Emergency Medical Care for Illegal Aliens on the Line in Funding Talks

Emergency medical care for thousands of illegal immigrants in Orange County may be on the line in negotiations between the county Health Care Agency and 34 hospitals, including the largest provider of medical services to undocumented residents, UCI Medical Center.

At issue in the negotiations, which are to continue next week, is the fate of $8.4 million that the county was providing annually to UCI to help defray the costs of caring for patients who do not qualify for Medi-Cal or a separate program, the Indigent Medical Services program. The vast majority of these patients are believed to be illegal aliens.

Although the issue is now under negotiation, the county has told UCI that it does not plan to renew the agreement when it expires on July 1.

Concern Expressed

But Leon Schwartz, director of the medical center in Orange, said that he has concerns about the effectiveness of new state and federal funding programs designed to offset the costs of medical care for some illegal aliens.

He said that without the $8.4 million from the county, the medical center is expected to show a deficit of $11 million next year, up from an expected $5-million deficit this year.

Medi-Cal, Schwartz said, reimburses the hospital at about 60 cents to the dollar for 40% of the hospital’s patients. The Indigent Medical Services program, for which 12% of UCI patients qualify, reimburses the hospital at about 50 cents to the dollar, he said.

What Schwartz estimates to be illegal aliens account for an additional 5% or 6% of the hospital’s patients.

“There is a sizable population out there that is undocumented,” he said. “And I think it is the county’s responsibility.”

‘Look at the Positive Side’

Instead of giving the entire $8.4 million to UCI, the county has offered the money to the 34 Orange County hospitals, including UCI Medical Center, that belong to the Hospital Council of Southern California.

“To look at the positive side, they did put the same amount of money on the table,” Schwartz said. “But the fact (that they said they would not renew the contract with UCI) does indicate a policy change.”

According to Jon Gilwee, regional director of the hospital council, when the county offered the $8.4 million to the hospitals, it said the money must be applied to the Indigent Medical Services program, which requires that patients be residents.

But the hospitals--which, aside from UCI, had been paying the cost of illegal immigrant care themselves--suggested instead that they be reimbursed for the care of illegal aliens.

Gilwee said that for the first year of the two-year council plan, UCI bills would have priority in recognition of the medical center’s disproportionate burden. After that, when the council hopes to determine just how many patients could be eligible for the county funds, Gilwee said the goal is to reimburse each hospital as expenses arise.

‘Is It Fair?’

“The university is the only one that receives any source of reimbursement” for illegal aliens, Gilwee said. “So in that sense, is it fair for one hospital to be compensated and all others not to be? That is a situation we are trying to rectify.”

The council plan, like UCI’s position that the county should renew its exclusive contract, is still under consideration in the negotiations.

Although county Health Care Agency officials said they could not comment on anything connected with the negotiations, Herbert Rosenzweig, director of medical services, said he expected some resolution next week.

He described as a negotiating ploy UCI’s position that the cancellation of its contract jeopardized funding for illegal aliens.