Who are we talking about and why is it important?
You will be supporting people who have been denied health care due to their immigration status and/or have real and legitimate fears of deportation if they try to access the system through regular channels. As immigration policies become increasingly exclusionary and conditional, it is more challenging to obtain legal status, and easier to lose it. The system judges you as “deserving” of care one day and “undeserving” the next. We believe that all people deserve to be treated as human beings and receive the care that they need regardless of immigration status.
Will my insurance cover me? Can I be sued?
If physicians are operating within their scope and code of conduct, they are covered to do pro bono work. Some doctors ask patients to sign a governing law and jurisdiction agreement (an example can be seen here) for their own comfort; however, neither Sanctuary Health, nor the Canadian Centre for Immigrant and Refugee Health Care in Ontario have had legal issues. If doctors have more questions, they can call the Canadian Medical Protective Association at (1-800-267-6522).
For more information, please read:
- CMA code of ethics: http://policybase.cma.ca/dbtw-wpd/PolicyPDF/PD04-06.pdf
- Access to medical care: https://www.cpsbc.ca/files/pdf/PSG-Access-to-Medical-Care.pdf
What kind of health issues are likely to come up?
Primary care, chronic disease, well woman and well child visits. Although patients are at high-risk of debt when they go to emergency rooms, all emergencies are directed to hospitals.
What if I need to refer them for diagnostics, or specialists?
We are advocating for solutions for free and subsidised options on a case-by-case basis. It is important to manage expectations about the scope of a general practitioner.
Do I need to change the way I order medications?
No. These patients will take the script to the pharmacy as other patients do. As with other patients who face financial barriers, we encourage you to support your patients by providing stock medications or pharmaceutical samples when possible.
How can I make my practice accessible to people with precarious status?
If you have to ask questions, personal details, or immigration status, it’s important to explain why you are asking first. Assure the patients that you are going to keep their information confidential and that you are only asking so that you can provide the best possible care. It is also important to manage expectations, and explain to the patient the scope of your practice. We encourage service providers, including medical practices, to endorse Sanctuary City principles and to display that endorsement with a sticker at the front desk.
I only speak English. Will I be able to communicate with the patient?
Sanctuary Health attempts to support people with translation when needed by finding volunteers who can accompany patients to appointments.
Who is Sanctuary Health?
Sanctuary Health is a grassroots community group. We deploy direct action, movement-building, community-engagement, and direct support strategies to advocate for access to services for all regardless of immigration status or documentation. We are committed to building cross-sectoral alliances of mutual support to advance the migrant-justice movement on unceded Coast Salish territories.