'No one keeps track of it': So-called 'medical deportation' not unique, expert says
ALLENTOWN, Pa. — The fate of a Dominican mother whose family is fighting to stop her medical repatriation — or, as some call, it “medical deportation” — from a local hospital is hardly unique, an immigration expert said.
- A recent situation regarding an undocumented patient at Lehigh Valley Health Network has brought up the legality of what some call “medical deportation"
- Professor Lori Nessel is the director of the Immigrants’ Rights/ International Human Rights Clinic at Seton Hall Law School
- Nessel said there’s a need for legislative reform at the federal level
As is allegedly happening with an undocumented immigrant woman in a coma at Lehigh Valley Hospital-Cedar Crest, hospitals hire private medical transport companies to fly uninsured/undocumented patients out of the country, rather than face treating them indefinitely, according to law professor Lori Nessel.
Nessel is the director of the Immigrants’ Rights/International Human Rights Clinic at Seton Hall University School of Law in Newark, New Jersey.
“I have even studied cases where people in border states were literally just driven and dumped across the border,” Nessel said.
Nessel spoke as a 46-year-old woman who has been publicly referred to as “S.C,” who is undocumented in the United States, faces "medical deportation, "according to her husband and supporters.
The husband, Junior Rivas, said complications during surgery resulted in his wife being put into a coma. He said the hospital administration told him they may have to transfer her from their Cedar Crest campus to the Dominican Republic.
They say Lehigh Valley Health Network gave the family a March 8 deadline to find an alternative, such as a placement in a long-term care home. With few financial resources, the family has not been paying for her care at the hospital.
'It’s essentially deportations'
Nessel said that only an immigration court or immigration judge can deport someone, so hospitals use the term "medical repatriation."
"Medical repatriation" is the transfer of undocumented patients in need of subacute care to their country of origin, according to the Transcultural Nursing Society.
“What's so troubling about these cases, is that they're essentially deportations, but that's not lawful because a hospital has no lawful right to deport," Nessel said.
"But certainly for the families involved, that's what's happening.”
Nessel said that if a patient is discharged domestically, there are guidelines in place about their care, but with international discharge, there's no follow-up.
"People might be surprised to hear about a hospital in Allentown, Pennsylvania, right, because you think, ‘Oh, this stuff goes on at the borders, you know, so Arizona or Texas or California.’ But it does happen all over. It's just really hard to quantify it because no one keeps track of it."Lori Nessel, director of the Immigrants’ Rights/International Human Rights Clinic at Seton Hall Law School in New Jersey
Through her work and research into the topic, Nessel has written law review articles and put together a practical guide for families or advocates faced with the situation. It's based on her interviewing lawyers who were successful in stopping medical repatriations.
In addition, one of her students in her clinical program spent a summer in Guatemala trying to do on-the-ground research on the subject by talking to those who have been through it.
'It does happen all over'
"People might be surprised to hear about a hospital in Allentown, Pennsylvania, right, because you think, ‘Oh, this stuff goes on at the borders, you know, so Arizona or Texas or California,’" Nessel said.
"But it does happen all over. It's just really hard to quantify it because no one keeps track of it."
Nessel said in her research, she has seen hundreds of cases of this type of medical repatriation.
Under the emergency medical treatment and labor act, or EMTALA, most hospitals have to take in a patient when they are in need of emergency services, regardless of whether they have health insurance and regardless of their immigration status.
However, Nessel said issues arise when patients are deemed “stable.”
“They can still be in critical condition, so it's not what we think of as stable, but technically, once someone is stabilized, then what happens is the hospital no longer receives any federal funding to continue to care for that person,” she said.
Nessel said it’s often cheaper for hospitals to hire a private medical transport company to fly an uninsured/undocumented patient out of the country than to treat them indefinitely.
“Hospitals will pay, I've seen pay, like a million dollars," she said. "I mean that's a lot, or hundreds thousands of dollars. It's still less than it's going to be to keep this person indefinitely in the hospital.
“You have an area where there's a gulf in sort of federal funding or protection. Hospitals are feeling pressure to get this person out of the hospital and then these companies come in and say, ‘OK, we can do that.'"
Legislative reform needed
Nessel said she felt that it’s unlikely because of the political climate in the country, but there’s a need for legislative reform at a federal level regarding "medical deportations."
“There's a role for both states and the federal government and I think there also just needs to be more oversight,” she said.
“I think you can't have a situation where there's a sort of pressure building on hospitals and private companies if these are people's lives. It's just too much at stake to leave it to private actors, that should be better regulated."
The fight to keep S.C. in the United States continues. As of late Thursday, she remained at Lehigh Valley Hospital-Cedar Crest.