Public Hospitals Renew Commitment to Keep Patient Immigrant Status Private
"Open Letter" in 12 Languages Promises Confidentiality
May 16, 2011
New York City Health and Hospitals Corporation (HHC) President Alan D. Aviles and Immigrant Affairs Commissioner Fatima Shama have joined together to issue a reassuring message to immigrant New Yorkers who may not be accessing healthcare services for fear of having their immigration status disclosed to federal authorities.
The message, delivered in an open letter written in 12 different languages, assures immigrants that every patient has a right to healthcare privacy. The letter underscores the public hospitals’ commitment to keep immigrant status completely confidential and to serve all New Yorkers regardless of their immigration status.
“For generations New York has been known as a city of immigrants, and for generations the public hospitals have cared for New York’s immigrant populations,” said HHC President Alan D. Aviles. “It is important to remind immigrant New Yorkers that they can get quality healthcare in our city without fear.”
HHC’s promise of privacy reflects Mayor Bloomberg’s Executive Order 41, which directs city employees to protect confidential information, including immigration status, belonging to people seeking city services. Executive Order 41 was issued to ensure that all New Yorkers, including immigrants, can access city services that they need and are entitled to receive.
“A vibrant and healthy immigrant community is key to ensuring New York City continues to thrive and we are committed to providing critical and quality services to all those living in our City, ” said Immigrant Affairs Commissioner Fatima Shama.
The letter from Aviles and Shama states in part, “We respect you and want to help you. People who work in a public hospital will not tell the Immigration Service or other law enforcement agencies your immigration status . . . Our public hospitals and health centers have a long and proud history of caring for everyone. That includes immigrants who are not citizens or legal residents and people who do not have money to pay for care. Our commitment is strong. It has not changed.”
Chung-wha Hong, Executive Director of the New York Immigration Coalition, said: “HHC is reaching out and renewing its promise to immigrants that its hospitals and health care providers will never share information with immigration authorities. Immigrants need to take this message to heart, and should feel safe getting health care at New York’s great public hospitals and clinics.”
The open letter will be distributed to HHC patients and staff, community and immigrant advocacy organizations, and ethnic community papers across the City. The letter, written in English, Spanish, French, Haitian Creole, Russian, Chinese, Korean, Urdu, Bengali, Polish, Albanian and Arabic, urges immigrants not to be afraid to go to an HHC hospital, emergency room or health center, and reconfirms HHC’s policy against disclosing patient information.
The open letter has been issued before: in 2006 in the midst of heightened debate concerning immigration laws and again in 2007.
Most children and pregnant women in New York City, regardless of immigration status, are eligible for health insurance. HHC staff helps all uninsured patients apply for insurance programs for which they may be eligible. The public hospitals also help patients who cannot get insurance by providing reduced, affordable rates under the HHC Options program.
In order to help determine whether uninsured patients are eligible for Medicaid and other available insurance programs, HHC financial counseling staff must ask patients for certain information that may include immigration status, proof of income, home address and date of birth. This information is kept completely confidential. HHC does not compile records or lists of undocumented immigrants nor does it share individual patient information with immigration authorities.
Last year, HHC cared for 1.3 million New Yorkers. Of those patients, more than 452,000 did not have health insurance, which represents a 14% increase over the last three years. (Of course, the uninsured in the City include many citizens and legal residents, as well as undocumented immigrants.)
HHC estimates that the annual cost to care for its patients without health insurance is about $950 million. Public hospitals here and elsewhere receive federal supplemental Medicaid funding in the form of Disproportionate Share Hospital (DSH) funding and Upper Payment Limit payments (UPL) to help cover indigent care costs, but those payments have been targeted for reduction under federal healthcare reform.
“Despite our present fiscal challenges and the further challenges ahead as healthcare reform unfolds, HHC will continue to serve as the City’s primary healthcare safety net, offering needed medical services to all New Yorkers including immigrants and fulfilling an essential role in maintaining the overall public health in our diverse city,” Aviles said.
HHC patients across the city speak more than 100 different languages. HHC’s diverse patient population is 43% Latino, 34 % Black, 5% Asian, 8 % White, and 10% is a wide mix of ethnicities. HHC also has a very diverse staff — more than 80% represent communities of color — and many speak multiple languages.
HHC has reduced language barriers and increased access for limited English speakers through its Limited English Proficiency (LEP) Program that includes:
- Widely available telephonic interpretation services;
- Specialized staff training in medical interpretation;
- Translation of health education information and important hospital policies in the top 11 languages spoken by HHC patients; and
- Multi-lingual signage throughout its facilities.
The New York City Health and Hospitals Corporation (HHC) is a $6.7 billion integrated healthcare delivery system with its own 420,000 member health plan, MetroPlusHealth, and is the largest municipal healthcare organization in the country. HHC serves 1.4 million New Yorkers every year and more than 475,000 are uninsured. HHC provides medical, mental health and substance abuse services through its 11 acute care hospitals, five skilled nursing facilities, six large diagnostic and treatment centers and more than 70 community based clinics. HHC Health and Home Care also provides in-home services for New Yorkers. HHC was the 2008 recipient of the National Quality Forum and The Joint Commission’s John M. Eisenberg Award for Innovation in Patient Safety and Quality. For more information, visit www.nychhc.org/hhc or find us on facebook.com/NYCHealthSystem or twitter.com/NYCHealthSystem.