The Immigrant’s Journal - Vol. 150

The Immigrant’s Journal Vol. 150

A Journey for a Better Life & Justice

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Protecting God’s Children From Distant Lands 26 Court Street, Suite 701, Brooklyn, NY 11242

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Nov 4, 2021

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Green Card: EB-3 for Nurses & Physical Therapists

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he Green Card or Resident Alien Card or Form I-551 is the permanent work and residence permit for foreign nationals who reside legally in the U.S. What are the basic requirements?

Employment-based immigrant visas typically involve three main steps (the entire process can take several years): First, the employer files a Labor Certification application with the U.S. Department of Labor, the purpose of which is to test the employer's local labor market for available workers. If no qualified and available workers are located, the position is certified as open for a foreign worker.

Second, the employer files an I-140 Alien Worker Petition with the USCIS.

Governor Hochul Signs Domestic Violence Legislative Package ....17

The purpose of this petition is to verify that the foreign worker has the minimum requirements to fill the open position and serves to classify the foreign person as eligible for a particular visa category.

Third, based on the Labor Certification and Alien Worker Petition, the foreign worker applies for an immigrant visa at a

U.S. Consulate. If the foreign worker is legally present in the U.S., they may instead apply for permanent resident status via a process called adjustment of status. A nurse in the U.S. can simultaneously apply for the I-140 and adjustment of status. continued on page 2

Why Noncitizens Should be Allowed to Vote on Election Day ....3

DHS Issues New Memo Restricting Enforcement Activities in ‘Protected Areas’ ....7

NOVEMBER IS DIABETES AWARENESS MONTH

Type 2 Diabetes: More Than One Type of Diet Can Help People Achieve Remission

BY DUANE MELLOR & ADRIAN BROWN THE CONVERSATION

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ntil recently, type 2 diabetes has mainly been managed by controlling risk factors – such as high blood pressure, cholesterol and blood sugar (glucose) levels – usually by prescribing drugs. But this approach doesn’t address the underlying causes of type 2 diabetes – such as

problems with the hormone insulin no longer effectively controlling blood sugar. While taking drugs can help to manage blood sugar levels, it won’t help unpick the biological causes behind type 2 diabetes.

A growing body of research shows that losing weight, either through surgery or dieting, can help address some of the underlying causes of type 2 diabetes. It

continued on page 13

5 Reasons to Become a Paralegal ....14

Brian Figeroux, Esq.

Safety-Proof Your Elderly Parents' Home ....11

The Importance of Compatibility in Relationships ....15

HOW TO GET A GREEN CARD Nurses and Physical Therapists/ continued from page 1 How do nurses and physical therapists benefit?

The immigrant visa is usually the only option for nurses because most nonimmigrant visa classifications are not available to the typical registered nurse seeking employment in the United States.

Presently, shortages exist in the U.S. health care industry. If you are a nurse or other health care professional, you may be able to offer your skills and be part of America's solution to the burgeoning health care deficit.

Registered nurses may enter the U.S. directly as a lawful permanent resident (LPR) or Green Card status. A benefit afforded to the nursing profession is that presently, the Petition for Alien Worker and U.S. Department of Labor classifies nursing as what is referred to as a "Schedule A" occupation. The advantage is that the often lengthy and expensive Labor Certification Process can be circumvented. After meeting certain requirements, LPR status allows nurses and their families to permanently reside in the U.S. through a sponsor.

Who may apply for Schedule A? •Registered nurses with a job offer from a U.S. hospital or medical center; •Physical therapists with a job offer from a U.S. employer; •Foreign nationals qualified to work in

one of the shortage occupations designated by the Department of Labor on the Schedule A list; •U.S. companies to sponsor the Green Card application for foreign nationals on one of the shortage occupations designated by the Department of Labor on the Schedule A list.

What are Schedule A Occupations?

The Director, United States Employment Service (Director), must determine that there are not sufficient United States workers who are able, willing, qualified, and available for the occupations listed below on Schedule A. Also, the wages and working conditions of United States workers similarly employed will not be adversely affected by the employment of aliens in Schedule A occupations.

Group I: •Persons who will be employed as phys-

2

ical therapists possess all the qualifications necessary to take the physical therapist licensing examination in the State in which they propose to practice physical therapy.

•Aliens who will be employed as professional nurses; and (i) who have passed the Commission on Graduates of Foreign Nursing Schools (CGFNS) Examination; or (ii) who hold a full and unrestricted license to practice professional nursing in the State of intended employment.

Definitions of Group I occupations: "Physical therapist" means a person who applies the art and science of physical therapy to the treatment of patients with disabilities, disorders, and injuries to relieve pain, develop or restore function, and maintain performance, using physical means, such as exercise, massage, heat, water, light, and electricity, as prescribed by a physician (or surgeon).

Group II: Aliens (except for aliens in the performing arts) of exceptional ability in the sciences or arts, including college and university teachers of exceptional ability who have been practicing their science or art during the year before applying and who intend to practice the exact science or art in the United States. For purposes of this group, the term "science or art" means any field of knowledge and/or skill with respect to which colleges and universities commonly offer specialized courses leading to a degree in the knowledge and/or skill. An alien, however, need not have studied at a college or university to qualify for the Group II occupation.

How does one apply or file for a green card for a nurse?

In a Schedule A case, the initial step is to file a Form I-140 application package with the appropriate supporting documentation to the appropriate USCIS Service Center. There are four regional USCIS Service Centers located in Vermont, Texas, Nebraska, and California, and each service center has jurisdiction over a section of the country.

A case is properly filed in the service center having jurisdiction over the place of employment or in the service center covering the region where the employer's office is located. continued on page 4

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3

TIME FOR ACTION

Why Noncitizens Should be Allowed to Vote on Election Day

BY TALI FARHADIAN WEINSTEIN

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n Tuesday, millions of people across the country who could have the right to vote won’t be able to. Nearly 14 million legal permanent residents, not to mention hundreds of thousands of refugees and asylum seekers, have made their homes here and should be able to weigh in on local elections that have a direct effect on their everyday lives.

The New York City council is poised to allow this to happen, and to set a national example for how we integrate noncitizens into our communities. Last month the council held hearings on a bill that would allow certain noncitizens — lawful residents who have lived in the city for more than 30 days — to vote in city elections. In other words, any New Yorker with a green card could cast a vote for mayor, council member, comptroller and other local elected officials.

The bill’s sponsors have a veto-proof majority, and support from Eric Adams, the Democratic nominee to be the city’s next mayor. The council should pass the bill before its term ends this year.

And then the rest of the country should follow suit.

Right now, noncitizen voting is quite rare — so rare that it may sound exotic, or even unconstitutional. In fact, noncitizen voting is older than the republic itself. It was universal in colonial times and remained through the 18th and 19th centuries. What’s new is the argument that only citizens should vote, an idea that took hold in the early 20th century when a rash of nativist and racist local laws were passed to disenfranchise African Americans, Jews, Italians and others deemed “inferior” to the “white” population.

Yet even today, the possibility of noncitizen voting remains intact and to be seized; every state constitution except Arizona’s and North Dakota’s permits it.

Federal law explicitly recognizes that states and cities may allow noncitizens to vote in local elections, though not in federal ones.

Only 14 municipalities currently allow noncitizens to vote in at least one type of local election: one in California, two in Vermont and 11 in Maryland. But if New York were to join this small group, we could better challenge the weird idea that it is somehow “normal” to exclude

noncitizens from basic decisions about our shared civic life.

On the face of it, noncitizen voting is a matter of basic fairness. People who live, work and pay taxes in our communities should have a say in how they are governed. Noncitizen New Yorkers contribute nearly $3 billion per year in city taxes, for example.

But there will be less obvious benefits as well. For one thing, changing who votes could change who runs for office.

Advocates of the council bill estimate that it will immediately add more than 850,000 to the rolls in New York City alone, which should affect who becomes a candidate.

Letting noncitizens vote will also likely change how we think about resettlement of newcomers. Consider the 49,000 and counting Afghan refugees at domestic military bases on the verge of being settled by the federal government in communities around the country, where they can seek work authorization: Under the council bill model, many should be able to vote after settling into their new homes.

Many of these people have risked their lives, have lost friends and family, home and future, because they believe in our democratic ideals. We owe them the vote. Isn’t this the most basic aspect of democracy? Isn’t it what we and they fought for? Instead of thinking of giving them a special right, we should see this as another responsibility for people who want to actively contribute in their new neighborhoods.

New Yorkers in particular understand the practical and symbolic importance of this bill, because the majority know the immigrant experience firsthand. Most New Yorkers grew up as I did, either as immigrants or with at least one immigrant in our households. We know that

citizens and noncitizens are in the same boat.

Last year, I was a candidate for a local office in New York City. In immigrantrich neighborhoods like Washington Heights, I regularly met grandmothers who told me they would ask their children and grandchildren to vote for me, because they couldn’t themselves cast a vote.

Every time I heard this, I thought about my father. My dad was 30 years old when he came to this country, seeking asylum after we fled the violence and antisemitism of revolutionary Iran.

Although my parents quickly got authorization to work here, my dad turned 45 before he became a citizen and could cast his first vote. In those 15 years of waiting, it would not have “made sense” for a candidate like me to direct my energies to someone like him. Multiply him by a million, and that’s a huge part of the city to overlook.

For those of us who hoped that President Joe Biden would quickly correct federal anti-immigrant policies, the past months have been a source of frustration and disappointment. Last month, American law enforcement officers who looked like cowboys appeared to whip desperate Haitians seeking refuge in our country. We left behind tens of thousands of Afghan allies during the summer evacuation.

Comprehensive immigration reform — or even more modest and seemingly popular legislation, such as to legalize the status of “Dreamers” — remains as elusive as it did during the Obama administration, thwarted recently by the Senate parliamentarian. In fact, no president since Ronald Reagan has managed to transform the immigration system dramatically for the better. Maybe New York City can open the way for real change.

Letting noncitizens vote is no substitute for immigration reform on the federal level, but it is meaningful and within the power of most cities, towns and counties.

Let’s hope that a year from now, noncitizen voting will be the new normal around the United States. l Article first appeared on NBC News Think: Opinion, Analysis, Essays. Tali Farhadian Weinstein, is a former federal and state prosecutor, is an NBC News and MSNBC legal analyst. She came to the United States and sought asylum as a child in 1979.

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HOW TO GET A GREEN CARD Nurses and Physical Therapists/ continued from page 2 What kinds of documents must be submitted with an I-140 employmentbased immigrant petition?

Supporting documentation must be submitted with the I-140. This supporting evidence includes the following: •Completed PERM labor certification forms (the recruiting process under PERM need not, however, be completed); •A posted notice of the job opening.

•This notice must include a job description, work hours, and rate of pay.

•The notice must be posted on the worksite for a minimum of ten business days; •Evidence that the petitioning employer has the financial ability to pay the salary offered to the nurse. Evidence of this ability shall be either in the form of copies of annual reports, federal tax returns, or audited financial statements.

If the U.S. employer employs 100 or more workers, the USCIS may accept a statement from a financial officer of the organization; •CGFNS certificate or nurse license from State where the nurse will be working or proof of passing the NCLEX licensing exam and evidence that the nurse cannot obtain a license because they cannot obtain a social security number; •Nursing diploma or degree; •Nursing registration/licensure from the country where the degree was obtained.

The CGFNS certificate provides evi-

dence that the nurse has complied with a three-step review of their nursing skills: 1. A credentials evaluation 2. Passage of an English language proficiency exam 3. Passage of the CGFNS qualifying exam Once these requisites have been met, the Commission on Graduates of Foreign Nursing Schools will issue the nurse a CGFNS certificate. The purpose of this certification program is to serve as a predictive evaluation process to accurately judge which nurses will be able to meet the requirements for U.S. licensure once admitted to the country. If the nurse has already passed the NCLEX-RN exam, they are exempted from the requirement of obtaining a CGFNS certificate.

What is a "VisaScreen," and when do the health care workers require it?

The VisaScreen certificate is the health

4 care workers' credentialing certificate. It must be presented to the USCIS before adjusting status and a U.S. consulate before issuing a permanent residency visa. The certificate is NOT required at the start of the adjustment application or prior to an I-140 application's approval.

Registered Nurses already present in the U.S. may now file for LPR status on behalf of their employer/sponsor.

Typically for these nurses, the process is much easier. They will receive work authorization (much more quickly than through consular processing) within approximately 90-120 days of filing the Petition for Alien Worker and Adjustment of Status application.

Adjustment applications typically take 18 to 24 months at USCIS regional service centers. A nurse still needs to present a VisaScreen Certificate prior to completing the adjustment of status.

Finally, nurses must meet and satisfy the requirements of the Petition for Alien Worker and State Board of Nursing in the State for which they intend to practice nursing. Additional limiting criteria may vary among the State's department of professional regulation.

Free consultation A specialized immigration attorney should always be your first point of contact regarding immigration questions and concerns. For a FREE, no-obligation legal consultation. The number to call is 855-768-8845. You can also visit www.askthelawyer.us l

FWD.us Statement on the Latest White House Build Back Better Framework Including Immigration Relief

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ASHINGTON, DC: FWD.us President Todd Schulte issued the following statement on the latest Build Back Better Framework released from the White House, which includes $100 billion dollars for immigration relief: “Immigration relief is vital to our nation's continued recovery and to ensuring that millions of immigrant families can remain together and more fully contribute to their communities. The ability to live without fear of deportation, to legally work, and to travel outside the country to visit family would be transformational policy changes that represent the most significant immigration reforms in decades. We are glad the White House and Senate Leadership Committee continue to be confident in the inclusion of immigration relief in the reconciliation package."l

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FAMILY MATTERS

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Time-Saving Shortcuts for Working Moms

BY JANET HOWARD

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orking moms essentially have two jobs: their work and their family. It can be difficult to keep up with the combined tasks because there are only so many hours in a day, 24 to be exact. That's why shortcuts are so important for working moms.

A time-saving shortcut can be anything related to work tasks or home tasks that saves you time but still delivers the outcome you need. For example, using a grocery delivery service saves you the time it takes to go to the store, shop, wait in line, and drive home. However, the end result of having groceries is the same, and you can check that item off your to-do list while pocketing those freed-up minutes.

Most of your daily tasks as a working mom can be streamlined. The more you take advantage of these shortcuts, the more time you will get back in your day for things like exercise, self-care, therapy, or meditation. It could even be time you spend watching TV and eating ice cream on the couch! Whatever you choose to do with your bonus minutes is up to you.

How to create a time-saving shortcut Identify some of your most time-con-

suming tasks and write them down. This will vary from mom to mom, so it's important that you really nail down what is relevant for you and your life.

For inspiration, here are a few common time-sucking tasks that could be streamlined: packing lunches, driving kids to activities, meal planning, cleaning the house, and cooking. For work, tasks could include answering emails, attending meetings, and phone calls with colleagues.

It's important to put thought into where time is lost in your day and where it could be regained. However, if some of your time-sucking responsibilities aren't flexible and can't be streamlined, don't get frustrated. There should be at least one or two tasks that can be streamlined.

Start there, and that may help you become more creative in how to save time in other areas.

Once you have identified the tasks you want to streamline, brainstorm how you could create a shortcut. This should be done thoughtfully for each item. For example, if meal planning and cooking take too much time out of your day, consider subscribing to a meal service. If that isn't the right solution for you, consider other ideas, such as cooking larger batches on the weekend.

For each task, you should have at least

two possible time-saving solutions. You don't have to tackle all of your tasks at once though. Consider streamlining just one task, feelingthe pride in regaining those minutes and a bit of sanity, and letting that motivate you to move on to another task.

The motivation you find will come from using your saved minutes wisely.

Therefore, it's important to really think about what is missing in your day. Is it self-care time? Is it more sleep? Putting even just five regained minutes towards something you desperately need will be impactful for your life. It will also lower your stress.

Tips for shortcut solutions Although there is no one-size-fits-all solution to saving time in your day, there are many options. Some of these options may work for you, and some might not

work. Start with what seems plausible for you and your life. From there, try to add some solutions of your own that aren't already on the list.

Here are some solutions to time-sucking tasks: •Hire a housecleaner •Start a carpool •Try a meal delivery service •Try a grocery delivery service •Hire a babysitter •Hire a tutor •Use the hot lunch option at school •Sign up for activities within walking distance of your home or child's school •Block off work time for deliverables on your work calendar •Skip or ask to cancel meetings if they aren't important •Multi-task during meetings that aren't important •Start work 10 minutes early to catch up on email •Ignore phone calls if you are busy, and return calls when you have time Most people don't think about how they can streamline their day because they don't realize how much time they can save. Motivate yourself to want to save time by identifying exactly how you would spend that time and how it would improve your life.l

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IMMIGRANTS’ CONCERNS

7

DHS Issues New Memo Restricting Enforcement Activities in ‘Protected Areas’

BY REBEKAH WOLF

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he Department of Homeland Security (DHS) issued “Guidelines for Enforcement Actions in or Near Protected Areas”—a new memo that provides a framework for when and where DHS law enforcement entities can conduct enforcement activities in sensitive locations. The memo applies to enforcement activities of both U.S. Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP). It covers both the enforcement of civil and criminal laws and is effective immediately.

The new memo has four sections: an outline of the foundational principles, the definition and examples of “protected areas,” exceptions to the scope of the memo, and information about training officers to comply with memo. It replaces two previously issued memos, one which applied to ICE and the other to CBP. It keeps in place the April memo which addresses enforcement activity at courthouses specifically.

In the latest memo, DHS Secretary Alejandro Mayorkas emphasizes that its purpose is to ensure that enforcement

activity does not interfere with individuals’ access to essential services or engagement in essential activities. It refers to locations where such activities occur as “Protected Areas.”

While the memo does not contain an exhaustive list of such areas, it does give several examples, such as: •Schools and other places where children congregate.

•Medical and mental health facilities (including places for vaccines and testing).

•Places of worship or religious study (regardless of whether it is a structure dedicated to those activities or temporarily in use for them).

•Community centers.

•Place where funerals, weddings, rosaries, or other religious or civil ceremony occur.

•Places where there is an ongoing parade, demonstration, or rally.

While all these general categories of locations were included in some form in the prior memos, the new policy provides more examples of what kind of locations should fall within those categories. For example, the new memo

Secretary Mayorkas Editorial credit: lev radin / Shutterstock.com

greatly expands the category of “community centers” to include sites like domestic violence shelters, food pantries, community-based organizations, and homeless shelters.

The memo also adds a new category of locations where disaster relief or emergency response is being provided, such as along evacuation routes or where family reunification after a disaster is being organized. These expansions are in response to concerns raised by advocates during disasters such as the massive flooding in Houston, Texas in 2017.

Significantly, Secretary Mayorkas also emphasizes that the memo applies not only to the locations themselves, but also the areas “near” these locations. He reiterates that the purpose is to avoid interfering with immigrants’ access to these areas.

The current memo also narrows the scope of the prior policies, further limiting immigration officers’ abilities to carry out arrests in sensitive locations.

The most dramatic change is the elimination of a large exception in the prior CBP policy, which exempted all enforcement activities “at or near an international border.” Under the old policy, this exception rendered limitations on enforcement practically useless in border communities. The new change was welcomed by advocates in those border communities, who had previously reported CBP arrests occurring in border-area hospitals and other locations that will be protected under the new memo.

Unfortunately, the new memo doesn’t fix certain problems in the Biden administration’s April 2021 memorandum on enforcement activities at courthouses. continued on page 9

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IMMIGRANTS’ CONCERNS

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ICE Makes It Impossible for Immigrants in Detention to Contact Lawyers

BY EMMA WINGER & EUNICE CHO

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fter he was beaten and tortured by police “Ben G.” a 35-year-old veterinarian from Nicaragua fled to the United States. When he crossed the border into the United States, he requested asylum. U.S. Immigration and Customs Enforcement (ICE) eventually transferred Ben to the Winn County Correctional Center, an ICE detention facility in rural Louisiana located four hours away from the nearest metropolitan area. It is also the facility with the fewest immigration attorneys available in the entire country.

Despite passing the government’s initial screening and having a credible fear of persecution, Ben was still unable to find a lawyer. As a fellow detained person noted, “without having knowledge, we’ll go directly to the slaughterhouse.”

Ben’s story illustrates the monumental barriers that detained immigrants face in finding lawyers to represent them. As described in a letter sent October 29 by the American Immigration Council, the ACLU, and 88 legal service provider organizations to Department of

Homeland Security Secretary Alejandro Mayorkas, ICE detention facilities have systematically restricted the most basic modes of communication that detained people need to connect with their lawyers and the rest of the outside world, including phones, mail, and email access.

This must change. The immigration detention system is inherently flawed, unjust, and unnecessary. The best way to eliminate these barriers to justice is to release people from detention.

Although immigrants have the right to be represented by lawyers in immigration proceedings, they must pay for their own lawyers or find free counsel, unlike people in criminal custody who have the right to government-appointed counsel.

In many cases, detained immigrants cannot find lawyers because ICE facilities make it so difficult to even get in touch and communicate with attorneys in the first place.

The importance of legal representation

for people in immigration proceedings cannot be overstated. Detained people with counsel are 10 times more likely to win their immigration cases than those without representation. Yet the vast majority of detained people — over 70% — faced immigration courts without a lawyer this year.

ICE has set the stage for this problem by locating most immigration detention facilities far from cities where lawyers are accessible. Each year, ICE locks up hundreds of thousands of people in a network of over 200 county jails, private prisons, and other carceral facilities, most often in geographically isolated locations, far from immigration attorneys.

Even when attorneys are available and willing to represent detained people, ICE detention facilities make it prohibitively difficult for lawyers to communicate with their detained clients, refusing to make even the most basic of accommodations. For example, many ICE facilities routinely refuse to allow attorneys to schedule calls with their clients.

As described in the letter, the El Paso continued on page 9

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9

IMMIGRANTS’ CONCERNS Enforcement in ‘Protected Areas / continued from page 7

Immigrants in Detention/ continued from page 8

ICE and CBP enforcement activities at courthouses are extensive, mainly due to expediency—it is an easily-accessible location where the appearance of a particular individual at a specific time and date is often public knowledge.

The practice of courthouse arrests was so widespread during the prior administration that advocates argued it undermined the justice system. Individual states passed laws trying to prevent ICE arrests in state courthouses.

While the new memo that applies to protected areas except courthouses allows for enforcement activities to occur in those locations if “no other safe alternative location exists,” the April courthouse memo also included a loophole that allows enforcement activities to occur at a courthouse if it “would be too difficult to achieve the enforcement action at [an alternative location].” That additional caveat has some advocates concerned that enforcement activity at courthouses will continue, despite the new memo.

As with anything regarding DHS enforcement, questions remain about how the memo will be implemented, and what mechanisms will be put in place to ensure compliance by individual officers.l

Immigration Collaborative reported that staff at the Torrance County Detention Facility in New Mexico have told their lawyers that they simply don’t have the capacity to schedule calls in a timely manner, delaying requests for more than one week or more.

The University of Texas Law School’s Immigration Law Clinic attempted to schedule a video teleconferencing call with a client at the South Texas ICE Processing Center. An employee of the GEO Group, Inc., which runs the facility, told them that no calls were available for two weeks.

Even when detained people can speak with lawyers, ICE detention facilities cut these calls short, leaving legal providers like the Florence Immigrant and Refugee Rights Project in Arizona unable to complete intakes for potential clients in complex immigration cases in less than 20 minutes.

ICE detention facilities also fail to deliver legal mail on time to detained people, refuse to give detained people faxed documents, prevent access to email, and even confiscate legal paperwork, all of which violate ICE’s own policies.

For example, as an attorney with Mariposa Legal Services in Indiana reported that the Boone County Jail in Kentucky, which detains immigrants for

Downtown, Chicago-July 13, 2019: Protest against ICE and Customs and Border Patrol Detention Centers. Front line marchers with banners supporting immigration. Editorial credit: Antwon McMullen / Shutterstock.com

ICE, has failed to replace a faulty fax machine — the only mechanism for requesting client calls or visits. Boone County has also refused to allow any calls on Thursdays, brought incorrect people to meet with attorneys, and has used attorney-client rooms as housing cells when the facility is overcrowded.

The attorney also reported that the facility failed to deliver legal paperwork sent via FedEx to a client in detention.

This is only the tip of the iceberg. Legal advocacy groups have documented how ICE and telecommunications corporations inhibit communication between detained immigrants and their families, advocates, and allies. On multiple occasions, federal lawsuits have forced ICE

to make improvements designed to provide immigrants in detention access to counsel and the courts in select facilities.

ICE must continue to do so at those select facilities and expand those protections to all facilities in the detention system.

Immigration detention is inhumane, and it is a key barrier to access to justice. But so long as people are detained, ICE must ensure that detention facilities provide immigrants with timely access to counsel.l Emma Winger is a Staff Attorney, American Immigration Council, and Eunice Cho is a Sr. Staff Attorney, ACLU National Prison Project.

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10

IN THE NEWS

Monoclonal Antibody Treatments Save Lives

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he NYC Health Department reminded New Yorkers and health care providers that monoclonal antibody (mAb) treatments are available and lifesaving. From December 2020 through October 20, 2021, at least 25,000 doses of monoclonal antibodies were administered to eligible New Yorkers at high-risk for severe COVID-19 outcomes who tested positive for COVID19. Monoclonal antibody treatments have averted at least 1,100 hospitalizations and at least 500 deaths among people treated in New York City. mAb treatments can help anyone diagnosed with COVID-19, regardless of vaccination status, particularly those at higher risk of severe disease. NYC Health + Hospitals offers mAb treatments at 11 hospitals regardless of immigration status or ability to pay.

“The science shows that monoclonal antibody treatments work and can make all the difference when it comes to the severity of COVID-19 illness,” said Health Commissioner Dr. Dave A. Chokshi. “New Yorkers, get tested for COVID-19 as soon as you have symptoms. Once diagnosed, please speak with your health care provider about this lifesaving treatment.”

“All of our 11 hospitals have monoclonal antibody treatments for those eligible,” said Andrew Wallach, MD, Ambulatory Care Chief Medical Officer

at NYC Health + Hospitals. “There is no out of pocket costs for the treatment, and we will treat anyone regardless of their immigration status or ability to pay.”

When given early after symptom onset, mAb treatments can decrease the risk of hospitalization and death due to COVID19, which is why it is crucial to get tested for COVID-19 as soon as symptoms begin – the sooner someone is tested, the sooner treatment can begin.

Monoclonal antibody treatments are authorized as treatment for non-hospitalized patients with mild to moderate COVID-19 who are at a high risk of progression to severe disease. One product, REGEN-COV, is authorized for the prevention of illness for certain people at high-risk that were exposed to COVID19. The U.S. Food and Drug

Administration (FDA) has authorized mAb treatments for emergency use and they are shown to be safe in clinical studies. mAbs work similarly to antibodies that the immune system makes and help fight COVID-19 while the immune system begins to make its own antibodies.

Those who receive mAb treatment should wait three months after treatment before getting vaccinated.

Monoclonal antibody treatment is more effective if begun shortly after symptom onset or exposure. The Health Department and NYC Health + Hospitals are working to ensure that health care providers and the public are aware of this important treatment option so that eligible people can seek care right away if they test positive for COVID-19 or after an exposure.

Treatment should be given as soon as possible after a patient has a positive COVID-19 test result and within 10 days of symptom onset. Per the FDA’s emergency use authorization, mAb treatment is authorized for patients 12 years of age and older who weigh at least 88 pounds (40 kilograms) and who meet at least one of the following criteria: •Older age (for example, age ≥65 years of age) •Obesity or being overweight (for example, BMI >25 kg/m2, or if age 12-17, have BMI ≥85th percentile for their age and gender based on CDC growth charts)

•Pregnancy •Chronic kidney disease •Diabetes •Immunosuppressive disease or immunosuppressive treatment •Cardiovascular disease (including congenital heart disease) or hypertension •Chronic lung diseases (for example, chronic obstructive pulmonary disease, asthma [moderate-to-severe], interstitial lung disease, cystic fibrosis and pulmonary hypertension) •Sickle cell disease •Neurodevelopmental disorders (for example, cerebral palsy) or other conditions that confer medical complexity (for example, genetic or metabolic syndromes and severe congenital anomalies) •Having a medical-related technological dependence (for example, tracheostomy, gastrostomy, or positive pressure ventilation (not related to COVID-19)) •Other medical conditions or factors, such as race or ethnicity, that may place people at higher risk due to long-standing systemic health and social inequities Post-exposure prophylaxis should be considered for patients meeting the above criteria who were exposed to a person with confirmed COVID-19 and are not fully vaccinated or not expected to mount an immune response to the vaccine. l

Early Action is Key! Ask Your Doctor About Monoclonal Antibody Treatment Monoclonal antibody treatment is for people who have COVID-19 or were recently exposed to someone who has had COVID-19. Monoclonal Antibody Treatment: • Helps your body 昀ght COVID-19 while your immune system begins to make its own antibodies • Reduces your risk of becoming sick from COVID-19 and avoid hospitalization • Is recommended for anyone age 12 and older who is at high risk for severe COVID-19 illness, such as older adults and people with other health conditions • Is NOT a substitute for vaccination To 昀nd a site offering monoclonal antibody treatment, visit nyc.gov/health/map.

To 昀nd a vaccination site, visit nyc.gov/vaccine昀nder or call 877-VAX-4NYC (877-829-4692).

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GENERATIONS

11

Safety-Proof Your Elderly Parents' Home

BY CHRIS TOBIAS

A

s our parents and other elderly relatives and friends age, people are looking for ways to help them safely stay in their own homes. It is important to assess a person's home environment early in the aging and caregiving process. Preparing an elderly person's home environment when they can still understand and adapt to such changes is often more effective.

Make a Safety Checklist First, do your research. Do some reading about the most common hazards that seniors face in their homes. Make a generalized list of possible issues, including things like: •Doors in and out •Staircases •Rugs •Lighting •Slippery flooring •Insufficient phones or means of calling out •Clutter/hoarding •Smoke alarms, carbon monoxide detectors, radon detectors •Pathways through the home •Furniture (blocking paths or difficulty of getting in and out of) •Bathing and personal hygiene routines •Toilet height

person considers to be items of sentimental or other value. Tread lightly, literally and figuratively. When you start to make lists of items that need to be fixed, cleaned, removed, or adapted, try to have as gentle a conversation as possible with the person in whose home you are working.

Be empathetic: perhaps go through your own living quarters first with a similar checklist and note how you feel about downsizing or changing your surroundings. It's not so easy, is it?

•Temperature settings for water heater This is by no means a comprehensive list, but it should give you an idea of some of the biggest risks within the home.

Assess the Home Now take your checklist and move through the home you're safety-proofing, room by room. Make notes about possible issues, possible fixes, and any outstanding maintenance or organizing tasks that need to be performed.

If you are not able to perform this assessment yourself, home health providers and other eldercare consultants can be hired to perform it for you and your care recipient. They can help you see the entire picture of a person's living situation, point out risk areas, and help rank issues in the order of importance for which should be tackled first.

In addition to ranking issues in order of importance, it will also be important to consider the magnitude of the jobs waiting to be done. Are the necessary fixes things you can do yourself? Or will you need to contract with a home builder or handyperson to help you with the more complex items? If there is a larger improvement that needs to be made, like the addition of a ramp into the house, make plans to speak to several contractors, get bids, and schedule the work.

You will also have to confer with your

care recipient to discuss the costs of such work. Do they have the resources to remodel their home? Or would it make more sense to have a conversation about moving into a home or apartment that would be smaller, easier to maintain, or already has such safety features in place?

Be Kind This is not an item that shows up on most DIY home-safety checklists, but it is very important when dealing with a person who needs additional help and accommodations (especially when that person may not want to believe they need help).

When assessing the place where someone lives, remember that a lot of their identity can be tied up in it and their belongings. What may look like clutter or hoarding to you might be what the other

Go slow. Depending on what you find in a person's home, you might be tempted to try and fix everything at once. However, that's likely to be too much work for you and too sudden a change for the resident.

Pick one or two of the most pressing needs and start there. Invite the person to either help you fix things or arrange to keep them company when contractors you hire to perform work are there. As time passes you will be able to address more issues (large and small) if you pace yourself and give your care recipient time to adjust and accept.

A little bit of preparation often goes a long way. Prepare your safety checklist, do a home assessment, and remember to be kind to yourself and the person you're helping, and that will provide the most comforting environment of all.l

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National Diabetes Month 2021

The good news is that by making healthy lifestyle changes, it is possible to manage or reverse prediabetes and prevent it from turning into type 2 diabetes.

Prediabetes is a serious health condition that puts you at an increased risk for developing type 2 diabetes. Prediabetes a昀ects more than 1 in 3 U.S. adults—that’s 88 million people—but most people don’t know they have it.

Follow these tips to manage your prediabetes

01

02

03

Take small steps.

Move more.

Making changes to your lifestyle and daily habits can be hard, but you don’t have to change everything at once. Start small.

Limit time spent sitting and try to get at least 30 minutes of physical activity 5 days a week. Start slowly by breaking it up throughout the day.

Choose healthier foods and drinks most of the time.

04

05

06

Lose weight, track it, and keep it off.

Seek support from your doctor.

Stay up to date on vaccinations.

You may be able to prevent or delay diabetes by losing 5 to 7 percent of your starting weight.

People are more successful at managing their prediabetes if they have regular contact and support from trusted health care professionals.

The COVID-19 and 昀u vaccines are important for people who may be more likely to get very sick from COVID-19 or the 昀u, such as people with diabetes.

Pick foods that are high in 昀ber and low in fat and sugar. Build a plate that includes a balance of vegetables, protein, and carbohydrates. Drink water instead of sweetened drinks.

Visit niddk.nih.gov for more information on managing prediabetes.

Website niddk.nih.gov

Email healthinfo@niddk.nih.gov

Phone 1-800-860-8747

TTY 1-866-569-1162

Follow Us @NIDDKgov

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HEALTH

13 down into sugars which cause our blood sugar levels to rise. A low-carbohydrate diet means less blood sugar appears in the bloodstream, leading to improved blood sugar control.

For that reason, we initially defined remission using the definition each study used. Then, we compared the numbers of people whose blood sugar levels normalised without drugs for at least six months – which most consider to be true remission.

Type 2 Diabetes/ continued from page 1 does this by helping the body control blood sugar levels. This is significant as controlling blood sugar by improving how insulin is made and works is key to bringing type 2 diabetes into remission.

Most of this body of research so far has looked at using meal-replacement shakes to help people with type 2 diabetes, which is why this approach may be prescribed by a doctor. But, more recently, researchers have begun investigating other diets – such as low-carbohydrate diets – in achieving remission. Although research in this area is still emerging, study results have so far shown a lowcarbohydrate diet to be promising.

To better understand which diets are best at helping people achieve type 2 diabetes remission, our recent review looked at over 90 papers describing the effects of various diets on type 2 diabetes. We found that although the better quality research tended to focus on mealreplacement shakes used in clinical trials, other approaches (such as low-carbohydrate diets) were also shown to work well.

Our review found that meal-replacement diets helped around one in three people successfully achieve remission, while low carbohydrate diets were able to help around one in five people achieve remission. People who lost weight using both of these diets were able to stay in remission for up to two years if they maintained their weight loss.

Low calorie and Mediterranean diets were also able to help people achieve remission – but at much lower rates.

Only around 5% of people on low-calorie diets stayed in remission after one year, while only 15% of people on a Mediterranean diet stayed in remission after a year.

Mitigation v remission While low-carbohydrate diets help people achieve remission, there’s concern that blood sugar levels could potentially rise again as soon as more carbohydrates are eaten. This is why we suggest in our review that rather than call this remission, it should perhaps be called “mitigation of diabetes”, as type 2 diabetes is still present – but the negative effects are being well managed. We think that remission can only be achieved if fat is lost from around the organs. This allows insulin to be made and used effectively again.

But because carbohydrates are also a major energy source in our diet, eating less of these often results in consuming fewer calories – which typically results in weight loss. So if someone is able to maintain a low-carbohydrate diet long term, they will not only reduce blood sugar levels and risk of complications for their diabetes, but may also achieve remission.

Regardless, the evidence that we looked at in our review made clear that there are many ways a person can significantly improve their blood sugar levels through

Defining remission One of the big challenges we faced when writing our review was defining what “remission” is. Knowing how to define it was important so we could understand which diets worked best in helping people achieve remission.

The reason this was difficult is because the definition varies between different expert groups and research studies. Most define remission as a reduction of blood sugar levels below the range to diagnose diabetes – but some definitions state that this needs to be done without the use of drugs, while others do not. Other definitions say weight (especially fat around the midsection) must be lost to achieve remission.

Another challenge we faced when defining remission was that some reports suggest low-carbohydrate diets can normalise blood sugar levels even without weight loss. This happens because when we eat carbohydrates, they’re broken

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Especially:

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diet – and that this can lead to remission in many cases. The key thing we found with each type of diet is that at least 1015kg of body weight needed to be lost to achieve remission.

However, although weight loss seems to be the best predictor of success, it assumes fat loss from the pancreas and liver. It will be important for future studies to compare how these diets work for different ethnic groups, as type 2 diabetes can happen at lower body weights in different ethnic groups, who may have less weight to lose.

Not everyone may be able to achieve remission, but people who are younger (less than 50), male, have had type 2 diabetes for less than six years and lose more weight are more likely to be successful. This could be because these people are able to reverse the causes of their diabetes, recovering more of the pancreas’s ability to make insulin and the liver’s ability to use it. But this doesn’t mean others won’t be successful if they improve their diet and lifestyle, and lose weight.

Whether or not a person achieves remission, reducing blood sugar levels is important in managing the negative effects of type 2 diabetes and reducing risk of complications. But when it comes to choosing a diet, the most important thing is to pick one that suits you – one that you’re likely to stick to long term. l Duane Mellor is the Lead for EvidenceBased Medicine and Nutrition, Aston Medical School, Aston University. Adrian Brown is a Research Fellow & Lecturer, UCL

Are you looking to get into the health & wellness business?

Contact:

If you have other medical conditions

Stacy Young Board Certified Holistic Health Coach Tel: 917-459-8431

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JOBS & RECESSION

14

5 Reasons to Become a Paralegal attorneys, opposing counsel, vendors, staff members, clients, and others. The work is varied, and each day brings new challenges.

BY THE CHAMBER COALITION

A

career as a paralegal (also known as a legal assistant) can be a wonderfully fulfilling profession. Paralegals perform legal, regulatory, and business-related research for lawyers working at their organization.

Most of the time, paralegals work for law offices, non-profits, corporations' legal departments, or courts. These professionals also provide legal support services to attorneys. They assist lawyers in filing motions, memoranda, pleadings, and briefs in various court systems and accompany lawyers to see clients and go to court. Here are five great things about being a paralegal: 1. Rise in Pay Paralegal compensation has risen steadily in the past decade. As paralegals perform a broader and more complex range of tasks (paralegals even represent clients in court in certain countries and administrative tribunals), their earnings continue to rise. The average paralegal salary hovers at around $50,000 per year, but paralegals often make more through bonuses. Overtime hours can also add significant cash to a paralegal's paycheck.

2. Explosive Employment Outlook The paralegal field is one of the fastestgrowing professions on the globe. The U.S. Department of Labor, Bureau of Labor Statistics, predicts the employment of paralegals and legal assistants by over 25 percent, much faster than the average for all occupations. Among the factors driving this growth is client demand for cheaper, more efficient delivery of legal services. Since hourly rates charged by attorneys are typically double or triple the rates of paralegals for the same task, law firm economics mandates the increased use of paralegals to minimize costs. As a result, a paralegal career is one of the hottest non-lawyer jobs in the legal industry.

3. Easy Career Entry Unlike lawyers who must complete seven years of formal education and pass the bar exam to practice law, you can become a paralegal in as little as a few months of study.

4. Intellectual Challenge Paralegal work is intellectually challenging and involves a range of high-level skills. The most successful paralegals are problem-solvers and innovative thinkers.

Paralegals must become subject matter experts in their specialty areas and master legal procedure, research, drafting, and other skills. They must stay on top of ever-changing laws and new legal trends and developments while interfacing with

5. Rising Prestige As paralegals perform more complex and challenging work, paralegal prestige is rising. Paralegals are no longer simply lawyer's assistants; they assume corporate management roles, leadership roles in law firms, and entrepreneurial roles in independent paralegal businesses. Over the years, paralegals have transcended the image of glorified legal secretaries to become respected legal team members.

Ready to Take the Leap?

A career as a paralegal can be rewarding professionally and personally and offers a unique opportunity to help others; options vary, depending on the paralegal's practice area. Paralegals in the public interest sector help poor and disadvantaged segments of the population with legal issues ranging from protection from domestic abuse to assistance preparing wills. Ready to take the leap, the next step? Call us at 718-722-9217 or visit www.freeparalegal.org to complete your registration which includes payment.l

Need Assistance? Call 718-722-9217.

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LOVE & RELATIONSHIPS

15

The Importance of Compatibility in Relationships tionship. However, emotional incompatibility can cause challenges in the relationship. For instance, an introvert and extrovert can have difficulty communicating. An outgoing partner may enjoy parties, travel, and adventures, while the other prefers dinner and a movie at home.

The extrovert may eventually feel stifled by their introvert partner. Likewise, the introvert may feel pressured to be more outgoing. These differences may seem minor, but in time they could become sources of dispute in the relationship.

BY MARY CAMPBELL

A

relationship usually begins with an attraction. It may be physical appearance, personality, or sense of humor. However, there is something about a person that draws another to them. Although there is nothing wrong with attraction, it is not a solid foundation for a relationship. Compatibility is necessary for a lasting relationship.

What is Compatibility?

Compatibility is more than just having similar interests. It is necessary to have similar core values. What are core values? Core values are work ethics, religious beliefs, child-rearing techniques, and the importance of family. These values comprise who you are as a person.

Why is Compatibility Important?

People certainly do not have to have identical core values to have a lasting relationship. However, they do have to be willing to understand their partner's core values. They also have to be willing to compromise. For instance, if a couple has vastly different core values regarding child-rearing, issues are bound to arise.

One parent may take an authoritarian approach to discipline while the other is more permissive. In time, the permissive parent will undermine the parental authority of the other parent by overriding decisions and giving in to the child's desires. The two parents need to communicate their feelings honestly and compromise by developing a parenting style that is neither authoritarian nor permissive.

Types of Compatibility Physical Physical and sexual compatibility are

most important in the early stages of a relationship. However, maintaining sexual satisfaction is vital for a healthy relationship. As people age, they become more comfortable in their relationships.

While physical satisfaction is still important, they may focus more on love, trust, and dependability.

Emotional Emotional compatibility is how you express your feelings. Couples need to support each other emotionally.

Emotional compatibility helps people to feel comfortable and secure in their rela-

Financial Financial compatibility includes work ethics, spending habits, saving, budgeting, and financial planning. Financial incompatibility is a primary source of problems for many couples. You may have one partner who is a workaholic and another that procrastinates. You may have one person who saves frugally and another that spends lavishly. Such financial behavior will undoubtedly lead to arguments. It is best to have some level of financial compatibility. It will be necessary to reach a compromise regarding financial goals. continued on page 17

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We Speak NYC Conversation Classes are now online!

We Speak NYC (WSNYC), developed by the NYC Mayor’s Office of Immigrant Affairs, is an Emmy Award-winning English language learning program for intermediate level learners.

WSNYC provides civic-focused instruction through videos, education materials, community conversation classes, an interactive website, and now, in response to COVID-19 and the need for social distancing, We Speak NYC is offering online conversation classes!

Participants can register to be a part of an online community and safely meet people, learn about NYC services, and practice their English conversation skills with peers. Each class covers information on important topics such as workers' rights, healthcare, and workforce development.

Want to participate? Visit nyc.gov/learnenglish to https://wespeaknyc.cityofnewyork.us/wsnyc-online-classes/

find a class at a time that works for you!

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LOVE & RELATIONSHIPS

17

Governor Hochul Signs Domestic Violence Legislative Package

G

overnor Kathy Hochul on October 28, signed a domestic violence legislative package into law. Legislation S.1557/A.4496 requires the release of individuals from utility corporation services in instances of domestic violence.

Legislation S.1555A/A.465-A will make it easier for a victim of domestic violence to apply to have their voter registration records sealed from public view.

"My mother worked with domestic violence survivors all her life, and I'm proud to continue the mission to put an end to abuse and support the needs of survivors and families," Governor Hochul said.

"Requiring utility companies to release survivors of domestic violence from their contracts freeing up funds for necessities as they get their feet on the ground in a new home and keeping those new homes' addresses confidential ensures survivors can live there safely."

Legislation S.1557/A.4496 amends the public service law in relation to requiring

Gov Hochul. Editorial credit: lev radin / Shutterstock.com

the release of individuals from utility corporation services in instances of domestic violence. This legislation provides an escape clause for victims of domestic violence so they will not have to continue paying for services at a location they have fled.

Assemblymember Carmen De La Rosa said, "We thank Governor Hochul for signing this important legislation that will go a long way in returning dignity to survivors of abuse. Intimate partner violence manifest itself in physical, verbal, and economic abuse. This legislation

will allow survivors a release to ensure that can rebuild their lives and futures."

Legislation S.1555A/A.465-A amends the election law to ease the process for keeping a registered voter's name and address from being disclosed to the public. Previously, a victim of domestic violence would have to apply to the Supreme Court for a court order to keep the information from being disclosed.

Now, a victim of domestic violence can make an affirmation directly to the Board of Elections asking for the voter registration information to be kept confidential for four years.

Assemblymember Nily Rozic said, "No survivor should have to give up their right to vote in order to protect themselves from abuse. This law will ensure that survivors of domestic violence have a fair and straightforward way to keep their voter registration details confidential enabling them to vote without fear. I applaud Governor Hochul for signing this crucial legislation into law to ensure the safety of all New Yorkers."l

Compatibility continued from page 15

Spirituality Religion can be a touchy subject, even for people who love each other. For instance, an atheist and a devout Christian would certainly lack spiritual compatibility. However, people do change their religious views or convert to another faith. Religion is a topic that couples should discuss openly and honestly.

Perfect compatibility is not a requirement for a good, loving relationship. However, it does help to have similar values, ethics, and goals. People that have the same goals and dreams are more likely to work together to achieve them. Compatibility is not the only quality necessary for a healthy, lasting relationship.

Communication and compromise are vital in developing and maintaining a great relationship. Love, compatibility, good communication, and compromise are the ingredients for a great relationship. l

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WELCOME TO AMERICA

18

$1/Day Labor Program for Immigrants in Detention Ruled Unlawful in Washington State

BY REBEKAH WOLF

I

n a landmark court decision, Geo Group—one of the largest private prison companies that own and/or manage dozens of immigrant detention centers across the United States—was found to have violated Washington state’s minimum wage laws. The company has been ordered to pay over $23 million, $17.3 million of which will go directly to immigrants who were paid just $1/day for labor inside the detention center in backpay.

This decision comes after years of attempts to challenge the so-called “dollar-a-day” program, which is a coercive practice forcing many immigrants to work for insignificant pay that exists in immigration detention centers throughout the United States. The judge’s decision in the Washington case sets a new precedent, ruling that immigrants who work while held in detention are in fact employees and therefore subject to minimum wage laws.

Owning and operating private immigra-

tion detention centers is an extremely lucrative business. Part of what makes them so profitable is that internal operations such as cooking and cleaning are often “in-sourced” to the people who are detained, being paid $1/day.

The Washington lawsuit began in 2017 when the state’s attorney general sued Geo Group for unjust enrichment— claiming that the company was unfairly enriching itself by bypassing regular labor laws. Separately, private attorneys brought claims on behalf of individuals at a detention center in Tacoma, asking for back-pay. The judge eventually ruled in favor of both, granting $17.3 million in back pay to individual workers. Another $5.9 million went to Washington state as repayment for the unjust enrichment.

Advocates have struggled to challenge the practice of using the labor by detained individuals in detention centers at extremely low wages for years. Some have even compared its use to labor trafficking, claiming it arguably violates the Trafficking Victims Protection Act. Others have argued it violates the United

States’ anti-slavery laws.

Lawsuits have been brought against major private prison companies like Geo Group and CoreCivic in states around the country, but with various levels of success. The government regularly argues that the detained people aren’t “employees” and that participation in the work is voluntary. But detainees have reported threats of punishment if they refuse the work, such as being placed in solitary confinement or forgoing the ability to purchase necessities from the com-

missary.

Exploiting detained immigrants for their labor—at $1 per day and sometimes less—is inhumane. With the recent decision in the Washington lawsuit as precedent, hopefully fewer people will remain trapped in detention as the cost of detention for the government increases with labor costs, and more of those that do will receive fair wages for their work inside detention centers.l

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