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Fewer Illegal Hospital Patients

Fewer undocumented patients, funds good news for Copper Queen hospital



BISBEE — Three or four years ago, Jim Dickson, CEO of Bisbee’s Copper Queen Community Hospital, was not feeling very upbeat.

He had had to cut back on employees and hours, shutter his skilled nursing facility and close the hospital’s maternity ward. The reductions, he says, were largely due to a massive influx of patients from Mexico — illegal immigrants or residents of nearby Naco, Sonora — who could not pay for services.

Today, however, things are looking brighter for the hospital and its CEO. Federal funds that provide partial compensation for treating undocumented immigrants have finally started to come in. And even better, Dickson says, the number of undocumented patients at the hospital has gone into rapid decline.

“It might be the increased number of Border Patrol agents in the area or it might be the notoriety of the Minutemen,” he said. “But there are just not as many people crossing from Mexico (into the Bisbee area).”

“Whoever is doing it, they are doing a good job because it has meant financial viability for us.”

As evidence, he points to numbers from March and April — traditionally two of the busiest months for undocumented patients. In the past, these were months when the hospital would write off as much as $30,000 in uncompensated losses. But Dickson says the amount has now dropped to less than $7,000.

Pausing to knock on wood, Dickson says he has not been called in at night in the past two years — a common occurrence in years past.

Statistics from the U.S. Border Patrol’s Tucson Sector also support Dickson’s assertion that local illegal crossings are declining. The agency reported 10,230 apprehensions of undocumented immigrants in Cochise County in March 2006, less than 50 percent of the 21,232 recorded in March 2005.

And the good news for the Copper Queen Memorial Hospital is that not only has undocumented patient flow declined, but federal funds are now coming in to help offset the cost of their treatment.

Section 1011, a recently implemented measure of the Emergency Medical Treatment and Labor Act (EMTALA), provides $250 million per year for fiscal years 2005-08 to compensate physicians and hospitals for emergency health care given to undocumented immigrants. Reimbursement is partial, and so while the Copper Queen billed $6,500 in Section 1011 costs for the third quarter of 2005, the hospital received a check for only $2,366.

In all, Arizona’s hospitals received nearly $3.3 million in Section 1011 payments for the third quarter of 2005. The Sierra Vista Regional Health Center received $29,125 while Community Health Care of Douglas got $77,064.

While any level of federal contribution is good news for the Copper Queen, the arrival of the funds has been bittersweet for Dickson, since they come after his years of greatest loss — such as 2004, when he reported deficits of $450,000.

Perhaps the most important benefit of the reimbursement program, he says, is that it has established an accounting system that allows hospitals like his to accurately measure the number and impact of undocumented patients.

Due to sparse and overloaded health care facilities in nearby Naco, Sonora, the Copper Queen Community Hospital — especially its emergency room — has long been a magnet for Mexican citizens who come to the U.S. legally on shopping and tourist visas.

Dickson explained that the hospital does not turn away Mexican patients, documented or otherwise. Federal law requires emergency rooms to treat patients regardless of their ability to pay, and, furthermore, the hospital is concerned that people carrying transmittable diseases like antibiotic-resistant TB and staph infections might return to their border communities untreated.

In an effort to help Naco residents receive attention at emergency rooms in the larger Sonoran cities of Agua Prieta and Cananea, the Copper Queen Community Hospital donated an ambulance to the city.

But while Dickson realizes that his facility will always have some level of demand from the border, he is now finding that it can be managed. “(Patient flow) is not going to stop,” he said.