MALDEF

Hospitals Carrying Out Legally Questionable Deportations

To limit their patient-care responsibilities, some American hospitals have engaged in a troubling practice that places immigrants at risk. A recent story in The New York Times documents how several hospitals have privately initiated deportations of immigrant patients for post-hospital care. In addition to noting a particularly shocking episode in which a sick baby, who is an American citizen, almost got deported, the article offers a sample of statistics highlighting the phenomena. As examples, one Phoenix hospital deports about 96 immigrants a year, and since the beginning of 2007, Chicago hospitals have sent 10 patients back to Honduras.

While noting broader trends, the story especially focuses on the story Luis Alberto Jiménez, an undocumented immigrant who suffered severe injuries in 2000 after a drunk driver crashed a stolen van into a car carrying Jiménez and two others. Martin Memorial, a Florida hospital, ultimately leased a plane for $30,000 and deported Jiménez, who was uninsured, to Guatemala, his country of origin. The Times story makes clear, however, that deportations privately carried out by U.S. hospitals affects all immigrants and not just undocumented ones:
Mr. Jiménez’s benchmark case exposes a little-known but apparently widespread practice. Many American hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance.1
The story notes that although federal law requires that hospitals receiving federal funds ensure that needy patients receive adequate post-hospital care, immigrants face obstacles that prevent them from receiving certain governmental funds. At the federal level, for example, Medicaid does not cover long-term care for undocumented immigrants or recently arrived legal ones. At the state level, governments won’t provide funding for post-hospital care for needy undocumented immigrants, legal immigrants here temporarily, or legal permanent residents who have resided in the U.S. for fewer than five years.

Far from being an accepted practice, however, these private deportations raise legal questions that have not been resolved. Legal action taken by Mr. Jiménez’s family, moreover, is apparently the first time that one of these deportations has been challenged. The legal questions revolving around the deportations stem from the very nature of the hospitals’ actions themselves:
[T]he hospitals are operating in a void, without governmental assistance or oversight, leaving ample room for legal and ethical transgressions on both sides of the border. Indeed, some advocates for immigrants see these repatriations as a kind of international patient dumping, with ambulances taking patients in the wrong direction, away from first-world hospitals to less-adequate care, if any.2
In fact, even a spokesman from Jiménez’s former U.S. hospital claims that the hospital’s actions should be viewed as experimental.3  In Jiménez’s case, the questionable legality is not mitigated by the fact that the Guatemalan government openly received Jiménez and promised quality medical care. Medical experts retained by Jiménez’s family have expressed deep concerns about the adequacy of the care Guatemalan facilities could provide:
Dr. Miguel Garcés, a prominent Guatemalan physician and public health advocate, said in a deposition that serious rehabilitation ‘is almost nonexistent’ in Guatemala outside private facilities. He predicted that Mr. Jiménez would be taken in and then released from the country’s one public rehabilitation hospital within a matter of weeks.4
Ultimately Garcés’s fears became reality. After a Florida judge found for the hospital and authorized the deportation, Jiménez returned to Guatemala and entered the nation’s National Hospital for Orthopedics and Rehabilitation (NHOR). A few weeks later, however, the NHOR discharged Jiménez to another hospital. When they visited him, his family found Jiménez in deplorable conditions.

In May, 2004, a Florida appeals court reversed the earlier decision, arguing that deportations have to meet federal guidelines and that the Martin Memorial’s deportation did not satisfy such criteria. The decision did not affect Jiménez much because by then he had already returned to Guatemala. Nonetheless, the legal community now has a potential precedent to cite in Jiménez’s case. Furthermore, aided by a prominent Floridian firm, Jiménez’s cousin is currently suing the hospital for the personal injury of false imprisonment—essentially arguing that Martin Memorial’s actions constituted kidnapping.

Now living in an isolated hilltop home with his mother, Jiménez and his condition have worsened. He regularly experiences "violent seizures, each characterized by a fall, protracted convulsions, a loud gurgling, the vomiting of blood and, finally, a collapse into unconsciousness."5 His story should serve as caution for anyone thinking that hospital-initiated deportations pass legal and moral muster.
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1. Deborah Sontag, "Immigrants Facing Deportation by U.S. Hospitals," The New York Times, 3 Aug 2008
2. Id.
3. Id.
4. Id.
5. Id.

Copyright 2009 MALDEF — Mexican American Legal Defense and Educational Fund