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  1. #1
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    Debate resumes on county care for illegal immigrants

    http://www.sacbee.com/101/story/101416.html

    Health costs scrutinized
    Debate resumes on county care for illegal immigrants
    By Ed Fletcher - Bee Staff Writer

    Published 12:00 am PST Monday, January 1, 2007
    Story appeared in METRO section, Page B2


    Over the last 10 years Sacramento County has provided non-emergency medical care to thousands of illegal immigrants -- each treatment in violation of federal law.

    How many? Nobody knows. The five county clinics serving the poor don't ask for proof of citizenship.

    The county considered turning away illegal immigrants in response to 1996 federal welfare legislation, which banned public agencies from providing all but emergency medical care to illegal immigrants.

    But after months of debate, the county kept the long-standing policy in place: Don't ask.

    "We didn't go to the board and say 'Let's break the law,' " Penelope Clarke, administrator of the Countywide Services Agency, said of those 1996-97 board discussions. "We have never asked at our clinic for documentation."

    The county's practice did prompt a 2003 lawsuit. But, by and large, the practice has continued without much hullabaloo since the board's non-decision 10 years ago.

    Now, however, the policy is under scrutiny on several fronts. A new California law has changed the ground rules. The 2003 lawsuit, which was dismissed, is under appeal. And, with new budget woes, at least one county supervisor is questioning the expense of treating undocumented residents.

    When the issue was being debated in 1996, county medical officials estimated that 630 undocumented immigrants visited the eight county-funded clinics in 1995, at a cost of more than $200,000.

    Officials currently estimate that the County Medically Indigent Services Program served 5,300 illegal immigrants in 2005 at a cost of $3.1 million.

    But Clarke said in a recent interview that while the county "likely" served illegal immigrants, officials don't know for sure.

    "We didn't know whether we were or we weren't, because it wasn't a piece of information we were gathering," said Clarke.

    As of today , the legal gray cloud over Sacramento County will disappear.

    The 1996 federal legislation allows states to opt out of the provision barring undocumented immigrants from receiving non-emergency medical care.

    California officially takes that step today -- thanks to SB 1534, which was approved in the waning hours of the 2006 legislative session. The bill was carried by former state Sens. Deborah Ortiz and Richard Alarcón.

    Ortiz, who represented Sacramento until she was termed-out in 2006, said providing medical care for those without legal standing in the county was a "good sound public health decision."

    Ortiz and others said that turning illegal immigrants away could result in diseases spreading throughout the broader community.

    That argument has lived on through the many rehashings of this debate.

    Months of passionate testimony in 1996-97 was triggered by a staff recommendation that the county eliminate the care to comply with federal law.

    Some warned of further flooding to hospital emergency rooms, others talked about widespread epidemics. After months of postponing a decision, the county did nothing and the debate cooled.

    The issue was forced back onto the supervisors' radar when one of its own doctors sued the county.

    In 2003, Dr. Gene L. Rogers brought suit against the county alleging that the county was putting public funds at risk by providing non-emergency medical care to undocumented residents -- in violation of federal law.

    Rogers' suit alleged that the board deliberately breached federal law by providing funds for the treatment of illegal immigrants.

    This, according to the suit, could lead to the loss of federal funding to lawful residents.

    Rogers was medical director of the county indigent care program at the time he filed suit and currently serves as a consultant to the program. He did not return calls for comment.

    The type of suit used by Rogers, a qui tam action, is typically used by individuals seeking to protect the government from being fleeced. After the suit was initiated, the state and federal officials declined to take the case over, as the law allows.

    In July, the qui tam action was dismissed on the grounds that an individual, like Rogers, who is not an attorney, cannot represent third parties -- in this case, the federal government.

    The decision is being appealed to the U.S. Court of Appeals.

    Those backing continued non-emergency medical care to undocumented clients found reason for relief with the signing of the Ortiz bill and the dismissal. Others have lingering concerns.

    In September, the Sacramento County board voted 3-2 to support the Ortiz bill. Supervisors Susan Peters and Roberta MacGlashan gave no explanation at the time for their opposition.

    In an interview with The Bee, board Chairwoman MacGlashan said the board should "take a look at" ending the care.

    "I have concerns about the amount of general fund dollars spent through this program to provide care for undocumented aliens," MacGlashan said.

    While she supports continuing to provide immunizations to the undocumented, MacGlashan said much of the estimated $3.1 million spent could be used on "people who are here legally." She added that public benefits should not be a incentive for illegal immigration.

    "I think it's something that we have to take a look at, likely in this next budget," said MacGlashan.

    William A. Sandberg, executive director of the Sierra Sacramento Valley Medical Society, said the county would be making a mistake if it cut care to illegal immigrants.

    "Everybody understands there are limited resources and we ought to take care of our own first," Sandberg continued, "but when it come down to humanitarian issues, we need to treat those people."

    About the writer:

    * The Bee's Ed Fletcher can be reached at (916) 321-1269 or efletcher@sacbee.com.

  2. #2
    Senior Member Dixie's Avatar
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    SB 1534 Looks like a token piece of legislation. What I have read about it, it resolves nothing for the Sacramento problem.

    It does not specifically address the immigration status of the eligible. It only discusses the income eligibility. The state passed the buck. Now it is left for the counties and cities to decide if they are going to refuse services because of immigration status using the 1996 federal law.

    Dixie
    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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