State of Washington, et al., v. Trump., et al

Filing 202

NOTICE of Lodging Additional Declarations re 198 Amended Complaint, ; filed by Plaintiffs Commonwealth of Massachusetts, State of California, State of Maryland, State of New York, State of Oregon, State of Washington. (Attachments: # 1 Updated Imdex of Declarations in Support of Third Amended Complaint, # 2 Decl of Negin Ingbrigtsen, # 3 2nd Decl of Sadaf Amin, # 4 Decl of Janet Billups, # 5 Decl of Janet Camp, # 6 Decl of Susan Capalbo, # 7 2nd Decl of Margaret Everett, # 8 Decl of Anke Schennink, # 9 2nd Decl of Lovely A. Warren, # 10 Decl of Wim Wiewel, # 11 Decl of Lydia Wood, # 12 Decl of Joseph E. Fahey, # 13 2nd Decl of Aaron O. Lavine, # 14 2nd Decl of Eric Scherzer, # 15 3rd Decl of Eric Scherzer)(Melody, Colleen)

THIRD
DECLARATION OF
ERIC SCHERZER

THE HONORABLE JAMES L. ROBART

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UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF WASHINGTON
STATE OF WASHINGTON; STATE
OF CALIFORNIA; ST ATE OF
MARYLAND; COMMONWEALTH
OF MASSACHUSETTS; STATE OF
NEW YORK; and STATE OF
OREGON,

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CIVIL ACTION NO. 2:17-cv-00141-JLR

DECLARATION OF ERIC
SCHERZER

Plaintiffs,
V.

DONALD J. TRUMP, in his official
Capacity as President of the United
States; U.S. DEPARTMENT OF
HOMELAND SECURITY; ELAINE
C. DUKE, in her official capacity as
Acting Secretary of the Department of
Homeland Security; REX
TILLERSON, in his official capacity
as Secretary of State; and the UNITED
STATES OF AMERICA,
Defendants.
Pursuant to 28 U.S.C. § 1746(2), I, Eric Scherzer, hereby declare as follows:
1. I am the Executive Director of the Committee of Interns and Residents/SEID Healthcare

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("CIR"), a national union representing interns, residents, and fellows in the medical field.

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CIR is headquartered in New York City and our California Regional office is located in

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Alameda, California. As the Executive Director, I am in communication with CIR members

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in order to understand the day-to-day problems and issues confronting members in their
workplaces. I work with our work site organizers to address and resolve concerns that
members bring to our attention, which range from issues that impact their work

environment to larger social and political advocacy items that impact the patients they care

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for. I attend meetings with our members and have numerous one-on-one conversations with

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our member leaders.

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2. I have personal knowledge of the statements set forth below. The legal department of

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SEIU's International office, headquartered in Washington, D.C., assisted in gathering

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information related to these statements in conjunction with the CIR legal department and

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CIR's former California Regional Director.
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3. CIR is the oldest and largest housestaff union in the country, representing more than 15,000

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interns, residents, and fellows in all specialties in public and private hospitals across the

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country. CIR members include interns, residents, and fellows in California, New York,

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New Jersey, New Mexico, Massachusetts, Florida, and Washington, D.C. and comprise

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approximately 13% of all U.S. resident physicians.
4. CIR represents over 4,000 resident physicians in the State of California and is the major

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union representing medical interns, residents, and fellows in the state. Many of these CIR
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members work in safety-net and university hospitals in California. CIR represents members

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in Los Angeles County Hospital-USC Medical Center, Los Angeles County- Harbor-

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UCLA Medical Center, U.C. San Francisco Medical Center, U.C. Irvine Medical Center,

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Alameda Health System - Highland Hospital and others in California. A breakdown of

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resident physicians that CIR represents in each of the State of California hospitals and

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clinics is attached as Exhibit A.
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5. President Trump's September 24, 2017 Proclamation "Presidential Proclamation Enhancing

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Vetting Capabilities and Processes for Detecting Attempted Entry Into the United States by

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Terrorists or Other Public Safety Threats" ("Proclamation") causes serious harm to CIR

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members. Although we do not collect visa information, I know from personal experience

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that CIR members in many of the county and university hospitals are foreign physicians in
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the United States on temporary visas. CIR members are also citizens and nationals of many

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of the countries listed in the Proclamation. The Proclamation affects nationals of Chad,

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Iran, Libya, Somalia, Syria, Yemen, North Korea, and Venezuela seeking to travel to the

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United States.

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6. The Proclamation followed a March 6, 2017 Executive Order and an earlier January 27,
2017 Executive Order, both of which were halted by nationwide preliminary injunctions.

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Shortly after the January 27, 2017 Executive Order went into effect, CIR issued a notice

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advising all nationals of the affected countries not to travel outside of the United States. We

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also warned foreign nationals from other countries not listed in the January 27, 2017

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Executive Order to avoid international travel. We cautioned other members on visas to

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travel outside of the United States only after consideration of the possible risks associated

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with travel during this unpredictable time.

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7. The Proclamation continues to harm CIR members and potential CIR members from the
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listed countries. The Proclamation states that individuals from the eight countries may
apply for a waiver to enter the United States based on several factors including hardship, if

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entry would not pose a national security risk and if entry would be in the national interest.

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However, there is little guidance on how the waivers could be obtained. Moreover, the

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waivers are discretionary, and there is no review of the denial of a waiver.

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8. Also families of CIR members from many of the listed countries may be prohibited from

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entering the United States. Some interns and residents obtain non-immigrant visas in
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advance of their spouses and children in order to get settled and facilitate their families'

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adjustment to life in the United States. Under the Proclamation, family members of many

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physicians hoping to join their CIR spouse or parent in the United States would be

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prevented from receiving a non-immigrant visa after October 18, 2017. CIR members are

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harmed directly when their family members are prohibited from entering the United States.
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In my conversations with CIR members, I have learned the importance of the emotional and

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day-to-day support and assistance family members provide to interns and residents who

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work on average 80 hours a week and sometimes more. The well-being of CIR members

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will be adversely impacted if separated from family members due to the September 24,

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2017 Proclamation.

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9. In California, CIR held meetings with CIR members following the harrowing experience of

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a Sudanese CIR member, a second-year resident in Internal Medicine at Interfaith Medical

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Center in Brooklyn. This resident was denied entry back into the United States on his valid

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H-lB visa after he attempted to return to the United States from a short trip to Sudan. He

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was only able to return following an order issued by a district court judge in the Western

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District of Washington that halted the implementation of the January 27, 2017 Executive

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Order. The January 2 7, 201 7 Executive Order and the denial of entry to this Sudanese CIR
member caused great concern to doctors, patients, and hospitals throughout California. In

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response to these concerns, CIR staff organized meetings of CIR members to discuss the
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negative impact of the Executive Order on the stability of patient care including what would

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happen to CIR member' s patients if CIR members were unable to return to the United

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States from trips abroad. CIR members also voiced concern about their patients'

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expressions of fear following the issuance of the two Executive Orders and the

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Proclamation. Patients were fearful of attending medical appointments or coming to the

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hospital for any reason. In February 2017, Alameda Health System, a hospital where CIR

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represents members, sent out information to patients welcoming them to the hospital to

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encourage patients to come to the hospital if needed. The Alameda Health System notice is

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attached as Exhibit B.

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Harm to Residents of California

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10. A significant number of doctors in California are citizens and nationals of the countries

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listed in the Proclamation. These physicians are responsible for the lives of thousands of

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Californians, and residents of California are reliant on the medical services that these

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physicians provide. CIR members see patients in clinics and hospitals throughout the state

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of California in areas of particular need such as Bakersfield. Although CIR does not

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compile statistics regarding the religious preferences of our members, many of our

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members originate from countries with Muslim majority populations. I believe that the
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Proclamation will prevent many doctors from the listed nations from participating in
residency programs in the United States and serving the people of California.

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11. I know that the experts in the field estimate a significant shortage of physicians in the next

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seven years. As Californians age and more care is required for the Baby Boom generation,

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this shortfall is projected to increase. The shortage of physicians will have negative

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consequences for medically underserved communities in California in urban areas such as
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Los Angeles, Oakland, and San Francisco where CIR members working in county hospitals
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provide essential care as well as hospitals in the Central Valley of California such as

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Bakersfield. CIR members are concerned that fewer patients will be able to obtain

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preventative and non-emergency care, and more people will be forced into seeking higher

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cost emergency room care.

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12. The shortage of even one physician can have serious implications for the safety-net

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hospitals in which many CIR members work. In meetings and one-on-one conversations
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with CIR members, I've learned the difficulties of managing patient care when a physician
is ill or unable to work for any reason.
13. CIR immigrant physicians provide much needed culturally sensitive care. A multicultural

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group of physicians provides Californians with a workforce capable of establishing trust

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with patients of all nationalities and religions. Establishing trust with patients is one of the

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cornerstones of effective patient care. Without a trusting relationship between patients and

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physicians, information that is critical for diagnosis and treatment is difficult to obtain.

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Culturally sensitive care that creates trusting patient-physician relationships is especially

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imp011ant in California, a state whose population is one of the most diverse in the nation.

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Uncertainty in Non-immigrant Visa Issuance Limits Residency Progr~1 and Exacerbates
ms
Physician Shorh,gcs
14. The vagaries in the process of extending and renewing H-1 B visas, the impact of travel

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outside the United States on visa renewal, the process of obtaining waivers of the Executive

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Order restrictions, and other visa processing issues negatively affect CIR members and

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potential members. These interns and residents have begun to consider seeking alternate

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training and long-term work in other countries like Canada, the United Kingdom, or
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Australia, rather than face the uncertainty caused by the Proclamation and the prior
Executive Orders.
15. The lack of certainty in obtaining non-immigrant visas also impacts the process of

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recruiting medical school graduates to residency programs in California and throughout the

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United States. This highly competitive process, known as the National Resident Matching

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Program ("the Match"), which pairs medical school graduates with hospital residency

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programs, will be compromised if medical graduates from the listed countries are matched

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with residency programs and then not issued the non-immigrant visa required for entry into

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the United States and participation in the residency programs. International medical school

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graduates participating in the Match must spend years preparing for the requirements and

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investing substantial funds. There are numerous examinations to prepare for and pass, as

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well as travel to the United States to participate in in-person interviews at residency
programs. If the medical school graduate is successful in the Match process and is from one

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of the listed countries, many will be required to obtain a waiver and non-immigrant visa.
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All residents must enter the United States prior to July 1 to begin their residency training.

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Because the waiver application is completely discretionary, medical school graduates from

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the listed countries may look to residency programs in Europe and Australia rather than

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waste time, energy and resources in applying to residency programs in the United States.

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Although residency programs in California are considered highly desirable, these

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limitations in obtaining a non-immigrant visa will impact all residency programs in the

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United States, even the highly sought-after programs in California. Currently hospitals are
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beginning to interview medical school graduates for next year's residency class. Nationals

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of Iran and Syria, who are prohibited from entering the United States on non-immigrant

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visas under the Proclamation, may not be able to take the mandatory exams and participate

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in in-person residency interviews. Even if they are granted a waiver for these purposes, they

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are not guaranteed a visa if they are matched with a residency program and hospitals may

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decide not to rank these medical school graduates regardless of their qualifications.
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16. I believe that the failure to train these highly qualified medical school students will
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translate into a less qualified physician workforce over time. At a time when international

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medical school graduates constitute nearly one quarter of all physicians in the United

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States, the Proclamation erodes confidence in the possibility of participating in U.S.

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residency programs and is detrimental to maintaining a sufficient number of top quality

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physicians in the United States.

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17. The process of becoming a trained and competent physician is one that requires tremendous

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sacrifices and challenges, including long hours, years of education and training,
responsibility for the lives and well-being of patients, and often hundreds of thousands of

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dollars of debt. The Proclamation increases the hurdles that already exist for international

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medical school graduates. CIR members from the listed countries confront insecurity about

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their future as physicians in the United States. Even following completion of residency
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programs, CIR members who wish to continue living in the United States will need to

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obtain extensions of H-18 visas or in the case of physicians in the United States on J-1

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visas, waivers of the foreign residency requirement. The process of extending visas or

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obtaining waivers is now further complicated by the Proclamation. The stress and worries

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that international physicians face affects not just those individuals, but their patients, their

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colleagues, their hospitals, and the medical system as a whole . Patients may worry that their

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doctors will not be able to continue caring for them. U.S. physicians are concerned that
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there will be gaps in coverage if their colleagues are not available, and that their own

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workload will increase. Hospitals must rethink "matching" the most qualified interns and

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residents if international medical school graduates are not permitted to enter the United

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States in a timely manner and commence training. The medical system as a whole must

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compensate for the decreased quality of the physician workforce.
18. The Proclamation will likely continue to cause great injury to CIR members, the hospitals

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where they train, and the communities that they serve.
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I declare under penalty of perjury that the foregoing is true and correct.

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Executed on this _[]___ day of October, 2017

~> ~
Executive Director
Committee of Interns and Residents/SEID Healthcare

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Exhibit A

Committee of Interns and Residents
SEIUHealthcare®

California Residents Represented by CIR
*
1465

* Residents at UCSF serve patients at both the Zuckerberg San Francisco Genera l Hospital and
the San Francisco VA M edica l Center.

520 Eighth Avenue, Suite 1200, New York, NY 10018
Phone: [phone] Fax: [phone]
E-mail: [e-mail] http://www.cirseiu.org

Exhibit B

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Home > News > Alameda Health System Reaffirms Commitment to Serving All

Alameda Health System Reaffirms Commitment to Serving All

Alameda Health System Reaffirms Commitment to Serving All
AHS Board of Trustees Issues Resolution in Response to Recent Immigration Policy Changes
Oakland, Calif. (Feb. 21, 2017) – The Alameda Health System (AHS) Board of Trustees has adopted a resolution reaffirming the health system's
commitment to providing healthcare services for all, including vulnerable populations and the uninsured, without regard to income, ethnicity, sexual
orientation, gender identification or citizenship.
As an integrated public health care system, which is committed to improving the health and wellness of all people, particularly vulnerable populations
and the uninsured, AHS wants to reassure all that they can seek care at all of our facilities without fear.
The AHS Immigration Resolution affirms that AHS and all its facilities, medical staff members, employees and contractors will treat all patients who
require its services without regard to race, color, religion, national origin, citizenship or immigration status.
A copy of the resolution is available here.
About Alameda Health System
Alameda Health System (AHS) is a leading public health care provider and medical training institution recognized for its world-class patient and
family-centered system of care. Our mission, Caring, Healing, Teaching, Serving All, reflects our commitment to promoting wellness, eliminating
disparities and optimizing the health of all communities in Alameda County. We currently provide more than 4,500 jobs and are home to more than
1,100 physicians across nine facilities, including five hospitals and a network of community-based wellness centers. For more information,
visit AlamedaHealthSystem.org.

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