Immigrant families in NC face barriers to enrollment in safety-net programs

Language barriers, misinformation and complex eligibility rules keep North Carolina’s immigrant families from enrolling in safety-net programs, according to a new report from the Urban Institute.

The report released Wednesday recommends making translators for languages other than Spanish more widely available, customizing outreach to immigrant groups, and engaging more community health workers in outreach. 

The immigrant population in North Carolina is growing more quickly than it is nationwide, the report notes. Immigrants in the state are less likely to be enrolled in health and nutrition safety net programs than immigrants nationally, the report says, citing a February study published by Carolina Demography. 

According to the Urban Institute, 26% of children in North Carolina families with low incomes have at least one immigrant parent, and nearly 32% of immigrant adults with limited English proficiency spoke a language other than Spanish. 

Immigrant families face hurdles common to all benefit applicants: problems reaching social service agencies, lack of transportation, and difficulties navigating the online application system. 

Additionally, immigrant families face language barriers, fear of deportation or disqualification for permanent residency, complex eligibility rules and problems supplying information required on applications,  the report said. 

The Urban Institute report was compiled using information from other studies, interviews with immigrants, representatives of state and local social service offices, and members of local, regional and statewide organizations, with a focus on Wake, Forsyth, Pitt and Catawba counties. 

There’s confusion among immigrant families and some social service workers about eligibility requirements, said Hamutal Bernstein, a Urban Institute senior fellow and the report’s lead author. 

“These are complex bureaucratic processes,” she said. 

The report recommends mandating consistent training across counties on enrolling immigrants in safety-net programs such as Medicaid, food aid, and WIC, the supplemental nutrition program for women, infants and children. 

WIC is open to eligible residents regardless of immigration status. Medicaid and food nutrition services are open to legal immigrants after a five-year waiting period. The rules can be complicated to unravel for “mixed status” families where some members are US born and others are lawful residents or undocumented residents. 

Immigrants fear exposure to immigration enforcement and disqualification for permanent residency if they apply for benefits, the report said. 

A Trump-era rule would have denied immigrants permanent residency if they used or were expected to use Medicaid or public nutrition or housing programs. The Biden Administration reversed the rule. 

Concerns about disqualification for permanent residency persist, according to the report. 

State and local agencies should reach out to immigrant communities to allay those worries, Bernstein said. Immigrant-serving organizations and community health workers should be engaged to help with outreach. 

Community health workers are effective navigators, Bernstein said. “Tapping into that network could really be impactful.”

To bridge language barriers, the report recommends the state pay for multilingual outreach efforts, centralize translation and interpretation contracts, and make sure translated materials are easy to understand and culturally relevant to different immigrant groups. The report recommended counties hire more bilingual and multilingual staff. 

Taking staff shortages into account, counties could share multilingual staff and pool resources, Bernstein said.