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A hospital on border going over the edge

As the cost of treating nonpaying illegal immigrants rises, Copper Queen’s administrators struggle to prevent closure.

By David Kelly

June 20, 2004

BISBEE, Ariz. — Besieged by illegal immigrants who jam its emergency room, then disappear without paying, tiny Copper Queen Community Hospital is growing desperate.

The 13-bed private facility lost $800,000 caring for migrants last year and $500,000 the year before. At this rate, hospital administrator Jim Dickson predicts, he’ll shut down in three years, leaving the town of Bisbee without a hospital.

The more business I do, the more money I lose, he said.

It’s the same story at other border hospitals struggling to cope with record numbers of illegal immigrants sweeping through Arizona.

Carondelet Holy Cross Hospital in Nogales lost $500,000 last year. Tucson Medical Center closed its trauma center because of uncompensated care. And University Medical Center in Tucson loses close to $1 million a month in unpaid care.

The century-old Copper Queen sits astride the Naco corridor, the busiest gateway for illegal immigrants in the nation. Border agents have made 154,000 arrests here this year.

Every day hundreds of immigrants set off from Naco, Mexico, six miles from Bisbee, and head north through this ragged edge of Arizona. If they get hurt in the desert or while being smuggled in vans and trucks, they usually wind up at Copper Queen. The facility also takes emergency transfers from Naco, which has no hospital.

The numbers are incredible, said Stephen Lindstrom, medical director at Copper Queen. They are constantly bringing in dehydrated and injured Mexicans, but I don’t think we’ve ever got a dollar.

A study last year by the U.S.-Mexico Border Counties Coalition examined healthcare costs in 28 border counties in Arizona, New Mexico, Texas and California. It found they had lost $200 million treating illegal immigrants that year.

Statewide, Arizona is losing $150 million annually caring for undocumented immigrants, health officials said.

If there is a rollover accident near the border and the nearest hospital is in Bisbee, the economic consequences can be catastrophic, said John Rivers, president of the Arizona Hospital and Healthcare Assn. Securing the border is a federal responsibility, and at some point they have to step up and provide a safety net for these hospitals giving care.

Congress recently set aside $1 billion to reimburse states for treating illegal immigrants. Arizona will get $40 million annually over four years starting in 2005, about one-fourth of what it actually spends.

Dickson said that without substantive immigration reform, the money would only be a stopgap.

Until then, he’s buying time for Copper Queen by improving facilities across the border. He has donated a new bed and suction equipment to Naco and is trying to give the city an ambulance.

Dickson hopes Naco will use the ambulance to take patients to hospitals in Agua Prieta, Mexico — 30 miles away — rather than Bisbee. Such gifts can backfire. An ambulance given to a hospital in Nogales, Mexico, ended up being used by drug dealers to smuggle marijuana into Arizona.

Dickson recently went to Naco to talk to city leaders about the donations.

A park in front of the adobe City Hall was filled with men awaiting coyotes, the smugglers who would lead them across the border. A pharmacy on the corner catered to Americans seeking cheap prescription drugs. And a new clinic was going up nearby. Mexican officials said the clinic would focus on treating U.S. citizens fleeing high medical costs.

Accompanied by Josie Mincher, Copper Queen’s emergency room director, Dickson was ushered in to see Municipal President Francisco Vicente Torres Bracamonte, Naco’s top official.

Torres, 28, looked a bit nervous, but Dickson got right to the point.

Tell him we can get him an ambulance in 60 days and I’m looking into getting him a defibrillator, he said, as Mincher translated for him.

Dickson asked about the equipment he had donated.

It’s still in storage, Torres said, explaining the complexities of Mexican bureaucracy.

Dickson shook his head.

Even when you try to help, you can’t, he said.

Torres said thousands of people heading north had swelled Naco’s 6,500 population. Local medical facilities, he said, offered little more than first aid. When told Copper Queen could shut down, he seemed stunned.

It would be a grave problem, Torres said. Many lives would be lost. I’d be willing to work with anyone to keep it from closing down.

Later, Dickson and Mincher drove along Naco’s wide, sun-blasted dirt roads to one of the city’s three threadbare clinics.

Inside, the musty rooms were mostly empty. The floors were grimy and the windows in the doctors’ lounge broken and sealed with newspaper. A wrinkled picture of the Last Supper did little to brighten the place.

We would like doctors and nurses and equipment, said Rafael Martinez, clinic vice president. A nurse said an electrocardiograph was needed.

We gave you suction equipment, Dickson said glumly. But it’s sitting in a warehouse along with a new bed.

Dickson, 57, has spent more than 30 years in healthcare. He came to Bisbee five years ago, and his timing couldn’t have been worse. Border crackdowns in California and Texas had begun funneling immigrants through the Arizona desert.

The Tucson sector of the Border Patrol, which includes Naco and Bisbee, has made 325,000 arrests this year, the most in the country.

They have quadrupled the Border Patrol down here. They have helicopters — everything you can imagine, Dickson said. And yet no one around here will say things have gotten better.

Copper Queen Community Hospital sits in the quirky, former mining town of Bisbee, population 6,100. The one-story facility is the third-largest employer in Cochise County, with 120 employees. Those who work here, whose lives are bound up in the complex culture of the border, recalled simpler times when illegal immigrants were fewer and less desperate. Migrants once traded work for food, and Americans walked over the border for fresh shrimp on weekends.

Now people are frustrated with a situation that has lowered their quality of life and is threatening their jobs.

Linda Morin, a Copper Queen nurse, runs a cattle ranch near the border with her husband, George. For a year they slept with the television on to mask the sounds of barking dogs and illegal immigrants running through their yard, until the migrants found another route. One morning, they woke to find more than 300 immigrants on their land.

It was like Woodstock or the county fair, recalled George Morin. I never saw so many people in my entire life.

But at the hospital, his wife treats illegal immigrants in the emergency room.

Here, I disassociate myself from it, she said. You can’t have a job like this and feel angry all the time.

Hospital officials say the Border Patrol won’t pick up illegal immigrants once they are treated because they would have to pay their bill, so they are released.

Border Patrol spokesman Mario Villarreal said the government would pay only if the injured immigrants were in custody.

When we come across someone in dire distress, we call emergency services and they are given treatment, he said. At that point, they are not in our custody and we haven’t made a determination of their legal status.

If the hospital told border agents it was treating hurt illegal immigrants, Villarreal said, we wouldn’t respond.

A bill sponsored by Rep. Dana Rohrabacher (R-Huntington Beach) that would have required emergency rooms to check citizenship and report illegal immigrants to authorities was defeated last month.

For Dickson, it’s further proof that chaos reigns on the border.

But I’m going to stick it out, he said. I’ll just keep dancing and trying to make it work another day.

A hospital on border going over the edge

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