School Finance

A ‘chilling effect’: Immigrants may decline school-based health services if proposed rule is adopted, advocates say

PHOTO: Christina Veiga

One student stands out in Dr. Viju Jacob’s mind when he thinks about all the patients he’s seen in his 15 years at school-based health clinics: a Central American immigrant enrolled at a Bronx high school in 2012.

The student did not have insurance, which Jacob said is common for new immigrants, but the clinic offers free care regardless of a student’s immigration or insurance status. That’s thanks to Medicaid funding from other students’ claims.

Over the next four years, the student returned to the clinic, located in his school, when he needed a physical or simple treatment. But it wasn’t just his physical health that improved.

“He got a lot of soft emotional support,” Jacob said. “Coming to us, having people who spoke his language or his native language to sort of encourage him, help him with filling out forms.”

Jacob and immigrant advocates worry students like this may not get the support they need under a new federal proposal that would make it tougher for immigrants to successfully seek green cards if they rely on public benefits.

“Especially in New York City and in the New York City public school system, a large portion of the student population in some shape or form is on Medicaid or Medicaid managed care,” Jacob said. “That is such a large pool that could be affected if this rule gets implemented.”

To receive a green card, immigrants currently have to prove they won’t be a burden on the government, so officials already consider the cash benefits that they receive when reviewing applications. But now, for the first time, the Department of Homeland Security wants to expand the rule so that green cards can be denied to immigrants who rely on benefits such as non-emergency Medicaid, Medicare Part D, food stamps or forms of housing assistance.

Researchers and immigration advocates believe that even though a final decision on the proposal is months away, news of this rule could persuade large swaths of immigrants to halt their public benefits, out of fear it will affect their ability to become permanent U.S. residents — even if that’s not the case.

For example, the proposal currently includes an exemption for Medicaid benefits used by school-based health services, an official from the city’s department of education said. But with uncertainty remaining about how the rule change might be enforced, or additional changes that could occur in the future, many advocates for immigrants worry that those applying for green cards may decide it’s better to avoid Medicaid altogether rather than risk utilizing benefits that could create problems for them down the line.

In a recent analysis, the city estimated that 75,000 New York City immigrants may decide to choose between benefits and a green card.

And fewer Medicaid enrollees would mean fewer dollars rolling into clinics that serve at least 387 schools across the system, since they operate through partnerships with healthcare providers and depend, in part, on Medicaid funding that students may claim. It’s too early to tell what the impact might be, but advocates, analysts, and even the federal government have acknowledged that the rule change could result in a drain on funding.

“It’s bad enough for the families, and it’s even worse for us because we rely heavily on that funding stream,” said Jacob.

Clinics were a big part of Mayor Bill de Blasio’s first-term education agenda, which involved providing more schools with wrap-around services.

“Taking away services that keep children well-fed and healthy is wrong,” said Jaclyn Rothenberg, a spokeswoman for de Blasio, in a statement to Chalkbeat. “We’ll continue to ensure that our children, regardless of their and their family’s immigration status, have the resources they need to succeed in and out of the classroom.”

It’s not clear how many children are enrolled in the school-based clinics or how many, on average, use them. At first the city’s Department of Education didn’t respond to requests for comment about the rule change, including what portion of Medicaid funds buoy school health clinics, which are run by medical centers, local hospitals and community organizations.

Two days after an initial version of this story was published, a department of education spokesman noted that the rule exempts school-based services that are reimbursed by Medicaid, but did not comment further.

According to Jacob, who is also board chairman of New York School Based Health Alliance, it’s typical for clinics to receive between two-thirds to half of their funding from Medicaid. The rule is expected to threaten the livelihood of similar clinics in other states, such as Colorado.

If enough people pull out of Medicaid, clinics could seek specific grant funding instead, Jacob said.

This is the latest immigration issue that New York City’s top education officials have had to grapple with. In the past, they’ve been quick to respond, such as reassuring families that their information is safe with the school system. Last year, a school in Queens turned federal immigration agents away after they showed up and asked about a fourth-grader. (U.S. Citizenship and Immigration Services said it was an administrative inquiry.)

Last March, the school system updated guidance for principals on immigration issues, stating that only local law enforcement can enter a school unless they have a warrant or unless imminent harm is expected.

The Department of Homeland Security touts its proposal by saying its primary benefit would “help ensure that aliens who apply for admission to the United States, seek extension of stay or change of status, or apply for adjustment of status are self-sufficient, i.e., do not depend on public resources to meet their needs but rather rely on their own capabilities and the resources of their family, sponsor, and private organizations.”

In addition to the carve-out for school-based health services, the rule change wouldn’t affect free and reduced-price lunch, which is universal in New York City. The rule also wouldn’t apply to families making less than 15 percent of the federal poverty level, refugees, asylum-seekers, legal immigrants in the military or immigrants who receive assistance after natural disasters.

Still, the Kaiser Family Foundation estimates that a “chilling effect” could even dissuade people who are enrolled in the Children’s Health Insurance Program, also known as CHIP, from continuing to receive the benefit. CHIP is not currently included in the proposed rule change but may be added at a later date; the Department of Homeland Security has invited comment on this possibility. Other analyses come to a similar conclusion, including a June report from the Migrant Policy Institute.

“In theory people should understand that they don’t need to disenroll their child from benefits because that’s not going to affect them,” said Mike Greenberg, a senior fellow at the Institute, which did an analysis of the “chilling effect” the rule could have. “In practice it may still have that effect because this is very complicated, and we’re operating in an environment of so much fear and uncertainty.”

Beyond clinics losing funding, immigrant parents might be too scared to let their children go to an in-school clinic. Advocates said there is a fear among immigrants over what information government institutions are collecting and how it could be used against them.

Christina Samuels, manager of education policy at the New York Immigration Coalition, said her organization has raised these concerns with the education department, which has said it would protect families’ information. School health clinics don’t ask about immigration status and are exempted from the current proposed rule change.

In Jacob’s experience, students of different ages use the school health clinics for different reasons. Elementary-school students tend to show up because their parents’ work hours are at odds with doctors’ appointment times, and they can’t afford to take a day off. Those children may have an injury looked at, receive treatment for a stomach ache, or get an immunization.

Middle-schoolers usually get their shots or physicals, and some start to ask about reproductive health. And in high school, students receive a number of services, and preventative and emergency contraception may be addressed.

Outside organizations help staff counselors and social workers at some city schools, which staffers say are already stretched thin. Those, too, could also see more demand as students lose reliable access to food and healthcare, Samuels said.

She also pointed to the mental stress on immigrant students digesting another immigrant-related proposal out of Washington, such as the proposed ban on travelers from certain Muslim countries.

“Now we’re getting into a period where we’re really concerned about the mental health and behavioral health of students,” Samuels said.

City Hall officials have blasted the proposed rule but have also cautioned that no changes have gone into effect. In a recent press conference, De Blasio said President Donald Trump is trying to “hurt the very people who are contributing to our economy and our future. It makes no sense and we are going to fight it.”

Last week, the federal government opened a 60-day period that allows public comment on its rule. After that, officials will take another 60 days to make a final decision.

CORRECTION: A previous version of this article suggested that school-based health benefits were subject to the proposed rule change. Under the proposal, these benefits are exempt.

school facilities

Cold temps close Memphis state-run schools, highlighting bigger issue of repairing costly, aging buildings

PHOTO: Caroline Bauman
Georgian Hills Achievement Elementary was one of four school closed Tuesday due to heating issues.

More than 1,200 students in Tennessee’s turnaround district stayed home from school on Tuesday because their school heating systems weren’t working properly.

Temperatures dipped below 35 degrees, and four schools in the Achievement School District opted to cancel classes because of boiler issues: Georgian Hills Achievement Elementary School, Frayser Achievement Elementary School, Corning Achievement Elementary School, and Martin Luther King Jr. High School. In addition, Kirby Middle School decided to close Wednesday.

Aging school buildings in Memphis have caused headaches and missed school time for Shelby County Schools and the Achievement School District, which occupies buildings rent-free from the local district. Just last week, Hamilton High School in Shelby County Schools closed for two days after a power outage caused by heavy rain, and Kirby High School remains closed because of a rodent infestation. Kirby’s students are being housed in different schools for the rest of the semester while repairs are made to rid the school of pests. And Shelby County Schools had to deal with the dropping temperatures on Tuesday as well, with Westwood High School and Oak Forest Elementary ending classes early due to their own heating issues. Westwood High will remain closed Wednesday.

But Tuesday’s closures for state-run schools point to a larger issue of facilities: In a city full of older school buildings needing expensive updates, who pays, and who does the work? There is a formal maintenance agreement between the two districts, but the lines that divide responsibilities for repairs are not always clear.

Shelby County Schools is responsible for bigger fixes in the state district, such as new roofs or heating and air conditioning systems, while the state district’s charter operators are responsible for daily maintenance.

Bobby White, chief of external affairs for the Achievement School District, said they are working with Shelby County Schools to resolve the heating problem at the three elementary schools, two of which share a building. But he said that the issues won’t be fixed by Wednesday, and the schools will remain closed.

“We know it throws off our teachers and students to miss class,” White said. “It’s an unfortunate situation. And it underscores the larger issue of our buildings not being in good shape.”

The charter organization Frayser Community Schools runs MLK Jr. High School as part of the Achievement School District, and a spokeswoman for Frayser said they were handling the boiler repairs on their own as opposed to working with Shelby County Schools. School will remain canceled at the high school on Wednesday.

“Currently our maintenance team is working with a contracted HVAC company to rectify the heating issue,” Erica Williams told Chalkbeat. “Unfortunately, it was not resolved today, resulting in school being closed Wednesday. While our goal is to have school as soon as possible, we want to make sure it’s in a comfortable environment for our students.”

The state district was created in 2012 to turn around the state’s lowest-performing schools by taking over local schools and giving them to outside charter organizations to run. Shelby County Schools has a crippling amount of deferred maintenance for its school buildings, including those occupied by the state district, that would cost more than $500 million. The Shelby County district prioritizes how to chip away at that huge cost based on how many children are affected, the condition of the building, and the type of repair, spokeswoman Natalia Powers told Chalkbeat, adding that the district has made some major repairs at state-run schools.

But Sharon Griffin, chief of the Achievement School District told Chalkbeat previously that one of her goals is to resolve problems more quickly with Shelby County Schools when a major repair is needed to avoid lost class time.

Still counting

Jeffco bond measure that had been failing pulls ahead in narrow race

PHOTO: Andy Cross/The Denver Post
Students work on breathing exercises during a yoga class at the end of the school day at Pennington Elementary School.

Update: Over the weekend, the bond measure pulled ahead and is currently headed toward passage, with 50.3 percent of the vote. We’ll continue to update this post as new results come in.


Vote tallies released Thursday in Jefferson County show that a $567 million bond request is down by just 132 votes, opening up the possibility that it might yet pass.

We previously reported that Jefferson County voters had approved a $33 million local tax increase but turned down the bond request. At midday Wednesday, just 48 percent of voters had said yes. The gap was roughly 7,000 votes, and the trend hadn’t changed since the first returns were posted Tuesday evening. It appeared to mark the second time in two years that Jeffco voters had turned down a request to issue debt to improve school buildings.

But by Thursday evening, with additional ballots counted, the margin by which Jeffco Measure 5B was failing had narrowed significantly. The 132-vote margin is currently within the window that would trigger an automatic recount. A mandatory recount is triggered when the difference is one half of one percent of the number of votes cast for the higher vote count, according to officials from the Secretary of State’s office.

Backers of the tax measures are holding out hope the result could change.

District officials said they plan to use the proceeds of this year’s tax measures to raise teacher pay, increase mental health support for students, beef up school security, expand career and technical education, improve science facilities, add more full-day preschool, and buy classroom materials and technology.

On Wednesday, Katie Winner, a mother of two students in Jeffco schools, told us the two tax measures were closely tied and both equally needed.

“I want to know what voters were thinking,” she said. “I didn’t see one without the other.”

We’ll keep tabs on the counting and update you as soon as we have a final tally.