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Fresno County's Undocumented Residents Face Uncertain Health Care Future

Aug 19, 2014

Building Healthy Communities, an activist group in Fresno County, is rallying for health care for all county residents.
Credit Diana Aguilera / Valley Public Radio

Juana Paredes is a farmworker who lives in Fresno. A couple days ago, she took her daughter and niece with her to the Mosqueda Community Center and joined others in a rally to stop Fresno County from dismantling a program that offers health care to undocumented residents.

Juana Paredes, a Fresno County resident, urges the county to continue serving the undocumented through the MISP program.
Credit Diana Aguilera / Valley Public Radio

Sitting in the front row, Paredes says she showed up because she has a clear message to Fresno County— continue health care services for the undocumented.

"The people that are thinking of excluding undocumented should think twice because there are many undocumented families and many kids who need the program," Paredes says.

After 30 years, Fresno County may no longer provide specialty care for undocumented residents through its Medically Indigent Service Program.

Paredes says if that’s the case she wouldn’t know where to turn for help.

“Oh no, that means I would no longer have help when it comes to my health," she says.

"When people get sick you can't turn their backs on them," Supervisor Henry Perea says.

Last year, the county asked a judge to dissolve an order from 1984 that requires the county to provide health care services for its undocumented population. Officials say they simply can’t afford to continue the services because of health funding cuts from the state.

And in April, a judge ruled that the county is no longer required to offer these services to the undocumented. County officials say an estimated 6,000 people who are undocumented currently use these services.

Now, Assemblymember Henry T. Perea who represents Fresno is offering the county a possible short term solution. Perea negotiated a deal to defer the county’s payment of $5.5 million for road funds to the state, but with some strings attached.

"What we did in the budget is said ok the state will defer the county’s payment of that 5 million for the next five year but we want for one year for the county to use those funds to continue the MISP program so that the underserved can continue to receive health care," Perea says.

He says that these funds would cover the gap when it comes to specialty care, such as cancer treatment or other critical needs.

"If an undocumented farmworker goes to the emergency room and it turns out that the farmworker has a serious issue that needs to be delt with the specialty care funds are there to help offset those medical costs," Perea says.

Now, the county has to figure out the next step. Later today, the county will look at two options. They could accept the money but they would have to keep the program as it is. Or they could reject the $5.5 million, leaving undocumented residents out on the street without specialty health care.

Building healthy communities, an activist group in Fresno, says the county should take the deal.
Credit Diana Aguilera / Valley Public Radio

If the county does change the eligibility of the program, it would allow the county to end its long running contract with Community Regional Medical Center. It works something like this: the county pays the hospital a fixed amount of about $21 million per year. The hospital says the program costs much more than that.

According to county officials, Assemblymember Perea’s deal doesn’t provide enough money to continue these services. The annual cost of providing program services to the undocumented through the hospital could cost up to $30 million.

I contacted the offices of all five county supervisors. The only supervisor who agreed to talk was Aseemblymember Perea’s father – Supervisor Henry Perea. He says the county should accept the deal.

“In my head it should be an easy one, let’s take the money and lets provide health care like we should be,” Perea says.

Supervisor Perea says a person’s immigration status shouldn’t be used to exclude people from receiving any type of health care.

"When people get sick you can’t turn their backs on them," Supervisor Perea says. "To me it’s a fundamental right of human rights, doing the right thing and not taking advantage of them and thinking they don’t exist.”

Activist Sandra Celedon Castro, with Building Healthy Communities, says Fresno County should take the offer.

"It's really hypocritical to say we care about farmworkers and we care about farmers but not when it comes to their health," activist Sandra Celedon Castro says.

"We hope that the board has heard the message loud and clear from the community from over 1,000 folks that have spoken to them at one point or another that are urging them to one take the 5.5 million dollars and two continue the program in extent to undocumented residents so that we all have health care," Castro says.

Castro points out that the supervisors in their chamber have a huge banner highlighting the wealth that agriculture brings into the region.

"It’s really hypocritical to say we care about farmworkers and we care about farmers but not when it comes to their health," she says.

Supervisor Perea is against eliminating health care services to the undocumented. He says if the county were to accept the agreement, its obligation to continue services is only until that money runs out.

“There are some people that are saying this 5 million dollars really isn’t 5 million dollars it’s going to be a 5 million dollar obligation that were going to have for the next 5 years.”

He says that’s not the case.  

“Our job is making sure that supervisors that are going to make the decision understand the fact that no, this is 5 million dollars, one time use money," Supervisor Perea says. "We’re going to use it until it runs out. Hopefully it will last at least a year while we figure out the long term solution.”  

Assemblymember Perea says they’re debating a possible solution at the state level but nothing is guaranteed.

"In the event something doesn’t move forward state wide we have to take a hard look at what we can do locally."

Juana Paredes, the farmworker in Fresno, is a bit nervous about the future.

"The undocumented people are the ones that suffer the most, because we don’t have papers we often don’t go to the doctor," Paredes says.

She says the undocumented community needs to stay strong.

"We all need to unite."

Fresno County Board of Supervisors is scheduled to discuss this topic and hold a public hearing today.