Providing Support for Patients' Temporary Medical Visa Process for Genetic Services in the United States as a Genetic Counselor

Sammy is a 2-year-old child with mucolipidosis III gamma (ML IIIγ), an inherited metabolic condition with symptomatic treatment but no cure. Sammy is from a country where outpatient genetics services are limited and related costs are not covered by insurance. Lack of a formal genetics evaluation in her home country meant that she could not be referred to specialists for her condition. 

Sammy’s family applied and obtained a B-2 visa for medical care in the U.S., allowing her to receive in-person genetic services (a thorough genetics evaluation, including genetic counseling and a physical exam by a medical geneticist) and multidisciplinary care from rheumatology, orthopedic, cardiology, and plastic surgery specialists, for some time. In-person care made Sammy’s care management more effective and accessible through facilitating communication methods via face-to-face interpreter services, establishing stronger familiarity and rapport with the care team, and providing patient navigator assistance for navigating the healthcare system and their adjustment to the country.

As time neared the end of their initial temporary visa sponsorship, the family needed to file for a visa extension. Sammy’s genetics team, the genetic counselor and the geneticist, provided a medical support letter and a letter of support for relief of deportation. In addition to the documents provided the team reached out to institutional services such as a social worker, child-life specialist, and animal-assisted therapy to help the family navigate the psychosocial challenges faced. 

This family faced many challenges including navigating a genetic diagnosis of a child, attempting to understand the temporary medical visa process, and navigating a new healthcare system. The genetics team worked towards establishing rapport, alleviating barriers by providing institutional resources, and ensuring support for the family as they navigated their medical journey. 

 References

Alpert J. S. (2024). Face-to-Face Versus Digital Encounters in the Clinic. The American journal of medicine, 137(5), 379–380. https://doi-org.ucsf.idm.oclc.org/10.1016/j.amjmed.2023.06.015

Chen, A. H., Youdelman, M. K., & Brooks, J. (2007). The legal framework for language access in healthcare settings: Title VI and beyond. Journal of general internal medicine, 22 Suppl 2(Suppl 2), 362–367. https://doi.org/10.1007/s11606-007-0366-2

Moulaei, K., Sheikhtaheri, A., Fatehi, F., Shanbehzadeh, M., & Bahaadinbeigy, K. (2023). Patients' perspectives and preferences toward telemedicine versus in-person visits: a mixed-methods study on 1226 patients. BMC medical informatics and decision making, 23(1), 261. https://doi-org.ucsf.idm.oclc.org/10.1186/s12911-023-02348-4

Raas-Rothschild A, Spiegel R. Mucolipidosis III Gamma. 2010 Jan 28 [Updated 2019 Nov 21]. In: Adam MP, Feldman J, Mirzaa GM, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK24701/

These resources are provided to help you become more familiar with B-2 medical visas, explore how to write a letter in support of medical visa sponsorship, and more. They may not specifically center on healthcare or genetic counseling aspects.

Writing a Letter of Medical Support

1. B-2 Visa for U.S. Medical Treatment: Who Qualifies (LINK)

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Writing a Letter of Medical Support

3. Formatting for Letters Provided by your Doctor or Therapist for Immigration Waiver Purposes (LINK)

4. Immigration Recommendation Letter (LINK)

5. Guide to Immigration Letters of Support for Family Members (LINK)

Journal Articles & Reports Highlighting Patient Experiences & Challenges

1. Presidential Immigration Policies: Endangering Health and Well-being? - Gostin, L. O., & Ó Cathaoir, K. E. - 2017 (LINK)

2. Fatal Flights: Medical Deportations in the U.S. . Free Migration Project and University of Pennsylvania Law School Legislative Clinic - Bennion, D., Torres-García, A., Rodarte Costa, E., Monnat, J. - 2021 (LINK)

Resources for Patients

1. Letter Template for Patients to Provide to Care Team to Request Letter of Support (LINK)

2. Tips on How to Choose a Doctor to Write a Letter in Support (LINK)

3. The National Association of Charitable Clinics (LINK) 

4. Immigration Advocates Network (LINK) 

To find additional resources please see "patient resources" under our resource tab. 

Jean Yasis, BS  is a second-year genetic counseling student and genetic counseling assistant at University of California San Francisco. She is a current DACA recipient, and she contributes towards community engagement to expand the reach of genetics for minority groups.

Stephanie Soto, BS is a bilingual genetic counselor and a recent graduate of the University of Maryland, Baltimore's genetic counseling training program. Her past experiences in community outreach initiatives and community-funded opportunities have inspired her passion for increased efforts to increase accessibility and advocacy, specifically for underserved communities in the genetic counseling field.

Betty Diaz, MS is a bilingual genetic counselor and a recent graduate of Sarah Lawrence College. As a current DACA recipient, Betty is passionate about improving access to genetic counseling services for underserved communities and advocating for equitable healthcare interpretation services. 

Dalia Vargas, BS is a prospective genetic counseling student and medical assistant at Colorado Heart and Vascular. She is a current DACA recipient interested in improving access to healthcare for underrepresented communities. 

Daniela Diaz Caro, MS, CGC  is a bilingual research genetic counselor at Columbia University Irving Medical Center. She is a previous DACA recipient and has an interest in working to expand access to genetic counseling services in Latin America and marginalized communities in the United States. 

Stefania Alastre, MSPH, LCGC s a bilingual genetic counselor at Moffitt Cancer Center. She is a previous DACA recipient and is particularly interested in improving access to genetic services for minority and underrepresented communities. 

Alicia Lewis, BA  is a prospective genetic counseling student, current Master of Health Administration Student and Senior Clinical Research Coordinator at Columbia University Medical Center.