Impact of COVID -19 on Im m igrants in Alam e da County

Luna KohutMiche lle Rive ra Lope zSale m Sulaim anAnni Wang

May 1, 2020

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1.LOCAL CONTEXT

Density Distribution of the Fore ign Born Population

3Source: ACS 2018 1-year estimates

▷ 32% are fore ign born

▷ 44% are not c itize ns

▷ 56% are na tura lize d c itize ns

▷ 129,500 are undocum e nte d

Regions and Countries of Origin

5Source: ACS 2018 1-year estimates

Educational Attainment

6Source: ACS 2018 1-year estimates

Economic Status

7Source: ACS 2018 1-year estimates

Language Abilities

8Source: ACS 2018 1-year estimates

▷ 43.7%of Chinese house holds spe ak Eng lish “le ss than ve ry we ll”

▷ 25.7%of Mexican house holds spe ak Eng lish “le ss than ve ry we ll”

▷ 16.9%of Filipino house holds Eng lish “le ss than ve ry we ll”

▷ 15.4%of Indian house holds spe ak Eng lish “le ss than ve ry we ll”

Takeaways

▷ Im m igrants are m ost conce ntra te d in the Fre m ont, Union City, San Le and ro, and Oakland are as .

▷ The b igge st im m igrant g roups are Chine se , Ind ian, Me xican, Filip ino, and Vie tnam e se .

▷ The b igge st language ne e d s are Chine se and Spanish.

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2.HOW IS COVID-19

IMPACTING THE FOREIGN-BORN POPULATION?

EDUCATION

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General Overview

▷ Each school d is tric t d iffe rs in the re source s availab le to the ir s tude nts .

▷ We chose to do a case s tudy on Oakland Unifie d .

▷ The re are othe r d is tric ts (Albany, Em e ryville , Be rke le y, e tc .) tha t have high ne e ds but offe r fe we r se rvice s .

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▷ ~51.1% of child re n tha t a tte nd Oakland Unifie d spe ak anothe r language a t hom e .

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Case Study: Oakland Unifie d Language Ne e ds

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▷ Language speakers that have the m ost lim ite d English:○ Chine se○ Spanish ○ Vie tnam e se○ Othe r Asian or Pac ific ○ Arabic○ Russian, Polish or

Slavic○ Fre nch, Haitian or

Cajun○ Tagalog

Case Study: Oakland Unifie d Language Ne e ds

▷ Languages Offered on OUSD website:○ Spanish○ Chine se○ Khm e r○ Arab ic

▷ Language s Offe re d on Alam e da County Office of Education we bsite :○ Spanish○ Chine se (Sim plifie d and

Trad itional)○ Fre nch ○ Ge rm an○ Hm ong○ Ita lian○ Japane se○ Kore an○ Portugue se○ Russian 15

▷ Language spe ake rs tha t have the m ost lim ite d Eng lish:○ Chine se○ Spanish ○ Vie tnam e se○ Othe r Asian or Pac ific ○ Arab ic○ Russian, Polish or

Slavic○ Fre nch, Haitian or

Cajun○ Tagalog

Case Study: Oakland Unifie d Language Ne e ds

Free Lunch Locations

▷ The pove rty rate for im m igrants in Alam e d a County is 5.8%.

▷ Many of the se house hold s d e pe nd on school lunche s as a source of food for the ir child re n.

▷ The re are gaps be twe e n the physical d istribution of im m igrants who live in pove rty and locations offe ring fre e school lunche s at this tim e .

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Poverty Density and Free Lunch Locations

Source: BIMI & Alameda County Office of Education

▷ Children who attend OUSD:○ 25.6% Fam ilie s with incom e be low the pove rty

le ve l○ 28.4% Fam ilie s with Food Stam p/ SNAP be ne fits

(National Ce nte r for Ed ucational Statistics 2017)▷ 9%-48% Foreign Born Population in Poverty▷ There is a gap be twe e n fore ign born fam ilie s that live in

are as of high pove rty and the re source d istribution of locations offe ring fre e school lunche s

▷ Re source s Availab le :○ Mond ay: 8:00-12:00 , 3 bre akfasts , 3 lunche s, 3

d inne rs pe r stud e nt and 1 ad ult m e al pe r child ○ Thursd ay: 8:00-12:00 , 2 bre akfasts , 2 lunche s, 2

d inne rs pe r stud e nt and 1 ad ult m e al pe r child ○ 12 school site s○ Me als se rve d the we e k of April 23,2020: 204,711

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Case Study: Oakland Unifie d Pove rty and Lunch Locations

29.1%

42.5%

24.7%

10.6%

▷ Resources offered by Oakland Unified:

○ Free e-books through lib rary se rvice s

○ Computer Access : m ust call to re que st a chrom e book

○ Inte rne t Acce ss : Som e of the firs t d e vice s that we re le nt to s tud e nts have access to hotspots but the re is no fre e wifi re source s . OUSD re fe rs to Com cast’s 60 d ays for $9.99 program for low incom e fam ilie s

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Case Study: Oakland Unifie d Inte rne t/ Com pute r Acce ss

▷ In Alameda county ~95% of households have access to a computer and ~91% of households have internet access .

▷ As of April 14, 2020 , the re que sts for d e vice s from m e m be rs of OUSD we re 1,422 and re que sts for hot spots we re 2,514.

▷ OUSD has announce d tha t the y are working with c ity organiza tions and d onors to he lp c lose the te chnology gap . As they receive donations the district will be purchasing devices or hot spots .

▷ OUSD ordered more Chromebooks but d ue to Covid -19 the y are e xpe rie ncing d e lays .

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Case Study: Oakland Unifie d Inte rne t/ Com pute r Acce ss

Policy Recommendation: Educational Re source s

1) It is im portant to match the languages that are needed with languages that are provided on websites and on flyers. Many school d istric ts only offe re d two language op tions (Spanish and Eng lish).

1) Sim ilar to Oakland Unifie d othe r school d istric ts a re only offe ring fre e lunch in som e of the ir school site s. The re are fore ign born com m unitie s tha t don't have a loca l acce ss to the se re source s . Opening more locations for those who live in high poverty would re lie f financia l s tre ss on the se com m unitie s.

1) Alam e da County Office of Education should provide funding for internet access and not just com pute r be cause the re is a highe r ne e d for inte rne t. Distributing de vice s with hot spots is ide a l if only one stude nt is in ne e d , but in a re as with m any stude nts in ne e d , offering access to community hotspots would be m ost ide a l.

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EMPLOYMENT AND OCCUPATION

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Service and Business -Re late d Im pacts

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▷ A high pe rce ntage of im m igrants work in industrie s tha t would m ake the m “e sse ntia l worke rs” (17% are in the se rvice industry).

▷ The re are no le gal standards for e m ploye rs re gard ing the p rote c tion of the ir worke rs (National Im m igra tion Law Ce nte r).

▷ Layoffs in the Bay Are a , inc lud ing Alam e da County, have incre ase d g re a tly ove r the past m onth (The Me rcury Ne ws) - immigrants who are laid off or unable to find work need financial assistance from non -profits and governmental aid.

▷ Essential immigrant workers must be provided with the necessary protection.

Availability of Personal Protection Equipment

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▷ While the Occupational He alth and Safe ty Adm inistra tion and the CDC have offe re d e m ploye rs guidance on COVID-19, no enforceable legal standard or regulation is in place to require employers to take certain minimum steps to p rote c t worke rs who are on the frontline s of this c risis and risking the ir he a lth and safe ty (National Im m igra tion Law Ce nte r).

▷ Many donation c linics, such as the Alam e da County Disaste r Re lie f Funds, do not provide PPE to m ig rant e sse ntia l worke rs o the r than worke rs involve d in the m e d ica l industry.

Case Study: Nonprofit Financial Assistance

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▷ On the app lica tion, the re is a warning tha t “UndocuFund-SF support is only availab le base d on the m one y we can ra ise . [...] We m ay not be ab le to he lp e ve ryone . By com ple ting this app lica tion, you will be adde d to our waiting lis t.”

▷ Due to the organization’s limited resources and funding , the tim e line for the g rant and crite rion for se le c tion are uncle ar.

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▷ Under the CARES Act, most individuals e arning le ss than $75,000 are e lig ib le for a one -tim e cash paym e nt of $1,200 . [...] To be e lig ib le for a cash re bate , ind ividual file rs and the ir spouse if filing jo intly must have valid Social Security Numbers (SSNs).

▷ This excludes undocumented immigrants. (National Law Im m igra tion Ce nte r)

Case Study: National Financial Assis tance

Policy Recommendation: PPE for Esse ntial Worke rs

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1) The Alam e d a County Gove rnm e nt should ins titute a b ill tha t introd uce s pe riod ic rand om che cks to ensure that employers have personal protective equipment for all workers readily available . The se m e asure s would prote c t e sse ntia l worke rs , e spe c ia lly immigrants, who are disproportionately affected by COVID -19 due to lack of protective equipment .

1) The Alam e d a County Gove rnm e nt should consid e r the im ple m e nta tion of government -sponsored community PPE drives tha t have a channe l sys te m with im m igrant com m unity ce nte rs . For e xam ple , ind ivid uals who contribute hand m ad e face m asks or d onations of hand sanitize r spe c ifica lly for im m igrant com m unitie s could qualify for a tax d e d uction or othe r incom e be ne fits .

Policy Recommendation: Econom ic Re lie f Efforts

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1) The Alam e d a County gove rnm e nt should provide funding and assistance to nonprofits tha t se rve vulne rab le popula tions , e spe c ia lly im m igrants , d uring this tim e . Such fund ing and ass is tance would a llow organiza tions to support more individuals , provide more clarity re gard ing the ir se le c tion and tim e line proce ss , and give more assistance to ind ivid uals in com ple ting the applica tion.

1) Gove rnm e nt se rvice s for COVID-19 e conom ic re lie f should im ple m e nt rapid response consultant lines for application and translation help . Through this , the y can a id im m igrants in p rocuring and id e ntifying ne ce ssary d ocum e nta tion, and id e ntifying spe cific re lie f fund s tha t ca te r toward s the the ir e conom ic and c itize nship s ta tus .

HEALTHCARE

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Immigrant Use of Health Services

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▷ Around 84,000 ind ividuals a re uninsure d in Alam e da County, and an ove rwhe lm ing pe rce ntage of the se ind ividuals (65,000 individuals) are non eligible due to immigration status .

▷ Accord ing to He althAffa irs .org , the Inadm issib ility on Pub lic Charge Grounds penalizes immigrants who have used forms of public assistance including Medicaid , m aking it harde r for the m to ad just the ir im m igra tion sta tus.

○ Eve n as te sting and tre a tm e nt for COVID-19 has be e n e xp lic itly e xclude d from the pub lic charge rule and as the U.S. Citize nship and Im m igra tion Se rvice s (USCIS) has e xp lic itly e ncourage d im m igrants to re ce ive care , m any im m igrants had a lre ady ac te d to lim it the ir inte rac tions with m e d ica l institutions and the ir re liance on pub lic assistance .

Case Study: MediCal and Highland Hospital

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▷ One p rob le m with Me d i-Cal is tha t coverage for refugees is short -term , and organiza tions ra ise conce rns about the com plica te d pape rwork and p rob le m s with the syste m tha t le ave pe op le without cove rage e ve n whe n the y think the y have it. Me d i-Cal cove rage doe s not sta rt until two months after the date of qualification, and m e m be rship cards take as m uch as five months to arrive. ○ Many Alam e da County re fuge e s face syste m atic issue s tha t cause the m to

incre asing ly im pacte d by the slow Me d ica l p roce ss.

▷ Source : m ig ra tionpolicy.org and Johns Hopkins Unive rsity HUB

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▷ Immigrants usually utilize emergency hospitals and urgent care at the last second , and ofte n don’t utilize p re ve nta tive care .

▷ There exists a treatment paradox: For m any im m igrants, the re is a pe rce p tion tha t la rge r fac ilitie s a re ide a l for he a lth care due to re source abundance , and have be tte r se rvice s and m ore language acce ss. Howe ve r, in re a lity, clinics are a better option , both in te rm s of language acce ss and in te rm s of ob ta ining p rim ary care for the ir whole fam ily.

▷ Highland Hospital is the m ain e m e rge ncy hosp ita l in Alam e da County, and is utilized more by immigrants and refugees than any othe r he a lth fac ility be cause it will acce p t insurance le ss pa tie nts . Howe ve r, both Child re n’s Hosp ita l and Kaise r a re ide ntifie d by com m unity organiza tions as having be tte r language acce ssib ility than Highland . Immigrants without insurance are barred from these smaller clinics, which are better -equipped for language needs.

▷ Source : Language Acce ss Ne e ds in Alam e da County: The California Endowm e nt

Case Study: Me d iCal and Highland Hosp ital

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▷ Free COVID-19 te sting is p rovide d to pe op le who live or work in Alam e da County re gard le ss of insurance or im m igra tion sta tus, m e aning tha t this se rvice is acce ssib le by a ll Alam e da County re side nts.

▷ Priority appointm e nts will be g ive n to he a lth care worke rs and those tha t a re a t the highe st risk.

▷ However, almost ALL of the testing places are by drive -through - and a ll re quire e ithe r online scre e nings, re fe rra ls , or the cre a tion of an appointm e nt. Only about two se rvice s offe r walk-up only, but a ll re quire appointm e nt c re a tions, and a few require physician referrals.

▷ Many require appointments, but few offer language services to accommodate phone calls to create these these appointments.

COVID-19 Te sting

Policy Recommendation: Distribution of Inform ation

1) Im ple m e ntation of specific warnings for Medicare and MediCal usage , and assurance that re liance on gove rnm e nt be ne fits for COVID-19 will not cause d ifficulty in m ig ration on all gove rnm e nt insurance -re late d we bsite s. Sim ilarly, government outreach to com m unity le ade rs, flie rs, schools, and im m igrant school ce nte rs will he lp to e nsure this inform ation is wide ly-availab le .

1) Im ple m e ntation of a MediCal card tracking portal available in several languages in which ind ividuals are ab le to track the status of the ir Me d iCal app lication, card shipm e nt p roce ss, and whe the r the ir curre nt status is p rote cte d to incre ase p roce ss transpare ncy.

1) To d ispe rse pub lic inform ation on what clinic or he althcare p lan is be st suite d for the various ne e ds, incom e , and insurance status of m ig rants,

a) The Alam e da County Gove rnm e nt should offe r consultants that recommend specific hospitals or clinics that fits within the m ig rant’s socioe conom ic cond itions, language ne e ds, and e m e rge ncy-re late d situations with COVID-19 sym ptom s.

b)Pamphlets de tailing all availab le clinics listing language support and p re ve ntative hosp ital tre atm e nt m ust be re le ase d to all m ig rant com m unity ce nte rs, post office s in im m igrant-he avy d istricts, schools, clinics, and supe rm arke ts.

c) Social workers should re m ain in constant contact with im m igrant-he avy schools, le gal, and social ce nte rs to e nsure that inform ation is re ad ily d ispe rse d . 39

Policy Recommendation: COVID -19 Te sting and Tre atm e nt

1) Expe nd budge t of $30 ,000 ,000 allowing mobile computers that have one -step contact with face -to -face bedside virtual medical interpreters in large hosp itals such as Highland Hosp ital to im prove its se rvice s with im m igrant patie nts, particularly as the hosp ital is the m ost popular choice for im m igrants. As COVID-19 rate s incre ase , the budge t for translation se rvice s m ust be im prove d . The se com pute r syste m s d ire ctly offe r a translation se rvice that can re ach a translator within se conds, and the n aid conve rsations be twe e n he althcare p rofe ssionals and patie nts.

1) Government grants for large hospital units and small clinics to purchase PatientPing , which allows sharing of patie nt inform ation, d ischarge s, and re ce nt te sts conducte d on patie nts. This allows im m igrants to acce ss clinics for re hab ilitation and COVID-19 tre atm e nts - if re fe rre d to a large hosp ital without ade quate translational re source s, patie nts can be re fe rre d to sm alle r clinics e quippe d for language spe cifications. Whe n d ischarge d , all hosp itals with the syste m will have acce ss to te sts conducte d and tre atm e nt history to p re ve nt doub le te sting p roce dure s.

1) COVID-19 testing centers should include increased walk -in mobile facilities and locations d ire ctly ne xt to BART and pub lic bus stations to incre ase te sting acce ss for im m igrants who have little acce ss to p rivate transportation, are unab le to p lace phone calls , or do not have re fe rrals from physician office s.

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FOOD ACCESSIBILITY

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Use of Food Stamps

42Source: ACS 2018 1-year estimates

Food Insecurity

▷ Food inse curity is d e fine d by the U.S. De partm e nt of Agriculture as “lim ite d or unce rta in availab ility of nutritionally ad e quate food s or unce rta in ab ility to acquire the se food s in socia lly acce p tab le ways .”

▷ Alam e d a County a lre ad y has a 12.2% rate of food inse curity (Fe e d ing Am e rica).

▷ COVID-19 is m aking life e ve n m ore challe ng ing for those that are food inse cure and those living payche ck-to-payche ck.

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Locations of Food Banks

▷ Many of the pe ople now d e pe nd ing on food banks have ne ve r had to d o this be fore , and it can be d ifficult to navigate . Offic ia ls in Alam e d a County Socia l Se rvice s Age ncy have m ad e things e as ie r by introd ucing a ne w inte ractive m ap that a llows use rs to id e ntify food se rvice s c lose s t to the m .

▷ The m ap is availab le a t acgov.org / m aps/ food -se rvice s .htm

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Barriers for Immigrants

▷ Although this e ffort is succe ssful in p rovid ing inform ation, it is not a lways in a language -accessible way.

▷ Additionally, ind ividuals m ight not be ab le to le ave the house or m ight not have access to transportation to the se se rvice s .

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Immigrant Serving Organizations▷ The Center for Empowering Refugees and Immigrants (CERI) is an

organization that re ce ive d fund ing from Alam e d a County Be havioral He alth Care Se rvice s and works to he lp m e m be rs of the ir com m unity through:

○ Delivering groceries to e ld e rs and to fam ilie s with sm all child re n.

○ Translating COVID -19 related information and sharing it with c lie nts .

○ Outre ach to local le ad e rs to advocate for more emergency funds for c lie nts who ne e d cash ass is tance for re nt or g roce rie s .

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▷ Vietnamese American Community Center of the East Bay is a refuge and resource for low -income, South -East Asians and other underrepresented immigrant communities.

○ They work on community frontlines to help care for the underserved immigrant and refugee families in their community.

○ They provide COVID -19 information and graphics in Vietnamese.

○ They work with Alameda County Community Food Bank to distribute to those in need and to also provide translation services.

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Im m igrant Se rving Organizations

Policy Recommendation: Food Insecurity

▷ Subsidizing programs for food delivery companies to partne r with food banks to d e live r to m igrant com m unitie s .

▷ Im ple m e nting m ore widespread distribution of easy -to -use sources that g ive inform ation on a ll food banks , and incre as ing c ircula tion of the avgov.org m ap .

▷ Alam e d a County should re cognize the organizations that are a lre ad y ad d re ss ing food inse curity in und e rre pre se nte d com m unitie s and allot more funding towards these organizations .

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Thank you!Questions?