Patrick McGee

Estimates for immigrant care clash with 2004 data
By Patrick McGee
Fort Worth Star-Telegram
Friday, August 24, 2007

A consultant’s cost projections for allowing illegal immigrants in a preventive program are dramatically higher than what JPS experienced three years ago.

Allowing illegal immigrants into Connection, the Tarrant County hospital’s free preventive healthcare program for poor people, would cost more than $40 million now and more than $100 million in 10 years, according to JPS’ consultants, Austin-based Phase 2 Consulting.

But during eight months in 2004, when illegal immigrants were allowed to enroll, the cost to serve them in the JPS Health Network’s Connection program was a fraction of that.

COSTS

The consultant predicts:

It would cost $41.3 million in 2007 to open JPS Connection to illegal immigrants, according to Phase 2’s report.

What happened in 2004:

In June 2004, JPS Chief Executive David Cecero estimated that providing preventive healthcare to illegal immigrants cost $750,000 to $900,000 over 18 weeks. Phase 2 said the hospital would spend that much in one week in 2007.

Consultant’s response

Phase 2 consultant Michael Romano, chief author of the study, said his estimates are higher partially because Connection did not include pharmacy services in 2004.

But pharmacy services were part of Connection in 2004, and the patients’ co-payment has not changed, according to JPS Chief Financial Officer Gale Pileggi. She said the services are more restricted now; patients are only eligible for up to five 90-day prescriptions per month. There was no limit in 2004.

Romano also predicts higher costs because he believes more illegal immigrants would use Connection than in 2004, so many more that additional hospital beds would be needed.

ENROLLMENT

The consultant predicts:

In 2007, 29,000 illegal immigrants would sign up for Connection.

What happened in 2004:

A staff report given to the JPS board of managers’ finance committee in November 2004 details illegal-immigrant enrollment in 2004. Enrollment peaked at 921 in March 2004; it dropped by more than two-thirds in April when proof of county residency was required. After that, enrollment averaged 295 a month, only 12 percent of the average monthly enrollment of 2,417 foreseen by Phase 2. Meeting Phase 2 predictions would require more than 2 1/2 times the March enrollment and eight times the average after that. The county residency requirement is still in place.

Consultant’s response

Romano said he believes that JPS would have seen illegal-immigrant enrollment eventually reach the higher levels he predicts. “Had the [eight months of 2004] experiment gone on longer, I think they would have gotten close to the experience that we projected,” he said.

HOSPITALIZATIONS

The consultant predicts:

The report says 385 illegal immigrants would be admitted to the hospital in 2007 if the Connection policy changes. That would be 193 in six months. Romano said he took into consideration JPS’ 2004 experience and the fact that health and immigration experts have found illegal immigrants to be a young and healthy group that, despite common perceptions, uses hospitals much less than the rest of the population.

But none of this appears in the report. In fact, the report says, “We have assumed that the undocumented population will be admitted for hospital care at the same rate as the JPS Connection enrolled population.”

What happened in 2004:

Sixty-six illegal immigrants were admitted to the JPS hospital during six of the months that Connection was open to them. For every 10 citizens admitted to Connection, one was hospitalized. For every 33 illegal immigrants admitted to Connection, one was hospitalized.

Consultant’s response

Romano said he stands by his predictions and believes that they are based on reasonable estimates. He said the eight months of enrollment seen in 2004 was too short a time to be an accurate predictor.

“Looking at the experience of a couple of months’ worth of enrollment figures to us was not as valid,” he said.

OTHER HOSPITALS

The consultant states:

The report says the county hospitals in Dallas and El Paso have 80,000 and 72,000 people, respectively, in their preventive healthcare programs for poor people. The numbers were used to predict enrollment in Tarrant County.

What the hospitals say:

Robert Behrens a spokesman at Parkland Memorial Hospital in Dallas, said it serves only half of what the Phase 2 report states. Gloria Sanchez, a spokeswoman at Thomason Hospital in El Paso, said it serves only about a third of what the report states.

Consultant’s response

Brent Hardaway, senior managing director of Phase 2 Consulting, said that if the hospitals’ numbers are correct, it would only make their predictions wrong by one-third.