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  1. #1
    Senior Member mapwife's Avatar
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    Feds to end funding of ER care for migrants

    (Link has a lot of blogging and an online pole)

    Published: 08.28.2008
    Feds to end funding of ER care for migrants
    Hospitals say they will not deny treatment
    HEIDI ROWLEY
    Tucson Citizen

    Tucson-area hospitals estimate that providing emergency care for illegal immigrants has cost them more than $66 million since 2005.

    The federal government has reimbursed them for $13 million of that through a Medicare program that began in 2005.

    But on Oct. 1, the beginning of the federal 2009 fiscal year, even that financial help will go away when the reimbursement program ends.

    Hospitals are federally mandated to treat anyone needing care, and most health-care professionals feel a moral responsibility to do so.

    Caught between concerns about their own financial health and the tensions over the nation's immigration policies, local hospitals try to send illegal immigrants who need expensive or long-term care back to their country of origin.

    Patients' families have challenged such transfers by hospitals in Phoenix, and The New York Times reported earlier this month about a Florida case in which a hospital transported a patient to Guatemala while the transfer was being challenged in court.

    Local hospital officials say they transport patients only with patient or family consent and with approval of officials from the country of origin.

    University Medical Center has been unable to transfer an unidentified patient it calls Adobe - who can't communicate as the result of a brain injury from an April rollover - because it has been unable to find his family or establish his country of origin.

    "You can't just put somebody on an airplane," said James Richardson, UMC's vice president and in-house counsel.

    UMC, which has the only Level 1 trauma center in southern Arizona, shoulders the greatest expense among local hospitals for treating illegal immigrants.

    It lobbied unsuccessfully in Washington, D.C., in July to extend the federal reimbursement.

    "This is a federal problem," said hospital CEO Greg Pivirotto. "This should not be an Arizona, Tucson or UMC issue.

    I'm sorry that (the federal reimbursement is) going to go away."

    But, he said, "we're never going to turn away somebody who needs care."

    Under Section 1011 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003, the government designated $250 million a year to be divided among the 50 states for emergency care of illegal immigrants.

    Arizona received $44.5 million in fiscal year 2007.

    Hospitals that want Section 1011 funds have to prove that administrators tried to collect from the patient and other funding sources.

    Section 1011 is to be used as a last resort, said UMC spokeswoman Katie Riley.

    UMC received $2 million from Section 1011 in both 2007 and 2006.

    According to information submitted to Medicare, UMC spent $11 million and $8 million in 2007 and 2006, respectively, on care for illegal immigrants. The costs do not include care given after a patient is considered stable.

    Pivirotto estimates UMC has seen a 50 percent increase in illegal immigrant patients this year, partly because of the many rollovers of vehicles transporting them in the state. He expects the hospital to spend even more on patient care for foreign nationals in 2008.

    The government has not given hospitals any guidance on what to do with illegal immigrants. It is up to the hospitals to decide the best practice, said Bill Pike, director of public policy and community affairs for Carondelet Health Network, the parent of Tucson's St. Joseph's and St. Mary's hospitals.

    Pivirotto estimates UMC transfers about 50 patients a year to their home countries, the majority to Mexico. UMC has been transporting patients for about 20 years, he said.

    Pike estimates Carondelet's two Tucson hospitals send fewer than a dozen patients a year to their countries of origin, and knows only of two patients sent from St. Mary's so far this year.

    Tucson Medical Center sends five or six patients a year, said spokesman Mike Letson.

    Hospitals are not required to ask patients about their immigration status and do not automatically turn patients over to border authorities.

    Rich Polheber, CEO of Holy Cross Hospital in Nogales, said only patients arrested by Border Patrol agents are turned over. And that's after their care is concluded.

    "(The Border Patrol) will never say they are their patients," he said. "If (the patients) are under arrest, (the Border Patrol has) to pay for them."

    Instead, Polheber said, he will sometimes see Border Patrol agents waiting outside the hospital entrance for a specific patient. But it doesn't happen often. If patients can leave on their own, they usually just walk out the door.

    Pivirotto said the same thing happens at UMC because agents seem interested only in finding out who the driver was when there is a rollover with illegal immigrants. In most cases, patients are allowed to walk away.

    UMC's Richardson said that to send a patient to another country, the hospital has to receive permission from that country's consulate and also locate adequate care for the patient. Until that process has been completed, a patient can't be discharged.

    Letson said that at TMC, no patients will be transported to another country without their consent.

    How quickly those patients leave for their home country depends on the hospital's relationship with that country.

    Barbara Felix, UMC's international patient services coordinator, said that if a patient can be transported to northern Mexico, the discharge plan can be started almost immediately. Her husband, a retired doctor from Hermosillo, Son., can often direct her to a former colleague who can care for the ill patient. She has also established relationships with many of Mexico's hospitals and the Mexican consulate in Tucson, which makes it easier to get permission to transport a patient and design a discharge plan.

    However, Felix said she is seeing more patients from Guatemala, El Salvador and Ecuador, where she has not established professional relationships.

    Felix is arranging for UMC's first transport of a Salvadoran patient, one of three sent to the hospital after a crash near Florence on Aug. 7. The other two patients have gotten better and have left on their own, but because of the extent of his brain damage, UMC is unable to release him.

    A family member from the East Coast has come to be with him, and the man's mother, who is in El Salvador, recognized his picture from a broadcast about the crash in her country. He is still at UMC while the Salvadoran consulate completes the paperwork that would allow him to be taken to a hospital in El Salvador. It may be another week before he leaves, UMC's Riley said.

    Polheber, the CEO of Holy Cross in Nogales, is also a member of the health services committee of the Arizona-Mexico Commission, which is a collaboration between Arizona and Mexico. Through the commission, Polheber has organized training in Arizona for nurses and doctors from Mexico and vice versa.

    "The Arizona-Mexico Commission serves as developing linkages and friendships when you need to work on the transfer piece," Polheber said. "We, particularly in our hospital here, have developed a relationship with Hospital General across the border."

    Both Polheber and Pivirotto expressed a desire to transfer patients to hospitals where the patient can receive advanced care. For both hospitals, that includes donating equipment and services that will enhance the level of medical care provided.

    "I think it would be helpful if there was a methodology and agreement developed between Mexico and the United States on how patients would be transferred," Polheber said. "It would be nice to say, 'Lets develop a system.' At this point everyone is doing the best they can."

    With or without federal guidance or funds, Tucson-area hospital administrators say they will continue to care for everyone who needs care and will continue to transport patients across the border, when appropriate.

    "Section 1011 won't change our actions," Carondelet's Pike said. "It will just create a bigger financial strain."

    http://www.tucsoncitizen.com/ss/frontpage/95093.php
    Illegal aliens remain exempt from American laws, while they DEMAND American rights...

  2. #2
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    Story timed just right for the DNC
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  3. #3
    Senior Member crazybird's Avatar
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    The federal government has reimbursed them for $13 million of that through a Medicare program that began in 2005.
    A medicare fund paid into for our elderly and disabled. OUR elderly and disabled who have paid in. And they wonder why medicare is going. It seems to fund everything but what it's intended for.
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    Senior Member crazybird's Avatar
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    But on Oct. 1, the beginning of the federal 2009 fiscal year, even that financial help will go away when the reimbursement program ends.
    I can hear the whining now.
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  5. #5
    Senior Member miguelina's Avatar
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    We have illegal aliens ignoring federal laws every day, why shouldn't the hospitals do the same thing once they're no longer reimbursed for them? Demand cash up front or don't take them on. Harsh? Not really, just sound business sense.
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    "

  6. #6
    ELE
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    Americans get health care help NOT uninsured illegals.

    It is time for the hospitals to be taken off the hook. Only American citizens or those with health insurance should be treated. If illegals want health care they can go get it in there county of origin! They are NOT our responsibility!
    Join our efforts to Secure America's Borders and End Illegal Immigration by Joining ALIPAC's E-Mail Alerts network (CLICK HERE)

  7. #7
    Senior Member azwreath's Avatar
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    And what will this mean for all of the clinics......including those run through hospitals.......providing freebie prenatal care and count on reimbursement through medicare?

    Hmmmm........this could be interesting to the anchor baby crisis.

    Further, it seems to me that hospitals will now be forced to regroup and begin to eliminate ALL care to illegals except for life and death emergencies. This just may bring about the end of illegals using ERs as private physicians and deliveries being restricted to ONLY situations presenting an ACTUAL life and death situation to mother and/or baby.

    So basically, this move by the government may not be all bad. Quite honestly, we could be seeing the government beginning to pull the welcome mat out from under the IAs a little at a time.
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  8. #8
    Steph's Avatar
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    "Hospitals are federally mandated to treat anyone needing care"

    I thought they just needed to make them stable. Why do hospitals stabilize the illegal, and then provide even more medical care that may be nice to have, but isn't necessary to keep them alive? For example, childbirth is considered a life-threatening emergency in all cases for some reason. So they should just deliver the anchor, but why also provide expensive pain killers (I'm not talking about for a c-section, because obviously a woman can't have major abdominal surgery without anasthesia)? If it's absolutely necessary, give her a c-section. If she just wants one for personal reasons or convenience, too bad, and for all other births, if she insists on having her anchor in this country, she should do it without the pain killers, do it and go home without the free diaper/formula samples etc. If baby ends up in the NICU, the parents shouldn't be given free meals, like they are at UMC. They should receive nothing but the life-saving basics. If they started doing this, instead of the way they do things now, maybe illegals would have their babies in their own countries. Yesterday there was an article in the paper about an illegal who jumped a border fence and broke both her ankles. She was transported by helicopter to the hospital for treatment. WHY??? Broken ankles are NOT life threatening, and certainly not bad enough to require transport by helicopter. She was sitting by the border fence, so why was she given care? Just because she hurt her ankles jumping a very high fence? Her life wasn't in danger. She should have been carried back to the other side and deposited there for transport to a Mexican hospital. She was in no danger of dying. It's bad enough we as taxpayers have to pay these bills when they are dying, but why do we also have to pay for non life-threatening medical care? If an American or legal resident does have a true emergency, they have to wait in the ER for hours, along with all those illegals who are there for the flu, a runny nose, or long-term health issues that they get free care for in the US. (Need dialysis? Have cancer? Diabetes? Just come to the US and we'll treat you for free! Are you an older American with one of these health issues? Need medication? Ummm, well, then, don't buy groceries. Go without electricity or use as little as possible. Keep your home 60 degrees in winter, and don't use fans or AC in the summer. Or what the hell, just go without your meds, because the US gov't doesn't care about you! No American should be forced to choose between medication they need and eating or using the heat/cooling, but they make those choices every day while illegals just get what they need and more at our expense. Crazy.

  9. #9
    Senior Member Gogo's Avatar
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    Where you aware of this?

    A Page One story Tuesday about a new federal Medicaid requirement described imprecisely to whom the requirement applies. Under a provision of the Deficit Reduction Act of 2005, as of July 1 all US citizens who sign up for Medicaid or renew their benefits will have to provide documentation of their citizenship. Eligibility rules for legal immigrants have not changed.

    No such proof is required now.

    The requirement was tucked into the Deficit Reduction Act of 2005, which President Bush signed into law earlier this year.
    This article was written in 2006

    http://www.boston.com/yourlife/health/o ... ealthcare/
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  10. #10
    Senior Member Gogo's Avatar
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    This is what got it all started:

    EMTALA

    http://www.aaem.org/emtala/

    Became law in 1986
    Join our efforts to Secure America's Borders and End Illegal Immigration by Joining ALIPAC's E-Mail Alerts network (CLICK HERE)

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