Entrants costly to hospitals, patients

Scope of crash injuring 29 unusual; bill passed on to consumers routine

By Brady McCombs

Arizona Daily Star

Tucson, Arizona | Published: 04.09.2008

http://www.azstarnet.com/allheadlines/233584

The costs to four Tucson hospitals that treated 29 illegal entrants injured in a rollover crash Monday near Benson will be sizable and largely unreimbursed.

The medical-care costs not covered by a federal reimbursement program will eventually be passed on to consumers, officials at the hospitals said Tuesday.

The incident — which resulted in the death of one Guatemalan woman and has three men in critical condition — was extraordinary in the number of people involved and the severity of their injuries. But it's just the latest example of Southern Arizona hospitals' being forced to treat illegal border crossers with no assurances of reimbursement.

"It's a daily event for us," said Kevin Burns, University Medical Center's chief financial officer. "This one gets attention because it's such a large number of people and such a catastrophic event, but we deal with this day in and day out."

Of the four hospitals, only University Physicians Healthcare Hospital at Kino has estimated the cost of this crash. The hospital, which treated 11 of the 29, estimates it cost between $44,000 and $55,000, spokeswoman Sarah Frost said.

The faith-based Carondelet Health Network, which runs St. Joseph's, St. Mary's and Tucson Heart hospitals in Tucson and Holy Cross Hospital in Nogales, takes its duty to "care first and worry about payment later" seriously, but it doesn't mean the costs don't add up, said Bill Pike, director of public policy at Carondelet. Four of the illegal entrants landed at St. Joseph's.

"In the big picture of things, when health-care organizations provide a lot of charity care, those dollars are billed into or carried over to people who do pay for care," Pike said. "You and I, we all pay for care for the uninsured."

Burns echoed that: What doesn't get reimbursed eventually gets covered by consumers because the hospital needs to operate at a reasonable profit margin to stay in business. UMC treated seven of the injured border crossers and is still caring for two Guatemalan men in critical condition.

"Effectively, not getting these costs covered by the federal government means we end up passing that cost on to consumers in insurance premiums," Burns said.

Treating foreign patients without medical insurance costs UMC about $5 million a year, Burns said. The hospital is reimbursed about $1.5 million a year through a federal program designed to pay hospitals for emergency care given to illegal entrants.

It costs Carondelet about $4 million annually to care for illegal entrants, Pike said. Tucson Medical Center, which treated nine of the injured, and Kino didn't have yearly cost estimates available Tuesday.

Records from the Arizona Hospital and Health Care Association show that in 2006, the federal program reimbursed Arizona hospitals $24.7 million for treating illegal entrants. Tucson hospitals received about $4.5 million:

● Carondelet: $1.85 million.

● UMC: $1.76 million.

● Tucson Medical Center: $917,398.

The program reimbursed ambulances statewide in 2006 a little more than $2 million and physicians $1.7 million.

Burns and Pike are in Washington, D.C., this week advocating for the extension of the federal reimbursement program, known as Section 1011. It's set to expire in September. The program pays hospitals at a rate of about 15 cents on the dollar, they said.

"This is very much a largely unfunded mandate," Burns said. "It doesn't just affect us; it affects every hospital in the state of Arizona."

The impacts aren't just financial. Treating the uninsured, who include many U.S. citizens as well, takes time and resources away from treating paying customers, Burns and Pike said.

"We have a very busy ER department, and this really tends to tie up our ER and trauma," Burns said.

Rollover under investigation

The crash occurred at about 5 a.m. Monday on Interstate 10 near Empirita Road, about 10 miles west of Benson. A van loaded with illegal border crossers tried to evade the Border Patrol and rolled. Ambulances and helicopters transported 29 illegal entrants.

The cause of the rollover is still under investigation and may take investigators several days to determine, said Officer Quent Mehr, state Department of Public Safety spokesman.

A 21-year-old Guatemalan woman died at the scene.

Officials with the Guatemalan Consulate in Phoenix have notified her family, said Oscar Padilla, the Guatemalan consul general in Phoenix.

Three Guatemalan men remain in critical condition, two at UMC and one at Good Samaritan Hospital in Phoenix, Padilla said.

In total, at least 20 of the 31 involved in the crash were Guatemalan.

Those who have been released from hospitals are in the custody of the Border Patrol, he said.

Vincent Picard, spokesman for Immigration and Customs Enforcement, said there also were eight from Ecuador, two from Mexico and one from El Salvador. The two Mexican men were arrested and referred to the U.S. Attorney's Office on suspicion of being the smugglers.

No charges have been filed yet, said Sandy Raynor, spokeswoman for the U.S. Attorney's Office.

The Ecuadorean consul general in Los Angeles, Eddie Bedón, flew to Tucson to visit with the Ecuadoreans in hospitals and at detention facilities.

ICE officers will hold some of the illegal entrants involved as witnesses for a possible criminal trial, Picard said. They'll be given parole and allowed to work, because it can take a long time for a criminal trial, he said.

The rest will be set up for formal removal proceedings and held in detention centers in Eloy and Florence. The removal process can take several weeks to several months, Picard said.

● Star reporter Dale Quinn contributed to this story. ● Contact reporter Brady McCombs at 573-4213 or bmccombs@azstarnet.com.

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There's no more strudel in tiny Nutrioso as visa woes idle popular cafe

By Tom Beal

ARIZONA DAILY STAR

Tucson, Arizona | Published: 04.09.2008

http://www.azstarnet.com/allheadlines/233532

Strict enforcement of immigration laws has created a schnitzel and spaetzle shortage in the Arizona White Mountains hamlet of Nutrioso.

Friends of German nationals Joerg and Beate Bohlig and patrons of their shuttered German restaurant, Cafe Beate, are up in arms over the State Department's refusal to renew the couple's visas.

Friends are far between on the sparsely populated eastern end of the White Mountains in Apache County, which boasts a population of 6.2 people per square mile.

A decent restaurant is even more precious. Nutrioso, population 222, has one other and it's open "sporadically," according to resident Penny Chipman.

The Bohligs' gourmet German and European fare attracted diners from nearby towns and from the tonier tourist towns of Arizona Rim Country to the west. The couple had been living in Nutrioso for 10 years and had operated Cafe Beate for eight of them, living here under an E-2 visa, which was issued in 1998 and renewed in 2003.

The E-2 is colloquially called the "millionaire's visa." Its purpose is to "stimulate investment and economic activity by foreigners in the United States," said Steve Royster, spokesman for the Bureau of Consular Affairs at the U.S. State Department.

When Beate Bohlig flew to Germany for a visit with an ailing sister in January, the couple was in the process of renewing the visa for another five years. That application was turned down, and she was not allowed to board a plane back to the States.

Joerg Bohlig returned to Germany in February for a visa interview with the U.S. Consulate in Frankfurt, thinking he could straighten matters out. "We were sent away like stupid schoolkids," he wrote in a letter to his friends in Arizona.

Now both Bohligs are stuck in Germany.

Ultimately, the Bohligs were sent a form letter telling them their application had been turned down because, "You failed to demonstrate that the investment is more than a marginal one solely for earning a living."

The Bohligs' lawyer, Gerd Zimmermann, and their neighbors in Nutrioso, argue that the definition of "marginal" is a good deal different in Apache County than it is elsewhere.

The county ranks among the poorest in America, said Kristi Zieler, aide to Apache County Supervisor David Brown. Its median household income of $26,592 compares unfavorably to the state of Arizona ($43,696) and the country ($44,334).

Nutrioso has little economic activity, said Zieler. "There is no industry there. There are no retail stores. It is a very small mountain town. The restaurant is about the only economic activity going," Zieler said.

Supervisor Brown said he's eaten at Cafe Beate. "It's a great restaurant and as far as the county goes, we don't have many of those to start with."

Brown said he would consider it "a significant investment anywhere in Arizona."

Brown said he did not know the details of the Bohligs' immigration problems and hadn't formed an opinion, though he said it "doesn't seem fair."

Penny Chipman, who operates Arizona Mountain Fly Fishing in Nutrioso with her husband, Chip, said the economic impact of the Bohligs' restaurant is huge, by local standards. "There is not much up here and even a little trickle-down is phenomenal."

She said the restaurant draws customers from Alpine, 8 miles away, and from the resort village of Greer, 35 miles away, as well as from nearby New Mexico towns.

Tucsonans Joe and Lou Bagnara, who spend summer months in Greer, wrote a letter in support of the Bohligs' application.

Lou Bagnara said on the phone that the restaurant is made special by the Bohligs. They remember their customers' birthdays and anniversaries, and they make a great Jaeger Schnitzel (veal with mushrooms).

"These people are an asset to the whole mountain community," said Bagnara.

Zimmermann, who is helping the Bohligs seek reconsideration of their application, is collecting letters from neighbors and patrons and from elected officials in Apache County and beyond.

Royster said State Department officials cannot comment on individual visa applications.

He said the standard for an E-2 visa is "substantial investment in an economic enterprise."

"There is no hard-and-fast dollar amount, but the investment should be substantial," he said.

Decisions about what that means "are up to the officers who review the application," he said.

Zimmermann said he hopes to convince officials in Frankfurt that the Bohligs' investment in Nutrioso is substantial. He said it exceeds $500,000, including the purchase of the building and grounds for $250,000 eight years ago, and extensive remodeling to create the restaurant and an adjoining bed-and breakfast room.

Chipman said residents of the region have adopted the cause of the Bohligs. The big fir tree in front of the Nutrioso post office is festooned with ribbons, she said, and folks in nearby Luna, N.M., have begun tying ribbons to a tree there.

Chipman misses the cuisine and misses having somewhere to send her clients for dinner, but, "It's more than that — these are friends and neighbors," she said.

● Contact reporter Tom Beal at 573-4158 or tbeal@azstarnet.com.

Ariz. cops may get immigrant law role

Plan advances in state House; aim is to give issue to voters

By Howard Fischer

Capitol Media Services

Tucson, Arizona | Published: 04.09.2008

http://www.azstarnet.com/allheadlines/233555

PHOENIX — Arizona voters could get a chance to require law-enforcement officers to ask people they arrest if they're in the country legally.

If they're not, police would have the option of referring them for prosecution, or if no charges are pursued, turning them over to U.S. Immigration and Customs Enforcement.

HCR 2039, given preliminary approval in the state House on Tuesday, also would prohibit state or local governments from having any policies, official or otherwise, forbidding officers to ask those they stop about their immigration status. The proposal also would make it a crime just to be in the country in violation of federal immigration laws.

The measure still requires final House action and Senate approval before it goes to voters.

Rep. Russell Pearce, R-Mesa, proposed the measure as a ballot item because Gov. Janet Napolitano has previously vetoed a similar plan — a tactic he used before for several items voters approved in 2006 after the governor had nixed them.

At the center of the debate is what role local law enforcement should play in dealing with the estimated 450,000 or more people in Arizona illegally.

Pearce said rank-and-file police officers want the ability to stop and detain illegal entrants. But he said many have been stymied by city or police-chief policies that block them from routinely asking about immigration status.

If someone believes city or county officials are directing their officers not to enforce the law, that person can sue.

Judges would be empowered to withhold all state funding "until the policy is rescinded" or levy penalties of $5,000 per day.

The measure provoked a sharp debate among lawmakers over how active a role state and local governments should take in dealing with illegal immigration.

Rep. Tom Chabin, D-Flagstaff, said legislators should not be telling individual communities what the priorities of police should be.

"Some like the way the local sheriff does 'sweeps' to capture dishwashers and people who clean our homes and people who work in nursing homes," he said, referring to Maricopa County Sheriff Joe Arpaio.

"Law enforcement in local jurisdictions has their own discipline and their own community standards and their own sense of priority of keeping the streets safe and capturing real criminals," he said. "We don't see the need, then, of this nuisance legislation."

And Rep. Tom Prezelski, D-Tucson, said this kind of law would be "wasting the time of our police departments."

Pearce said the measure is not designed to make police become immigration enforcers. He said the measure, if it becomes law, would ensure that individual officers have the ability to pursue cases in which they believe people are here illegally, even if all they do is to call ICE.

But Rep. Steve Gallardo, D-Phoenix, said nothing in the law now bars officers from notifying federal officials of people they suspect are illegal entrants.

"This takes it a step further," he said. "It gives them a whole 'nother layer of responsibility," Gallardo continued, which would create more work for police who should be fighting crime.

Rep. John Kavanagh, R-Fountain Hills, countered that police are now blocked from using their judgment because of local "sanctuary" policies, which he said tie the hands of officers.

"During the course of a routine patrol, arrest or summons, they should be able to pursue the immigration status of anybody they have reason to believe is here illegally," Kavanagh said. "If they would do this, we would have plenty of enforcement, and we would be removing many dangerous criminals from our streets.

"Let's give the local cop on the street the authority to use his instincts and his training to take care of this problem," he said. "Illegal immigration should not be exempt from scrutiny and good-faith efforts of our law-enforcement officials to crack down on this problem."

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Opinion

Guest Opinion

Farmers have access to plenty of field hands

By Hal Netkin

Special to the Arizona Daily Star

Tucson, Arizona | Published: 04.09.2008

U.S. Rep. Raúl Grijalva says that farmers in Yuma are not planting sections of their fields out of fear that they won't have enough workers to harvest the crops. As a solution to this problem, Grijalva supports legislation by state Sen. Marsha Arzberger, D-Willcox, and state Rep. Bill Konopnicki, R-Safford, who represent agriculture-heavy districts, to create a state-sponsored guest-worker program.

But why are these politicians and farmers opting for an Arizona guest-worker program when the federal government already has on?. It's called the H-2A visa program designed for U.S. companies hiring foreign workers to perform agricultural labor or services of a temporary or seasonal nature.

The program has a number of benefits for employers, most notably the assurance of a legal, documented work force and the reduction of labor turnover with the resulting loss in productivity. No restrictions are made on the number of H-2A workers that are admitted yearly.

So why don't Arizona farmers like the program?

Maybe it's because they don't like the H-2A visa requirements intended to protect workers from exploitive working conditions. Or they don't like having to pay the same wages as comparable U.S. workers would have to be paid as determined by the Department of Labor.

Or they don't like having to provide the worker with an earnings statement detailing the worker's total earnings, the hours of work offered and the hours actually worked. Or they don't like having to provide housing to all H-2A workers, which must be inspected by the Department of Labor to assure minimum federal standards.

Or they don't like having to provide transportation to and from the worker's temporary home as well as transportation to the next work place when the contract is fulfilled. Or they don't like having to provide meals or facilities in which the workers can prepare food. Or they don't like having to provide worker's compensation insurance. Or they don't like having to provide health insurance. Or they don't like the messy red tape.

If farmers had to comply with the federally mandated requirements, it would defeat the advantages of hiring cheap illegal immigrant labor in the first place. What farmers really want is to legalize the on-demand hiring of the same cheap labor they have always hired, with the taxpayers footing the bill for workers' benefits.

So why don't some politicians like Grijalva push for the H-2A visa program? Could it be that they want "temporary" to really be "permanent" — advocating that in return for the "cheap" lettuce produced, temporary workers and their families deserve a path to permanent U.S. citizenship?

What is certain is that neither the farmers nor the politicians are really interested in what is good for America — and Arizona is in America.

Write to Hal Netkin at HalNetkin@E-VerifyForYou.com.