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Higgins urges CBP to create guidance on caregiver crossings as US-Canada border travel restrictions continue


Tue, Jul 28th 2020 10:40 am

Patient caregivers met with uncertainty at northern border 

Congressman Brian Higgins is calling for the U.S. Customs and Border Protection (CBP) to establish clear guidance for patient caregivers when crossing the U.S.-Canada border to give better certainty to families and the medical institutions providing care.

In a letter to the CBP’s Acting Commissioner Mark Morgan, Higgins writes, “At a time when families are contemplating very difficult decisions about the health of their loved ones, whether a caregiver can legitimately cross the border should not be a concern. … Families who are trying to manage care of a devastating disease should have the support network available to provide the comfort and create the healthy environment needed to recover.”

Due to the COVID-19 pandemic, travel across the border has been restricted with limited exceptions for travel deemed essential, including that for travel that is medically necessary. CBP has discretion on what is medically necessary for an incoming patient and could subsequently deny admission to a caregiver based solely on its own assessment of need for emergency and routine care. These restrictions, originally established March 24, have been extended through August (at this time).

Western New York is home to several hospital and health care providers, specializing in intensive treatments to treat rare and complex diseases, which often provide care to Canadian patients seeking treatment that many not be readily available in their country.

One of these hospitals is Roswell Park Comprehensive Cancer Center in Buffalo, which offers a scarcely provided immunotherapy, chimeric antigen receptor T-cell therapy (CAR-T), used to treat cancer that can require up to a 20-day in-patient stay, as well as outpatient visits that vary based on the clinical presentation of the disease. Roswell Park has a longstanding relationship with the Ontario Ministry of Health to provide these treatments to Canadian patients. The intensive nature of the treatment can often necessitate care from more than one caregiver. Often patients have arrangements that allow for two caregivers to provide assistance in rotation to ensure quality, 24/7 care.

"We view caregivers as essential members of our care teams. They are advocates – a patient's eyes and ears, psychosocial and emotional support – especially before and after CAR-T therapy," said Shirley Johnson, MBA, MS, RN, NEA-BC, chief clinical operations officer at Roswell Park. "I hope we can gain some consistency in allowing caregivers to come across the border to support their loved ones for treatment."

Higgins serves as co-chair of the Northern Border Caucus, Congress’s oldest and largest congressional member organization dealing with the U.S.-Canada relationship. Founded in 1994, this bipartisan group of members has acted to highlight policy concerns and issues affecting the economic, cultural and political partnership between the two countries.

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