Some Bay Area Hospitals Might Decline Federal Funding for Treating Undocumented Immigrants
Hospitals in the San Francisco Bay Area say they might not accept an offer from the federal government for funds to partially reimburse the cost of treating undocumented immigrants, citing the potentially "onerous" reporting requirements and the possibility that patients will be deterred from seeking care, the Oakland Tribune reports (Vesely, Oakland Tribune, 5/13).
Under a program announced by CMS officials in July 2004, the federal government will offer U.S. hospitals $1 billion over four years to cover the cost of emergency care for uninsured patients, regardless of their citizenship status.
The federal government has allocated $250 million for each year of the program. The government will distribute two-thirds of the funds among all states and the District of Columbia based on their relative estimated percentages of the total number of undocumented immigrants. The six states with the largest number of apprehensions of undocumented immigrants for each fiscal year will receive the remainder.
California hospitals this year will receive as much as $71 million in additional federal funding under the program.
Hospital staff will be required to ask patients whether they are eligible for Medicaid, whether they have a border crossing card and whether they are foreign-born. However, hospitals cannot ask patients directly whether they are undocumented immigrants.
Hospital staff do not have to ask the questions when patients volunteer that they are undocumented immigrants. In such cases, hospitals staff can check a box and sign a form.
CMS Administrator Mark McClellan said hospitals are not required to ask people about their citizenship status.
However, hospital personnel will have to make photocopies of documents that indicate the immigrant status of patients, although in most cases they will not have to submit the documents to the federal government.
McClellan said that the federal government will not use information about undocumented immigrants obtained from hospital visits in "routine civil immigration proceedings." However, in rare cases, the federal government could use the information in criminal investigations, he said (California Healthline, 5/10).
Rachel Kagan, a spokesperson for the California Association of Public Hospitals, said it could be difficult for some California hospitals to comply with the requirement that hospitals collect new data and fill out additional forms. Kagan said, "This will no doubt increase the administrative burden on hospitals," adding, "Going from not collecting any information to collecting information is a big concern."
Patricia Barrera, policy director for the Alameda Health Consortium, said the reporting requirement could discourage undocumented immigrants from seeking care at participating hospitals. "We know that if patients find out that they're going to be tracked, that does have a chilling effect on people getting services," she said.
Dave Kears, director of the Alameda County Health Care Services, said Alameda County hospitals could get $2 million to $3 million annually under the program. He said, "This may be money left on the table. It's an empty gesture." Kears said, "It has to do with whether or not we want to go on a path that creates distrust between us and our patients."
Officials for Alameda County Medical Center, which treats most of the uninsured patients in the county, said ACMC is "studying the new regulations to understand how they may impact our finances and operations" (Oakland Tribune, 5/13).