Miami Herald: Crackdown urged on undocumented migrants’ mental healthcare

The Miami Herald published this article on March 7, 2010.

With a waiting list for Florida mental health facilities, a state debate is emerging on whether illegal immigrants should have the same rights to public healthcare as legal residents.

BY CRISTINA SILVA

Herald/Times Tallahassee Bureau

TALLAHASSEE — Mentally ill patients are being placed on waiting lists for treatment because Florida’s mental health institutions are crowded with illegal immigrants.

The crisis puts Florida at the forefront of a national debate over whether illegal immigrants should enjoy the same public healthcare rights as legal residents.

Florida’s mental health facilities have spent $19.6 million to care for at least 86 undocumented immigrants counted during an informal November survey and more unidentified illegal immigrants could be in custody, state officials said. The growing population has put a strain on the state’s mental health resources, contributing to a waiting list of 60 beds.

State officials want to turn the illegal immigrants over to federal immigration officers. However, Florida lawmakers would first have to exempt illegal immigrants from patient confidentiality laws.

The Republican-led Legislature could be sympathetic to the idea.

“If the state of Florida is spending money on illegal immigrants. . . it would be more appropriate for them to go back to their countries and get treatment there,” said Rep. Paige Kreegel, R-Punta Gorda, who chairs the Health Care Services Policy committee.

In the meantime, the state has plans to create an identification policy that would encourage all of its mental health centers to verify a patient’s immigration status.

The Department of Children and Families, which oversees the state’s mental health hospitals, will also work more closely with undocumented immigrants who want to return to their native countries.

“We don’t think it is appropriate for people to stay in the hospital if they don’t need to be there,” said Sally Cunningham, the state’s chief of mental health treatment facilities. “It is not just a cost issue, it is a service issue.”

State mental health institutions serve some of Florida’s most dangerous residents, including sexually violent predators, alleged criminals deemed incompetent to stand trial, defendants not guilty by insanity, those reported to be a threat to public safety and the mentally ill. These patients can’t be turned away, Cunningham said.

Individual mental health institutions began informally reporting the number of undocumented immigrants to the state in 2008.

Reported numbers have since hovered near roughly 85 illegal immigrants, mostly from Caribbean nations.

Illegal immigrants do not qualify for Medicaid, almost ensuring their stays at mental health hospitals could be an average of 25 days longer than other patients because they cannot easily be discharged to assisted living facilities or group homes after they are declared mentally stable.

Treatment costs for illegal immigrants are marginal, representing less than 3 percent of the state’s $349 million mental health budget.

To immigration critics, that is too much money.

Bob Dane, spokesman for the Federation for American Immigration Reform in Washington, D.C., which wants to reduce immigration, said legal residents should not have to wait for healthcare given to undocumented immigrants.

“The tremendous surge of illegal immigrants has put a strain on the health industry,” he said. “We are in the life-boat dilemma. We are trying to help everyone and no one is getting the proper help.”

Florida has no choice but to pursue deportation options, he said.

“Is it really fair to deny legal residents care to give treatment to illegal residents?” he said.

Florida has long been a breeding ground for immigration precedents.

In a benchmark case dealing with the obligations of hospitals toward uninsured illegal immigrants, a jury in Stuart decided last year that a local hospital did not act unreasonably when it returned a severely brain-injured patient to his native Guatemala against the will of his guardian.

Immigration advocates are appalled by the movement to deny undocumented immigrants the same rights as legal residents.

“It has the potential to make enforcing public safety in immigrant communities worse,” said Susana Barciela, policy director for the Florida Immigrant Advocacy Center in Miami. “You’ll have people not reporting people who may be a danger to themselves or to other people.”

Stripping illegal immigrants of their privacy could also threaten the rights of other patients, she said.

“They could identify anyone as undocumented,” she said. “How do you know who is getting privacy and who isn’t getting privacy?”