Thread: {Sob}Oklahoma law adds risk to health-care decisions

Tougher Oklahoma law adds risk to health-care decisions
Tuesday, September 9, 2008 2:59 AM
By Todd Jones

THE COLUMBUS DISPATCH

Leonardo Carrizophotos for The Dispatch
Patients wait to be seen by doctors at the Tulsa Health Department, whose clinic gets half its income from county property taxes and the other half from a federal grant. The vast majority of its patients are illegal immigrants.


Above: At the Tulsa clinic, a pregnant Latina learns about a healthful diet to benefit her health and that of the baby she's carrying.


Left: Childhood immunizations are part of the routine care provided by the clinic.
TULSA, Okla. -- Hysteria spread among Oklahoma's Latinos as soon as the governor signed a tough immigration law.

The parents of 2-month-old Edgar Castorena were caught in that web of fear, uncertain what to do when their baby suffered from 10 days of diarrhea.

"They were terrified to take the baby to the emergency room because they were afraid they'd get reported and deported," said Laurie Paul, executive director of the Community Health Connection clinic in Tulsa.

Even though the law wasn't in effect yet, the Mexican couple feared taking their son to a hospital. Instead, they took him to Paul's small, federally funded clinic, where nearly 70 percent of the patients are Hispanics.

It was too late.

The baby died of a ruptured intestine as an ambulance raced him to a hospital.

Critics of Oklahoma's law point to Edgar's death in July 2007 as an extreme example of how cracking down on illegal immigration can have unintended consequences.

The law that his parents feared so much provides an exception for emergency medical care, so they had nothing to fear in taking him to an emergency room.

But they didn't understand.

Health care -- who deserves it, when they can get it and who pays for it -- is an inescapable issue in the immigration debate.

Oklahoma's law, which took effect last November, has church pastors worried about being arrested for transporting illegal immigrants to doctor visits. It also has health-care workers concerned about the possible spread of disease if patients don't seek care for fear of deportation.

"Most of us in public health have the same mind-set: Health services should not be political," said Doug Ressler, associate director of the Tulsa Health Department.

Even longtime, legal residents have been hurt by the law's strict paperwork requirements, which call for those applying for Medicaid or renewing eligibility to prove their citizenship.

The Oklahoma Health Care Authority reported in December that nearly 6,000 people were dropped from SoonerCare, the state's medical program for the poor, because they failed to meet the new documentation requirements.

Of those dropped, 10 percent were Hispanic, 58 percent were white and 62 percent were children.

The law, however, remains popular. Its supporters are quick to point to an estimate by the Federation for American Immigration Reform that Oklahoma spends about $207 million a year in public funds for illegal immigrants, a cost not broken down into specific expenditures such as health care.

"We simply can't afford to become the welfare state of the world," said state Rep. Randy Terrill, a Republican from Moore, Okla., who wrote the new law.

FAIR, a nonprofit immigration-reform group based in Washington, D.C., came up with its figure by applying studies of nine other states to its estimate of 83,000 illegal immigrants in Oklahoma.

The Oklahoma Senate Task Force produced a study in 2006 that showed the state's emergency rooms treated 13,179 illegal immigrants in a four-year period ending in 2006 at a total cost of $27.4 million.

More than 80 percent of that money was spent on labor and delivery of babies.

Pat Fennell, a member of that task force, said the

$9.7 million spent in 2006 on emergency medical care for noncitizens is less than 1 percent of the Oklahoma Health Care Authority's budget.

"That's all (noncitizens) qualify for," Fennell said. "They don't qualify for welfare or food stamps or child-care subsidies. People are not informed. They hear millions of dollars are being used to subsidize (illegal immigrants), so they think they get everything free, and that's a fallacy."

The state spent an estimated $8.5 million for more than 2,700 births to illegal immigrants in 2006.

"When their babies are born, it's still a cost, and the taxpaying citizens are paying for that," said Carol Helm, founder of the lobbyist group Immigration Reform For Oklahoma Now. Numbers, however, don't tell the entire story about the fallout for health care.

One provision of the law makes it a felony to transport, conceal, harbor or shelter an illegal immigrant in Oklahoma. Violators can be imprisoned for a year, fined $1,000 or both. "The human aspect can't be forgotten," Paul said. "It's the moral thing to do, to take care of someone."

The man who wrote the law doesn't question its morality.

"In regards to health care, we used compassion, common sense, and carved out reasonable exceptions to meet federal law," Terrill said. "We just don't kick people in need of certain services to the curb. We have an obligation, as Christians and as a society, to help in certain cases. Not all cases, but in some cases."

For others, there are lines they're willing to cross, no matter the cost.

"I'm willing to go to jail over this," Fennell said. "I'm not going to violate my moral principles in denying those in need."

Lonnie Vaughn doesn't want to go to jail but he, too, is willing.

As pastor of Southern Hills Baptist Church in Tulsa, his self-assigned duties include picking up members of his church -- including several noncitizens -- each Sunday morning and driving them to worship services.

Sometimes, he takes them to a health clinic.

"This law has made a felon of me," said Vaughn, who is white. "I'm suddenly a bad guy, or the devil himself, because I reach into the Hispanic community and try to help."

Is Vaughn breaking Oklahoma's law by transporting immigrants to a doctor's office?

"If you're doing something for solely charitable, educational, humanitarian or religious reasons, it doesn't trigger the statute," Terrill said.

The law is open to interpretation. Terrill says agencies break the law if their assistance furthers an illegal immigrant's ability to stay in the country or if that assistance involves tax funds.

The law's ambiguity was intended to soften it but instead caused confusion among immigrants.

"It created the most fear because there's no definitions," said Fennell, executive director of the Latino Community Development Agency, a social-service center offering 21 programs in Oklahoma City.

The fear caused a drop-off in patients at many clinics frequented by Latinos.

"What's happened is whole families, with children born here, facing (medical) emergencies are afraid to ask for help," said the Rev. Victor Orta, president of the American Dream Coalition, an immigrant-advocacy group in Tulsa.

The Community Health Clinic, with Latinos making up 67 percent of its clientele last year, has a file cabinet with five drawers full of charts for patients who haven't returned. Paul said the average visits for all clients dropped from 2.5 annually to 1.9 in that year.

"We had a lot of people come in and ask for their medical records because they weren't coming back," said Leticia, a nurse at the Tulsa clinic.

Her husband, who is not a U.S. citizen, won't go to a doctor if he's sick because he's afraid of being stopped and deported.

"Unless he thinks he's dying, he stays home," Leticia said. "If he thinks he'll make it, he works."

After fear initially kept them away, some patients began returning to the Tulsa Health Department, where undocumented Hispanics make up

98 percent of its prenatal clients, 90 percent of its family clinic patients and 95 percent of its dental cases.

Still, nurse Eliana Quintero said some patients haven't returned for vaccinations, and many tell her that they won't go to the hospital because they're afraid of being turned in to immigration officials.

"If they have a communicable disease, then the whole public could be harmed by that," Ressler said.

The metro Tulsa phone book lists 13 pages of churches in the overwhelmingly Protestant city of nearly 400,000, sometimes referred to as "The Buckle of the Bible Belt."

Many new churches with Latino congregations opened as Oklahoma's Hispanic population grew nearly 45 percent between 2000 and 2007.

"Hispanic pastors provide more services than any mainstream church would ever think of providing," said the Rev. Julian Rodriguez, pastor of Iglesia Eficaz in Tulsa. "If a person needs to go to a doctor in a regular church, they're not going to call a pastor to take them and translate. But Hispanic pastors have to show up or set up a system to help."

Such a calling has made some pastors confront their mission because of the state's new immigration law.

"We respect man's law because the Bible teaches us to respect it," said the Rev. Miguel Rivera, president of the National Coalition of Latino Clergy and Christian Leaders. "But the problem is, we have to also identify and serve and be committed to human beings. These are human beings."

Roman Catholic Bishop Edward J. Slattery of the Tulsa Diocese filed a friend-of-the-court brief, arguing that provisions of Oklahoma's immigration law "discourage and even criminalize the providing of the most basic spiritual, social and humanitarian services to those who are most in need of assistance."

Terrill, a Baptist, sees money at the root of such criticism.

"I can understand the reason why religious organizations say and do the things they are doing," he said. "Baptists use private money.

Catholic Charities uses taxpayer money. The reason (Catholics) are upset with (the law) is it ends federal funds. They certainly have an economic interest in their charitable organization when it does outreach work to use federal funds for a number of illegal aliens."

Margarita Summers, a caseworker at Catholic Charities in Tulsa, laughed when told of Terrill's comments. A Catholic Charities spokesman said

2 percent of its budget comes from taxpayer money.

"We are criticized that we are breaking the law by helping people," Summers said. "Some of our contributors mentioned that if the support they're giving us goes to supporting illegals, then they'll stop helping us with support."

Oklahoma's law has only strengthened Summers' desire to provide help to immigrants in the Hispanic neighborhood of Kendall-Whittier.

"I want to contribute and make a difference in a situation of injustice," she said. "If I have to fight for what is just and right, I will do so."

And Lonnie Vaughn will keep risking jail by picking up undocumented Hispanics in his van and taking them to church and medical clinics.

"I'm OK until I see a cop," he said. "I guarantee you that I have both hands on my steering wheel and I'm wiping sweat off my forehead when I see a cop. I can't help it. I'm nervous. Somehow, I know I'm committing a felony."

Free-lance photographer Leonardo Carrizo served as interpreter for interviews with Spanish-speaking sources.

tjones@dispatch.com

http://www.columbusdispatch.com/live/co ... ml?sid=101

The parents of 2-month-old Edgar Castorena were caught in that web of fear, uncertain what to do when their baby suffered from 10 days of diarrhea.

"They were terrified to take the baby to the emergency room because they were afraid they'd get reported and deported," said Laurie Paul, executive director of the Community Health Connection clinic in Tulsa.

They were more concerned with themselves rather than the baby, disgraceful!

These people are not held hostage in the US, they are free to leave. In fact, they are strongly encouraged to leave, yet they refuse.

None of these "organizations" should be getting ANY federal money to use on illegal aliens!

"That's all (noncitizens) qualify for," Fennell said. "They don't qualify for welfare or food stamps or child-care subsidies. People are not informed. They hear millions of dollars are being used to subsidize (illegal immigrants), so they think they get everything free, and that's a fallacy."

Gimme a break! The more anchor babies they have, the more welfare and other freebies they get! You don't call that subsidizing? I do. This HAS to stop!

The law is open to interpretation. Terrill says agencies break the law if their assistance furthers an illegal immigrant's ability to stay in the country or if that assistance involves tax funds.

Then why is this clinic still open? They are using TAX funds to enable illegal aliens to get health care!

Patients wait to be seen by doctors at the Tulsa Health Department, whose clinic gets half its income from county property taxes and the other half from a federal grant. The vast majority of its patients are illegal immigrants.

"We are criticized that we are breaking the law by helping people," Summers said. "Some of our contributors mentioned that if the support they're giving us goes to supporting illegals, then they'll stop helping us with support."

Oh it's alot more than "some" contributors. I stopped giving for this reason.

Hysteria spread among Oklahoma's Latinos as soon as the governor signed a tough immigration law.

I have this perverse vision of a bad soap opera.

or a bad Japanese movie with a red phone ringing and everyone stops with terror in their eyes staring at the phone for 3 minutes. No lie I saw a movie like that and the whole audience was falling out of their seats.

I'd say this is pretty poor reporting.