Aid Arrives at Arizona Hospital as Immigrants Dry Up
RENEE MONTAGNE, host:
One charge frequently leveled by foes of undocumented workers is the cost federal, state, and local governments shoulder to provide health and education services. One hospital on the Arizona border, the Copper Queen Community Hospital, has been a dramatic example of the burden that border hospitals face.
The hospital in Bisbee, Arizona, is only five miles from Mexico. Here's what hospital CEO Jim Dickson said in an NPR interview a year and a half ago.
Mr. JIM DICKSON (CEO, Copper Queen Community Hospital, Bisbee, Arizona): On any given day we have 3,000 to 4,000 immigrants crossing the border here.
MONTAGNE: The hospital spent millions of dollars caring for that tide of sick or injured immigrants. Federal money is finally coming in to help, but now the hospital doesn't need it so much.
NPR's Ted Robbins explains.
TED ROBBINS reporting:
In 2004, Congress appropriated $1 billion in emergency aid to hospitals like the Copper Queen, in Bisbee. The hospital spent so much on things like emergency aid for border crossers it had to close its skilled nursing and maternity wards.
But the Copper Queen didn't get its first check until earlier this spring. CEO Jim Dickson.
Mr. DICKSON: I would--sure would have liked this two and a half years ago. It would have helped me defray some of my losses.
ROBBINS: Why did it take so long? Well, the government had to hire a private contractor to administer the program: Texas-based Trailblazer Health Enterprises. That company already handles some states' Medicare payments, but hospitals in other states like Arizona, had to set up entirely new billing systems.
Then, there was a controversy over paperwork. The government wanted hospitals to ask patients if they were in the country illegally. Many hospitals refused, saying patients who needed care would be too fearful to get it. The compromise is a federal form that tries to answer the question without really asking it.
Copper Queen's Jim Dickson.
Mr. DICKSON: It asked--the first question asked, is the patient eligible to enroll in Medicaid? Undocumented documentation. It's a conundrum; you can't do it. And then they ask, is the patient a Mexican citizen crossing the border? Attach a copy of the patient's DESP15I94. None of them have this. They're illegal immigrants.
ROBBINS: So how do you get paid?
Mr. DICKSON: We make a--we make an attempt, and we then document that we tried, and we put down, did not respond, does not have.
ROBBINS: A spokesperson for the Federal Centers for Medicare and Medicaid Services, the agency in charge of the money, says it's normal for a new program, even an emergency program, to take 27 months to make a first payment.
But finally, the money began arriving. And while a billion dollars seems like a lot, divided up between thousands of hospitals across the country, it's not. The Copper Queen's first reimbursement: $2,400 - one-fourth of what it asked for.
And now, the hospital doesn't need to ask for so much.
Mr. DICKSON: You look down at the border and now there's a fence about two miles long with lights every 50 yards, and so forth. It looks almost like a war zone.
ROBBINS: In the last year, a massive build-up of border patrol resources on this side, and Mexican government resources on the other side, have slowed the flow of crossers along this section of the border.
Mr. DICKSON: I would say we used to have at least one or two a day. Now we're down to none for two or three weeks. Am I happy? Absolutely. Is it myopic? Yes, because it's happening now over to some other hospital down the road.
(Soundbite of Emergency room traffic)
ROBBINS: Two hours down the road, at UMC--University Medical Center in Tucson.
Ms. BARBARA FELIX (Coordinator for International Patient Services, University Medical Center, Tucson, Arizona): I don't think it's any better. I--no, not at all. I think we see more people every year.
ROBBINS: Barbara Felix is UMC's coordinator for international patient services. She deals with all patients who are not U.S. citizens.
Ms. FELIX: You know, I saw 40-some patients last month. I mean, that's very high. Now, not all of these people were people that necessarily jumped over the fence. Some of them are people that have come in on their border crossing cards. Some of them are here legitimately, you know, and they become ill.
ROBBINS: As the only high-level trauma hospital in the region, UMC expects to write off $12 to $14 million in charity care for its fiscal year, ending in June.
Right now, no one knows exactly how much charity care goes to the undocumented, but as hospitals across the country submit the new paperwork, the true costs of healthcare for illegal immigrants may emerge.
Ted Robbins, NPR News, Tucson.
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