Medical Examination of Aliens – Revisions to Medical Screening Process
2009-02-10 2009-02-10
CDC-2008-0002-0004 CDC-2008-0002-0002
05:00:00 05:00:00
https://api.regulations.gov/v4/comments/CDC-2008-0002-0004 https://api.regulations.gov/v4/comments/CDC-2008-0002-0002
Susan Anonymous
Debardeleben Anonymous
I am writing to comment on the proposed changes to the medical screeningrequirements for admittance to the United States.  I urge you to remove therequirement that aliens be negative for HIV for short-term visits to the UnitedStates.  The current policy, refusing entry even for short visits for peoplewith HIV, does not make sense in todays world.  It is known that HIV hasspecific methods of transmission, and the likelihood that an HIV-positiveforeign visitor would present an unusual risk of disease is extremely low.  Inan economy that is currently struggling, it is not a good idea to refusevisitors who present a low risk, or to discourage visitors who are HIV-negative,but visit other places that do not place harsh restrictions.Additionally, it is extremely close to the change in administration, and I urgeyou to postpone the publication of the final rule until after the newadministration is in place in late January, 2009.  Because this issue is of asensitive and foreign relations matter, the new administration should weigh inon it.Thank you. The CDC has indicated that this rule will not affect medical examinations of aliens in the U.S.  A plain language reading of section 212(a)(1) of the Immigration and Nationality Act, and 42 C.F.R. 34.1, 34.3(a)(1), do not support this conclusion.  Even so, this rule would create a dangerous precedent, perhaps one that the CDC did not intend to happen.   The CDC is creating a double standard: an alien in the U.S. with a newly identified disease would not be found inadmissible but an alien overseas with the same disease would be found inadmissible.  Such a conclusion does not support the intent of the immigration and public health laws.  Aliens in the U.S. are no less of a danger to the public health.  Rather, they are more of a danger as they are already in the U.S.  This rule would, among other things, encourage aliens to avoid overseas medical examinations and to find ways to illegally enter the U.S.  This rule does not address the issue of what the CDC and USCIS could or would do if an alien in the U.S. had a newly identified disease.  The CDC and USCIS must be ready, able and willing to deal with such a consequence.  Avoidance of the issue would threaten public health.The best approach to this issue would be to apply the same standards to medical examinations performed overseas and those in the U.S.  Whether aliens are overseas or in the U.S., the threat to public health is no different.  If the CDC truly intends to limit this rule to overseas medical examinations, then it should revise 42 C.F.R. 34 to clearly differentiate between overseas medical examinations and to those in the U.S.  Currently, 42 C.F.R. 34.3(c) contradicts the Immigration and Nationality Act and 42 C.F.R. 34.1, 34.3(a)(1).   For medical examinations in the U.S., the CDC should include an additional regulation to allow civil surgeons to discretionarily screen for newly identified diseases.  If this is not feasible, then the additional regulation should provide guidance if an alien in the U.S. has a newly identified disease.  While it may not be a common scenario now, it could be common in the future.