The National Conference of State Legislatures has released its half-year analysis of immigration related legislation in all 50 states.  During the first six months of 2009, more than 1400 bills have been considered around the country, surpassing the total for all of 2008. Some bills employ an “integrative approach,” whereas others are enforcement-oriented, i.e. designed to deny state-funded services to undocumented immigrants. Although New Jersey was rated as “somewhat integrative” in its approach to immigration in 2008 by the Progressive States Association, a research and advocacy organization, largely on the basis of the work of Governor Corzine’s Blue Ribbon Panel on Immigrant Policy, the State may move into the “inactive” category in 2009.

 

Out of 259 laws and resolutions enacted nationally during the six-month period, only four were passed in New Jersey, and they had slight connection to contemporary immigration issues. State resolution 85 --the most significant state action -- seeks to raise public awareness of Ellis Island’s role in American history and to promote rehabilitation and reuse of its buildings, perhaps as a conference center devoted to contemporary immigration issues.

 

NCSL noted the following examples of integrative actions taken by state legislatures during the six-month period:

 

• The State of Iowa appropriated $200,000 for a “Cultural Community Grant Program,” to create a cultural and educational center to showcase immigrant communities from Southeast Asia.

• The State of Missouri appropriated $200,000 to establish a special program to provide naturalization assistance to elderly and other immigrants unable to benefit from or attend classroom instruction in English or citizenship.

• A new law in Tennessee required the Department of Labor and Workforce Development and the Department of Education to establish and administer a grant program, called the “We Want To Learn English Initiative,” to provide resources for immigrants and refugees in Tennessee to learn English. Classes will be held where immigrants “live, work, pray, and socialize, and where their children go to school.”  The law appears designed to “lay the foundation for receiving federal funds targeted towards immigrant integration.”   

A few other noteworthy actions include the following:

 

• Louisiana created an advisory council to propose ways to eliminate obstacles to the effective delivery of governmental services to Latinos

• Minnesota extended the life of the Working Group on Ethnic Heritage and New Americans, originally created in 2007, until June of 2011.

• Texas created an advisory committee to establish and recommend qualifications for certain health care translators and interpreters.

The Progressive States Association has given its highest rating of “integrative” to seven states: California, Illinois, Maryland, Massachusetts, New Mexico, New York, and Washington.

The New Jersey Health Initiatives (NJHI) Program of  The Robert Wood Johnson Foundation has awarded over $2.5 million in grants to promote health literacy in immigrant communities in New Jersey, to be  implemented by 11 lead agencies over a three-year period beginning on July 1, 2009. Health Literacy has been defined by the foundation as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.”  Low health literacy has been called the "silent and invisible threat" to the health of millions of Americans, especially prevalent among immigrants, whose lack of English skills puts them at greater risk of illness and disease.

 

In April of this year, Literacy Volunteers of New Jersey convened the first New Jersey Summit on Health Literacy, in part with financial support from New Jersey Health Initiatives and the Walmart Foundation. The summit provided an opportunity for health care professionals and literacy educators to communicate with each other and to form local collaborations.

 

Some of the projects funded by NJHI reflect the development of these local collaborations. A grant to the Bergen Community Action Partnership in Hackensack, for example, will permit the introduction of a 15-hour health literacy curriculum component into the Partnership’s current ESL program. At the same time, a nurse practitioner from Bergen Volunteer Medical Initiative will provide health counseling to program participants, while other practitioners will receive in-service training focusing on cultural differences and the impact of language on health outcomes.
 

In Elizabeth, the International Rescue Committee, a refugee resettlement organization, has partnered with the Elizabeth Port Community Health Center to provide a health orientation program for newly-arrived refugees. In Newark, the Ironbound Community Corporation is partnering with the School of Nursing at UMDNJ to conduct a series of community health fairs and literacy seminars focusing on the needs of the low literate immigrant Latino population. In Trenton, working with Capital Health System and other partners, Catholic Charities of the Diocese of Trenton will work to embed health literacy objectives and learning activities into ESL and GED classes held at its South Ward Centro de Recursos para Familia.

Other lead organizations funded by NJHI include:  Jefferson Park Ministries, the Rutgers-Camden Center for Strategic Urban Community Leadership, the North Hudson Community Action Corporation, The Zufali Health Center, AtlantiCare, Inc., the Northern NJ Maternal/Child Health Consortium, and the Gateway NW Maternal and Child Health Network.

An influential report issued issued by the California Health Literacy Initiative in 2003 made the following ten policy recommendations, some of which seem to be embodied in this year's series of NJHI grants:

1. Funding for adult education should be increased. Increased funding will help alleviate the numbers of individuals struggling with low literacy skills, and will provide more opportunities to reach low literate adults with health literacy training.

2. Plain language materials should be available to patients at every stage in the health care process, and patients who require assistance with filling out paperwork should be able to easily obtain it.

3. Innovative multimedia methods for delivering health information should be explored and developed.

4. Positions such as Peer Educators and Patient Advocates should be funded and provided for in medical reimbursement. Peer Educators and Patient Advocates can accompany patients to office visits and answer questions and explain terminology, paperwork, and procedures.

5. Doctors should use plain language and should use the "teach-back" method to ensure comprehension.

6. More research is needed on effective techniques for clear communication with all patients.

7. Medical professionals and adult literacy providers should seek collaborative relationships to address issues raised by low health literacy.

8. Research into effective training techniques for medical providers is needed. Health literacy training should be part of ongoing professional education, beginning with schools of medicine and nursing.

9. Health care systems need to be designed with the awareness that a significant percentage of patients struggle with low literacy skills. Materials such as informed consent forms and discharge instructions need to be written at a plain language level, and should be accompanied by audiotapes or videotape instructions.

10. Advocates for improved language access and advocates for greater health literacy should partner to determine how the two issues overlap and interact.

 

Some Comparisons between the Reports of the Maryland Council for New Americans and the New Jersey Blue Ribbon Panel on Immigrant Policy
 

The release of the report to the Governor of Maryland by the Maryland Council for New Americans permits some interesting comparisons between the approaches to immigrant integration taken by advisory bodies in Maryland and New Jersey.  Stemming from policy initiatives by Democratic governors,  both the Maryland Council and the New Jersey Blue Ribbon Panel on Immigrant Policy issued their reports within six months of each other.  

Report size is certainly one big difference. The New Jersey report appears more comprehensive, treating of issues like labor law enforcement, federal immigration law enforcement, and in-state tuition that are absent from the Maryland report.  With 98 recommendations and hundreds of pages of appendices, the New Jersey report, however, is voluminous and seems to lack a clear sense of short and long-term priorities. By way of contrast, Maryland chose to focus on four key issues: workforce, citizenship promotion, financial services, and governmental access. Within these four broad areas, there are 15 general recommendations, and within each general recommendation, 46 specific recommendations.  At 65 pages, the Maryland report is about half the length of the New Jersey report.

Despite the rather unwieldy nature of the New Jersey report, its treatment of a number of issues, such as labor law enforcement, is quite sophisticated and prescient, especially in light of the new survey showing rampant labor law violations among low-wage, predominantly immigrant, workers in Chicago, Los Angeles and New York City. After reviewing recent efforts of the NJ Department of Labor and Workforce Development to enforce compliance with state and federal labor laws, especially in low-wage industries that employ large numbers of immigrants, the New Jersey report offers specific legislative recommendations to extend protections to additional workers and increase penalties for non-compliance. The report also calls for a "targeted approach in the investigation of industries with high incidences of labor standards violations but low complaint rates."  Curiously, the Maryland report is silent on these issues.

As might be expected in a state that has yet to bring an in-state tuition bill to the floor of its legislature, the New Jersey report forcefully argues for legislative relief for undocumented high school students, brought to this country by their parents at an early age, raised and educated in New Jersey, many with outstanding academic credentials, who can't attend New Jersey institutions of higher education without paying out-of-state tuition. A supplemental 20-page paper in the appendix to the New Jersey report buttresses the case for such a relief. Here again, the Maryland report is silent on the issue, even though an in-state tuition bill appears closer to passage in Maryland than in New Jersey, having passed in the Maryland house at least once, but failing to secure passage in the Senate.

Maryland seems to have the advantage in its treatment of a few key issues, such as language and cultural competence, citizenship, and the creation of an office of immigrant affairs. With language and cultural competence, the New Jersey report devotes most of its attention to vendor compliance with Title VI requirements for language access, calling, for example, for standard contract language mandating such compliance. Although the New Jersey report touches on the need for state agencies to achieve compliance, it is largely silent on the process and resources for achieving such compliance. The Maryland report, on the other hand, reviews the history of state compliance, including the impact of the state's 2002 comprehensive language access law, and points out weaknesses that need to be addressed in the future.
 
Maryland also focuses a great deal of attention on the issue of citizenship, something largely ignored in the New Jersey report. Pointing out that the number of new legal immigrants in Maryland is far outpacing the number of persons naturalizing, the report calls for the establishment of  "a robust coordinatied citizenship initiative for Maryland with a companion citizenship public education campaign," modelled after successful programs in other states. Such a program would be implemented through a network of New Americans Welcome Centers housed at "existing immigrant friendly community-based organizations."  The New Jersey report, on the other hand, seems to downplay the importance of citizenship because the state's  48% naturalization rate in 2006 was higher than the national average of 42%. Missing from the report is the kind of assessment undertaken by Maryland, which looked more closely at recent trends in naturalization, rather than aggregate totals for the foreign-born in general.

The Maryland Council is quite emphatic that the creation of a high-level New Americans office is its "primary recommendation, crucial to the implementation of its 15 "key recommendations." By way of contrast, the New Jersey report seems to dance around the issue, pushing its report on the issue into the appendix without limited, and somewhat guarded, textual reference.

Unlike the New Jersey Blue Ribbon Panel on Immigrant Policy, which ceased to exist upon the issuance of its final report, the Maryland Council on New Americans is a standing body which meets at the behest of an Executive Committee, comprised of the Secretary or designee of four state departments. Thus, the Council is in a position to monitor implementation of its recommendations. True, the New Jersey report calls for the institutionalization of a Council-like structure in one of its recommendations, but whether such a structure will ever see the light of day remains to be seen.
 

There is another notable difference between the New Jersey and Maryland initiatives: New Jersey’s effort seems to have been less transparent in its deliberations. In Maryland, minutes of Council and work group meetings have been posted on the council web site. In New Jersey, such documents, if they existed, were not made available to the general public.  Indeed, whatever had been posted on the New Jersey Public Advocate’s website, seems to have been relegated to a less accessible part of the web site. One would be hard pressed to find any evidence of interest in immigration as an issue, judging from the content on the Public Advocate’s home page today. 

 

Resources available to the English Literacy and Civics Program would be increased substantially under a bill introduced in both the House (HR 3249) and Senate (S.1478) by Rep. Mike Honda (Calif.) and Sen. Kirsten Gillibrand (N.Y.). Current spending would increase from $70 million to $200 million in FY 2010, $250 million in FY 2011, and $300 million in FY 2012.  In addition, the formula for distributing these grants to the state would change. The proposed bill would require the Secretary of Education to award grants based on the size and growth of the immigrant population in each state. The bill also renames the Office of Citizenship within USCIS to the Office of Citizenship and Immigrant Integration, and expands its mission to include the integration of immigrants. The new office would be empowered to make grants to states to: (1) form State New American Councils to develop and implement comprehensive immigrant integration plans and disseminate information pertaining to effective English acquisition and civics education programs; and (2) award subgrants, through such Councils, to local governments to assist them in integrating immigrants into communities pursuant to such plans. The bill also permits the office to accept private donations in support of its activities.