U.S. Hospitals Quietly Deport Hundreds Of Undocumented Immigrants

hospital-deportHundreds of immigrants who are in the U.S. illegally are put through a little-known removal system run not by the federal government trying to enforce laws, but by hospitals seeking to curb high costs.

In interviews with immigrants, their families, attorneys and advocates, The Associated Press reviewed the obscure process known formally as “medical repatriation,” which allows hospitals to put patients on chartered international flights, often while they are still unconscious. Hospitals typically pay for the flights.

“The problem is it’s all taking place in this unregulated sort of a black hole … and there is no tracking,” said law professor Lori Nessel, director of the Center for Social Justice at Seton Hall Law School, which offers free legal representation to immigrants.

Now advocates for immigrants are concerned that hospitals could soon begin expanding the practice after full implementation of federal health care reform, which will make deep cuts to the payments hospitals receive for taking care of the uninsured.

Health care executives say they are caught between a requirement to accept all patients and a political battle over immigration.

Hospitals are legally mandated to care for all patients who need emergency treatment, regardless of citizenship status or ability to pay. But once a patient is stabilized, that funding ceases, along with the requirement to provide care. Many immigrant workers without citizenship are ineligible for Medicaid, the government’s insurance program for the poor and elderly.

That’s why hospitals often try to send those patients to rehabilitation centers and nursing homes back in their home countries.

Civil rights groups say the practice violates U.S. and international laws and unfairly targets one of the nation’s most defenseless populations.

“They don’t have advocates, and they don’t have people who will speak on their behalf,” said Miami attorney John De Leon, who has been arguing such cases for a decade.

Estimating the number of cases is difficult since no government agency or organization keeps track.

The Center for Social Justice and New York Lawyers for the Public Interest have documented at least 600 immigrants who were involuntarily removed in the past five years for medical reasons. The figure is based on data from hospitals, humanitarian organizations, news reports and immigrant advocates who cited specific cases. But the actual number is believed to be significantly higher because many more cases almost certainly go unreported.

Some patients who were sent to their country of origin subsequently died in hospitals that weren’t equipped to meet their needs. Others suffered lingering medical problems because they never received adequate rehabilitation, the report said.

Gail Montenegro, a spokeswoman for U.S. Immigration and Customs Enforcement, said the agency “plays no role in a health care provider’s private transfer of a patient to his or her country of origin.”

Such transfers “are not the result of federal authority or action,” she said in an email, nor are they considered “removals, deportations or voluntary departures” as defined by the Immigration and Nationality Act.

Patients are frequently told family members want them to come home. In cases where the patient is unconscious or can’t communicate, relatives are told their loved one wants to return. Sometimes they’re told the situation is dire, and the patient may die, prompting many grief-stricken relatives to agree to a transfer.

The American Hospital Association said it does not have a specific policy governing immigrant removals, and it does not track how many hospitals encounter the issue.

There are expectations that medical removals will increase with implementation of health care reform, which makes many more patients eligible for Medicaid. As a result, the government plans to cut payments to hospitals that care for the uninsured.

Some hospitals call immigration authorities when they receive patients without immigration documentation, but the government rarely responds. Taking custody of the patient would also require the government to assume financial responsibility for care.

Jan Stipe who runs an Iowa Methodist department finds hospitals in patients’ native countries that are willing to take them. The hospital’s goal, she said, is to “get patients back to where their support systems are, their loved ones who will provide the care and the concern that each patient needs.”

The American Medical Association’s Council on Ethical and Judicial Affairs issued a strongly worded directive to doctors in 2009, urging them not to “allow hospital administrators to use their significant power and the current lack of regulations” to send patients to other countries.

Doctors cannot expect hospitals to provide costly uncompensated care to patients indefinitely, the statement said. “But neither should physicians allow hospitals to arbitrarily determine the fate of an uninsured noncitizen immigrant patient.”

http://www.huffingtonpost.com/2013/04/23/us-hospitals-deportation-immigrants_n_3139272.html?utm_hp_ref=mostpopular

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Posted on April 25, 2013, in Article and tagged . Bookmark the permalink. Leave a comment.

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