GREENFIELD — A U.S. Department of Health and Human Services decision, now being challenged in court, that would make people with certain legal statuses ineligible to receive help through community health centers and Head Start has local organizations considering how this might impact their operations.

The Department of Health and Human Services decided on July 10 to rescind the 1998 interpretation of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996. The decision reclassifies community health centers, Head Start and other programs as “federal public benefits,” which are federally funded safety net programs.

This reclassification prohibits people with certain legal statuses, such as those who are in the U.S. with Temporary Protected Status or under the Deferred Action for Childhood Arrivals (DACA) policy, and undocumented immigrants from accessing these benefits, as status verification would be required to check eligibility.

“For over two decades, the 1998 policy [has been] undercutting the law by allowing illegal aliens to access programs Congress intended only for the American people,” reads a July 10 statement from the Department of Health and Human Services. “With this update, HHS is complying with the law — ensuring that federal benefits are administered with transparency, legal integrity and fairness to the American people.”

Following this announcement, a lawsuit by 20 attorneys general across the United States, including Massachusetts Attorney General Andrea Joy Campbell, was filed against the Department of Health and Human Services, the Department of Justice, the Department of Education and the Department of Labor in the U.S. District Court of Rhode Island. On July 25, the government agreed to temporarily pause the implementation of the Personal Responsibility and Work Opportunity Reconciliation Act changes until September.

The lawsuit alleges the reclassification is unlawful, with a statement from Campbell’s office declaring the changes were made “without following required procedures under the Administrative Procedure Act and by misapplying PRWORA to entire programs rather than to individual benefits.” The lawsuit also argues that the change violates the Constitution’s Spending Clause by imposing new funding conditions on states without fair notice or consent.

Local impact

With the Department of Health and Human Services’ decision being challenged in court and the reclassification being on hold for now, Community Health Center of Franklin County CEO Dr. Allison van der Velden said her organization is still receiving guidance on how to be compliant with the changes, especially as a nonprofit receiving federal funding.

“It’s important to note that there aren’t any changes yet, because we are still awaiting guidance,” she said.

Similarly, retiring Community Action Pioneer Valley Executive Director Clare Higgins said the Head Start program, overseen by Community Action, is still operational and enrolling at its locations in Franklin and Hampshire counties, but declined to comment further while awaiting legal guidance on the issue.

Head Start provides support services for low-income expectant parents and children ages 5 and under. Services include physical and mental health, disability and nutrition support. The program also provides resources and learning activities for children and their parents. Community Action Pioneer Valley serves more than 300 children through its locations in Amherst, Turners Falls, Northampton, Westfield, Agawam, Orange and Ware.

At the Community Health Center, immigration status data is not being collected, and van der Velden said that, as a nonprofit, it is exempt from requiring immigration status verification, which is part of the original Personal Responsibility and Work Opportunity Reconciliation Act. The act states that nonprofits “shall” request this information, but it is not a requirement.

If the legal challenges fail and the Community Health Center of Franklin County is required to operate as a federal public benefit, the center would be prohibited from providing care to people with certain legal statuses and undocumented immigrants. Green Card holders would still be eligible to receive care.

“If people are in that group, and these challenges are unsuccessful and we receive guidance, we will not be able to serve certain groups of people based on their immigration status with any part of our business that’s funded with federal funds,” she explained.

Van der Velden noted that the medical record software that the center currently uses doesn’t allow for data on someone’s immigration status to be collected. Without that data, van der Velden said it’s difficult to say how many people would be impacted in Franklin County. The center operates clinics in Greenfield, Turners Falls and Orange.

However, national data from the health policy research and news outlet KFF states that three in 10 immigrant adults report a community health center is their source of health care, and 42% of likely undocumented immigrants (or roughly four in 10) state they get their care from a community health center.

Further complicating the issue is the health center’s federal Section 330 grant that requires service be provided to all residents of an area, regardless of immigration status. The center’s annual budget of $20 million includes around $2 million in federal funding, van der Velden said.

To van der Velden, this potential eligibility change concerns her as it would take away access to health care for portions of the population that were once able to rely on community health centers.

“The effect that this will have on communities, on health care access for everybody and [the] general well-being of communities will not be beneficial,” she said.

As the challenge makes its way through court, van der Velden stressed that the Community Health Center of Franklin County is still offering health care to everyone at its Greenfield, Turners Falls and Orange locations.

Erin-Leigh Hoffman can be reached at ehoffman@recorder.com or 413-930-4231.