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International Patient Dumping

International Patient Dumping. Private Hospital “Deportations” of Uninsured Immigrants. Nisha Agarwal, Director, Health Justice Diversity Rx Conference October 19, 2010. Overview. The cases. NYS workgroup on medical deportations. What role for law? . How to message?. The cases.

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International Patient Dumping

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  1. International Patient Dumping Private Hospital “Deportations” of Uninsured Immigrants Nisha Agarwal, Director, Health Justice Diversity Rx Conference October 19, 2010

  2. Overview The cases NYS workgroup on medical deportations What role for law? How to message?

  3. The cases

  4. Luis Jimenez - Florida Originally from Guatemala; undocumented; uninsured; hit by drunk driver & hospitalized Hospital incurs $1.5M in costs; unable to find rehab center willing to take uninsured patient; also unwilling to pay costs Hospital decides to send patient back to Guatemala above objections of guardian; litigation ensues Now: in Guatemala, receiving virtually no health care; jury found hospital did not behave unreasonably; attorneys filed for new trial

  5. Kong Fu Yu - New York Originally from China; undocumented; uninsured; elderly; suffered stroke & hospitalized Hospital unable to find facility to accept patient; decide to send him back to China above guardian’s objections Hospital files motion to have court proceedings closed to media, to have guardian removed Now: hospital looking into obtaining PRUCOL status for patient, in hope of getting benefits

  6. NYS workgroup

  7. Goal: Understand problem, develop solution “We really need a definitive answer on how to proceed in cases like these.” - William Phillips, jury foreman, Jimenez case

  8. Approach Multi-sector; national, state & local partners; some providers included; NYIC, NYAM & NYLPI coordinate Sub-committees: Legal, policy, messaging/communications, data collection, services/appropriate care Structured interviews with social workers, advocates and other service providers Legal research & creation of rapid response team

  9. Initial Findings Social workers reporting 4-5 cases per year in which patient threatened with forced repatriation Hospitals lack understanding of inter-relationship between immigration law & benefits eligibility; patients lack knowledge about discharge rights; language barriers impact discharge Resources are wholly inadequate for hospitals and patients Lack of knowledge among providers & advocates about the resources that do exist

  10. Role for law?

  11. Rapid Response Team Multi-sector (attorneys, social workers/providers) Connect patient, advocate & hospital to available resources, if possible Provide limited, emergency legal representation - e.g. discharge appeals, TROs Catalog cases, introduce some accountability into system for hospitals

  12. Impact Litigation? Anti-patient dumping laws Discharge planning laws Preemption Tort law

  13. How to message?

  14. Possibilities Engage financial arguments? Ethical/human rights framework? More than just about undocumented immigrants Draw links to “traditional” patient dumping, build alliances

  15. Thank You! Nisha Agarwal, Director, Health Justice 212-244-4664 x353 nagarwal@nylpi.org www.nylpi.org / healthjustice.wordpress.com twitter: @healthjustice

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