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New Mexico Tries Triage, Immigration Policy

LAS CRUCES - The state is trying out a new policy expected to reduce the number of uninsured Mexican nationals seeking emergency medical care on the U.S. side of the border, including expectant mothers about to give birth.

Under the policy, anyone attempting to pass through the Columbus port of entry to seek medical care will first have to be evaluated at a clinic in Palomas, Mexico, which lies along the border three miles south of Columbus in southern Luna County. Only those with emergencies will be allowed to cross.

An official at Mimbres Memorial Hospital and Nursing Home in Deming, the usual destination for patients driven by ambulance from the Columbus port of entry, said the new triage protocol is expected to cut the number of births from mothers living in Mexico.

In 2009, there were 142 babies born at Mimbres Memorial by mothers transported from the Columbus port of entry after arriving there in labor, said Pam Wade, the obstetrics director at the hospital.

But Paul Dulin, director of the state Office of Border Health in Las Cruces, said the triage policy has nothing to do with concerns voiced recently by some Republican politicians about "anchor babies," the children of undocumented immigrants who are granted automatic U.S. citizenship by virtue of being born in the country. The mothers giving birth in Deming generally return to Mexico.

Dulin said the new policy was two years in the making and a product of an agreement between the governors of New Mexico and Chihuahua, Mexico, signed in May 2008.

"We are very excited about getting this in place," Dulin said. "It allows for a balance going back to our effort to have a coordinated network of care, realizing that lots of services can be provided in Palomas."

Dulin said the policy is also a response to the expected end of federal funds to reimburse hospitals, doctors and ambulance services for emergency health services provided to undocumented immigrants.

Under federal legislation signed into law in December 2003, $1 billion was allocated to all states for such services. New Mexico received nearly $12 million in fiscal years 2007 and 2008 and has about $7 million left, Dulin said.

The Palomas Health Center this year has finally been staffed sufficiently to provide around-the-clock service to patients. The policy assumes that most non-life-threatening cases, such as uncomplicated births, can be treated at the Palomas clinic.

Other nonemergency cases can be referred to hospitals in Ciudad Juárez or Nuevo Casas Grandes, both about a two-hour drive from Palomas.

In emergencies in which immediate attention is required, such as gunshot wounds or other severe trauma or a birth with complications, foreign nationals will be granted "humanitarian parole" at the port of entry. A U.S. Customs and Border Protection officer will accompany the patient to the nearest hospital, Mimbres Memorial.

In emergency cases, a patient is supposed to obtain a doctor's certificate declaring that urgent medical attention is needed, to be presented at the port of entry. But Dulin said, "If it's severe trauma - they've got four gunshots in them - they are not going to go to the clinic first."

Dulin said the policy is in a "pilot phase" while state officials await final comment from Customs and Border Protection, the federal agency that operates the Columbus port of entry.

Customs and Border Protection spokesman Roger Maier in El Paso said the policy was under review.

Ken Riley, emergency medical services coordinator with the Columbus Fire Department and Ambulance Service, said that the policy has been in effect for about two weeks and that calls for service are "now down drastically."

Riley, who himself lives in Palomas to save on housing costs, said he does not believe the new policy is widely known in the town of about 7,000 people. "I know they still go to the port and ask for an ambulance and they are told they have to go to the (local) doctor," Riley said.


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