3/1/2005 - (Houston) Hospital district struggles with burden from beyond its border: (Use the taxes they PAY or refund their taxes and make them pay)
Hospital district struggles with burden from beyond its border:>Houston Chronicle
>March 1, 2005, 9:22AM
Funds fall short even as the cost of caring for those outside the county and nation soars
>By BILL MURPHYRicardo, >a 43-year-old Honduran with six children to feed, was taken to a
>Copyright 2005 Houston Chronicle
>After he was caught illegally crossing the Rio Grande in November,
detention >center in the Valley.
>Harlingen hospital. But immigration authorities balked at paying for heart
>He suffered a heart attack in late December and was treated at a
surgery and released him, advising him to seek treatment on his own, he says.
>General Hospital, where he underwent heart surgery in January.
>Still weak, he made his way to Houston and eventually to Ben Taub
>As the cash-strapped Harris County Hospital District operates on a
>that can't keep up with the needs of the county's poor, almost a thirdof
>its admitted hospital patients are coming from outside the county andeven
>outside the nation.$101
>Over the past 10 years, the district has provided $510 million in
>unreimbursed care to illegal immigrants, the district says. Another
>million was spent on unreimbursed care for residents of surroundingRadack
>"I think we have an obligation to provide care," Commissioner Steve
>said of treating immigrants. "There is a public health issue. When youhave
>a population that hasn't received preventive care, they are at risk ofhelp
>infecting the population at large. But the federal government needs to
>us provide such care."year spent 10.4 percent of its budget on
>Radack and others are less enthusiastic about providing free care to
>residents from other counties.
>The district last
>care for illegal immigrants - $80 million out of a $770 millionbudget, a
>Radack aide found while researching district spending.emergency
>Federal law requires hospitals to treat everyone who comes to
>rooms. Passed by Congress two years ago, the Medicare ModernizationAct was
>supposed to provide some relief by funneling $1 billion over fouryears to
>hospitals providing emergency care to illegal immigrants.it
>Left out of funding
>Texas was to get $47.5 million a year. The hospital district assumed
>would be in line for some of the money and that it would help offsetother
>cuts in Medicare, said Clifford Bottoms, the district's chieffinancial
>But state officials decided the money would go to private hospitals
>provide care to illegal immigrants,not charity hospitals such as Ben
>Bottoms said.to be
>Money has become so tight at the district that its officials are
>contemplating severe measures to balance the upcoming annual budget,
>considered by Commissioners Court on March 8. These include limitingbeds at
>patient prescriptions covered by the district and cutting available
>Ben Taub and Lyndon B. Johnson hospitals.budget
>Even though demand for the district's services has risen 8.2 percent
>annually since 2000, the district is expected to be given an annual
>next month calculated on a 1.3 percent increase in patient demand.care
>Not everyone agrees that the district should feel compelled to provide
>treatment for undocumented immigrants.
>"It's going to break all of us. There's no way we can provide health
>for illegal aliens," said J.C. Hernandez, founder and president ofrefuse
>Houston-based Americans for Zero Immigration.
>County officials don't buy the argument that the county ought to
>treatment to illegal immigrants.Robert
>"It's a moral issue; it's a public health issue," said County Judge
>Eckels. "This is how we do things in America."care
>Radack said the federal government should increase funding for such
>because it has the mandate of keeping people from crossing the bordersand
>isn't doing enough to prevent illegal immigration.from
>Advocates say illegal immigrants would have few places to turn if the
>district closed its doors on them.
>Mark Zwick, who runs Casa Juan Diego, a nonprofit Houston shelter for
>immigrants, said that in the past year, four illegal immigrants fell
>scaffolding while working for low wages on construction sites inHarris
>County. The accidents left threeof the workers paraplegics and the
>a quadriplegic, he said.electrician
>Casa Juan Diego cared for them while they recuperated in one of its
>Heights-area homes or paid for them to be cared for elsewhere.
>Ricardo lives in one of the homes and hopes to regain his strength
>following his heart surgery. When he does, he will work as an
>or painter and begin to send money back to Honduras, where his wife ishe
>trying to care for their children, he said through a translator.
>"They depend on me," he said. Ricardo said he is grateful for the care
>has received at Ben Taub. "They attended me very well."children,
>Ricardo asked not to be identified fully because he is in the country
>"If they are building our houses, mowing our grass, watching our
>the least we can do is to take care of them when they are sick," Zwickanother
>said. "To abandon people when they work very inexpensively is
>County officials don't take issue with that but do complain about
>strain on the district's budget - providing unreimbursed care toresidents
>from surrounding counties.their
>Last year, the district spent more than $15 million on such care.
>Radack said he will ask County Attorney Mike Stafford to see if civil
>action can be taken against out-of-county residents who don't pay
>bills and will ask District Attorney Chuck Rosenthal whether criminalnow
>charges could be brought.
>"This money is coming straight out of the pockets of the Harris County
>taxpayers. This is a theft of services," he said.
>Intended to provide a safety net for the county's poor, the district
>serves as a regional safety net, Bottoms said.from around the region are taken to Ben Taub because
>a top facility. And residents from surrounding counties turn to thebecause
>district because fewer services are offered to the poor in most nearby
>counties, Bottoms said.
>False residency claims
>Some out-of-county residents falsely claim to live in Harris County
>it is easier to qualify for indigent health care than in mostsurrounding
>"You have to be dirt poor now before we'll take you," said County
>Commissioner Tom Stavinoha of Fort Bend County, where a family of four
>earning more than about $4,000 a year doesn't qualify for free care.
>State Sen. Royce West, D-Dallas, has filed a bill that would allow a
>regional hospital that serves as a draw to surrounding counties to
>some of the costs of treating out-of-county residents.require all counties to pay for health care for people
>The bill would
>annual incomes as high as 200 percent of the federal poverty level.That
>poverty level is $19,350 for a family of four.not
>Harris County Commissioner El Franco Lee said more federal funding,
>state or county money, is needed to pay for health care statewide.bulldozer,"
>"You aren't going to get anything from small counties with one
> OUT-OF-COUNTY PATIENTS
> More than 1,000 patients from other counties were admitted to
>County Hospital District facilitieslast year. They're often drawn by
>county's better facilities and easier eligibility requirements:sliding
> . Harris County: A family of four making up to $19,350 a year
>qualifies for free care, and those making up to twice that pay on a
>scale, often with minimal fees.family of
> . State standard, applied by many surrounding counties: A
>four qualifies only if it earns less than $4,064.
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