Care for Disabled Illegal Immigrants Periled

Nearly 200 severely disabled illegal immigrants under 24-hour care in California nursing homes are scheduled to be ousted within the next two months because the Legislature failed to pass a bill extending their care.

Gov. Pete Wilson last week sought to avoid one of the harshest impacts facing California as it implements the new federal welfare reform law--as well as a heartless political image--by calling for special legislation to continue nursing home care for illegal immigrants.

The governor’s plan was blocked in the final hours of the legislative session last weekend, however, when attorneys for the Assembly declared that it might conflict with California’s Proposition 187, the 1994 ballot measure that sought to stop many benefits for illegal immigrants.

Now, Wilson administration officials are proceeding to notify counties this week that the state will stop funding for the bedridden patients in the next 30 to 60 days. They add, however, that they hope to avert the crisis before then by finding another source of public or private funds.

“This is a concern to us,” said Sean Walsh, Wilson’s press secretary. “We clearly tried to establish a transition through legislation. . . . [But] we believe that some accommodation will be made to provide long-term care for these individuals.”

State officials said there are at least 180 elderly illegal immigrants in California’s long-term or nursing facilities who suffer from strokes or other debilitating conditions like Alzheimer’s disease.

Since 1988, they have received state-subsidized care under a bill authored by former state Senate Minority Leader Ken Maddy (R-Fresno) and signed by Gov. George Deukmejian. The same legislation also provided prenatal care for pregnant illegal immigrant women, which Wilson also ordered to be halted.

The cost of caring for bedridden illegal immigrants has been widely disputed by various government and industry officials.

Walsh said the cost is about $1 million per year. But the head of the state’s Medi-Cal division, John Rodriguez, and a spokeswoman for the state Health and Welfare Agency, Lisa Kalustian, said the annual cost is closer to $10 million.

Gary Macomber, executive vice president of the California Assn. of Health Facilities, a lobby group for the nursing home industry, said nursing homes receive about $73 per day for each of the roughly 200 illegal immigrant patients, or $5 million to $6 million per year.

The exact cost is critical because the governor is now seeking to avert the crisis by asking the nursing homes and private charities to absorb the burden.

If an alternative is not found within the next two months, officials said, they believe the illegal immigrant patients would be transferred to public hospitals and categorized as emergency medical cases.

The federal welfare legislation, which banned many public services for all illegal immigrants, required states to continue emergency medical care.

That emergency hospital care, however, is likely to cost the state far more than it is now paying the nursing homes to care for the same patients, said John Nelson, a spokesman for Assembly Speaker Curt Pringle (R-Garden Grove).

Macomber estimated that hospital care would cost about 10 to 15 times more.

Those hospital bills would be charged to county indigent care budgets, which are already vastly underfunded.

In a related issue, Macomber warned of a far greater impact on long-term care facilities if the state decides to cut off legal immigrants, as provided in the federal welfare reform legislation signed last month by President Clinton.

Macomber said there are 14,000 to 15,000 legal immigrants now receiving care in California long-term or nursing facilities. “It doesn’t make any economic sense” to oust these patients and put them in more costly hospitals, he said. “It doesn’t make any humane sense.”

The federal law allows states to continue public services for legal immigrants at their own cost. California officials have not yet addressed the question of legal immigrants or the massive welfare overhaul called for in the federal legislation.

They must act no later than next July, but some still hold on to the possibility that a special session could be called to resolve the issues before the Legislature reconvenes in December.

Nelson said the special session may be the only way to avert a crisis with the disabled illegal immigrant patients. “It is an option and probably the only option that would resolve this administratively,” he said.

Walsh, however, downplayed the possibility of a special session, saying he is confident the crisis will be averted through alternative funding.

Macomber, however, questioned whether the private facilities could absorb the cost. “If a facility isn’t paid, they have the ability to initiate a discharge proceeding,” he said. “The fiscal reality is that they can’t subsidize them.”