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Headshot of author Kendra KuehnImmigrant Clients: Casework, Outreach, and Protection

by Kendra Kuehn, MSW, National Adult Protective Services Association

Adult Protective Services (APS) clients who are immigrants bring their own unique vulnerabilities and resource challenges, particularly for undocumented immigrants. According to the Migration Policy Institute, 44.9 million immigrants, or foreign born individuals, lived in the U.S. in 2019 and about 11 million were undocumented. In 2018, the U.S. Census Bureau reported that 13.9% of U.S. residents over age 65 were foreign born and this is expected to increase to 23.3% of the older adult population by 2060. There is limited research on undocumented immigrants with disabilities but existing health conditions are often compounded by a lack of access to health care and other supports according to Pew Stateline.

The National Domestic Violence Hotline and a recent study involving Los Angeles promotores, Spanish-speaking Latino community health workers, both note that immigrant survivors, particularly those who are undocumented, are unlikely to report abuse out of fear of deportation of themselves, family members, or caregivers. Victims may also face abuse specific to immigration such as destruction of important legal documents, threats of deportation, or purposeful delays in legal filings. Immigrant demographics and legal situations are vast and varied. The work and partnerships built by APS can help connect immigrant clients to greater support and raise awareness.

Working with Immigrant Clients

The supports and interventions APS can provide to immigrant clients varies based on the immigrant’s status, federal rules, and state rules. Learning the immigration status of a client can be a critical step in not only understanding their concerns but also the best course of intervention.

With undocumented APS clients, knowing what services, supports, and resources are available in the community and state is important. In California, there are several state-funded programs that APS can turn to for these clients. The Cash Assistance Program for Immigrants serves low-income senior and disabled immigrants not eligible for supplemental security income/state supplementary payment because of their immigration status. They may also be eligible for Cal-Fresh (Supplemental Nutrition Assistance Program) and Medi-Cal (Medicaid) since California maintains a state only funded portion of these programs.

For example, having a relationship with legal services can be crucial for these cases. Legal support can help you and your clients navigate the immigration and other benefits systems and work through challenges specific to immigrants such as an abuser threatening withdrawal of support for legal status, purposefully not filing papers, or lying to the victim about status or benefits.

Many older immigrants are more vulnerable to abusive situations due to the lack of access to benefits. After hospital discharge, older day laborers who aren’t able to work or other low-income immigrants without supports may be forced into neglectful or exploitive housing. One APS director in Texas highlighted current collaborations to address such unlicensed room and board homes. They noted some residents they have worked with are actually documented immigrants but may need help replacing paperwork. In other cases, APS coordinated with consulates for possible support and services. In addition to APS, the county attorney, district attorney, fire department, EMS, and elected officials are working to build certified room and board homes that offer an affordable option for immigrants and others.

icon of a book with a magnifying glass on top of itCase Example

APS programs have also worked to support repatriating (returning) clients to their home countries. In Texas, Cody Minze, Northwest District Director, shared a case recognized by the state in the Core Value Awards. The 70-year-old Jamaican client came to the attention of APS after she was found on a local university campus wandering in a confused state. The hospital found that she suffered from diabetes, dementia, high blood pressure, and poor eyesight. The case worker learned that she had come to the US for eye surgery 10 years ago and since then had moved between different areas in Texas and Florida. She was not eligible for Social Security, Medicare, or Medicaid and there were no family members able to assist her.

After looking at all options, APS worked with the hospital to help the client return to Jamaica. The hospital was able to use charitable funds to arrange for three months of long-term care in Jamaica if APS could get her there. APS worked with American Airlines and their Air Assist program to escort the client through both the Texas and Jamaican airports. Two APS workers were then able to accompany the client from the hospital to the airport. APS also worked with Jamaican authorities throughout the process. Overall, Minze noted that most of their success has been through collaboration with multiple entities including local non-profits, hospitals, and family when possible. Texas APS Director of Field Operations, Camille Payne, also noted working with consulates is important and added that determining citizenship and obtaining immigration documents can be a challenge.

Outreach to Immigrant Communities

From her APS experience, Camille Payne noted every person and their circumstances are different from the next. Research on outreach to immigrant communities reflects this statement. In 2021, Lifespan and the New York State Office of Victim Services convened a New York State Elder Abuse Summit focusing on underserved populations, including immigrants. While a full report will be out in the spring with an updated NYS Elder Abuse Action Agenda to work with multiple generations of underserved populations, Lifespan’s Paul Caccamise and Denise Shukoff shared some preliminary themes important to APS. As noted earlier, they also heard about the reluctance to report and fear of engaging with government are prevalent. A recurrent recommendation was to include members of the community in the planning and design of services.

Research in Los Angeles also reflects this recommendation with the successful use of promotores, to raise awareness of elder abuse. Reaching out to key immigrant groups in the community and bringing them into the conversation on service needs and gaps can move APS towards addressing these recommendations.

Federal Protections for Immigrant Victims

The Violence Against Women Act (VAWA), Trafficking Victims Protection Act, and other statutes provide for various forms of immigrant survivor support (overview available at VAWnet). The intent of these programs is to encourage the reporting of crime, to support victims, and improve investigations. APS is most likely to see VAWA self-petitions or U visa victims.

VAWA allows victims of battery or extreme cruelty by a U.S. citizen or permanent resident spouse or parent or citizen adult son/daughter to self-petition for lawful status in the U.S., receive work authorization, and receive public benefits. Immigrant victims of crime may be eligible for a U visa. One requirement for a U visa is that the applicant is helpful in any part of the process from detection to sentencing. This can include working with APS staff. The Toolkit for Adult Protective Services’ Use of the U Visa developed by the National Immigrant Women’s Advocacy Project, Legal Momentum, and the National Clearinghouse on Abuse in Later Life is an important resource for APS best practice in this area.

Working with immigrant clients, particularly immigrants who are undocumented, can bring a unique set of challenges. Bringing in community collaborations and sharing strategies with other APS programs can help build success in serving immigrant APS clients.



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