Read Stateline coverage of the latest state action on coronavirus.
As the COVID-19 crisis unfolds, the Trump administration has reversed long-established protections for children from Central America found alone at the border.
Unaccompanied children caught at the border may now be sent back to their home countries, despite a long-established policy that they be turned over to host families in the United States during court proceedings, according to U.S. Customs and Border Protection policy sent to Stateline.
The policy helped fuel a surge of Central American immigration dating back to the Obama administration as children fled gang violence in El Salvador, Guatemala and Honduras, often arriving alone to join mothers who had found work to support them in the United States. A 2008 law, enacted during the Bush administration, required that the children be transferred to U.S. homes to avoid putting them back into the hands of traffickers at the border.
Immigration advocates said the new policy, framed as a response to a March 20 order by the Centers for Disease Control and Prevention suspending travel from countries with coronavirus cases, is unfair to children seeking protection from violence.
“Sending back vulnerable children who are seeking refuge in the U.S. is not only a violation of the law, but inhumane,” said Jennifer Anzardo Valdes, director of the children’s legal program at Americans for Immigrant Justice, a Miami-based legal clinic.
Randy Capps, the director of research for U.S. programs at the nonpartisan Migration Policy Institute, said the new policy maintains that the CDC order invalidates protections under the 2008 law, a claim that will likely be settled in court.
The Center for Immigration Studies (CIS), which calls for lower levels of immigration, defended the border patrol policy.
“It’s impossible for these illegal arrivals to be screened for infection by the coronavirus, so putting kids through the standard processing would risk transmission of the disease to agents, staff and other kids,” said Jessica Vaughan, director of policy studies for CIS.
Federal Health Authorities Grant Greater Flexibility to States, Health Systems
Federal health authorities have given greater flexibility to states and health systems to meet the surge of COVID-19 patients, including allowing them to use non-hospital settings to treat cases, expanding the responsibilities of nurses and physician assistants and approving the use of telemedicine for dozens of medical services.
Previously, states had to apply for and receive permission from the Centers for Medicare and Medicaid Services to take such steps. The announcement relieves them of that administrative burden, enabling them to act immediately.
“This unprecedented temporary relaxation in regulation will help the healthcare system deal with patient surges by giving it tools and support to create non-traditional care sites and staff them quickly,” CMS Administrator Seema Verma said in a statement announcing the policy change.
The announcement gives hospitals permission to use off-site facilities, such as ambulatory surgical centers, for medical services normally performed only in a hospital. It enables hospitals to use non-hospital facilities for both patient care and quarantine sites. It also enables hospitals to perform COVID-19 testing of patients in settings outside the hospital, including at drive-thru and other non-campus sites.
CMS also will allow reimbursement for ambulances to transport patients with acute medical needs to locations other than hospitals, including community health centers, doctor’s offices, urgent care and ambulatory centers and facilities providing dialysis services.
CMS will allow hospitals to expand the responsibilities of non-physician medical providers to order tests and medications and perform other tasks that may have previously required a physician’s orders.
The order also allows hospitals to increase support for their medical staffs such as by providing multiple daily meals, laundry for their personal clothing or childcare services.
Finally, CMS has approved an expanded list of telehealth medical services for which it would provide Medicare and Medicaid reimbursement at the same rate as in-person encounters, including visits with emergency rooms and remote monitoring of chronically ill patients in their homes.
Testing Companies Overwhelmed by Backlog
Although testing is now reaching about 100,000 people a day, results often are delayed, as the private companies that conduct most of the testing — particularly in California — are overwhelmed with a backlog of tests. The slow results are “delivering a heavily lagged view of the outbreak to decision makers,” according to The Atlantic.
California has a backlog of more than 55,000 tests, and some counties have shown gaps in testing when compared with their counterparts.
Some hospitals in New York, the epicenter of the pandemic, still lack the capacity for reliable on-site testing, forcing them to send samples to labs and wait days for results.