New funds for immigrants could help-or hurt-services.
No one knows the impact undocumented immigrants has on hospitals. But concerns about the drain on resources have prompted the federal government to provide additional money for just that purpose.
But while some advocates applaud the new
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funding, others worry it could actually deter undocumented immigrants from seeking necessary medical care.
The new system went into effect last week-New Mexico is among the top states for the amount of money it is eligible to receive.
"New Mexico emergency care providers can be reimbursed for a total of up to $5 million split between the hospitals who decide to participate," Don Butterfield, spokesman for St. Vincent Hospital says.
In order to use the funds hospitals will have to ask suspected undocumented immigrants a series of sensitive questions about their backgrounds.
The forms instruct providers not to ask patients if they are undocumented. They do, however, provide a box to check should the patient volunteer such information. The forms also ask whether patients are Mexican citizens with a border-crossing card, and also requires verification of Social Security numbers.
"This opens up the hospitals to profile the patients they think are part of immigrant communities," according to Jennifer Ng'andu, health policy analyst for the National Council of La Raza, the nation's largest constituency-based Hispanic organization. "We're concerned about privacy protection. There's no guarantee of patient confidentiality," she says.
This factor, along with the questioning, has led some immigrant advocates to believe it will cause the undocumented to no longer view hospitals as safe havens and, thus, to opt against seeking life-saving care.
Butterfield says at first the St. Vincent's staff was put off by the prospect of having to question patients. The hospital, like most in the nation, does not ask patients information about their immigration status. "We don't want to be in the position of asking any questions that might discourage a patient from receiving healthcare at St. Vincent's." But Butterfield says when the hospital learned it wouldn't be required to directly ask patients about immigration status, anxieties waned. "They're actually encouraging hospitals not to directly ask [about immigration status]," he says. "We're more comfortable with that." Overall, the hospital is "pleased that we will receive some level of reimbursement to provide this important service to the community," according to Butterfield.
St. Vincent's doesn't yet know how much money it will receive or when the funds will be granted, Butterfield says. But when the money comes it will serve a need, Robert Jessen, a College of Santa Fe politics professor, says. "Hospitals definitely bear the brunt of immigrant care because [immigrants] don't have access to regular care and have to go to the emergency room for things that everyone else wouldn't go to the hospital for." Adds Betty Jean Shinas, a member of the City of Santa Fe's Immigration Committee and a social worker who has worked with immigrants for 15 years, "I feel that there are very little resources for the immigrant community. If this is going to help this community, I'm definitely in support of it." Ng'andu also says undocumented immigrants often turn up in hospital emergency rooms. That's why the program will have a large impact on them and on public health generally. However, Ng'andu maintains the impact will be negative because members of the undocumented population, who often go to hospitals with serious or even infectious conditions, will likely be deterred because of the questions.
Jessen and Shinas have a different outlook from Ng'andu's. "In terms of whether they'll still [seek treatment] all depends on how the hospitals implement the policy," Jessen says. He adds, "People in healthcare don't like to be policemen." Therefore, if the hospitals implement questioning in the least invasive manner possible, immigrants may not be disinclined to obtain hospital care. Moreover, they may report positive experiences with hospitals to others. "It's a very word-of-mouth community," Jessen says of the undocumented population. While Shinas acknowledges "there's going to be some kind of anxiety" in the undocumented community because of the questions, she believes steps can be taken to alleviate fears. Specifically, the purpose of the questions should be advertised, she says. "I think they can do it through the radio stations. They have ways they can get the word out through many organizations and different clinics that provide services to the community," she says. "I think it's important for them to inform immigrants how this information is going to be used. That's going to make it a little bit easier, and they will feel more comfortable."
