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November 2, 2018

The WSMA formally opposes DHS rule that increases adverse events for children

Seattle, Wash. - The Washington State Medical Association (WSMA) today sent a formal public submission into the Federal Register strongly opposing the proposed rule "Apprehension, Processing, Care, and Custody of Alien Minors and Unaccompanied Alien Children" (Document Citation 83 FR 45486, Agency/Docket Number: ICEB-2018-0002). The final day to submit comments on this proposed rule is November 6, 2018.

The U.S. Department of Homeland Security (DHS) and the Department of Health and Human Services (HHS) propose to “amend regulations relating to the apprehension, processing, care, custody, and release of alien juveniles.” In 1985, plaintiffs in a class action lawsuit, Flores v. Reno, challenged the policies of the legacy Immigration and Naturalization Service (INS) relating to the detention, processing, and release of child immigrants. The parties reached a settlement agreement, referred to as the Flores Settlement Agreement (FSA).

The Flores Settlement Agreement, in addition to placing other restrictions on the government’s actions, requires that children be released from custody within 20 days, (preferably to a parent) and establishes a general policy that a detained child be held in the least restrictive setting, taking into account the child’s age and special needs, until the child can safely be released (generally, in a non-secure facility licensed by a child welfare entity).

The administration's proposed regulation would end key provisions of the FSA. The WSMA submitted formal comment to the Department of Homeland Security opposing the proposed rule, opposing policy that is likely to increase Adverse Childhood Events (ACEs) and called on the administration to retain the Flores Settlement Agreement.

“The WSMA and our House of Delegates voted at our Annual Meeting in October to endorse a resolution that opposes family immigration detention and the separation of children from their parents in detention. The detention of children is harmful and medical research shows it can result in lifelong health and mental health consequences,” said Donna Smith, MD, past president of WSMA and Seattle area pediatrician.

From a healthcare perspective, children held in detention facilities experience increased Adverse Childhood Events (ACEs). ACEs refer to categories of abuse, neglect and household/family challenges that children experience during the first 18 years of life. Peer-reviewed research demonstrates that ACEs have negative health outcomes, and the more adverse events a child experiences, the more that child is likely to experience an increased severity of poor health outcomes.

Current immigration practices that force the separation of families result in children experiencing at least three ACEs—parental separation, emotional neglect and physical neglect from parents who are forcibly separated from their children and cannot provide care for them.

Experiencing an increased number of ACEs in childhood specifically has been shown to increase the risk for autoimmune disease, alcoholism, chronic obstructive pulmonary disease, depression, early death, illicit drug use, ischemic heart disease, liver disease, poor work performance, intimate partner violence, sexually transmitted diseases, smoking, suicide attempts, and unintended pregnancies into adulthood.

Studies of detained immigrant children have further shown that children often subsequently suffer negative physical and emotional symptoms from detention, including anxiety, depression and post-traumatic stress disorder.

The Washington State Medical Association opposes policies that force family immigration detention and the separation of children from their parents and it supports policies that promote unification of families at the border.

Photo courtesy of Trym Nilsen on Unsplash.

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