November 2018


Recent efforts to introduce new federal and state immigration legislation and to modify existing guidelines have resulted in an atmosphere of uncertainty and fear for many in immigrant, migrant, and refugee communities. This atmosphere was recently compounded by a directive to separate migrant children and parents detained after crossing the United States-Mexico border, including those seeking asylum. Although the practice of separating migrant families was halted at the end of June 2018, approximately 200 of the 2,654 separated migrant children had not been reunited with their parents as of September 21, 2018, and the number of migrant families in detention has soared, escalating concerns about the health and well-being of affected children.

Detention and family separation have the potential to cause short- and long-term harm to children, including toxic stress, anxiety, depression, and post-traumatic stress disorder, which can amplify previous trauma caused by the often violent, unstable, or destitute conditions many families flee to seek asylum or refuge in the United States (Linton et al. 2017). Members of the health philanthropy community have responded to this situation using a diverse set of strategies and approaches that attempt to mitigate the effects of these urgent, real-time issues on children and families.

Funding Legal Aid

Current immigration policies, including family separation directives, have created an overwhelming need for legal representation for those undergoing immigration proceedings or requiring case management support. Several health foundations have responded through rapid response funding, which use streamlined review and approval processes to administer funds within a week. The Colorado Health Foundation has responded to family separation locally through funding to legal aid organizations like the Rocky Mountain Immigrant Advocacy Network (RMIAN), a local nonprofit organization that provides legal support and representation to low-income men, women, and children in immigration proceedings. RMIAN also works to improve detention conditions, and promotes a more humane immigration system, including alternatives to detention. Another Colorado Health Foundation rapid response grantee is the Justice and Mercy Legal Aid Clinic (JAMLAC), a faith-based, nonprofit law firm that provides bilingual representation, consultation, and advocacy to immigrant communities.

The Jacob and Valeria Langeloth Foundation is championing efforts to reunite families and support asylum seekers by providing rapid response program, capacity-building, and staffing support grants to organizations working on the front lines. For example, the Florence Immigrant and Refugee Rights Project, the American Immigration Council, and Texas RioGrande Legal Aid are organizations providing legal representation to individuals undergoing immigration proceedings in border communities in Arizona and Texas.

The foundation has also funded Kids in Need of Defense (KIND) and the Refugee and Immigrant Center for Education and Legal Services (RAICES) for family reunification services. In addition to providing legal representation for migrant and asylee children, KIND is organizing teams of staff and volunteer lawyers to provide pro bono counsel to parents detained in the Port Isabel Detention Center outside of Brownsville, Texas. Grant funds will be used to hire staff to coordinate representation for separated parents and children. RAICES, also a Texas-based organization that provides low-cost legal services to underserved immigrant children, families, and refugees, has launched the Families Together Fund to provide case management for migrant families seeking reunification assistance.

Supporting Strategic Communications

With the objectives of releasing parents and children in detention, reducing family detention and deportation, and seeking humane alternatives to detention, the Langeloth Foundation is also supporting a multi-organization strategic communication and organizing campaign. A pledge movement to identify volunteers prepared to host families seeking asylum and eligible for parole will serve as a complementary piece of the campaign. These initiatives will be implemented by the National Religious Campaign Against Torture, Freedom for Immigrants, and Grassroots Leadership.

Addressing Fear in Immigrant Communities

Recognizing the short- and long-term social and emotional impacts of “zero tolerance” immigration policies, First 5 LA has taken several steps to address fears of detention and deportation among children and families. This includes joining other First 5 commissions in California to distribute Care, Cope, Connect, a resource developed by Sesame Street Workshop to help families discuss community stress and separation with young children. Additionally, First 5 LA has partnered with the California Community Foundation to provide resource and training support to child and youth-serving organizations such as early and education care providers, home visitors, and WIC staff to reassure clients about protecting their privacy and encourage them to continue to utilize public resources available to their families without fear of detention or deportation. Through its Best Start Communities effort, First 5 LA is also exploring partnerships with trusted community-based organizations in several Los Angeles neighborhoods to improve their response to the needs of immigrant youth communities by providing referrals and assistance with the navigation of resources and information.

At the national level, Blue Shield of California has funded the Kaiser Family Foundation to conduct research on the impacts of fear and toxic stress on immigrant communities. Blue Shield of California will plan to build on this research by convening a series of roundtable discussions to engage stakeholders across sectors in addressing this issue.

Ensuring Health Access for Immigrant Children and Families

Proposed public charge rules, rooted in misconceptions proclaiming immigrants to be a drain to the public benefits system, will likely become a deterrent for eligible immigrant families’ participation in Medicaid, CHIP, and other crucial safety-net programs. Permanent residency status may be altered, or Green Card applications could be denied for immigrant families who are deemed public charges, even when enrolling in public benefit programs for their citizen children (Kaiser Family Foundation 2018). Several California-based foundations have funded a range of organizations preparing for the implications of public charge rules through education, advocacy, and research efforts.

The California Health Care Foundation has responded by funding state-based hospital and provider associations such as the California Association of Public Hospitals and Health Systems, the California Academy of Family Physicians, and the California Primary Care Association to educate and engage members who will feel the front-line impact of public charge rules on immigrant communities. The foundation has also funded the Immigrant Legal Resource Center, and the University of California Center for Health Policy Research to support public awareness campaigns and conduct research forecasting the impacts of public charge rules on immigrant, health care, and safety-net providers. The California Immigrant Policy Center, funded by both the California Health Care Foundation and Blue Shield of California Foundation, will lead the Protecting Immigrant Families Campaign.

Through the #Health4All initiative, The California Endowment has simultaneously addressed anti-immigrant discourse and encouraged immigrant families to access much-needed public benefits. The program pushes to create a health care system that is inclusive of all Californians, regardless of immigration status. #Health4All has developed a public awareness campaign about undocumented immigrants’ crucial economic, workforce, and community contributions in California, while highlighting their lack of access to health care coverage.

A Know Your Rights campaign launched by the California Endowment encourages immigrants to continue utilizing public benefit programs, assures them that all application information is confidential, and informs them that their status will not change when accessing services. The program also provides resources and enrollment support for undocumented youth and Deferred Action status (DACA) recipients who may be eligible for health coverage. The California Medicaid program, Medi-Cal, provides full coverage for all income-eligible youth aged 19 or younger, regardless of immigration status.

Philanthropy’s Role in Challenging Times

Regional and national health foundations are exploring expanded views of their role in addressing the effects of complex, highly politicized issues on children, youth, and families in the communities they serve. The harmful short- and long-term effects of alarming “zero tolerance” immigration policies, such as family separation edicts, have identifiable, detrimental effects on the social and emotional well-being of not only detained children and parents, but also the health of communities anchored by immigrants. Health funders have an opportunity to address these issues, mitigate health impacts on vulnerable children and youth, challenge dangerous anti-immigrant rhetoric, and move strategies forward to create a more inclusive, tolerant, and healthy society.

Resources for Funders

Children, Youth and Family Funders Roundtable
Impact of Immigration Action on Children and Families

Early Childhood Funders Collaborative
Immigrant Children and Families

Grantmakers Concerned with Immigrants and Refugees
Family Separation & Detention Funding Recommendations


Brabeck, K. M., Lykes, M. B., & Hunter, C. (2014). The psychosocial impact of detention and deportation on U.S. Migrant children and families. American Journal of Orthopsychiatry, 84(5), 496-505.

Kaiser Family Foundation. Potential Effects of Public Charge Changes on Health Coverage for Citizen Children. May 2018.

Linton JM, Griffin M, Shapiro AJ. (2017). American Academy of Pediatrics Council on Community Pediatrics Policy Statement. Detention of Immigrant Children. Pediatrics. 139(5).

Miller, A., Hess, J. M., Bybee, D., & Goodkind, J. R. (2018). Understanding the Mental Health Consequences of Family Separation for Refugees: Implications for Policy and Practice. American Journal of Orthopsychiatry, 88(1), 26-37.

Rojas-Flores, L., Clements, M. L., Hwang Koo, J., & London, J. (2017). Trauma and Psychological Distress in Latino Citizen Children Following Parental Detention and Deportation. Psychological Trauma: Theory, Research, Practice, and Policy, 9(3), 352-361.

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