+ Advocates immigration resource page.

FAQs by Feldesman-Tucker, at the Request of the California Primary Care Association

Issues covered in these FAQs include protections for Personal Health Information, public and private spaces within health centers, and potential implications of being a “sanctuary location.”

Update (August 2017) Resource Slides from Centers for Disease Control (CDC) to Assist Clinical Providers in Caring for Immigrant Patient Populations

A detailed presentation addressing basic information about refugee resettlement, immunization programs, CDC’s role in screening patient populations and health center resources for health providers caring for immigrant populations. Prepared by the Immigrant, Refugee and Migrant Health Branch of CDC.

Update (August 2017) Resource Slides from the National Immigration Law Center (NILC) on “Supporting Immigrant Clients”

A detailed presentation providing updates and recent policy developments about providing services to immigrant populations.

NILC Health Care Toolkit for Providers

The toolkit includes tools for understanding rights as providers, resources to help providers understand patients’ rights, tips and suggestions for creating safe spaces for patients and staff, and sample materials that can be adapted for facilities. These materials are updated on an ongoing basis. The toolkit is accessible at and requires a one-time, free registration.

Resource Slides from the National Immigration Law Center (NILC) on “Protecting Your Immigrant Patients’ Access to Health Care” (April 2017)

A detailed presentation addressing basic information about immigration and health access; recent policy developments; providers’ and patients’ rights; and creating safe spaces. See page 43 for a sample notice about being a “safe space.”

NILC Fact Sheet for Health Care Providers

This fact sheet outlines legal rights of health care providers and patients, and limits on enforcement powers of immigration officials.

NILC Issue Brief: “Is It Safe to Apply for Health Insurance or Seek Health Care?”

This fact sheet provides information that all families should have when they apply for and enroll in health insurance programs or seek health care services.

Advisory from the Northwest Immigrants’ Right Project

This document, recommended by NILC, discusses how to respond if immigration agents come to your building


This page covers an emergent topic facing health centers and is updated periodically to be responsive to those issues. This provides general information and is not a substitute for legal advice. Consult with an attorney who can advise your organization based upon local, state and federal laws.