The county could begin asking the citizenship status of people getting immunizations, checkups and disease screenings at health department clinics starting in January.
Sedgwick County Commission Chairman Richard Ranzau proposed the idea this month, saying it could help determine how many illegal immigrants use the county health department.
“I think they are using a lot of services, personally,” Ranzau said. “But, in our own community in Sedgwick County, do we really know for sure unless we ask the question?”
County employees are drafting a form that would ask anyone seeking benefits from the health department about his or her immigration or citizenship status. They hope to have a final version by Nov. 19. If approved by commissioners, the form could be in clinics by Jan. 1.
Commissioners who support the idea say no one would be denied services. But immigration and public health groups say it will discourage some families from seeking care, which could put community health at risk.
“It absolutely will have negative consequences for people seeking health support for their families in need,” said Douglas Greenaway, president and CEO of the National Women, Infants and Children Association, a nonprofit education and advocacy group.
Ranzau has also been criticized by immigrant and progressive groups for asking the state to restrict illegal immigrants from using the WIC nutrition program, which he calls a “welfare program under the guise of a public health program.” One group plans to submit its application for his recall soon.
The county health department served 41,411 unique visitors between October 2014 and the start of this month, according to county data. It provided immunizations, family planning, dental work, cancer screenings, sexually transmitted disease exams, tuberculosis control and services to mothers and infants.
Asking a question about legal status would give the county hard numbers about whom the health department serves, Commissioner Jim Howell said.
“We’re simply collecting data,” Howell said. “We’re not discriminating or even suggesting that we would limit resources or services to anybody based on the answer to this question. We would just like to understand who the population is.”
The data would test assumptions about illegal immigration and the use of taxpayer-funded services, he said.
“We’ll never know the answer if we don’t ask the question,” Howell said. “There is nothing wrong with getting data.”
Howell said the county could create safeguards to protect the people who answer the questions.
“It’s possible we can collect the data and not even tie the answers back to the actual clients,” he said.
The county needs to clearly communicate it would not check for documentation of someone’s status, Howell said.
“If they want services, they ought to be willing to read the sheet and check the box and get their services, and they’re going to be fine.”
Ranzau said he didn’t know whether people would avoid the health department over questions about citizenship status.
“I can’t predict the future and what people will do or not do,” Ranzau said. “But supporters of illegal immigration are going to find every excuse in the book to try to say we shouldn’t at least gather data.”
Public health groups and immigration advocates say commissioners are floating a dangerous idea.
They contend illegal immigrants will be skeptical of a local government department asking about their immigration status. That may cause them not to seek health services, to the detriment of community health.
Jenny Rejeske, a health policy analyst with the National Immigration Law Center, said the policy would have a chilling effect.
“It creates these additional barriers, and immigrants are already reluctant and fearful to use services that are perceived to be government services,” Rejeske said.
“These kind of questions would only serve an anti-immigrant agenda and absolutely undermine public health,” she said.
Michelle Ponce, executive director of the Kansas Association of Local Health Departments, said ensuring individual preventive care benefits the entire community. Sedgwick is one of three Kansas counties not a part of the group.
“You would not want to put any kind of policy in place that would deter any individual from seeking that service,” Ponce said.
As an example, she said, “having pockets of unvaccinated individuals within a community increases risk of transmission of preventable diseases to everyone.”
Commissioner Dave Unruh, who opposes the change, doubts the county would get accurate data.
“I don’t think we would get truthful answers out of the folks that it seems like the chairman is focused on,” Unruh said.
“It would deter a lot of the people from seeking the services that we offer,” he added.
Djuan Wash, a spokesman for the progressive group Kansas People’s Action, said he thought maybe that was the intent of the proposal.
“These families are already afraid to begin with,” Wash said. “The goal is to make life so miserable for them that they self-deport.”
Role of public health
Ranzau said private and nonprofit groups should step up if they’re concerned about illegal immigrants avoiding county health services out of fear.
“If they’re truly concerned about that, they can pool their money and resources and open up their own clinic that’s not funded by taxpayers,” Ranzau said. “They can provide health care and whatever else they want to anybody they want and not ask any questions.
“They need to stop trying to tell other people they should be forced to subsidize illegal immigration,” Ranzau said.
But some say it’s the county commission’s role, as the board of public health, to promote the health of all residents.
Greenaway said immigration or citizenship status should not matter to a public health department.
“If someone walks through the door and they have tuberculosis, whether they are documented or undocumented, they have tuberculosis,” he said.
Gianfranco Pezzino, a Kansas Health Institute senior fellow, said there is a general attitude among public health officials to reach everyone in society.
“We should try to reach out to anyone that needs a preventive service as much as we can and try to remove as many barriers as we can,” Pezzino said.
Scope and legality
It is unclear how common this practice is nationwide and in Kansas.
Officials in neighboring Reno, Sumner, Kingman, Harvey and Butler counties told The Eagle on Friday they don’t ask for clients’ immigration status.
Sedgwick County staff members are studying whether any regulations would prevent them from asking people about their citizenship status.
Depending on the grant or service, the department may be limited in what it can legally ask, Ponce said.
“Many of the programs provided through health departments are funded federally,” Ponce says. “Some of the rules and guidelines around what can be asked of beneficiaries are set by the federal programs.”
For Pezzino, the legality of asking about citizenship status is not the issue.
“Just because they may do it legally is not a good reason to do it,” Pezzino said.
Howell said there are legitimate reasons to collect the data. He favors the final form including assurances about how the responses would be used.
“This is not some sneaky way to go after people and collect their names and addresses and somehow turn that over to immigration agents,” Howell said. “There is no sinister intent here.”
But Pezzino worries such assurances would be treated skeptically by the immigrant community.
“A government agency is not in the best position to provide those reassurances,” he said.