Crash Victim’s Coma Ends, but Not Troubles : Medicine: Illegal immigrant must leave hospital, has nowhere to go. Medi-Cal, INS say he’s not eligible for rehabilitation he must have.

The broken figure sitting in a wheelchair at Tustin Hospital Medical Center on Wednesday barely grasped the meaning of “good morning.”

Roberto Sanchez Morales, a 24-year-old illegal immigrant, has drifted out of a four-month coma with a hazy recollection of the past and an even foggier vision of the future.

He nearly died in a car crash. But now, the time has come: He must leave the hospital. How--and where--he will somehow get the therapy and rehabilitation to rebuild his body and mind has become the great and terrible question of his life.

“He’ll die if he’s released from the hospital,” said Sanchez’s cousin, Asuncion Sanchez.

For Roberto Sanchez, once strong and self-assured, this has been a terrible way to lose his dream and his dignity. In many respects, his story is like that of other seemingly faceless migrants.

In a nation where 37 million Americans lack health insurance, illegal immigrants are said to consume at least $2 billion in health care costs annually. In California alone, state health officials say, more than $880 million will be spent on health care for immigrants this year.

“What we have here is a broader issue: access to health care. Whether this man is here legally or illegally, he has, like everyone else in this country, the right to full and complete health care,” said John Palacio, an official for the Mexican American Legal Defense and Educational Fund.

Sanchez never wanted it this way.

Last April, he was a vital young man eking out a living by growing corn in a tiny village about 60 miles outside Acapulco. But the soil dried and became infertile. The region, saturated with jobless men, offered no help.

Penniless, married, with two infants and another on the way, Sanchez, like hundreds of thousands of his compatriots, sought to solve his woes by coming to this country illegally to work. He left his family behind.

In June he settled in San Juan Capistrano, where his brother, Socorro Sanchez, and cousin Asuncion live. Sanchez worked in menial jobs here and there, sometimes as a baker, making enough money to send some back home. But the luckless man saw his hopes for a better future for his wife and children shattered in a devastating car crash in August.

Followed by Border Patrol agents who wanted to question them about their resident status, Sanchez and four other Latinos tried to lose the agents by speeding away. Sanchez was a passenger in the car. They smashed into another vehicle and their car rolled down a ravine into a Lake Forest back yard.

While his four partners and the driver of the other car sustained broken bones and other somewhat significant injuries, only Sanchez was gravely hurt. He was taken with head trauma and broken legs to a county hospital, where he underwent brain surgery paid for by Medi-Cal.

After the surgery, he lapsed into a coma and was transferred to Tustin Hospital Medical Center. After four months unconscious, he emerged from his deep sleep in early January.

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Hospital officials are in a dilemma. Having seen the young man through a life-threatening period, they must now release him. It is not only a question of dollars, says Kathleen Santoro, manager of the hospital’s Case Management Department.

“We are not allowed to keep him here,” she said. Under its state license, the hospital can treat patients in a vegetative state or suffering acute trauma from brain injuries, broken necks, drug overdoses or near-fatal gunshot wounds.

Sanchez, she said, “is so much better than any of the (acute trauma) cases we are taking care of right now.”

And besides, the hospital, which is outfitted to deal with coma patients but not with their rehabilitation, can’t handle the next stage of his recovery.

Medi-Cal, which has paid the hospital more than $100,000 for Sanchez’s care during his comatose period and is willing to pay for his stay in a nursing home, will not pay for rehabilitation or for the period he has been at the hospital since he recovered consciousness two months ago.

Under Medi-Cal’s complex rules, he does not qualify, according to Santoro.

There would be help out there for him, Santoro said, if he had the money to pay for it.

Also, Immigration and Naturalization Service authorities say he doesn’t qualify for rehabilitation funding under its RUCOL (residing under color of law) program that allows people in the country legally to receive special medical assistance.

Virginia Kice, spokeswoman for the INS Western Region, said that in a situation such as Sanchez’s, “there doesn’t appear to be any relief. . . . I just don’t know that there are any provisions in our law that would entitle him to long-term health care if he is illegally in this country.

“My heart goes out to this man and his family,” Kice said. “He had an unfortunate set of circumstances, but what about the taxpayers? Should they be responsible for the costs of this man’s long-term (rehabilitation? Some U.S.) citizens need the same therapy and are not getting it.”

Sanchez, who can barely speak, appears not to understand his situation.

Family members who live in Orange County and who are indigent feel powerless. Having stayed away from the hospital for fear it would force them to take Sanchez with them, they finally went to see him this week.

The patient’s brother, Socorro, could not fight back the tears as he explained that he and the other five brothers in the clan, all of them back home in the state of Guerrero, Sanchez’s native state, are helping Sanchez’s family survive by “each cooperating a little, enough for (mother and children) to have something to eat each day.”

Family members say they understand the arguments against rehabilitative treatment for Sanchez, but they hope people will see beyond the politics of the situation and help their relative.

Donations may be sent to Arturo Montez, president, LULAC, P.O. Box 1810, Santa Ana, Calif. 92702, or people may call (714) 527-9007.