EMERGENCY Migration Ministry ADVISORY

A serious crises is developing... We should all be aware that new federal guidelines are now in force which will inhibit many of those we serve from seeking medical care. Hospital emergency rooms now must ask patients about their immigration status.

This will undoubtly deter Latino* and other immigrant communities from seeking emergency care. And it could lead to serious public health problems, including the spread of communicable diseases.

Undocumented immigrants ("illegals") fear that if they answer such questions, the information might be used against them in deportation proceedings. Therefore, most will be avoiding the hospitals regardless of their health.

Under a 1986 federal law, a hospital has to provide a medical examination and treatment to stabilize the condition of any patient who requests care in its emergency room, regardless of the person's ability to pay. Hospitals often absorb the costs when patients have no insurance or other source of payment.

The federal government is offering $1 billion to hospitals that provide emergency care to undocumented immigrants. But to get the federal monies -- which most hospitals desperately need to stay afloat ** -- hospitals would now have to ask patients about their immigration status and document the citizenship status of an undocumented population - an inherently difficult task. This new program was just created under the Medicare law. The health care money will be made available in four annual installments for services provided on or after Oct. 1st.

Previously, hospitals have never asked about one's immigration status. (It's the mission and philosophy of all Catholic hospitals to treat all without distinction.) Now this is changed! Hospitals must now ask ALL uninsured emergency patients about their citizenship or immigration status. The government says hospitals must not single out people who "look or sound foreign.''

The Department of Health and Human Services wants hospitals seeking reimbursement to ask patients these questions, among others:

1. "Are you a United States citizen?''
2. "Are you a lawful permanent resident, an alien with a valid current employment authorization card or other qualified alien?''
3. "Are you in the United States on a nonimmigrant visa'' of the type issued to students, tourists and business travelers?
4. "Are you a foreign citizen who has been admitted to the United States with a 72-hour border crossing card?''

And also under these new guidelines, photocopies of passports, visas, border crossing cards or other documents that establish the patient's status "should, if available", be included in the patient's file. Hospital employees will have to sign forms certifying that the immigration information for each patient was "true and complete'' to the best of their knowledge. Hospital administrators who knowingly submit false information to the government would be subject to civil and criminal penalties.

Federal officials emphasized that data on individual patients would not ordinarily have to be submitted to the government, but they also said that hospitals must keep it on file so federal auditors could check the information. They cite their legal obligation to prevent "inappropriate, excessive or fraudulent payments.''

* In many immigrant households, at least one parent is undocumented, but the children, having been born in the United States, are citizens. Most likely these undocumented parents will be terrified to seek care for their children, let alone themselves.

Immigrants can significantly impact on public health. The foreign-born population accounts for a growing share of tuberculosis cases in the U.S. - 53 percent of the 14,871 cases reported last year, according to the federal Centers for Disease Control and Prevention.

** i.e., St. Joseph's Hospital here in Queens is closing on August 27th due to fiscal insolvency.