Immigration Compliance and Worksite Enforcement: A New Risk Management Concern for Employers in the Healthcare Industry
Copyright 2010 American Health Lawyers Association, Washington, DC.
Reprint permission granted.
Further reprint requests should be directed to
American Health Lawyers Association
1025 Connecticut Avenue, NW, Suite 600
Washington, DC 20036
(202) 833-1100
For more information on Health Lawyers content, visit: http://www.healthlawyers.org.
Hector A. Chichoni, Esquire
Robert S. Groban, Jr., Esquire
Frederick Warren Strasser, Esquire
Epstein Becker & Green PC
New York, NY, and Miami, FL
Introduction
As the current debate over healthcare reform has dominated the headlines, the business of running America’s healthcare institutions has never been more challenging. Healthcare executives are being forced to navigate their institutions through the most difficult economic and regulatory environment in recent history. In this article, we hope to ease that management burden by identifying an area of regulatory exposure—immigration compliance and worksite enforcement—that many healthcare executives may overlook as they struggle to address all of their other operational needs. The additional regulatory exposure from inadequate immigration compliance becomes even more critical when you consider the healthcare workforce’s sheer size. The U.S. Department of Labor (DOL) identifies the healthcare industry as the country’s largest employer, accounting for more than fourteen million jobs annually.1 The DOL also estimates that the healthcare industry will add another three million new jobs from 2006-2016, more than any other industry. Managing a diverse healthcare workforce has never been simple given the unique way in which most hospitals and other healthcare institutions function. Unions, medical practices within hospitals, independent contractors, and third-party contractors can be found in nearly every large healthcare organization, along with a complex matrix of professional, quasi-professional, and non-professional employees that must be recruited, trained, and managed in a manner that comports not only with labor and employment laws, but also with regulatory requirements, licensing, and union agreements. Amid this vortex of legal obligations, it is easy to overlook the increasingly important legal responsibility of Form I-9 compliance. 2 As recent actions by the administrations former President George Bush and President Barack Obama demonstrate, however, the failure to address immigration compliance can have serious civil and criminal consequences to the organization, as well as its employees and senior management.
IRCA and Worksite Enforcement
When Congress passed the Immigration Reform and Control Act of 1986 (IRCA),3 it made it unlawful for employers to hire or retain undocumented workers and established a process, the Form I-9 process, that required employers to verify the identity and employment eligibility of all workers hired on or after November 6, 1986.4 In the twenty years following IRCA’s enactment, the Immigration and Naturalization Service and, later, its successor, Immigration and Customs Enforcement (ICE), targeted egregious violators and deported illegal workers— but levied few significant civil or criminal penalties against employers. When larger organizations were involved, the fines tended to be so minimal that they were not really considered a “serious” compliance issue. The regulatory calculus surrounding worksite enforcement changed radically following the September 11, 2001, terrorist attacks. This precipitated creation of the U.S. Department of Homeland Security (DHS) and led to substantially increased funding for worksite enforcement and border security. 5 Later, the Bush Administration’s support for comprehensive immigration reform created such a hostile public environment against undocumented workers that worksite enforcement, coupled with enhanced border security, were seen as essential prerequisites to any meaningful dialogue on how to fix the country’s broken immigration system. The result was an unprecedented number of public enforcement actions by the Bush Administration that focused primarily on rounding up illegal workers, not penalizing their employers. 6 The Obama Administration has pursued a different approach toward worksite enforcement and expanded its efforts beyond Form I-9 compliance to include H-1B fraud, 7 wage and hour complaints, compliance with the Public Access File requirements of the H-1B program,8 overall immigration fraud, and other areas where legal immigration and employment issues may intersect. As DHS Secretary Janet Napolitano noted, “DHS is focused on smart, tough and effective enforcement of the laws we currently have.” 9
The Vulnerability of Healthcare Employers to Worksite Enforcement Actions
The healthcare industry is not immune from regulatory scrutiny. Given the size and diversity of its workforce and increased union activity, the likelihood that healthcare employers will become targets for worksite enforcement actions seems apparent. This means that healthcare organizations need to identify the critical components of immigration compliance and then develop and incorporate more vigorous policies and procedures into their overall risk management program. Form I-9 completion and retention is the primary legal responsibility for most employers. Healthcare employers should have a uniform written policy for Form I-9 completion using only the form’s latest edition. 10 Such a policy is important to ensure that the organization not only confirms that all new employees are authorized to work, but also avoids discrimination claims that can arise when different Form I-9 completion procedures are used. 11 Under IRCA, an organization must retain its Form I-9 documentation for at least three years or one year following the employee’s termination—whichever is longer—and must make these forms available for inspection if requested by the DOL, DHS, or U.S. Office of the Special Counsel. An employer’s failure to properly complete and retain a Form I-9 provides the same basis for serious civil or criminal liability as if the form was never completed at all.
Under IRCA, an employer cannot use the Form I-9 process to screen candidates for employment. If a healthcare employer does not want to hire foreign nationals who require immigration sponsorship or have limited employment authorization, should it develop an employment application and interview process that will identify these candidates from the outset. 12 It should also implement an immigration employment policy which, among other things, defines the circumstances in which it will sponsor foreign nationals, if any. This policy should also make clear that the organization’s immigration sponsorship does not waive its employment at-will policies, guarantee success, or prohibit the organization from withdrawing its sponsorship for any reason or no reason at all. Such explicit language is particularly important in light of a decision like the Tenth Circuit’s ruling in DerKevorkian v. Lionbridge Technologies, Inc., 13 which held that an employer may have a fiduciary obligation to sponsor a foreign national in the absence of a specific policy. Proper completion of the Form I-9 process does not end an employer’s legal responsibility. Under IRCA, an employer who acquires “actual or constructive knowledge” that an employee does not have employment authorization can be subject to civil or criminal penalties. Such actual or constructive knowledge can arise in a variety of circumstances. For example, an employer would have reason to question the status of an employee who claims to be a permanent resident on his Form I-9—but then asks his manager for immigration sponsorship. Similarly, an organization that has information from a background check that contradicts the status claimed in the Form I-9 would also have constructive knowledge that the employee might be undocumented. Another common situation that might support a finding of constructive knowledge is the employer’s receipt of a “no-match” letter from the Social Security Administration (SSA). Prior to 2007, the SSA sent these letters to notify employers that the names and Social Security numbers (SSN) of certain employees did not match what the SSA had in its system. To ICE, an employer who fails to resolve this discrepancy has constructive knowledge that the subject employee(s) might be undocumented. 14 To the SSA, by contrast, these letters are simply correction requests issued to reduce the suspense fund and properly credit tax payments to the right employee. In this regard, the SSA neither has the authority to penalize employers that supply incorrect SSN information nor those that fail to respond to a no-match letter. While the SSA cannot share its no-match information with DHS under current law, the SSA can provide no-match information to the Internal Revenue Service, which does have the authority to investigate, audit, and ultimately fine the employer. 15 In 2007, the Bush Administration published a “safe harbor” rule that purported to establish a government-sanctioned procedure that employers could follow if they received a no-match letter. Those that followed this rule would receive safe harbor from criminal prosecution and protections against having constructive knowledge that an employee was not authorized to work. The rule was quickly challenged in federal court, which enjoined its implementation. 16 As part of this challenge, the SSA also voluntarily halted the issuance of new no-match letters until the litigation had concluded. On October 7, 2009, DHS rescinded its controversial no-match rule.17 ICE, however, still considers an employer’s receipt of and failure to address a no-match letter to be evidence of the knowing employment of an undocumented worker. With the rescission of the safe harbor rule, healthcare employers should be ready to receive new no-match letters from the SSA. Thus, they should have a policy in place for handling them as part of their overall immigration risk management practices. Of course, any employer who concludes that an employee does not have employment authorization must terminate that employee.
State Immigration Laws: The New Frontier
The failure of comprehensive immigration reform in August 2007 left the impression that the federal government was politically unable to deal with America’s immigration issues. Moreover, this legislative paralysis occurred as the 2008 presidential campaign was heating up and aspiring contenders lined up to demonstrate political toughness by proposing more rigorous measures addressing unlawful immigration. Colorado, the home of 2008 presidential candidate Representative Tom Tancredo (R), passed the first state legislation, which became effective on January 1, 2007. This law required all employers to sign a state affidavit verifying that their employees had work authorization and mandated that all state contractors use E-Verify, the federal government’s employment verification system. 18 Arizona, the home of Senator John McCain, the eventual Republican candidate for president, and former Arizona Governor and now DHS Secretary Janet Napolitano (D), promptly followed Colorado’s lead when it enacted even more stringent legislation in July 2007.19 Effective January 1, 2008, this law not only made it illegal to knowingly hire an undocumented worker, it also required all Arizona employers to utilize E-Verify or risk loss of their business license. 20 Colorado and Arizona initiated a growing trend of state legislation directed at the employment of undocumented workers. The June 2009 report of the National Council of State Legislatures found that forty-four states had passed 144 laws and 115 resolutions affecting foreign nationals and immigration. 21 While some see this as a positive step in controlling unauthorized employment, it has become a nightmare for employers who now must deal with a dizzying patchwork of federal and state laws and often conflicting compliance requirements. For larger healthcare organizations operating in multi-state arenas and varying jurisdictions, it simply ups the ante on ensuring compliance not only with federal immigration laws—but also with whatever laws now are imposed by individual states.
Immigration Risk Management: Best Practices
While the Obama Administration has shifted away from controversial worksite raids, it has made it clear that it intends to hold employers accountable for immigration law compliance. To emphasize this point, ICE issued more than 650 Notices of Inspection in July 2009 to employers in a wide range of industries suspected of Form I-9 and other serious worksite violations. 22 As the pressure for comprehensive immigration reform builds, the key to a more unified approach, especially in this difficult economy, remains strong worksite enforcement that penalizes employers who violate the law and employ undocumented workers. As a result, it is critically important for all employers in the healthcare industry to re-double their efforts and adopt policies that promote legal compliance and facilitate risk management. Healthcare employers looking for “best practices” may find assistance in the DHS’ ICE Mutual Agreement between Government and Employers (IMAGE) program. 23 Originally proposed in 2007, the IMAGE program has not attracted a large number of registrants, in large part because of its burdensome requirements. However, IMAGE does offer a set of “best hiring practices” that can serve as a model for developing policies and procedures that will better prevent potential worksite violations. 24 Not all best practices may be realistic for every employer. Nevertheless, the list provides a useful reference for organizations seeking to enhance their compliance efforts. It thus makes sense to review them in some detail.
E-Verify
ICE recommends that employers use the E-Verify program for all new hires. E-Verify allows registered users to better confirm the identity and employment authorization of new employees by running selected Form I-9 information through the DHS and SSA databases. Under federal law, it is a voluntary program, except for certain vendors who receive solicitations or contract awards under the Federal Acquisition Regulations. 25 Several states, however, require either employers or state contractors to use E-Verify.26 Based on recent pronouncements, it is clear that the Obama Administration is considering support for legislation that mandates that employers use E-Verify as a means of facilitating comprehensive immigration reform. Thus, employers in the healthcare industry should take a careful look at E-Verify so that they will be prepared to implement it in 2010 if necessary.
Form I-9 Training
ICE recommends that employers train all employees involved in the Form I-9 process and ensure that only trained employees participate in this process. The training should include the Form I-9 completion process, detection of fraudulent documents, and any other topics that relate to an employer’s particular circumstances.
ICE also recommends that employers provide annual updates on this training.
Continue Reading...
On July 23, 2009, a bipartisan group in the House and Senate reintroduced “The Secure America Through Verification and Enforcement Act” (“SAVE”), which would require employers to use E-Verify to ensure that their workers are authorized to work in the country. This SAVE legislation is largely the same as the bill first introduced in Congress on November 6, 2007. According to its sponsors, the SAVE is designed to reduce illegal immigration by gradually phasing in the use of E-Verify and increasing border security with additional border patrol agents and new technology and infrastructure..jpg)
On September 3, Hector A. Chichoni will be 
teaching the webinar Employers Targeted in Immigration Crackdown: How to Audit Policies Before ICE Does. 
On Wednesday, July 8, 2009, the Senate approved several amendments dealing with immigration enforcement and benefits which were not included in the 2010 homeland security appropriations bill (H.R. 2892) passed previously by the House. An amendment introduced by Senator Jeff Sessions (R-Ala) dealing with E-Verify was passed by a voice vote after a motion by Sen. Schumer (D-NY) to table it was rejected 44 to 53. Sen. Sessions’ amendment is extremely important because it could make the voluntary E-Verify program, in its present form, permanent and mandatory for all federal contractors beginning September 8, 2009.
he department’s intention to rescind the controversial No-Match Rule in favor of the “more modern and effective” E-Verify. In a surprising but decisive response, the Senate also adopted an amendment from Senator David Vitter (R-LA) that would prohibit the U.S. Department of Homeland Security (“DHS”) from using any Fiscal Year 2010 appropriated funds to rescind the No-Match Rule.
More concerning for employers, however, is the apparent administration’s pursuance of a more capable and technologically advanced version of E-Verify. Sen. Schumer has stated repeatedly that E-Verify does not “go far enough” and made clear in several occasions that he favors a hi-tech employment verification system which employs biometric identifiers such as fingerprints, eye scans, and more. Similarly, Secretary Napolitano, who believes E-Verify is a “smart, simple and effective tool” has also made clear, in agreement with Sen. Schumer that “we need to continue to work to improve E-Verify, and we will.”
light of present existing Memorandums of Understanding between governmental agencies which already allows for information sharing, past joint raids, and an appropriations bill which provides for $5.4 billion to fund DHS’s employment verification activities..gif)
On July 2, 2009, the U.S. Department of Homeland Security, Immigration and Customs Enforcement (“ICE”) launched a new and bold initiative to audit companies by issuing Notices of Inspection (“NOIs”) to 652 businesses nationwide..jpg)
businesses in New York, San Antonio, Seattle, and San Diego. ICE has also sent audit notices to 32 companies in Arizona. For a long time the government has been seeking new ways to impose E-Verify on all US employers. I believe the strategy behind these notices is to paint a picture of rampant immigration violations so, come September 2009, Congress will make E-Verify mandatory for every employer. For as much as the government loves E-Verify, it will never be a substitute for immigration reform or stop illegal immigration.
One of my articles, Immigration Enforcement Under Napolitano: A 180 Degree Shift To Employers, was recently published by ILW. I am reproducing it here in its entirety for your perusal: .jpg)
President Obama made it clear that his immigration plan was to “bring people out of the shadows, improve our immigration system, create secure borders, remove incentives to enter illegally and honor our immigrant troops.” However, the Obama administration has not provided any details as to how it is going to accomplish this plan. This has not only created a good amount of speculation, but also a good deal of frustration among U.S. employers. Yet, in spite of lacking details, the Obama has sent out “immigration signals” and employers should be prepared to feel the effects.
watch the design of the operations and that the focus will be on “unscrupulous employers” rather than on undocumented workers. She also stated that raids will continue where undocumented workers are present and that she expects to increase the focus on ensuring that employers “of unlawful workers are prosecuted for their violations.” Moreover, Napolitano pledged to increase the focus on criminal punishment for employer violators and to encourage them to work with federal immigration agents to “establish sound compliance programs that prevent unlawful hiring.” She also aims to continue boosting manpower on the borders and focusing on technology, such as ground sensors. At the same time, it is her full intention to enforce these methods in a fair manner across borders, ensuring that the law is applied.
A provision in the $787 billion stimulus bill that would have required employers receiving federal stimulus money to use E-verify was dropped from the bill. This move is a victory for employers in the construction business receiving assistance from the stimulus bill.
I am reproducing in its entirety the following article, I think you should read it:
On August 8, 2008, USCIS issued a statement informing the public that the 
new U.S. Passport Card may be used in the Employment Eligibility Verification form (I-9) process. USCIS also stated that "...last month, the Departments of State and Homeland Security announced that the new passport card was in full production. The new card provides a less expensive and more portable alternative to the traditional passport book, and will expedite document processing at United States land and sea ports-of-entry for U.S. citizens traveling to Canada, Mexico, the Caribbean, and Bermuda. While the new card is .jpg)
more limited in its uses for international travel 
(e.g., it may not be used for international air travel), it is a valid passport that attests to the U.S. citizenship and identity of the bearer. Accordingly, the card may be used for the Form I-9 process and can also be accepted by employers participating in the E-Verify program." USCIS states that the passport card is considered a “List A” document that may be presented by newly hired employees during the employment eligibility verification process to show work authorized status. “List A” documents are those used by employees to prove both identity and work authorization when completing the Form I-9. 
On July 31, 2008, the House approved "H.R. 6633" to extend E-Verify, the federal government's electronic employment verification system, by five years. In spite of the many signs previously given by U.S. Representatives approved without amendment, HR 6633 or the Employee Verification Act of 2008, 407-2. 
the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 to extend the life of the voluntary program five years to Oct. 31, 2013. U.S. representatives initially supported legislation to scrap E-Verify in favor of a new mandatory verification system, but according Giffords, she introduced a five-year extension to make time for more study of the current system. Further, Giffords told lawmakers during House floor remarks that "within five years or less, the federal government must develop a mandatory system that operates uniformly across all 50 states." Technically, the bill would 
authorize two Government Accountability Office studies about aspects of E-Verify. The first study would examine erroneous tentative nonconfirmations under E-Verify, specifically focusing on the causes of erroneous tentative nonconfirmations, processes to remedy errors, and the impact of such errors on individuals, employers, and federal agencies. The second study would analyze the effect of E-Verify on small businesses and other small entities using the program. That study would focus on the cost to small entities of complying with E-Verify, an estimate of the number of small businesses participating in E-Verify, an analysis of compliance requirements such as reporting and recordkeeping, and steps DHS can take to minimize the economic impact of participating in E-Verify. 
allow additional time to design a fair and effective employment verification system is a workable proposition for employees and employers alike. The bill now moves to the Senate, which is in recess until Sept. 8, 2008. 
On July 7, 2008, Missouri Governor Matt Blunt signed a bill, effective January 1, 2009, requiring employers contracting or receiving grants from the state in excess of $5,000 to use E-Verify. Missouri joins a growing number of states that, in the absence of a federal comprehensive immigration reform act, have chosen to regulate the employment of illegal workers. The Missouri bill shares similarities to other bills enacted in states such as: Colorado, Georgia, Minnesota, Oklahoma, Rhode Island, and Utah. However, this bill goes further by requiring employers with state-administered tax credits, tax abatement, or state-administered loans to also use E-verify. The 
bill also gives Missouri's Attorney General the authority to enforce the act. Missouri's Attorney General may now demand: 1) employers to provide identification information on their employees; 2) employers to provide identification documents within 15 business days of receiving such a request. Failing to abide by the request could result in the suspension of a company's applicable local licenses, permits, and exemptions until the documents are supplied, 3) employers to classify its employees correctly (i.e. knowingly classifying an employee as an independent contractor when he/she is not carries fines ranging from $50 to $50,000.) A contractor will not be liable for the unauthorized employment of an illegal alien if a subcontractor employing the individual provides a sworn affidavit that the employee is authorized to work in the US. Missouri's law does not substitute the federal requirement to complete Form I-9 Employment Eligibility Verification. 
Today we received the new employment verification From I-9, edition date 
06/16/08. Be aware that no previous edition of the same form will be accepted. Please, also note there are several important changes made to the Form I-9 process: 
In its report of June 2008, the U.S. Government Accountability Office (GAO) stated that while E-Verify may help employers detect fraudulent documents (and I would say indirectly), it cannot fully address the use of legitimate documents. This issue can only be fully addressed by individuals owning those documents. The GAO also points out that E-Verify is vulnerable to employer misuse and even, fraud. 
employee based on what could turn out to be an E-verify error could still land them a discrimination charge under the Immigration Reform and Control Act of 1986 (IRCA). IRCA prohibits discrimination when hiring and firing based on the basis of citizenship status or national origin. Such discrimination could result from firing an individual based on lack of employment authorization when the individual is in reality authorized. 
On June 4, 2008, Mark Sanford, governor of South Carolina signed into law an omnibus immigration bill (HR 4400), which requires employers to verify the identity of employees with either a South Carolina driver's license or through E-verify. This bill also denies non-emergency medical care for undocumented adult immigrants by state funded clinics and hospitals. One important issues is that because federal law requires that care be given without discrimination, local healthcare providers will be facing a significant challenge in following the law. In recognition of this challenge, perhaps, no state agency is tasked with enforcing the new restrictions. Further, the new law goes on to prohibit undocumented immigrants from attending public institutions of higher education or receiving state funded scholarships. One particular and concerning issue is that the chief of the South Carolina Law Enforcement Division is mandated to enter into a Memorandum of Understanding (MOU) with the federal government (ICE) regarding enforcement of federal immigration law. The new law also also allows for law enforcement personnel to be deputized and trained for these duties. According to AILA, the bill contains similar language to Oklahoma's Taxpayer and Citizen Protection Act of 2007 (H.B. 1804). 
established a Web site to assist employers comply with the new immigration law. But the new law mandates the Labor Department to investigate complaints against companies who are hiring illegal immigrants. According to the new law, South Carolina's Labor Department is also responsible for randomly auditing businesses to verify employees’ legal status. Businesses with 100 or more employees must comply by July1, 2009 and all other businesses must follow the law by July 1, 2010. The new Web site is www.llr.state.sc.us/immigration. Georgia also has a similar law. Is Florida next?
On June 24, 2008, The House Appropriations Committee approved a U.S. Department of Homeland Security funding bill for $39.9 billion. However, the bill also rejects an amendment to extend the federal electronic employment verification program or E-Verify..jpg)
The Civilian Agency Acquisition Council and the Defense Acquisition Regulations Council ("Councils") are proposing to amend the Federal Acquisition Regulation to require certain contractors and subcontractors to use the U.S. Citizenship and Immigration Services’ ("USCIS") E-Verify system as the means of verifying that employees are eligible to work in the United States. Government agencies affected by the proposed are the Department of Defense (“DOD”), General Services Administration (“GSA”), and National Aeronautics and Space Administration (“NASA”). The proposed rule states: "This rule proposes to amend the Federal Acquisition Regulation (“FAR”) to require that certain contracts contain a clause requiring that the contractor and certain subcontractors utilize the E-Verify System to verify employment eligibility of all newly hired employees of the contractor or subcontractor and all employees directly engaged in the performance of work in the United States under those contracts." Stay tuned, this is just the beginning. 
(“the Order”) amending Executive Order 12989. The Order, an aggressive move to keep illegal immigrants out of the US workforce, requires contractors and others doing business with the federal government to use E-Verify (formerly known as the Basic Pilot or Employment Eligibility Verification Program). E-Verify is an electronic employment verification system run by DHS in partnership with the Social Security Administration, which permits participating employers to electronically verify the employment eligibility of newly hired employees. E-Verify is voluntary for private companies, but mandatory for government agencies. The Order, which will also apply to new hires initially, in time, will affect millions of workers working for federal contractors nationwide. 
Interestingly, employers in the health care business using the Medicare program, janitorial services providing services to courts, universities getting federal student loans for its students or grants for some of its projects and programs, companies in the defense industry, and even contractors serving food in cafeterias in any government agency will be considered government contractors and will have to comply with this order. 