(CNN) - The Trump administration took steps this month to end a medical relief policy that allowed some undocumented families with serious medical conditions to remain in the United States while they received medical care.
The end to the policy has led to fear and confusion for families, as well as a scramble among US agencies to understand and explain the change.
Earlier this month US Citizenship and Immigration Services sent letters to family members who had requested relief from deportation, saying the agency's field offices "no longer consider requests for deferred action," except for certain military exceptions.
After media reports surfaced about the change in policy, USCIS said its field offices would no longer consider nonmilitary requests for deferred action -- temporary relief from deportation.
Instead the agency said it will defer to Immigration and Customs Enforcement to determine if nonmilitary issues "warrant deferred action," according to a spokesperson. ICE has discretion to determine who will and won't be arrested or deported.
Radio station WBUR first published the letters sent by USCIS.
"The government has threatened to deport them," said Anthony Marino, director of immigration legal services at the Irish International Immigrant Center, which represents families in requests for deportation relief. "It also means they are no longer able to provide for themselves. Parents are no longer able to work."
Marino's clients received letters that said they "are not authorized to remain in the United States. If you fail to depart the United States within 33 days of the date of this letter, USCIS may" commence deportation proceedings.
Most of the families Marino works with have children with medical issues, such as cancer, HIV or the need for feeding tubes or wheelchairs.
In some cases, families who sought relief had sick children who were US citizens. "Those families have to decide, 'Do we abandon them or stay?' " he said.
The families "are scared. They are confused. They are in fear for their lives. They are having very difficult conversations. Parents are asking questions like, 'Do I have to orphan my child?' " he said.
The shift does not affect those in Deferred Action for Childhood Arrivals or other established programs such as deferred action related to the Violence Against Women Act and the U Visa waiting list for some victims of certain crimes wiling to assist authorities, according to USCIS.
USCIS received around 1,000 nonmilitary deferred action requests per year, most of which were not approved, according to the agency. Most of these types of requests are related to family support or medical issues.
"This procedural shift was effective on August 7, 2019. Any pending requests will be denied and requestors will receive notices by mail," the USCIS spokesman added in a statement Friday.
There isn't an apples-to-apples comparison between the USCIS and ICE procedures.
Individuals can apply to ICE for a "stay of deportation or removal," but that's done only after someone has exhausted all immigration judicial proceedings and has been ordered removed, according to an ICE official. USCIS is the agency responsible for legal immigration benefits, including work authorization.
ICE does not accept "applications" for deferred action, a discretionary act that allows the Department of Homeland Security to delay or prevent immigration enforcement, according to ICE.
"ICE has broad discretion and exercises that discretion, as appropriate, on a case-by-case basis throughout the immigration enforcement process in a variety of ways," said ICE spokesman Shawn Neudauer, referring to decisions made regarding arrests, release from custody during immigration proceedings and prioritization for deportation.
The agency was caught off guard by USCIS' announcement shifting the deferment responsibility to ICE, according to three officials.
"We were not consulted before statements were made to the press," said one ICE official.
There is no new program at ICE for medical deferment, another ICE official told CNN.
A spokesperson for USCIS defended the decision on Friday, saying the move was made because "it is not appropriate for the agency to adjudicate requests for suspended enforcement not clearly assigned to USCIS in law or policy."
"The agency has updated its procedures to reflect that. USCIS coordinated with ICE ahead of this procedural change," the spokesperson added in a statement.
Lawmakers and immigration advocates expressed outrage over the change.
"Kids with cancer, cystic fibrosis, and muscular dystrophy are now being told that they must leave the country or be put in the hands of ICE. We cannot and will not let this stand," tweeted Sen. Edward Markey, a Massachusetts Democrat.
According to Markey, ICE told his staff that "it will force these immigrants to go through deportation proceedings before deciding their fate."
"This makes a barbaric policy even more dehumanizing," he added.
The American Civil Liberties Union said it will challenge the change in court, along with other organizations.
"By suddenly ending a program that expressly protects sick children and their families, the administration may be sending people to their deaths," said Carol Rose, executive director of the ACLU of Massachusetts.
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