NJ’s Undocumented Immigrants and COVID-19: Free-Falling Through the Safety Net

One undocumented woman lost her partner when he was sent home from the ER twice, despite increasingly serious symptoms of COVID-19. She’s far from alone
Credit: Andre Moura via Pexels
Safety net

COVID-19 has left Lucia’s life in shambles. Her partner of 27 years died last week, at home, after being released twice from a hospital despite probably having the disease and having serious trouble breathing. She has contracted the virus and, while she has lung damage and other conditions that put her at risk of complications, is at home. She has no job, no income and no idea what to do next.

Lucia (NJ Spotlight has changed her name to protect her identity because she is undocumented and fearful of immigration officials) is uninsured and among the estimated half million New Jersey immigrants who are undocumented and struggling through the pandemic without any real assistance from the government.

“I came to this country to get a better life,” Lucia, 63, said through an interpreter. “Everybody says this is the land of opportunity, but I have lost everything.”

A new report released by Make the Road New Jersey, an immigrant advocacy group, described the “extreme harm” that the undocumented are suffering during the pandemic and made 14 recommendations, including better access to health care and $600 weekly payments to immigrants who have lost a job.

Shutting out undocumented immigrants

“Immigrants without lawful federal immigration status are largely excluded from public health insurance and safety-net programs, as well as government aid for workers who lose their jobs or have their work hours cut,” the report notes. “This includes the federal stimulus payments, state unemployment benefits and federal Disaster Unemployment Assistance (DUA) and some temporary leave and disability payments.”

Sara Cullinane, director of Make the Road New Jersey, said the report’s findings “illustrate deep financial insecurity, an inability to access health care — even when individuals are sick from COVID — and deep concern about being able to pay for basic necessities: rent, food and medicine.”

The organization surveyed 226 residents in 24 cities across the state and found only one in four immigrants was working, 76% of the undocumented have lost a job, and 57% of the undocumented who were working had had their hours cut. Almost three in 10 immigrants were unable to pay their rent for the current month and 86% worry they won’t be able to pay next month. Some said they had been harassed or threatened by a landlord despite the state’s current moratorium on evictions.

Many of the undocumented fill jobs in industries that put them at elevated risk during the pandemic, including factories, warehouses, retail stores and restaurants. Most said they were not given sick days by an employer, despite state law requiring that, according to the survey. Some said their employers were checking staff temperatures and providing workers with masks and gloves, but others told of having to purchase their own protective equipment. Workers reported some instances of employers hiding confirmed COVID-19 cases and others said they had many sick coworkers.

Almost half of survey respondents reported that they or a loved one was sick in the past month, and most of those with an illness suspect or were told by a doctor that it was COVID-19. Roughly 85% of the undocumented have no health insurance and even those who do may not have seen a doctor due to fears of being deported or treated unfairly due to their status.

Getting COVID-19 on the job

Felix, an undocumented immigrant who lives in Passaic and did not want her last name used, is currently home after coming down with what is likely COVID-19 based on her symptoms — she has not gotten any treatment because she has no health insurance. She thinks it likely she got sick from working at a factory with others who were sick.

“Many people got sick, I got sick,” she said through an interpreter during an online press conference about the Make the Road report. “The only protective equipment they gave us was a covering for our mouths that was really just a hairnet. “We were all piled up on each other. We worked with less than one foot distance between each other.”

“Eduardo,” an undocumented immigrant, died of COVID-19 after being sent home twice from the ER.

Lucia and the man she calls her husband, although they were never married, said they likely got the virus from one of the men with whom they share an apartment. He had had mild symptoms before Eduardo (a pseudonym) got sick. She said they sought help for him at a Monmouth County hospital twice but he was released — twice — even as his symptoms grew progressively worse.

This is what she said happened:

While participating in a virtual support group on April 3 sponsored by Community Affairs and Resource Center (CARC), a nonprofit social services organization, Lucia mentioned that Eduardo was feeling sick with a sore throat. Members offered advice and help if she needed it.

By April 7, he was feeling significantly worse and that evening the two took a taxi to Monmouth Medical Center’s emergency room in Long Branch. She was not allowed to accompany him inside — the hospital currently has a “no visitor” policy in its emergency department due to the outbreak. After about two hours, he said a doctor told him he likely had COVID-19 and to go home: “You are going to get better there.”

But he didn’t. Two days later, Lucia took Eduardo back to the hospital. She said he was having great trouble breathing, was not eating and needed help to walk to the bathroom. At age 69 and diabetic, Eduardo had multiple factors that put him at risk of having complications from the virus. Again, Lucia had to wait outside. After a time, she said, Eduardo called and told her to go home because he was worried about her staying outside in the cold.

“He said, ‘Good-bye. I love you. I think I am going to die,’” she recounted, her eyes tearing.

Walking home from the ER

Lucia called a CARC case manager, asking for help. The case manager called the hospital and asked for an interpreter to help Eduardo talk to staff and to get him treatment — he had told Lucia he was lying in a bed. Later that evening, Lucia said she called the hospital and was told they were releasing Eduardo because “he was not that bad.” She said she asked them to call him a taxi because they do not own a car and live several miles away. But he left the hospital on foot. A taxi driver saw him and gave him a ride home.

Eduardo told her the doctor said his lungs were inflamed but he was OK to go home and should keep taking his diabetes medication.

On April 13, the hospital called to tell Eduardo that it could not find his COVID-19 test results and asked him to come back to be retested; he would not be charged. According to Lucia, Eduardo replied that he was feeling too sick to go to the hospital and that his wife was also unwell. He said the hospital staffer told him to go back to the hospital to get retested when he was feeling better.

She paused a moment, crying, then recounted her conversation with Eduardo: “I said, ‘What will we do?’ He said, ‘We will just wait at home. When it is going to happen, it’s going to happen. Let’s put everything in God’s hands.’”

On April 15, Eduardo was in distress and unable to breathe. Paramedics arrived but were not able to save him and he died around 7:45 a.m. Lucia said she was told to find a funeral home to handle arrangements and called CARC for help. Age 63, she has not worked for several years because she suffered lung damage due to tuberculosis, so they had been living on Eduardo’s salary as a painter. Ultimately, one of Eduardo’s adult children from his first marriage wound up taking care of the arrangements and 3 1/2 hours later his body was taken from their home.

Lucia said she is very sad about losing the man she calls her husband. She is also angry at what she considers a lack of appropriate treatment.

“Every human needs to be treated the same, we do need good medical care,” she said. “Even if you are an animal, you are taken to the vet and they would take care of you.”

Monmouth Medical Center’s statement

Monmouth Medical Center does not comment on individual patient cases but issued a statement in which it said the hospital provides a “high-quality patient-centered environment” of care to everyone, including those who may not speak English or those without insurance.

“There are a number of medical factors that are used in evaluating patients with possible COVID-19 to determine whether he/she should be admitted to the hospital or should return home to self-monitor,” according to the statement. “These include a thorough review of a person’s medical history, risk factors, vital signs and results of diagnostic testing.

“To ensure there are no language barriers, we have telephone and video translation services available for all patients who can’t communicate in English,” the statement continued. “All patients at Monmouth Medical Center are treated equally and receive outstanding care, regardless of his/her status as a US citizen or ability to pay.”

Nine days after losing her partner, Lucia is in isolation dealing with COVID-19 herself. She tested positive and said she is forcing herself to eat, drinking a lot of hot tea and walking around the house, even though she gets out of breath. She said she is feeling better than a week ago.

Her story of getting tested is an example of another problem the Make the Road report pointed out: It is very hard for the undocumented to get tested. Lucia said the CARC case worker called Jersey Shore University Medical Center to see if she could get a test, was asked if Lucia had insurance and when told that Lucia was uninsured was referred to the state’s free drive-through testing site at PNC Bank Arts Center in Holmdel. But because she does not have a car, Lucia could not go there. They eventually found an urgent-care clinic in another town that would test her; CARC is paying the $153 cost for the visit and test.

Jersey Shore University Medical on coverage

Dr. Kenneth N. Sable, regional president of Hackensack Meridian Health Southern Market, of which Jersey Shore University Medical Center is a member, said in a statement that the facility provides treatment regardless of whether a person has insurance.

“We carefully adhere to the Centers for Medicare & Medicaid Services’ Emergency Medical Treatment & Labor Act (EMTALA) to provide emergency services regardless of any individual’s ability to pay or insurance status. We are providing COVID-19 testing to symptomatic patients, in accordance with CDC guidelines at Hackensack Meridian Jersey Shore University Medical Center.”

New Jersey’s hospitals are required to provide charity care to all those who need medical care even if they are not insured. But state Health Commissioner Judith Persichilli said during Thursday’s press briefing on the pandemic that people should not be going to hospital emergency rooms to get a test.

“They are not testing centers,” she said. “There are 80 testing centers, every county now has one, and you should be able to go out and get tested if you’re having symptoms.”

There is no excuse for anyone to not receive necessary treatment, Gov. Phil Murphy said: “Nobody should be denied access to health care, so if that’s happening, we need to know about it.” Persichilli said anyone who is uninsured, including the undocumented, can get care at one of the state’s Federally Qualified Health Centers. The health department also takes complaints on its website and also has a telephone complaint hotline — 1-800-792-9770 l — people can call to report any denial of care.

Murphy said he is “open minded to the $600 a week” payment to immigrants that was recommended in the Make the Road report. He added, however, “Quite clearly, we’re running out of money.”

Where NJ can find the funds

Cullinane said that in order to have enough money to help immigrants — New York and California have set up special funds to assist the undocumented in their states — New Jersey can seek flexible federal funding and push for a greater stimulus and use money from a new federal lending program created to help states with budget emergencies due to the pandemic. She said that New Jersey’s undocumented pay roughly $604 million in state and local taxes and $1.1 billion in federal taxes each year.

The report includes a number of other recommendations for both state and federal governments, including:

  • The federal government should provide $2,000 monthly cash payments to all taxpayers, including the undocumented and others who pay taxes using an Individual Taxpayer Identification Number rather than a Social Security number.
  • Congress should expand coverage for COVID-19 testing and treatment under Medicaid to all people, regardless of immigration status.
  • New Jersey should follow the lead of California, New York and Massachusetts and expand access to public health insurance to all immigrants. The state should also provide mobile testing sites accessible to pedestrians for those who cannot drive. It should also allow doctors to provide referrals for free testing to the undocumented who confirm symptoms via a telephone assessment.

Lucia said she wanted to share what happened to her partner, however painful, because she “would like it to not happen to anyone else again.”