Immigrants’ Use of New York City Programs, Services, and Benefits: Examining the Impact of Fear and Other Barriers to Access

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Executive Summary

New York City is a “welcoming city” that encourages “all New Yorkers regardless of immigration status” to access the public benefits and services for which they qualify (NYC Mayor’s Office of Immigrant Affairs or “MOIA” 2021a). Moreover, it invests significant resources in educating immigrant communities on this core commitment and its lack of participation in federal immigration enforcement activities. However, this report by the Center for Migration Studies of New York (CMS) finds that immigrants in New York City still face significant barriers to accessing public benefits and services.  

The report is based on CMS research that examined immigrant fear and other barriers in three general areas: the use of public benefits, with a particular focus on the public charge rule; the use of public health services; and access to law enforcement and the courts. The report documents how Trump-era immigration policies perpetuated fear among immigrant communities, in the context of other barriers to accessing services and benefits, and why its detrimental impacts have persisted and outlived the Trump administration.

The research included semi-structured interviews with 75 immigrants across all five boroughs of New York City and two focus groups with immigrants in both English and Spanish. The interviews documented the prevalence and impact of fear and other factors that impede (and facilitate) immigrants’ use of public benefits and services. The respondents were from 30 countries across all regions of the world and had varied legal statuses and lengths of stay in the United States. The CMS research team also interviewed 16 social service providers from community-based organizations (CBOs) and New York City agencies, including the Department of Health and Mental Hygiene (NYC DOHMH) and the Human Resources Administration/Department of Social Services (HRA), and eight healthcare providers and social workers from the city’s public hospital system, NYC Health + Hospitals, who worked with immigrants across the city.  

The project ran from January 2020 through October 2021, spanning most of the last year of the Trump administration and most of the first year of the Biden administration. Data collection started in November 2020 and extended through the COVID-19 vaccine rollout starting in spring 2021. 

The report finds that Trump-era anti-immigrant rhetoric and immigration policies, including aggressive enforcement tactics and a new rule on the public charge ground of inadmissibility, exacerbated long-standing fear pertaining to lack of status, family separation, detention, and deportation. The COVID-19 pandemic has further increased the need for services and assistance for all New Yorkers, including immigrants.   

The report also finds that the change in administration, the widespread recognition of the essential work of immigrants in response to COVID-19, and the pandemic’s disproportionate impact on immigrant and minority communities did not eliminate immigrants’ fear or other barriers to accessing public benefits and protection in one of the most immigrant-welcoming communities in the country. Misinformation, language barriers, culturally-rooted concerns, and discrimination continued to impede immigrants from coming forward for needed services and benefits for which they or their family members are qualified. As one immigrant explained:

Yes, I’m aware the public charge act has been rescinded by the Biden administration, but people still think it is not safe. People will tell you, ‘Yes, but you never know when [the rule could] come back.’ They say they don’t want to jeopardize their chances of bringing their children, so they want to focus on the bigger picture as opposed to some money.

The report finds that while government agencies, hospitals, and CBOs have all taken steps to minimize gaps in service provision and to mitigate immigrants’ fear, more can and should be done. It offers the following top-line findings, supplemented by additional findings in the body of the report:

The Public Charge Rule and Immigrants’ Concerns on the Use of Public Benefits 

• Many respondents underutilized benefits for which they were eligible due to fears pertaining to immigration status, family separation, detention, and deportation. For example, a service provider recounted a case in which a mother feared that her US citizen children would be negatively impacted in the future for having used food stamps: 

She’s an immigrant. It’s her husband and her, and [her] two American citizen [children]. The husband died due to COVID. When she applied [for food stamps,] she really didn’t want to apply. She was under the impression that also her kids are going to be penalized and they’re going to have to pay this back when they grow up. Because she doesn’t have any status, she was afraid. If she want[ed] to apply, she could, for the kids. …  I had mentioned to her [what] the requirements [were], which [were] proof of income and address, and she said that she will get a letter from the employer, because that’s part of the requirements. When she asked for the letter, she got fired. She was just so devastated, because she was at her wit’s end. I called her, and she said, no, she didn’t want to be bothered. She was just so frustrated and devastated, and she just let it go.

• Trump administration policies and rhetoric led immigrants to increase their efforts to secure a safer immigration status, including citizenship, and obtain identification documents for themselves and their children. The study found that service providers had to step out of their regular roles to provide the services that the immigrant community needed. In the midst of an unprecedented public health crisis, for example, hospital workers were also helping to fill out patients’ citizenship applications.

• Context and location strongly influenced the comfort level of immigrants in sharing information which would allow them to access benefits and services. Many immigrants feared sharing identifying information in government buildings, but not as much in other settings or online.

• Large numbers of respondents feared the use of public benefits, including by their US citizen children, due to misinformation about the impact of the new public charge rule on their ability and the ability of family members to secure legal status or permanent residence. Social media has made it easier to spread incomplete information or misinformation about the presence of Immigration and Customs Enforcement (ICE) in local neighborhoods, as well as about the details of the public charge rule.
• Both immigrants and city and CBO workers reported that language remained the main obstacle to immigrants’ use of public benefits, despite the city’s efforts to provide translation services, and that miscommunications often resulted from pairing immigrants with interpreters who spoke a different dialect. Linguistic and cultural barriers prevented immigrants from gathering the information regarding benefits and services, which perpetuated misinformation. One city worker said, when there is a mismatch in dialect between the client and the interpreter:

[things are] not addressed properly. Also, the clients have a lot of emotions, a lot of backstories. If a client wants to express that, maybe [by telling a] backstory [to] help them get the benefit faster, when they receive that translation, it’s like getting to the main point and that’s it. This could be problematic because maybe the actual HRA worker will not take that client seriously.

Immigrants’ Concerns about the Use of Public Health Services

• Fears caused by rumors about ICE prevented immigrants from using hospital services and attending informational events such as health fairs. A hospital worker recounted of one of her patients:

When [she heard rumors that] ICE came, she disappeared on me — no phone calls, no returning. A lot of them stopped, but then they came back after reassurance, but I lost her for good, and that was hard. The clinic was a ghost town around that time. I don’t know if it was true, or if people were [just] so fearful. People were just scared to leave their house, … and clients just stopped coming. There were like months they would not come, and those who were on medication, those that needed to be seen, they weren’t answering the phone. 

• Several hospital workers said undocumented immigrants often let their ailments go untreated out of fear regarding their immigration status and, as a result, their conditions became emergencies.
• Immigrant respondents expressed less fear based on their immigration status about going to hospitals and health clinics than they did about visiting government offices or using public benefits.
• Immigrants began to trust their healthcare providers over time, even if they were initially hesitant to reveal sensitive identifying information to them. Overall, hospitals did a good job at educating immigrant patients about their rights and reassuring them of the confidentiality of patient information.
• Fears regarding immigration status, instilled by federal immigration policies, likely inhibited efforts to respond to and control the COVID-19 pandemic. In response to a hypothetical question, several immigrant interviewees said they would be hesitant about giving the names of people who were undocumented to contact tracers during the COVID-19 pandemic, for fear of legal repercussions.
• Immigrant respondents reported language differences were less of a barrier at public hospitals than in other public spheres. Many reported the interpretation and translation services at hospitals had improved over time. Linguistic and cultural similarities with their healthcare providers often helped immigrant patients to feel comfortable in sharing information with them.   

• Many hospitals provided interpretation services over the phone, but several immigrants still noted that the translation provided was not adequate and was not provided throughout the entirety of the process. 

• Fear of linguistic, racial, gender-based, or cultural discrimination when receiving or considering healthcare services deterred some immigrants from securing necessary healthcare.  

Immigrants’ Concerns about Law Enforcement and Engagement with Courts

• Respondents’ experiences with law enforcement were mixed. A large majority of immigrant interviewees said they would (hypothetically) call the police if necessary. However, some respondents also reported being hesitant to report crimes, because they believed (incorrectly) it might put them or others at risk of deportation or have other negative repercussions.
• Crimes against and witnessed by immigrants go under-reported due to language barriers and fear of misunderstanding. Some respondents said they would (hypothetically) not even try to call because of the language barrier. Others said they would only report crimes that no one else could report or that were very serious, as trying to communicate would not be worth the effort for small crimes. As one Chinese woman said, she does “not have the confidence to express something accurately.”

• Immigrants reported concerns about immigration status and detention would also (hypothetically) prevent them from testifying in court. As one Mexican woman explained, “I have heard that, … as an immigrant without status, one cannot go [to court], because ICE could arrive. With that fear, if you go, you take a risk.”

• Respondents from East and South Asia and the Caribbean were much more likely than those from North America and Central America to respond that they would testify in court with no concerns.

• Eighty percent of naturalized citizens said they would testify without fear, as opposed to just 26 percent of noncitizens who said they would testify without fear.

• Black, Middle Eastern, and Asian Americans reported discrepancies in crime reporting and police treatment based on race or ethnicity. The 2020 civil rights protests exacerbated distrust of the police among some immigrants and people of color.

Based on its research, CMS has identified a series of recommendations, which aim to improve public education; reduce language and literacy barriers; address the technological divide and unfamiliarity with bureaucratic processes; and enhance service provision and inter-agency coordination. These recommendations are made to a range of governmental and non-governmental stakeholders. Some of the key recommendations include:

• City agencies, including HRA and NYC DOHMH, should continue to work with immigrant-serving CBOs and also work closely with NYC Health + Hospitals, religious institutions, schools, and other entities that are considered trustworthy by immigrants to distribute informational materials in locations frequented by immigrants, such ethnic restaurants, grocery stores, and convenience stores, and on public transportation and in parks in immigrant neighborhoods.
• HRA, NYC DOHMH, NYC Health + Hospitals, and CBOs that provide social services to immigrants, schools, and religious institutions should continue to use flyers and print materials as their primary media to provide information about benefits and services to immigrant communities, supplemented by social media platforms and messaging platforms such as WeChat and WhatsApp.
• HRA, NYC DOHMH, and NYC Health + Hospitals should try to match clients and patients to an interpreter who speaks the same dialect, not merely the same language, and ensure that interpreters use clear and accessible language.

• NYC Health + Hospitals providers should consider immigrant patients’ level of education and technological literacy and follow up with them using their preferred method of communication.
• Agencies that administer benefits such as HRA and the New York State Department of Labor (NYS DOL) unemployment office should ensure application processes for benefits are flexible and assume a hybrid online/in-person model.
• HRA and CBOs that assist immigrants in applying for benefits should improve communication between their offices to provide accurate and uniform advice. One city worker recounted what happens when this is not the case:

A lot of times, by the time we see a client, the client has been to three, four different places already. … If they’re being told different things from those three, four places that they’ve been to before they come to you, what you say to them just falls to the wayside, because it’s just something else that someone else is saying. Because if it’s a policy, it’s going to be a policy whether you talk to the Social Security, Medicaid, or community-based organizations. It’ll be just one policy. If you’re speaking to all of these people and you’re being told three different things, you don’t trust what you’re being told. 

• NYC Health + Hospitals facilities should hold listening sessions with healthcare workers and immigrants to help these workers better understand the conditions and challenges faced by immigrants.
• Legal service providers, advocates, and CBOs should utilize MOIA and HRA resources to obtain information about eligibility for benefits, application processes, and policy changes.
• The New York State Senate should make it unlawful for ICE to make civil arrests at “protected” locations including medical facilities, schools, CBOs, public recreational facilities for children, and other social services establishments in the same way it has restricted arrests at state courthouses without a judicial warrant under the Protect Our Courts Act.
  

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