Robby Caceres was a young, undocumented day laborer who was cut down by a heat stroke while working on a roof last summer. Dazed with grief and fear, his brother and a cousin, also young 20-somethings, came to Casa Juan Diego with a plea for help.
It turned out Robby’s heat stroke was no ordinary fainting spell because he never snapped out of it. Doctors said his brain had been cooked. He was in a permanent vegetative state. With nothing more to do, they released Robby into his brother’s care – unconscious, bedridden for life and attached to a feeding tube.
Since last summer, we’ve been helping these young people so that someone can stay home to care for Robby. We also buy his medical supplies and provide him with adult diapers. It’s a heavy cross for Robby and his family.
We were reminded again of how critically important this work is of caring for the undocumented sick and injured by an alarming new report about the growing practice of what is formally – and euphemistically – called medical repatriation. Across the country, hospitals are circumventing the federal government and court system by unilaterally deporting hundreds of seriously ill or incapacitated immigrants like Robby to their home countries, without their consent.
The practice of medical deportation is widespread and the impact on patients is devastating. In a comprehensive study, Seton Hall Law School’s Center for Social Justice and New York Lawyers for the Public Interest documented 800 cases of attempted medical repatriation over the past six years. They note the number is surely much higher since medical deportations are not regulated and no reporting requirements exist.
The report documents scores of incidents where immigrants were repatriated by hospitals into facilities, hospitals or situations where adequate care was not available, including a car accident victim who died shortly after being left on the tarmac of a Guatemalan airport.
The net of these medical deportations is wide and has ensnared individuals of all ages and immigration status-es. One hospital attempted to medically repatriate a two-day old U.S. Citizen and her parents; others, a legal permanent resident and a youth who may have become eligible for the deferred action for Dreamers program, according to the report.
Families said they were often told by hospitals their relative would not survive, so they agreed to the transfer to ensure their loved one would be buried at home only later to realize they were incapable of providing proper, long-term care. Other times patients were repatriated against the family’s pleas and protests.
The practice violates both U.S. law and International human rights law. It strips immigrants of their due process and a right to a fair trial. It also deprives them of life, liberty, health, personal security and the protection of their family.
Hospitals in the U.S. are required to provide emergen-cy care to people regardless of their immigration status; the cost is reimbursed by government funds. But that obligation to provide care – along with the funding stream – ends once a patient is stabilized. After that, hos-pitals shoulder the costs alone, prompting the scramble to quickly transfer the patient elsewhere.
Lacking public insurance or disability insurance, the undocumented are out of luck at that point. Few rehabilitation centers, nursing and long-term care homes are willing to accept charity cases. The desperate, last resort of some hospitals has become medical repatriation.
The authors of the recent study predict the problem will worsen in 2014 when certain provisions of the Affordable Care Act take effect, dramatically reducing the amount of funds allocated to hospitals that treat a disproportionate share of uninsured patients.
Non-consensual medical repatriation is deplorable, unethical and illegal. It underscores the need for both fair immigration reform and adequate funding for hos-pitals and clinics that will continue to care for the uninsured – including seriously sick and injured immigrants.
Here in Harris County, we are fortunate to have Harris Health, a public health care system that provides extensive health care for undocumented immigrants through a financial assis-tance program popularly known as the Gold Card. Among other services, it covers routine exams, surgeries, hospital stays and some rehabilitative care. We don’t know what would happen to so many of our guests and undocumented friends if this compassionate system did not exist.
A gap still exists though when it comes to long-term care. We are the only organization in Houston that supports the undocumented caught in a tragic health crisis with long-term consequences. We understand the financial burden placed on the nation’s hospitals. We also know there is a great need for Christians to fill this gap in the Work of Mercy of caring for the sick.
Casa Juan Diego is willing to extend help to those who feel called to open a House of Hospitality for the undocu-mented sick and injured in their cities to help bring an end to the injustice of medical deportations. If you are discerning this, contact us at info@cjd.org.
To see a full copy of the report on medical repatria-tion, visit www.nylpi.org
Houston Catholic Worker, June-August, Vol. XXXIV, No. 3