Mu­nic­i­pal IDs help pre­vent med­i­cal mishaps, pro­vide ac­cess to care

Modern Healthcare - - NEWS - By Adam Ruben­fire

Hous­ton-based Me­mo­rial Her­mann was re­cently un­der fire af­ter clin­i­cal staff called po­lice to re­port an un­doc­u­mented im­mi­grant who pre­sented a fake ID along with her valid pri­vate in­sur­ance card at a clinic within the sys­tem.

The health sys­tem said staff were un­aware of Blanca Bor­rego’s res­i­dency sta­tus and ex­pressed re­gret over her ar­rest. It said it is re-eval­u­at­ing its pro­cesses fol­low­ing this “unique event” that had “noth­ing to do with immigration or res­i­dency sta­tus.”

But the in­ci­dent puts the spotlight on the chal­lenges of providers who care for the un­doc­u­mented, 60% of whom don’t have in­sur­ance, ac­cord­ing to the Healthy Amer­i­cas In­sti­tute at the Univer­sity of South­ern Cal­i­for­nia’s Keck School of Medicine, a re­search cen­ter fo­cused on im­prov­ing health in His­panic com­mu­ni­ties.

Not all providers ask for iden­ti­fi­ca­tion when pa­tients check in, but many do; it’s of­ten re­quired by man­u­als cre­ated by pay­ers, said Laura Palmer, a se­nior fel­low at the En­gle­wood, Colo.-based Med­i­cal Group Man­age­ment As­so­ci­a­tion. Emer­gency de­part­ments, on the other hand, must eval­u­ate and sta­bi­lize all pa­tients who come through their doors, re­gard­less of their abil­ity to pro­duce iden­ti­fi­ca­tion.

Dr. David Ansell, se­nior vice pres­i­dent for sys­tem in­te­gra­tion at Rush Univer­sity Med­i­cal Cen­ter in Chicago, has been a strong ad­vo­cate for un­doc­u­mented im­mi­grants’ healthcare. He said Rush staff gen­er­ally asks pa­tients for some form of ID to iden­tify al­ler­gies and pre-ex­ist­ing con­di­tions. They’re less con­cerned about ID va­lid­ity and more con­cerned that the pa­tient’s photo iden­ti­fi­ca­tion matches their med­i­cal record, he said.

“We just want to prop­erly iden­tify some­one, not prop­erly iden­tify their iden­ti­fi­ca­tion,” Ansell said.

To that end, a few U.S. cities have pro­vided mu­nic­i­pal IDs to un­doc­u­mented im­mi­grants and oth­ers, in­de­pen­dent of state and fed­eral agen­cies, which may in­quire about le­gal sta­tus. Though their uses dif­fer across the coun­try, the IDs can of­ten be used to ac­cess health and so­cial ser­vices, open bank ac­counts and prove iden­tity dur­ing in­ter­ac­tions with lo­cal law en­force­ment.

The move has been po­lit­i­cally charged, since many ar­gue it al­lows the

“We just want to prop­erly iden­tify some­one, not prop­erly iden­tify their iden­ti­fi­ca­tion.”

Dr. David Ansell, se­nior vice pres­i­dent for sys­tem in­te­gra­tion, Rush Univer­sity Med­i­cal Cen­ter, Chicago

un­doc­u­mented to en­joy some U.S. ben­e­fits.

IDNYC, the free iden­ti­fi­ca­tion card New York City launched in Jan­uary, pro­vides res­i­dents with pre­scrip­tion­drug dis­counts, among other ser­vices. Mayor Bill de Bla­sio’s ad­min­is­tra­tion has pro­vided sig­nif­i­cant out­reach and ed­u­ca­tion about the ID, said Nisha Agar­wal, com­mis­sioner for the mayor’s of­fice of im­mi­grant af­fairs in New York. “I think the the­ory be­hind the ID card is that New York­ers are bet­ter off with gov­ern­ment ID than with­out it,” Agar­wal said.

So far, 530,000 peo­ple have signed up for the pro­gram. Prior to the mu­nic­i­pal ID pro­gram, the not-for­profit New York Immigration Coali­tion of­ten worked with for­eign of­fi­cials to pro­vide un­doc­u­mented in­di­vid­u­als with IDs from their na­tive coun­tries’ con­sulates, said Claudia Cal­hoon, the coali­tion’s di­rec­tor of health ad­vo­cacy.

New York City Health and Hos­pi­tals Corp., which runs the city’s 11 public hos­pi­tals and var­i­ous clin­ics, does not re­quire any ID, nor does it in­quire about immigration sta­tus, Agar­wal said. In 2011, HHC also wrote an open let­ter to im­mi­grants that was trans­lated into 12 lan­guages, ex­plain­ing that they should not be afraid to see HHC providers. The sys­tem promised to keep their le­gal sta­tus con­fi­den­tial and treat im­mi­grants re­gard­less of their abil­ity to pay.

Many ad­vo­cates point to com­mu­nity and mi­grant health cen­ters as a safe place for un­doc­u­mented im­mi­grants to ac­cess care be­cause many cen­ters don’t ask for an of­fi­cial ID.

Par­tic­u­larly in mi­grant health cen­ters, le­gal iden­ti­fi­ca­tion of­ten isn’t a fac­tor be­cause un­doc­u­mented agri­cul­tural work­ers rarely have in­sur­ance, so there is less con­cern about iden­tity fraud, said Bobbi Ry­der, pres­i­dent and CEO of the Na­tional Cen­ter for Farm­worker Health. But some health cen­ters take photos of their pa­tients when cre­at­ing their med­i­cal record to ver­ify their iden­tity for fu­ture vis­its, she said.

A spokes­woman for the Na­tional As­so­ci­a­tion of Com­mu­nity Health Cen­ters, which rep­re­sents 9,200 fa­cil­i­ties in the U.S., said its goal is to pro­vide pre­ven­tive care over ex­pen­sive and of­ten un­nec­es­sary emer­gency care.

“Ev­ery­one ben­e­fits when there are no bar­ri­ers to af­ford­able and suc­cess­ful pre­ven­tive healthcare,” she said.

The Af­ford­able Care Act does not pro­vide in­sur­ance to un­doc­u­mented im­mi­grants, and ex­perts have urged sub­si­dies for of­ten young and healthy im­mi­grants as a way to boost the in­sur­ance ex­change mar­ket.

Com­mu­nity health cen­ters and other like-minded not-for-profit health or­ga­ni­za­tions say they need an open-door mes­sage.

“As a clin­i­cian, I’m not in the law en­force­ment busi­ness,” said Karen Moun­tain, a nurse prac­ti­tioner and CEO of the Mi­grant Clin­i­cians Net­work. “I’m in the busi­ness of try­ing to help peo­ple and save lives, and I can’t do that as ef­fec­tively if peo­ple are too afraid to seek help.”

“As a clin­i­cian, I’m not in the law en­force­ment busi­ness, I’m in the busi­ness of try­ing to help peo­ple and save lives, and I can’t do that as ef­fec­tively if peo­ple are too afraid to seek help.”

Karen Moun­tain, CEO, Mi­grant Clin­i­cians Net­work

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.