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Hospitals make changes to handle illegal aliens

Monday, May 23, 2005
By Kathleen Longcore
The Grand Rapids Press

A few years ago, a woman from China became very sick while in West Michigan and was admitted to Saint Mary's Health Care with a major infection.

She was in the hospital for nine months, but she was in the United States illegally and could not pay her bill.

The hospital not only picked up the tab for her care, but also paid to fly her back to China, said Micki Benz, a hospital spokeswoman.

This tale of charity care is dramatic, but many hospitals have similar stories about caring for illegal immigrants.

Now, the federal government is ready to help pay the bill. Earlier this month, officials kicked off a reimbursement program that allocates

$1 billion over the next four years to hospitals that care for patients who are in the country illegally.

The announcement has hospitals here scrambling to change admissions routines to capture this money. Most say they have not been asking patients who is here legally and who isn't, so they don't know how much money they might get.

"We're here to provide care, not to act as a branch of immigration. So there was no reason before to track patients," Spectrum Health spokesman Bruce Rossman said. "But we may soon be having to ask questions."

Spectrum does not know how much of the $2.7 million it provides annually in charity care might be reimbursed. Nor does Saint Mary's know what part of its $3 million in charity care is from this group. Charity care does not include unpaid hospital bills, which might be from illegal immigrants.

Gerber Memorial Hospital, in Fremont, sees many seasonal farm workers, but has no way to tell how many are not legal, said Angie Bennett, a spokeswoman for the hospital.

"But any reimbursement we could get for these folks would be a help," she said.

The biggest beneficiaries of the federal program will be hospitals in states with large populations of illegal immigrants. The top five are California, Texas, Arizona, New York and Illinois. Michigan ranks 17th, with an estimated population of 70,000 illegal immigrants.

Hospitals that want reimbursement will start asking about patients' immigration status. They also may ask for a green card.

Federal authorities stress that the information won't be used to deport patients. However, the questions could still pose problems, said Teresa Hendricks, director of the Michigan Migrant Legal Assistance Project in Grand Rapids.

Having a green card is not a good test, Hendricks said. There are 42 categories of people here lawfully who don't have a card, including refugees, those with political asylum, those on student visas, those with applications pending, and those with temporary protected status.

Hendricks also worries about which hospital patients will be questioned. "Will they ask only those people with an accent or a different color skin? Because that would be discrimination," she said.

Holland Hospital is ahead of the game in claiming a share of the estimated $1.7 million to be disbursed to Michigan hospitals this year. Hospital officials began tracking undocumented immigrants last fall and have already trained staff to find out who is not here legally.

"We came up with a brief screening form and began educating our admissions people to be culturally sensitive," said Tom Salisbury, who heads patient administration.

Salisbury said he didn't want hospital workers to be in a position of judging patients by their dress, their language or their skin color. So workers ask the same questions of every patient who is uninsured.

Just asking about immigration status at a hospital may give immigrants the impression they need to have documentation to get medical care, Hendricks said. And that could have "a chilling effect" on their willingness to seek care.

Salisbury said patients at Holland Hospital haven't been turned off by the questions. In fact, they seem relieved to hear there is financial assistance for their hospital visit, and that overrides their reluctance to reveal their status, he said.

Since October, the hospital has cared for 56 patients who said they weren't here legally. In eight months they ran up a bill of just over $125,000, an amount that supports the hospital's decision to go after the funds.

Getting the money might be "the tricky part," said Salisbury, who is still going through a 72-page government booklet outlining the program. There is no guarantee of dollar-for-dollar reimbursement, he said.



© 2005 Grand Rapids Press. Used with permission