MISSION — Between 20 and 25 undocumented immigrants arrive each week for kidney dialysis at Mission Regional Medical Center’s emergency room.
“They have no way of paying for it, and in six months they rack up $750,000,” said Mitch Ladyman, the hospital’s trauma coordinator. “That’s just a number we’ll never get reimbursed.”
And while the federal government has a $1 billion federal program intended to help with unpaid hospital emergency care, a recent Associated Press report shows a large chunk of that money has gone uncollected by cash-strapped hospitals.
Federal officials can’t explain why overburdened communities have not grabbed the cash.
Nationally, only 15 percent of the money has been handed out three-quarters of the way through the program’s first year, according to the AP.
Texas as a whole is slated to receive almost $25 million for the 2006 fiscal year.
Rio Grande Valley hospital officials say they take whatever disbursement they can or risk cutting hospital services essential to the community.
“We’ve definitely applied for and have definitely gotten some of it,” said Dan McLean, CEO at South Texas Health Systems in McAllen, which includes McAllen Medical Center and Edinburg Regional Medical Center.
The health group has collected about $2.41 million since it filed its first claim for its five facilities in February 2006.
That may seem large, but in the last eight months alone, the hospitals have provided more than $118 million in uncompensated care, said hospital group spokeswoman Dalinda Guillen.
The $1 billion financial dispensation is through September 2008 and authorized under the 2003 Medicare law. Hospitals are paid a percentage of the ER costs on quarterly cycles, so they receive money six to nine months after the actual procedures.
Some hospitals are reluctant to apply for funds because they don’t want to do the paperwork, say hospital and public health officials. The government also trims submitted hospital bills and returns money based on costs, not on services provided.
Hospitals feel uncomfortable asking patients about their citizenship status.
“A lot of undocumented patients already don’t access care,” said Sonal Ambegaokar, a health policy attorney at the National Immigration Law Center, a non-partisan policy center that works with low-income immigrants based in Los Angeles.
“The few that go in, if they hear they are being asked about their immigration status, they’ll assume they’ll not be able to get care … that will affect the public health.”
Local hospitals dismiss the objections, noting the required paperwork is only two pages long and their employees are trained to sensitively ask questions.
“I understand the reluctance of a hospital that doesn’t see that many undocumented patients,” said Mission hospital Chief Financial Officer Randy Slack. “But when you’re treating a number of undocumented patients, it’s worth your while to go through all the hoops and troubles to get partial reimbursements.”
Mission’s hospital has also received a “six-figure amount,” he said.
“It covers cost of supplies and labor, operations to treat those patients who are undocumented,” Slack said. “If money went away, we might have to find other areas to cut to keep bottom line balanced.”
For South Texas Health Systems, the trauma room or pediatric ICU unit could become financial casualties if it continues to lose money through uncollected ER care, McLean said.
“We literally can’t afford not to do this program,” he said.
Jennifer C. Smith covers health, environment and science issues
at The Monitor. She can be reached at (956) 683-4462. For this and
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