Illegal immigration today: Use of tax-funded services on the decline

October 17, 2011

Mark Duncan


YAVAPAI COUNTY - Four years ago, Yavapai County Supervisor Carol Springer commissioned a report from county departments in an effort to discover the financial impact of illegal immigration on local taxpayers. That report estimated that services to illegal immigrants cost more than $7.6 million.

Springer and her staff are now unable to locate that 2007 report, and Springer said time constraints prevented its reproduction to reflect current costs, but she did recall that the major areas of expense were in the criminal justice system, healthcare and schools.

Still, declining numbers of undocumented aliens in the area have led to obvious savings in the criminal system, with unprecedented decreases since 2008 in the number of unauthorized aliens in jail and on probation, and figures from Superior Court inferentially support the trend.

Translation services, which the courts provide for non-English speakers in many languages, have become far less in demand since the adoption of the Legal Arizona Workers Act in 2008. Court Administrator Debi Schaefer provided figures showing that the number of instances of court personnel providing interpreter or translation services dropped from 2,869 in fiscal year 2008 to 1,047 in fiscal 2011. The cost of those services, plus those of outside providers, decreased in the same time period from $154,882 to $94,687.

Schaefer noted that the courts provide these services "without regard to immigration status."

As for schools, Attorney General Tom Horne in September reaffirmed a basic tenet of Proposition 300, the 2006 ballot measure that denies taxpayer-funded benefits to illegal immigrants. Horne declared that an effort by the Maricopa County Community College District to allow undocumented students to qualify for in-state tuition as part-time students violated the law and the district promptly changed its mind on implementing the policy.

Locally, Prescott College only accepts students who are U.S. citizens, permanent residents, or have verified lawful immigration status, according to information provided by Ashley Mains, the school's communications coordinator. Mains further noted, without drawing conclusions, that the college's Aztlan Center, which once provided counseling and services for immigration-challenged residents, has effectively ceased operation.

Yavapai College's policies forbid students who lack proof of legal residence from qualifying for in-state tuition rates or receiving any state-funded financial aid.

In K-12 education, administrators and staff face a quandary in identifying students who may or may not be in the country legally, according to County School Superintendent Tim Carter, who said that prospective students need only to show immunization records (or sign a waiver) and proof of birth, regardless of nationality, in order to enroll.

"We're caught in the middle between a state that wants to decrease illegal immigration and federal laws that say we can't even ask," Carter said.

Carter did say that schools countywide experienced a significant departure of Hispanic students immediately after the implementation of the Legal Arizona Workers Act in 2008. That loss is reflected in the sharp decrease of students enrolled in the English Language Learners program, which provides concentrated English training in 17 "statistically significant" languages.

In the Humboldt Unified School District, the county's largest, for example, 564 students were enrolled in the program in the 2007-2008 school year, compared to 125 in 2010-2011.

In the matter of healthcare, Springer speculated that a decrease in the use of hospital services is somewhat attributable to the increasing popularity of the county's Community Health Centers.

Robert Resendes, director of the Yavapai County Community Health Services Department, allows that use of the centers is on the rise, but is unable to tell if the centers are providing services to people who aren't supposed to be here.

"If it's Arizona paying for the services, we would have to ask," Resendes said, noting that the only service his department provides that requires proof of legal residency is the issuance of food handler certificates. "But as soon as there's one federal dollar in a program, we're not allowed to ask."

Resendes pointed out that there is an advantage to the community in the department's policy of treating everyone that comes to them, regardless of the patient's circumstances. If someone with, for instance, tuberculosis was afraid to seek treatment for fear of being deported, that disease could spread through the population.

"It would be counterproductive to the community to not treat those patients," he said. "For population-based public health, it's a good idea to treat people no matter what. Individually, it's a political nightmare."

Hospitals face the same challenges, particularly in the case of emergency room services, a prime target of those who advocate action against illegal immigration. Tim Barnett, CEO of Yavapai Regional Medical Center, said it is impossible to be sure that the number of undocumented aliens coming to the hospital has decreased, but he believes it is so.

"It's still a burden on healthcare," Barnett said. "It's just tough for us to establish how much."

Barnett said that hospitals are ethically bound to treat anyone who comes, and that he wouldn't have it any other way.

"The wisdom of having (immigration status) established before you get treatment is ridiculous," he said. "We know how to care for people, not how to identify their status."

One indication of the apparent decrease in the use of medical services by undocumented immigrants is the trend of payments to the hospital through Section 1011 of the Medicare Modernization Act of 2003. That act provided for payments of $250 million each year through 2008, or until the entire fund was paid out, to cover medical services provided to "undocumented and other specified aliens."

Since January 2008, YRMC has filed more than $6 million in claims under the act, which pays on a per claim basis. Payments under section 1011 generally come in at between 10 percent and 20 percent of the amount claimed. The $6 million is less than 1 percent of the overall cost of care the hospital has provided in the time frame.

Analysis of the payments to YRMC, though, indicates that the amounts received have decreased considerably since the enactment of the Legal Arizona Workers Act in 2008 and the near-simultaneous collapse of the economy, particularly the housing industry that once employed many undocumented workers.

From a high total of $360,693 in 2006, the payments fell to just $45,142 in 2010.

Barnett said the decrease "seems to coincide with the lack of jobs and the employer sanctions which have become more stringent."

Payments to the Verde Valley Medical Center, on the other hand, actually increased in the period, to a high of $157,464 in 2010, but Pete Wertheim, Vice President of Strategic Communications for the Arizona Hospital and Healthcare Association, said higher payments can often be attributed to the long delays hospitals often experience between billing and payment.

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