In an article and video abstract being early released in Pediatrics this month, entitled “Implementation and Impact of a Novel Protocol for Inpatient Asylum-Seeking Children,” Chrisoula Cheronis, MD, Daniela Rey Ardillac, MPH, and Lisa Chamberlain, MD, from Stanford University lay bare the sobering statistics regarding the increased number of people (including children) arriving at the southern US border in search of asylum (10.1542/peds.2024-067987).
The authors also highlight how woefully unprepared many systems are to meet the needs—particularly the healthcare needs—of children who arrive. In fact, they note that only 12 states and the District of Columbia provide health coverage to income-eligible children regardless of immigration status—this when children who are seeking asylum often have more complex healthcare needs than others.
The authors studied the implementation of a novel way to assess and provide care for children seeking asylum, utilizing a team comprised of:
- An asylum-specific social worker, who provided information on topics including but not limited to legal aid, school enrollment, financial assistance, and medical coverage; assessed psychosocial stressors, and monitored on a monthly basis those with more need,
- A program manager, who monitored those with less need, and
- A lawyer.
Participants, all 42 of whom were Hispanic or Latino, were identified based on the knowledge that they moved to the US from another country and the following:
- The patient and/or family was being actively monitored by US Immigration and Customs Enforcement,
- The patient and/or family arrived from a detention center, and
- The patient and/or family arrived to the US within the past year.
Once it was determined that a given participant’s healthcare crisis was stabilized, that they had been properly oriented to the healthcare system and connected to relevant services, they were determined to have “graduated” from the program.
Authors tracked follow-up with subspecialty care and social work over a 32-month period:
- Approximately half of the participants required some form of subspecialty care, and nearly all made it to those follow-up appointments.
- While none of the participants had a primary care provider (PCP) when first enrolled, 96% had a PCP by the end of the intervention.
- One third had active mental health concerns identified.
- Food and/or housing insecurity was identified in approximately half of participants.
- Half of participants graduated from the program while the other half continued to receive and require monthly check-ins.
This contribution provides a way to integrate and track needed services provided to children who immigrate and who need ongoing care. While the reasons that people leave their countries are sometimes unfortunate, we should remind ourselves of the privilege we have to be able to provide services for those in need—especially the children.
